Body Mass Index Trajectory–Specific Changes in Economic Circumstances: A Person-Oriented Approach Among Midlife and Ageing Finns

Abstract

Economic disadvantage is related to a higher risk of adulthood obesity, but few studies have considered whether changes in economic circumstances depend on a person’s body mass index (BMI) trajectory. We identified latent BMI trajectories among midlife and ageing Finns and captured individual-level changes in economic circumstances within the BMI trajectories utilizing sequence analysis. We used the Helsinki Health Study cohort data of initially 40–60-year-old Finnish municipal employees, with four survey questionnaire phases (2000–2017). Each survey included identical questions on height and weight, and on economic circumstances incorporating household income and current economic difficulties. Based on computed BMI, we identified participants’ (n = 7105; 82% women) BMI trajectories over the follow-up using group-based trajectory modeling. Four BMI trajectories were identified: stable healthy weight (34% of the participants), stable overweight (42%), overweight to class I obesity (20%), and stable class II obesity (5%). Lower household income level and having economic difficulties became more common and persistent when moving from lower- to higher-level BMI trajectories. Differences in household income widened over the follow-up between the trajectory groups, whereas economic difficulties decreased equally in all trajectory groups over time. Our study provides novel information on the dynamic interplay between long-term BMI changes and economic circumstances.

Intergenerational social mobility and body mass index trajectories – A follow-up study from Finland

“…A Swedish study instead focused on intragenerational social mobility, and did not find it to be associated with BMI among 40–60-year-old adults ( Padyab & Norberg, 2014 ). Previous studies by our research group have shown persistent and slightly widening socioeconomic inequalities in BMI among middle-aged and ageing Finns ( Hiilamo et al, 2017 ; Salmela et al, 2020 ). This study proceeds from our previous findings and examines 1) whether intergenerational social mobility is associated with BMI trajectories from middle to older age (ages 40–77) and 2) whether these associations differ by gender and birth cohort.…”

“…We found that economic circumstances and health-related factors explained part, but not all, of the social mobility group differences in BMI trajectories. In previous studies, persistent socioeconomic inequalities in weight gain and obesity have been explained by multiple factors, such as prolonged financial strain ( Li, 2015 ; Salmela et al, 2020 ), learned unhealthy behaviors ( Albrecht & Gordon-Larsen, 2014 ; Novak et al, 2006 ), and psychosocial factors ( Chung et al, 2020 ; Claassen et al, 2019 ). However, none of them likely has a separate role in the process (Umberson et al, 2010); for example, health behaviors are argued to be insufficient in explaining—and thus, reducing—socioeconomic inequalities in obesity ( Gustafsson et al, 2012 ; Savitsky et al, 2017 ).…”

Group‐based trajectory modeling of body mass index and body size over the life course: A scoping review

“…Of these 22 studies with growth trajectories beginning in childhood, five studies 20,22,38,41,51 had measures until young adulthood (19–23 years old), 12 studies 16,30–32,36,42–50 had measures until midadulthood (38–50 years old), and five studies 5,14,17,18,46 had measures until older adulthood (60–80 years old). The remaining studies ( n = 37) 15,19,21–29,33–35,37,39,40,52–72 did not include any childhood measures, and only included measures >18 years of age. Of these 37 studies that only reported growth measures in adulthood, six studies 26,61–64,70 only included measures during the older adulthood period of life (≥60 years of age).…”

Lapsuuden ja aikuisuuden sosioekonomisten olosuhteiden yhteydet aikuisiän painonkehitykseen

“…Ensimmäisessä osatyössä (25) keskityin lapsuuden sosioekonomisiin olosuhteisiin ja lapsuudes sa tapahtuneisiin vastoinkäymisiin, kuten kiusatuksi joutumiseen ja perheen sosiaalisiin ja taloudellisiin vaikeuksiin. Toisessa osatyössä (26) tutkin aikuisiällä tapahtuneita muutoksia kotitalouden tuloissa ja koetuissa taloudellisissa vaikeuksissa eri painoindeksin kehityspolkuryhmien sisällä. Kolmannessa osatyössä (27) puolestaan keski-tyin sosiaaliseen liikkuvuuteen, jolla tässä tutkimuksessa tarkoitettiin koulutuksellista siirtymää tutkittavan vanhemman koulutustason ja oman koulutustason välillä.…”

“…Osatyö 2 paljasti, että kotitalouden tuloissa näkyvät erot painoindeksissä kasvoivat 17 vuoden seurannan aikana (26). Lisäksi henkilöt, joilla painonnousu oli suurinta, kärsivät to den näköisemmin taloudellisesta epävarmuudesta koko seurannan ajan.…”