The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia,
The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
Obes Facts. 2022;15(3):416-427. doi: 10.1159/000522433. Epub 2022 Mar 4.
Previous studies exploring associations of physical inactivity, obesity, and out-of-pocket expenditure (OOPE) mainly used traditional linear regression, and little is known about the effect of both physical inactivity and obesity on OOPE across the percentile distribution. This study aims to assess the effects of physical inactivity and obesity on OOPE in China using a quantile regression approach.
Study participants included 10,687 respondents aged 45 years and older from the recent wave of the China Health and Retirement Longitudinal Study in 2015. Linear regression and quantile regression models were used to examine the association of physical activity, body weight with annual OOPE.
Overall, the proportion of overweight and obesity was 33.2% and 5.8%, respectively. The proportion of individuals performing high-level, moderate-level, and low-level physical activity was 55.2%, 12.7%, and 32.1%, respectively. The effects of low-level physical activity on annual OOPE were small at the bottom quantiles but more pronounced at higher quantiles. Respondents with low-level activity had an increased annual OOPE of 26.9 USD, 150.3 USD, and 1,534.4 USD, at the 10th, 50th, and 90th percentiles, respectively, compared with those with high-level activity. The effects of overweight and obesity on OOPE were also small at the bottom quantiles but more pronounced at higher quantiles.
Interventions that improve the lifestyles and unhealthy behaviors among people with obesity and physical inactivity are likely to yield substantial financial gains for the individual and health systems in China.
之前探索身体活动不足、肥胖和自付支出（OOPE）之间关联的研究主要使用了传统的线性回归，而对于身体活动不足和肥胖对 OOPE 在百分位数分布上的影响知之甚少。本研究旨在使用分位数回归方法评估身体活动不足和肥胖对中国 OOPE 的影响。
研究参与者包括来自 2015 年最近一轮中国健康与退休纵向研究的 10687 名 45 岁及以上的受访者。使用线性回归和分位数回归模型来检验身体活动、体重与年度 OOPE 的关联。
总体而言，超重和肥胖的比例分别为 33.2%和 5.8%。高水平、中水平和低水平身体活动的比例分别为 55.2%、12.7%和 32.1%。低水平身体活动对年度 OOPE 的影响在底部分位数较小，但在较高分位数时更为明显。与高水平活动相比，低水平活动的受访者每年的 OOPE 增加了 26.9 美元、150.3 美元和 1534.4 美元，分别在第 10、50 和 90 百分位数。超重和肥胖对 OOPE 的影响在底部分位数也较小，但在较高分位数时更为明显。
改善肥胖和身体活动不足人群生活方式和不健康行为的干预措施，可能会给个人和中国卫生系统带来可观的经济收益。
