Volume 37 - Article 54 | Pages 1735–1760
The contribution of differences in adiposity to educational disparities in mortality in the United States
Abstract
Background: There are large differences in life expectancy by educational attainment in the United States. Previous research has found obesity’s contribution to these differences to be small. Those findings may be sensitive to how obesity is estimated.
Methods: This analysis uses discrete-time logistic regressions with data from the National Health and Nutrition Examination Survey (NHANES), pooled from 1988 to 1994 and 1999 to 2010, to estimate the contribution of differences in adiposity, or body fat, to educational differences in mortality. I show that results depend upon the measure of adiposity used: body mass index (BMI) at the time of survey or lifetime maximum BMI.
Results: College graduates were less likely than high school graduates to be obese at the time of survey (25% vs. 34.6%, respectively) and were also less likely to have ever been obese (35.7% vs. 49.4%, respectively). Lifetime maximum BMI performed better than BMI at the time of survey in predicting mortality using criteria for model selection. Differences in maximum BMI were associated with between 10.3% and 12% of mortality differences between college graduates and all others, compared to between 3.3% and 4.6% for BMI at the time of survey. Among nonsmokers, between 18.4% and 27.6% of mortality differences between college graduates and all others were associated with differences in maximum BMI.
Contribution: Adiposity is an overlooked contributor to educational differences in mortality. Previous findings that obesity does not contribute to educational disparities were based on BMI at the time of survey, which is less informative than maximum BMI. The contribution of adiposity to educational mortality differences will likely grow as smoking prevalence declines. Health surveys should collect information on weight history.
Author's Affiliation
- Yana Vierboom - Max-Planck-Institut für Demografische Forschung, Germany EMAIL
Most recent similar articles in Demographic Research
Two-dimensional contour decomposition: Decomposing mortality differences into initial difference and trend components by age and cause of death
Volume 50 - Article 41
| Keywords:
decomposition methods,
mortality
Decomposition analysis of disparities in infant mortality rates across 27 US states
Volume 50 - Article 40
| Keywords:
decomposition,
health disparities,
infant mortality,
United States of America
International completeness of death registration
Volume 50 - Article 38
| Keywords:
data collection,
death,
mortality,
statistics,
sustainable development goals,
vital registration
The effect of migration and time spent abroad on migrants’ health: A home/host country perspective
Volume 50 - Article 37
| Keywords:
Albania,
health,
Italy,
migrants,
propensity score
Incorporating subjective survival information in mortality and change in health status
predictions: A Bayesian approach
Volume 50 - Article 36
| Keywords:
Bayesian demography,
health,
mortality,
self report,
subjective mortality probabilities
Cited References: 50
Download to Citation Manager
PubMed
Google Scholar