Proposed relations between overweight/obesity and socioeconomic status, educational level and ethnicity

Socioeconomic status

• Results from the European Childhood Obesity Surveillance Initiative (COSI) indicate that the prevalence of obesity and severe obesity among children in Europe was common among children whose mothers had a lower level of education. 

• Consistently across countries, higher rates of obesity are found between individuals in the lowest income group, with inequalities more significant in women than in men. In the EU28, women and men in the lowest income group are, respectively, 90% and 50% more likely to suffer from obesity, compared to peers in the highest income group. Inequalities are generally greater in western European countries and lower in central European countries.
   

• Lower parental education was found to be a strong driver of prevalence of overweight in children, particularly in high-income countries.
• The economic determinants of overweight and obesity include the high costs of healthy foods and organized sport, economic crises, unaffordable housing, precarious work and area-level deprivation. Economic determinants influence the affordability and desirability of actions that promote a healthy weight. Indeed, these determinants have influenced the relative affordability of unhealthy diets for those living on low or no incomes, the widespread perception that unhealthy foods and beverages are cheaper than healthier options, and the pervasive marketing of unhealthy foods and beverages, especially to vulnerable populations such as children.

Educational level

• In most countries, the higher the level of education, the lower the prevalence of obesity; the obesity gradient is stronger in women than in men.

• People with a lower education level are also more likely to be overweight or obese than those with a higher education level in all EU countries. Differences in overweight prevalence across high and low educated people result in further inequality in health and employment outcomes.

Ethnicity

• Some ethnic minority groups (e.g. African migrants in the UK, Turkish migrants) have substantially higher obesity rates than others.
• In some of those ethnic groups (e.g.  African migrants in the UK), women appeared to be significantly more vulnerable to higher obesity rates than men.
• The gap in obesity between children from ethnic minorities and Caucasian children is larger than that observed in adults (UK and US).
   

• Higher levels of obesity in Roma children may be due to lack of access to cooking and food storage facilities. 

General environment

• The daily living conditions (that is, the conditions that determine our opportunities to be healthy and well across our life course) are uniquely experienced by different groups (as defined, for example, by ethnicity, socioeconomic position, disability and gender), and inequities in living conditions translate into inequities in individual opportunities to consume healthy diets and participate in sufficient physical activity.