Intersectional analysis of sex and socioeconomic status on obesity and comorbidities in Finland
Hlaing, Khin Yu Yu (2025-05-21)
K. Y. Y. Hlaing
21.05.2025
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Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202505213757
https://urn.fi/URN:NBN:fi:oulu-202505213757
Tiivistelmä
Obesity is a public health concern that contributes to long-term health inequalities. Sex and socioeconomic status (SES) have influence on obesity, but they were studied separately. Intersectional theory suggests different health risks arise from combined effects of multiple social dimensions. This study aims to identify whether intersection of sex and SES influence obesity (and comorbidity) risk beyond individual factors.
The study used data from the NFBC1966 to examine whether the intersection of sex and SES at age 31 was associated with the risk of obesity (and comorbidity) at age 46. The analysis included 1,441 individuals with complete data. A binary outcome was defined: normal BMI and no comorbidities, and obesity (and comorbidities). MAIHDA method was used to estimate fixed effects for sex, income, occupation, education; and random intercepts for 24 intersectional strata defined by combinations of these variables.
Predicted probabilities of obesity (and comorbidity) varied across intersectional strata, from 60% to 80%. Highest-risk groups included women with low income and no employment, and lowest-risk group included men with high income and post-secondary education. Interaction effects and residuals showed different risks than predicted. Fixed effects were not significant, and stratum-level variance did not explain the differences between groups. A key limitation of the study is the relatively small sample size which may limit precision of the estimates.
The findings indicate that intersectional effects contribute to obesity (and comorbidity) risk, even when individual predictors are weak. The study supports the value of MAIHDA in identifying group-level disparities for informed public health strategies.
The study used data from the NFBC1966 to examine whether the intersection of sex and SES at age 31 was associated with the risk of obesity (and comorbidity) at age 46. The analysis included 1,441 individuals with complete data. A binary outcome was defined: normal BMI and no comorbidities, and obesity (and comorbidities). MAIHDA method was used to estimate fixed effects for sex, income, occupation, education; and random intercepts for 24 intersectional strata defined by combinations of these variables.
Predicted probabilities of obesity (and comorbidity) varied across intersectional strata, from 60% to 80%. Highest-risk groups included women with low income and no employment, and lowest-risk group included men with high income and post-secondary education. Interaction effects and residuals showed different risks than predicted. Fixed effects were not significant, and stratum-level variance did not explain the differences between groups. A key limitation of the study is the relatively small sample size which may limit precision of the estimates.
The findings indicate that intersectional effects contribute to obesity (and comorbidity) risk, even when individual predictors are weak. The study supports the value of MAIHDA in identifying group-level disparities for informed public health strategies.
Kokoelmat
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