Income-related inequality in obesity and its determinants in Spain: What happens beyond the obesity threshold?

Abstract

This paper computes and decomposes income-related inequalities in three metrics of obesity, namely, status, depth and severity, for Spain, a European country characterized by a universal health care system with very high and rising obesity prevalence rates. Furthermore, this paper investigates the main determinants of the reduction in obesity inequalities observed over time among the female Spanish population. To compute these inequality indexes, we use cross-sectional and individual-level data gathered from the Spanish National Health Survey. We document income-related inequalities in obesity, that are more pronounced in depth and severity and are to the detriment of poor women in Spain. University education is the most important determinant for all three inequality indexes. We further report that inequalities in obesity tend to decline over time for women, which is explained mainly by a substantial decrease in the degree of inequality in secondary education and a large decrease in the income elasticity of obesity.