# Analysis of inequities between demographic and social determinants associated with overweight and obesity

## TL;DR

This study examines how factors like age, sex, race, and income relate to overweight and obesity in a large population survey.

## Contribution

The study reveals distinct patterns of overweight and obesity prevalence across urban/rural, sex, and race groups, particularly highlighting disparities among black women.

## Key findings

- Overweight and obesity were more common in urban men than rural men, but not in women.
- Higher income was linked to lower BMI in women, except for black women, who had the highest obesity rates.
- Rural men had significantly lower BMI and obesity prevalence compared to urban men.

## Abstract

To assess demographic and social determinants associated with the prevalence of overweight and obesity from a population survey.

Cross-sectional study with 28,153 adults participating in the 2017-2018 Household Budget Survey. Self-reported weight and height were used to estimate the prevalence of overweight and obesity, in addition to information on sociodemographic characteristics such as age (continuous), sex (male/female), skin color or race (white, brown, and black), location of residence (urban or rural), and per capita family income (quartile). Linear regression models were used to assess changes in mean BMI according to age and income in each area (urban/rural), stratified by sex and race/skin color.

In men, overweight and obesity were more prevalent in urban than rural areas, but there was no such difference in women. Income was quadratically related to the mean BMI among women, while in men the prevalence increased with income. In women, higher income was associated with lower BMI, except for black women, who did not show variation with income and were the ones with the highest prevalence of obesity. Men in rural areas had a much lower BMI and, respectively, a lower prevalence of obesity.

We found no difference between extreme groups of possible inequality with regard to overweight and obesity. However, the prevalence of grade I obesity in men was different according to the area, being higher in men living in urban areas; and the highest prevalence of obesity according to race/color occurred among black women in the highest income quartile.

Avaliar determinantes demográficos e sociais associados à prevalência de sobrepeso e obesidade provenientes de inquérito populacional.

Estudo transversal com 28.153 adultos participantes da Pesquisa de Orçamento Familiar 2017-2018. Utilizou-se peso e altura autorreferidos para estimar a prevalência de sobrepeso e obesidade, além de informações sobre características sociodemográficas, como idade (contínua), sexo (homem/mulher), cor ou raça (branca, parda e preta), localização do domicílio (urbano ou rural), e renda familiar per capita (quartil). Modelos de regressão linear foram usados para avaliar as mudanças na média de IMC segundo idade e renda em cada área (urbano/rural), com estratificação por sexo e raça/cor da pele.

Nos homens, o sobrepeso e a obesidade foram mais prevalentes em áreas urbanas do que rurais, mas nas mulheres não houve essa diferença. A renda relaciona-se de forma quadrática com a média do IMC entre as mulheres, enquanto nos homens a prevalência aumenta com a renda. Nas mulheres, maiores rendas associam-se a menor IMC, exceto para as pretas que não apresentam variação com a renda e são as que apresentam as maiores prevalências de obesidade. Já os homens na zona rural têm IMC muito menor e respectivamente menor prevalência de obesidade.

Não encontramos diferenças entre os grupos situados em extremos de possível iniquidade no que diz respeito ao sobrepeso e obesidade. Entretanto, a prevalência de obesidade grau I nos homens foi diferente de acordo com a área, sendo maior nos homens residentes da área urbana; e a maior prevalência de obesidade de acordo com a raça/cor se deu entre as mulheres pretas no maior quartil de renda.