Pérez Ferrer, C; (2015) Socioeconomic inequalities in obesity among Mexican adults 1988-2012. Doctoral thesis , UCL (University College London).

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Abstract

Background: Obesity prevalence in Mexico has risen substantially over the last 25 years. Its social patterning has not been systematically studied. Aim: To test the nutrition transition proposition of a crossover from lower to higher rates of obesity among the more disadvantaged groups, leading to emerging and increasing obesity inequalities as Mexico develops economically. Methods: Data came from four nationally representative surveys (1988, 1999, 2006, 2012); N=51,387 non-pregnant 20-49 year old women and N=18,988 20-49 year old men. Level of education and a household wealth index were used to calculate the relative and slope indexes of inequality (RII and SII respectively). Trends in RII and SII were examined in the period 1988-2012 for women. Change from 2006 to 2012 was examined for men. The contribution of mediating factors to obesity inequality was investigated. Results: There was support for the nutrition transition proposition among Mexican women. As the country developed economically, obesity became more prevalent among more disadvantaged women. Among men, there was no evidence of a reversal of the social gradient. Higher education and wealth were associated with higher obesity prevalence. Unexpectedly, educational inequalities in obesity among urban women declined over the study period. This was due to faster increases in obesity prevalence among women with more years in education compared to those with less. Psychosocial factors (food insecurity and aspired body size) explained a proportion of educational inequalities in obesity among women. Gender differences in educational inequalities in obesity were partially explained by differences in aspired body size. Conclusion: This detailed analysis of obesity inequalities in Mexico, and their recent trends, significantly develops existing literature. By using both education and household wealth as markers of SEP, the nutrition transition proposition was investigated in depth. The nutrition transition proposition fits the educational inequality pattern among Mexican women but not men.

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