Institutionen för folkhälsovetenskap / Department of Public Health Sciences
Abstract
The overall aim of the thesis was to study if Swedish obese male
adolescents become socioeconomicly disadvantaged in later life. Among
Swedish men born 1951-79, who went through military conscription
examination at age 18-20 years, the associations between obesity and
attained education, occupation, income, and disability pension have been
studied.
The target populations were identified in the Multi-Generation Register.
A record linkage was made between this register and data from the
following national registers: the Register of the Total Population, the
Swedish Military Service Conscription Register, the Population and
Housing Censuses, the Longitudinal Database of Education, Income and
Occupation, Statistics Sweden s Register on School Marks, the Cause of
Death Register, the Hospital Discharge Register, the Swedish Twin
Register, and the Swedish Young Male Twin Study.
The associations between body mass index in late adolescence and later
socioeconomic outcomes were analyzed by logistic regression, polytomous
logistic regression, and Cox regression among all study subjects and by
linear regression estimated with generalized estimating equations and
conditional logistic regression within brother pairs.
The results showed that obese Swedish men are doing worse in the
educational system than their normal weight counterparts even after
adjustments for intelligence, parental education and parental
socioeconomic position. Compared to normal weight counterparts, obese men
were 40% less likely to start a university education (hazard ratio 0.63
95% confidence interval 0.60; 0.66) and 50% less likely to actually
graduate (hazard ratio 0.48 95% confidence interval 0.44; 0.52). Second,
obese Swedish men had an increased risk of approximately 35% of receiving
disability pension (hazard ratio 1.35 95% confidence interval 1.19; 1.52)
compared to their normal weight counterparts when own and parental
socioeconomic factors were taken into account. Third, obese men were more
likely to move downward and less likely to move upward in the social
hierarchy compared to normal weight men. In addition, results showed that
obesity was longitudinally associated to low educational level, low
socioeconomic position and low income, irrespective of own intelligence,
environmental and genetic factors shared by brothers, and parental
socioeconomic position.
In conclusion, the results show that obesity in late adolescence has
socioeconomic consequences in later life. Explanations for these
consequences may be sought in the non-shared environment and are
speculated to be co-morbidities of obesity, personal characteristics of
obese individuals such as aspirations and self-esteem, or factors on the
societal level such as discrimination