Long-term trends in obesity prevalence by socio-economic group in five European countries and the USA: The relevance of the diffusion of innovations theory

Abstract Introduction: Cross-national comparison suggests that the timing of the obesity epidemic differs across socio-economic groups (SEGs). Similar to the smoking epidemic, these differences might be described by the diffusion of innovations theory, which states that health behaviours diffuse fro...

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Main Authors: Eva Kagenaar, Wanda Monika Johanna Van Hemelrijck, Anton E. Kunst, Fanny Janssen
Format: Article
Language:English
Published: Karger Publishers 2022-09-01
Series:Obesity Facts
Online Access:https://www.karger.com/Article/FullText/527070
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author Eva Kagenaar
Wanda Monika Johanna Van Hemelrijck
Anton E. Kunst
Fanny Janssen
author_facet Eva Kagenaar
Wanda Monika Johanna Van Hemelrijck
Anton E. Kunst
Fanny Janssen
author_sort Eva Kagenaar
collection DOAJ
description Abstract Introduction: Cross-national comparison suggests that the timing of the obesity epidemic differs across socio-economic groups (SEGs). Similar to the smoking epidemic, these differences might be described by the diffusion of innovations theory, which states that health behaviours diffuse from higher to lower SEGs. However, the applicability of the diffusion of innovations theory to long-term time trends in obesity by SEG is unknown. We studied long-term trends in the obesity prevalence by socio-economic group in England, France, Finland, Italy, Norway, and the USA and examined whether trends are described by the diffusion of innovations theory. Methods: Obesity prevalence from 1978 to 2019 by educational level, sex, and age group (25+) from health surveys were harmonised, age-standardised, Loess-smoothed, and visualised. Prevalence rate differences were calculated and segmented regression was performed to obtain annual percentage changes, which were compared over time and across SEGs. Results: Obesity prevalence among lower educated has exceeded that of higher educated groups, except among USA men, in all countries throughout the study period. A comparable increase across educational levels was observed until approximately 2000. Recently, obesity prevalence stagnated among higher educated groups in Finland, France, Italy, and Norway, and lower educated groups in England and the USA. Discussion: Recent trends in obesity prevalence by SEG are mostly in line with the diffusion of innovations theory, however, no diffusion from higher to lower SEGs at the start of the epidemic was found. The stagnation among higher SEGs but not lower SEGs suggests that the latter will likely experience the greatest future burden.
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spelling doaj.art-4029778cffbf4b4a898e4c1fbccb113b2022-12-22T03:31:17ZengKarger PublishersObesity Facts1662-40251662-40332022-09-0110.1159/000527070527070Long-term trends in obesity prevalence by socio-economic group in five European countries and the USA: The relevance of the diffusion of innovations theoryEva Kagenaarhttps://orcid.org/0000-0002-0134-4839Wanda Monika Johanna Van Hemelrijckhttps://orcid.org/0000-0003-1017-0620Anton E. KunstFanny Janssenhttps://orcid.org/0000-0002-3110-238XAbstract Introduction: Cross-national comparison suggests that the timing of the obesity epidemic differs across socio-economic groups (SEGs). Similar to the smoking epidemic, these differences might be described by the diffusion of innovations theory, which states that health behaviours diffuse from higher to lower SEGs. However, the applicability of the diffusion of innovations theory to long-term time trends in obesity by SEG is unknown. We studied long-term trends in the obesity prevalence by socio-economic group in England, France, Finland, Italy, Norway, and the USA and examined whether trends are described by the diffusion of innovations theory. Methods: Obesity prevalence from 1978 to 2019 by educational level, sex, and age group (25+) from health surveys were harmonised, age-standardised, Loess-smoothed, and visualised. Prevalence rate differences were calculated and segmented regression was performed to obtain annual percentage changes, which were compared over time and across SEGs. Results: Obesity prevalence among lower educated has exceeded that of higher educated groups, except among USA men, in all countries throughout the study period. A comparable increase across educational levels was observed until approximately 2000. Recently, obesity prevalence stagnated among higher educated groups in Finland, France, Italy, and Norway, and lower educated groups in England and the USA. Discussion: Recent trends in obesity prevalence by SEG are mostly in line with the diffusion of innovations theory, however, no diffusion from higher to lower SEGs at the start of the epidemic was found. The stagnation among higher SEGs but not lower SEGs suggests that the latter will likely experience the greatest future burden.https://www.karger.com/Article/FullText/527070
spellingShingle Eva Kagenaar
Wanda Monika Johanna Van Hemelrijck
Anton E. Kunst
Fanny Janssen
Long-term trends in obesity prevalence by socio-economic group in five European countries and the USA: The relevance of the diffusion of innovations theory
Obesity Facts
title Long-term trends in obesity prevalence by socio-economic group in five European countries and the USA: The relevance of the diffusion of innovations theory
title_full Long-term trends in obesity prevalence by socio-economic group in five European countries and the USA: The relevance of the diffusion of innovations theory
title_fullStr Long-term trends in obesity prevalence by socio-economic group in five European countries and the USA: The relevance of the diffusion of innovations theory
title_full_unstemmed Long-term trends in obesity prevalence by socio-economic group in five European countries and the USA: The relevance of the diffusion of innovations theory
title_short Long-term trends in obesity prevalence by socio-economic group in five European countries and the USA: The relevance of the diffusion of innovations theory
title_sort long term trends in obesity prevalence by socio economic group in five european countries and the usa the relevance of the diffusion of innovations theory
url https://www.karger.com/Article/FullText/527070
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