Social Status as a Mediator of Self-Perceived Health, Quality of Life and Health-Related Behaviour in Obesity

Abstract

Objectives:

Obesity prevalence is increasing worldwide and associated with a high health risk. Unfavourable psychological factors, lower self-ratings of health and worse health-related behaviour can be found in individuals with a low socioeconomic status (SES). Therefore, the aim of our study was to investigate whether normal weight vs. obese subjects with a high vs. low socioeconomic status (SES) differ with regard to self-perceived health, quality of life and health-related behaviour.

Methods:

Data of the Austrian Health Interview Survey (ATHIS) 2006/07, precisely of 8015 subjects were analysed stratified by sex and adjusted by age concerning these outcomes.

Results:

The results have shown that men and women with a low SES differ significantly from those with a high SES in terms of self-perceived health, quality of life, intensity of physical activities, alcohol consumption, and eating behaviour (men: p <0.001; women: p<0.001). A significant interaction between the body mass index (BMI) and SES occurred in men concerning quality of life in the domains physical (p<0.05) and psychological health (p<0.01), in women as to self-perceived health (p<0.01), quality of life in the domains physical health (p<0.01) and environment (p<0.05), as well as physical activities (p<0.01).

Conclusion:

The SES has a strong negative impact on health-related variables, especially in obese subjects, and therefore risk assessment in the primary health-care setting should include socioeconomic factors. Furthermore, a continued strong public health programme is required with an absolute priority placed on obese subjects of low SES.

Zusammenfassung

Hintergrund:

Die Prävalenz der Adipositas nimmt weltweit zu und ist mit einem hohen Gesundheitsrisiko verbunden. Personen mit einem niedrigen sozioökonomischen Status (SES) weisen ungünstige psychologische Faktoren, ein schlechteres Gesundheitsverhalten, und eine schlechtere subjektive Gesundheit auf. Daher war das Ziel dieser Untersuchung Unterschiede zwischen normalgewichtigen und adipösen Personen mit einem hohen vs. niedrigen SES in Bezug auf deren subjektive Gesundheit, Lebensqualität und ihr Gesundheitsverhalten zu analysieren.

Methode:

Zur Prüfung der Fragestellung wurden die Daten der österreichischen Gesundheitsbefragung 2006/07 von 8015 Personen in Bezug auf diese Variablen geschlechtsstratifiziert und alterskorrigiert analysiert.

Ergebnisse:

Die Ergebnisse haben gezeigt, dass sich Männer wie auch Frauen mit einem niedrigen SES signifikant von jenen mit einem hohen SES in Bezug auf die subjektive Gesundheit, die Lebensqualität, die Intensität des Bewegungsverhaltens, den Alkoholkonsum und die Ernährung unterscheiden (Männer: p<0,001; Frauen: p<0,001). Weiters wurde eine signifikante Wechselwirkung zwischen dem Body Mass Index (BMI) und dem SES bei Männern in Bezug auf deren Lebensqualität in den Bereichen physische (p<0,05) und psychische Gesundheit (p<0,01), und bei Frauen hinsichtlich der subjektiven Gesundheit (p<0,01), der Lebensqualität im Bereich physischen Gesundheit (p<0,01) und Umgebungsfaktoren (p<0,05), sowie der Häufigkeit ihres Bewegungsverhaltens (p<0,01), festgestellt.

Schlussfolgerungen:

Der SES hat einen wesentlichen Einfluss auf gesundheitsrelevanter Variablen – vor allem bei Vorliegen von Adipositas – was beim Risikoscreening in der primärmedizinischen Versorgung berücksichtigt werden sollte. Weiters sind Gesundheitsprogramme, speziell für adipöse Personen mit niedrigem SES, dringend erforderlich.

Key words

socioeconomic status - self-perceived health - health-related behaviour - quality of life - obesity

Schlüsselwörter

sozioökonomischer Status - subjektive Gesundheit - Gesundheitsverhalten - Lebensqualität - Adipositas

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