Quantifying gender inequalities in obesity: findings from the Turkish population-based Balcova Heart Study

Abstract

Objectives: Sparse evidence is available to explain obesity variations between genders in the Turkish population. To our knowledge, no previous study has analysed the magnitude of gender differences in obesity using common social determinants of health. We aimed to quantify gender inequalities in obesity in terms of education, employment status, occupation and perceived income in a Turkish population.

Study design: The study design used is a cross-sectional study.

Methods: Population-based data from the Balcova Heart Study (n = 16,080) were analysed. Logistic regression models were used to calculate the crude and adjusted odds ratios (ORs) when comparing obesity prevalence in women vs men within each category of social determinants.

Results: Women had a higher risk of being obese than men (adjusted OR [aOR] = 2.04 [95% confidence interval {CI}: 1.7-2.1]). Gender inequality in obesity decreased as the level of education increased, from 'primary school' (aOR = 2.5 [95% CI: 2.2-2.8]) to 'university' (aOR = 0.9 [95% CI: 0.6-1.1]). Women had a higher risk of obesity within the 'unemployed' category compared with men (aOR = 2.2 [95% CI: 1.6-3.0]). Gender inequality in obesity decreased with a higher perception of income, from 'low' (aOR = 2.1 [95% CI: 1.6-3.0]) to 'high' (aOR = 1.5 [95% CI: 1.2-2.0]).

Conclusions: These findings highlight the fact that gender inequalities in obesity are greatest within populations of low education, unemployment and lower perception of income. Reduced gender inequality in obesity prevalence was seen for the subpopulation with professional occupations, with women having decreased odds of obesity compared with men. Conversely, unemployed women had increased odds of obesity compared with unemployed men. Increasing the status of women should be prioritised in policies to tackle obesity in the Turkish population and in similar developing populations elsewhere.

Keywords: Gender; Inequality; Obesity; Social determinants.