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Measuring and tracking obesity inequality in the United States: evidence from NHANES, 1971-2014

Overview of attention for article published in Population Health Metrics, April 2016
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Measuring and tracking obesity inequality in the United States: evidence from NHANES, 1971-2014
Published in
Population Health Metrics, April 2016
DOI 10.1186/s12963-016-0081-5
Pubmed ID

Tae-Young Pak, Susana Ferreira, Gregory Colson


Because people care about their weight relative to peers and society, obesity inequality plays a role in explaining obesity incidence and the impacts of being obese on subjective well-being. While the increase in obesity prevalence and mean body mass index (BMI) is well documented, the measurement of distributional changes and corresponding obesity inequality is yet to be fully explored. The present study analyzed BMI data for adults aged 20 to 74 from the National Health and Nutritional Examination Survey (NHANES) I (1971-1974), II (1976-1980), III (1988-1994), and continuous NHANES (1999-2014). We applied tools developed to measure income inequality to analyze the inter-temporal variation in the BMI distribution among US adults. Using stochastic dominance tests, we construct partial orderings on cumulative BMI distributions during the study period. Shapley decompositions and inequality indices are employed to quantify the source and extent of temporal variation and decompose the inequality into within and between-group components considering age, gender, and race. The BMI distribution of each NHANES study first-order stochastically dominated the BMI distribution of the previous wave from 1971-1974 to 2003-2006, whereas more recent comparisons failed to reject the null hypothesis of non-dominance. The Shapley decomposition analysis revealed that horizontal shifts of BMI distributions accounted for a majority of the increase in obesity prevalence since 1988-1991. Especially in recent years when the rate of obesity growth has slowed down, the contribution of the redistribution component dropped significantly and even became negative between 2007-2010 and 2011-2014. The inequality indexes consistently show a worsening of obesity inequality from the mid-1970s to the mid-2000s regardless of population subgroups, and this disproportionate shift of the BMI distribution is unlikely to be a result of a changing ethnic composition of the US population. Our findings demonstrate that seemingly similar increases in obesity prevalence can be accompanied by very different patterns of distribution change. We find that the early phase of the obesity epidemic in the US was largely driven by increasing skewness, whereas more recent growth is a population-wide experience, regardless of demographic characteristics. Increasing morbid obesity certainly played an important role in the initial phase of the epidemic, but more recently the BMI distribution has largely horizontally shifted to the right.

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Mendeley readers

The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 3%
Unknown 28 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 21%
Researcher 4 14%
Student > Ph. D. Student 4 14%
Other 3 10%
Student > Postgraduate 3 10%
Other 5 17%
Unknown 4 14%
Readers by discipline Count As %
Medicine and Dentistry 9 31%
Economics, Econometrics and Finance 3 10%
Agricultural and Biological Sciences 2 7%
Nursing and Health Professions 2 7%
Psychology 2 7%
Other 3 10%
Unknown 8 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 April 2016.
All research outputs
of 7,499,955 outputs
Outputs from Population Health Metrics
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Outputs of similar age
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Outputs of similar age from Population Health Metrics
of 14 outputs
Altmetric has tracked 7,499,955 research outputs across all sources so far. This one has received more attention than most of these and is in the 52nd percentile.
So far Altmetric has tracked 208 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.3. This one is in the 39th percentile – i.e., 39% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 271,808 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.
We're also able to compare this research output to 14 others from the same source and published within six weeks on either side of this one. This one is in the 28th percentile – i.e., 28% of its contemporaries scored the same or lower than it.