The association between obesity and race among Brazilian adults is dependent on sex and socio-economic status

Abstract

AbstractObjectiveTo verify the association of race, independent of socio-economic status (SES), with obesity among Brazilian adults.DesignWe investigated data from the 2008–2009 Brazilian Household Budget Survey. Obesity was defined using the WHO classification. Self-declared race was classified as White, Black and ‘Pardo’ (Brown). Factor analysis with principal component extraction was used to derive the SES index. The association between race and obesity independent of SES, adjusted for demographic variables, was estimated using multiple logistic regression, accounting for the survey design. Interaction term between race and SES was tested.SettingBrazilian households (n 55 970).SubjectsAdults aged 20–65 years (n 80 702).ResultsThe prevalence of obesity was 14·9 %. The first factor explained 51 % of the variance and was used as a SES indicator. Odds of obesity increased with increasing SES level for men and for Black women, whereas Brown and White women showed a decrease of obesity. The association between race and obesity was modified by SES level in both sexes. At lower level of SES (−2 sd), Black and Brown in comparison to White men had 35 and 27 % decreased odds of obesity, respectively. For women, at lower SES level, only Black compared with White women had 30 % decreased odds of obesity. At the higher SES level (+2 sd), Black women compared with White presented a threefold increase of obesity.ConclusionsRacial disparities in obesity are SES level- and sex-dependent in Brazil. Strategies exclusively targeting reductions in SES disparities are likely ineffective for decreasing racial disparities in obesity among women.