Gender and marital status clarify associations between food insecurity and body weight

Prior research shows that food insecurity is associated with being overweight in women, with few and ambiguous results in men. Little is known about the characteristics and roles of individuals who are most likely to be both food insecure and overweight or obese. This study analyzed associations between food insecurity and body weight, and whether gender and marital status are involved in that relationship. Using multiple regression models, we examined food insecurity, marriage, and body weight among 4338 men and 4172 women aged > or = 20 y in the 1999-2002 NHANES. Married men were more likely to be overweight than men in all other marital-status categories except for those living with partners. Divorced men were more likely than never-married men to live in a household with very low food security. Compared with fully food-secure men, marginally food-secure men were heavier, whereas men with low food security were lighter. Compared with fully food-secure women, marginally food-secure women also showed a tendency to be overweight (P = 0.05), whereas women with low food security were more likely to be obese. When considering the interaction between food insecurity and marital status, food insecurity was related to a greater likelihood of obesity among married women, those living with partners, and widows, when compared with never-married women. Sensitivity analyses suggest this effect was concentrated among marginally food-secure women. These findings indicate that food insecurity relates differently to body weight for men and women, and that partnering plays a strong part in this relationship for women.     

Older carers in the UK: are there really gender differences? New analysis of the Individual Sample of Anonymised Records from the 2001 UK Census

The aim of this paper is to disentangle the role of gender and partnership status in the caring commitments of older people (age 65 and over). Logistic and interval regression models are applied to individual records from the 2001 UK Census to estimate: (1) the impact of gender on the likelihood of being a carer; (2) the impact of gender on the hours of care provided; and (3) the impact of gender on the likelihood of being a carer for different groups defined by marital status. In the general population the share of women who provide care is higher than the corresponding share of men, but men have a higher probability of being carers among people aged 65 or above. This phenomenon is largely explained by gender differences in marital status. As older men are more likely to be married, and married people are more likely to be carers, we observe higher levels of caring among older men. Once differences in marital status are accounted for, the relationship between gender and care provision among older people is overturned. In particular, we find that, without controlling for household size, limiting long-term illness or marital status, the odds of being an informal carer are lower for older women than men [odds ratio (OR): 0.85; 95% confidence interval (CI): 0.83–0.87]. Once these factors are accounted for, older women have higher odds of caring than older men (OR: 1.12; 95% CI: 1.09–1.15). Restricting the sample to care providers, and controlling for the same factors, it is shown that older women supply on average 3.77 (95% CI: 3.14–4.40) more hours of care per week than older men. Gender differences in the provision of care among older people disappear only when considering married individuals and adjusting for the presence of other household residents affected by a limiting long-term illness.     

The social patterning of relative body weight and obesity in Denmark and Finland

BACKGROUND: Relative body weight is typically inversely associated with social status in affluent societies but studies comparing the social patterning of relative body weight and obesity in different countries have only seldom been conducted. The aim of this study was to analyse and compare the social patterning of relative weight and obesity by occupational status, educational attainment and marital status between Danish and Finnish women and men. METHODS: Data from the Finnish Survey on Living Conditions and the Danish Health and Morbidity Survey, both collected in 1994, were compared. Relative weight was studied by using body mass index (BMI), and those with BMI > or =30 kg/m(2) were regarded as obese. Logistic regression analysis was used to examine the social patterning of obesity in the pooled dataset. Two-variable interaction effects were tested separately. RESULTS: Compared with their Danish counterparts, Finnish women and men had higher average relative weight and they were more often obese. There were no country differences in the socio-economic patterning of obesity by educational attainment, but a stronger patterning of obesity by occupational status was found among Danish women. Moreover, non-married women in Denmark were more likely to be obese than their married counterparts. CONCLUSIONS: Finns have higher relative weight and they are more often obese than Danes. The social patterning of obesity was similar in both studied countries but stronger in Denmark.     

Body weight status of adults: United States, 1997-98

OBJECTIVE: This report presents estimates for underweight, healthy weight, overweight, and obesity for U.S. adults aged 18 years and over. Based on self-reported height and weight, data are shown for selected population subgroups for both sexes and for men and women separately. METHODS: Body weight status of U.S. adults was estimated using data from the 1997-98 National Health Interview Survey (NHIS) for 68,556 adults aged 18 years and over and Body Mass Index (BMI) (weight/height2) criteria established by the World Health Organization (WHO). The NHIS is administered in households throughout the United States using computer-assisted personal interviews (CAPI). The combined overall response rate in 1997-98 was 77.2%. Statistics shown in this report were age adjusted to the 2000 projected U.S. population. FINDINGS: Over one-half of adults (54.7%) were overweight and 1 in 5 (19.5%) were obese in 1997-98. Women (49.5%) were more likely than men (36.3%) to be of healthy weight although men and women were equally likely to be obese. Obesity was most prevalent among middle-aged adults, among black non-Hispanic adults and Hispanic adults, and among adults with less education and lower income. Rates of obesity by marital status differed by gender: married men (20.4%) had higher rates of obesity than separated and divorced men (16.8%), and married women (18.4%) had lower rates of obesity than separated and divorced women (23.2%). Obesity was lowest among adults living in the West and those living in a metropolitan statistical area (MSA), but outside the central city (i.e., the suburbs). CONCLUSIONS: Overweight and obesity were widespread in the United States in 1997-98 and prevalence varied significantly by population subgroup.     

Social inequalities in the association between partner/marital status and health among workers in Spain

The objectives of this study are to examine the association between partner/marital status and several health outcomes among workers and to assess whether it depends on gender and occupational social class. The sample was composed of all workers aged 21-64 years interviewed in the 2006 Spanish National Health Survey (8563 men and 5881 women). Partner/marital status had seven categories: married and living with the spouse (reference category), married and not living with the spouse, cohabiting, single and living with parents, single and not living with parents, separated/divorced and widowed. Four health outcomes were analysed: self-perceived health status, mental health, psychiatric drugs consumption and hypertension. Multiple logistic regression models stratified by sex and social class were fitted. Female manual workers who were cohabiting were more likely to report poor self-perceived health status, poor mental health status, psychiatric medication consumption and hypertension than their married and living with the spouse counterparts. In that group the prevalence of poor health outcomes was even higher when compared with single people. Among male non-manual workers, being married and not living with the spouse was associated with poor self-perceived health status, poor mental health status and hypertension. There were almost no differences in health between being married and the rest of partner/marital status categories for different combinations of gender and social class and, even, some groups of single people reported better health outcomes than people who were married. Our results show no evidence that being married and living with the spouse is unequivocally linked to better health status among Spanish workers. They emphasize the importance of not only considering marital status, but also partner status, as well as the role of gender, social class and the sociocultural context in the analysis of the association between family characteristics and health.     

The contribution of specific causes of death to mortality differences by marital status in the Netherlands

The purpose of this study was to describe the differences inmortality by marital status in the Netherlands in the period1986–1990 for specific causes of death and to estimatethe contribution of each specific cause to the differences intotal mortality. We have used mortality and population datafrom Statistics Netherlands. Poisson regression was used tocalculate relative risks of dying from the specific causes ofdeath. The relative risks and the overall mortality rates wereused to estimate the contribution of the specific causes ofdeath to the differences in total mortality by marital status.For men the general pattern was that the divorced had the highestrisks, followed by the never-married and that the widowed hadrisks closest to married men. For women the general patternwas that the divorced had the highest risks, while widowed andnever-married women alternately had risks closest to marriedwomen. Important exceptions to these risk patterns were foundfor, among others, infectious and parasitic diseases among menand breast cancer among women. External causes of death in particular,contributed more to the excess mortality of the 3 unmarriedgroups of men and women than expected, while the contributionsof malignant neoplasms and diseases of the circulatory systemwere lower than expected on the basis of the percentages ofthese causes of death in mortality in the married population.Since the causes of death that contributed disproportionatelyto the excess mortality of the unmarried almost all have unhealthylifestyles as important risk factors, we argue that the majorityof the mortality differences by marital status can be explainedby social causation (marital status affects health through lifestyledifferences). However, longitudinal data are necessary to ruleout selection effects (effect of health on marital status),preferably controlling for sociodemographic confounders suchas socioeconomic status and taking into account living arrangements.     

Marital status, intergenerational co-residence and cardiovascular and all-cause mortality among middle-aged and older men and women during wartime in Beirut: gains and liabilities

Studies from the West have shown an increased risk of mortality with various indicators of social isolation. In this study, we examine associations of marital status and intergenerational co-residence with mortality in Lebanon, a country that suffered wars and atrocities for almost 16 years. Using data from a retrospective 10-year follow-up study (1984-1994) among 1567 adults aged 50 years and older in Beirut, cardiovascular disease and all-cause mortality rates (per 1000 person-years) were computed for men and women separately. Age-adjusted Mantel-Haenszel rate ratios (RR) and their 95% confidence intervals (CI) were estimated, and associations were examined using multivariate Poisson regression analysis. Most men (91.3%) were married at baseline, in contrast to only 55.4% of women. Compared to men, women were more likely to be living in one- and three-generation households and with a married child at baseline. While widowhood was associated with an increased risk of all-cause mortality among men only, being never married was associated with a higher CVD mortality risk among men and women. The presence of an adult married child was associated with a significantly higher mortality risk for men and women, even after adjusting for household socioeconomic indicators, marital status, lifestyle variables or pre-existing health-related conditions (hypertension, cholesterol, and diabetes) at baseline. The popular belief that co-residence with adult children reflects greater support networks and an avenue for old age security may not be a valid presumption in the Lebanese context during times of war.     

Marital status and body weight,weight perception,and weight management among U.S. adults

Married individuals often have higher body weights than unmarried individuals, but it is unclear how marital roles affect body weight-related perceptions, desires, and behaviors. This study analyzed cross-sectional data for 4,089 adult men and 3,989 adult women using multinomial logistic regression to examine associations between marital status, perceived body weight, desired body weight, and weight management approach. Controlling for demographics and current weight, married or cohabiting women and divorced or separated women more often perceived themselves as overweight and desired to weigh less than women who had never married. Marital status was unrelated to men's weight perception and desired weight change. Marital status was also generally unrelated to weight management approach, except that divorced or separated women were more likely to have intentionally lost weight within the past year compared to never married women. Additionally, never married men were more likely to be attempting to prevent weight gain than married or cohabiting men and widowed men. Overall, married and formerly married women more often perceived themselves as overweight and desired a lower weight. Men's marital status was generally unassociated with weight-related perceptions, desires, and behaviors. Women's but not men's marital roles appear to influence their perceived and desired weight, suggesting that weight management interventions should be sensitive to both marital status and gender differences.     

Official marital status, cohabiting, and self-rated health-time trends in Finland, 1978-2001

BACKGROUND: Married persons are healthier and live longer than single, divorced, and widowed persons. Time trends in self-rated health (SRH) by marital status and cohabitation have remained largely unstudied. We aim to assess the levels and trends of SRH by official marital status and cohabitation, and to study the causes of these differences. METHODS: Two nationally representative cross-sectional surveys were conducted 20 years apart in Finland. Data on self-reported marital status, SRH, education, smoking, and long-standing illness were collected from Finns aged 30-64 years in 1978-80 (Mini-Finland Health Survey, N = 6102, response rate 96%) and 2000-01 (Health 2000 Survey, N = 5871, response rate 92%). RESULTS: SRH has improved in the last 20 years, but differences between marital status groups have not reduced. In 2000-01, non-married persons reported worse SRH than married persons. Among men, single [cumulative odds ratio (COR) = 1.55; 95% confidence interval (95% CI) 1.22-1.99] and divorced (COR = 1.55; 95% CI 1.17-2.05) persons showed the poorest SRH, while among women widows (1.53; 95% CI 1.04-2.26) were the most disadvantaged group. The SRH of cohabiting persons did not significantly differ from that of married persons. Differences in educational structure, smoking, and the prevalence of long-term illness explain part of the marital status differences in SRH among men, but less so among women. Among both single men and women as well as among widowed women, SRH had improved slightly less than in the other groups. CONCLUSION: The challenges on public health posed by growing numbers of currently not married people are likely to increase.     

肥胖的群体差异及影响因素——基于CFPS2018数据分析

目的 了解中国成年人肥胖流行现状以及锁定肥胖的高危人群,为肥胖的预防干预工作提供指导。 方法 从2018年中国家庭追踪调查（CFPS2018）提取所需数据,运用SPSS 19.0 统计软件进行统计学处理,肥胖的群体差异检验,等级变量采用秩和检验,二分类变量采用〖XC小五号.EPS;P〗检验;肥胖的影响因素检验采用多因素logistic回归。 结果 研究样本2 854例,肥胖占比7.1%。肥胖患病率在不同教育程度（Z=-2.29,P=0.02）、不同性别（χ2=10.10,P<0.001）以及不同婚姻状况（χ2=5.62,P=0.02）的群体分布有统计学意义。其中,男性及有伴侣的群体是肥胖高危人群。同时,受教育程度、性别和婚姻状况是肥胖的直接影响因素。 结论 积极有效的肥胖干预工作应该:（1）减重资源向男性肥胖倾斜;（2）针对有伴侣的群体开展家庭式的肥胖干预,缓解肥胖的婚姻状况差异;（3）在社区开展健康知识普及活动缓解教育水平不同带来的肥胖差异。     

Marital status and health: United States, 1999-2002

OBJECTIVE: This report presents prevalence estimates by marital status for selected health status and limitations, health conditions, and health risk behaviors among U.S. adults, using data from the 1999-2002 National Health Interview Surveys (NHIS). METHODS: Data for the U.S. civilian noninstitutionalized population were collected using computer-assisted personal interviews (CAPI). The household response rate for the NHIS was 88.7%. This report is based on a total of 127,545 interviews with sample adults aged 18 years and over, representing an overall response rate of 72.4% for the 4 years combined. Statistics were age-adjusted to the 2000 U.S. standard population. Marital status categories shown in this report are: married, widowed, divorced or separated, never married, and living with a partner. RESULTS: Regardless of population subgroup (age, sex, race, Hispanic origin, education, income, or nativity) or health indictor (fair or poor health, limitations in activities, low back pain, headaches, serious psychological distress, smoking, or leisure-time physical inactivity), married adults were generally found to be healthier than adults in other marital status categories. Marital status differences in health were found in each of the three age groups studied (18-44 years, 45-64 years, and 65 years and over), but were most striking among adults aged 18-44 years. The one negative health indicator for which married adults had a higher prevalence was overweight or obesity. Married adults, particularly men, had high rates of overweight or obesity relative to adults in other marital status groups across most population subgroups studied. Never married adults were among the least likely to be overweight or obese.     

Marital status and suicide in the National Longitudinal Mortality Study

OBJECTIVES: The purpose of the study was to examine the effect of marital status on the risk of suicide, using a large nationally representative sample. A related objective was to investigate the association between marital status and suicide by sex. METHODS: Cox proportional hazards regression models were applied to data from the National Longitudinal Mortality Study, based on the 1979-1989 follow up. In estimating the effect of marital status, adjustments were made for age, sex, race, education, family income, and region of residence. RESULTS: For the entire sample, higher risks of suicide were found in divorced than in married persons. Divorced and separated persons were over twice as likely to commit suicide as married persons (RR = 2.08, 95% confidence intervals (95% CI) 1.58, 2.72). Being single or widowed had no significant effect on suicide risk. When data were stratified by sex, it was observed that the risk of suicide among divorced men was over twice that of married men (RR = 2.38, CI 1.77, 3.20). Among women, however, there were no statistically significant differentials in the risk of suicide by marital status categories. CONCLUSIONS: Marital status, especially divorce, has strong net effect on mortality from suicide, but only among men. The study showed that in epidemiological research on suicide, more accurate results would be obtained if samples are stratified on the basis of key demographic or social characteristics. The study further observed that failure to control for relevant socioeconomic variables or combining men and women in the same models could produce misleading results.     

Marital and cohabitation status as predictors of mortality: a 10-year follow-up of an Italian elderly cohort

The relationship between mortality and marital status has long been recognized, but only a small number of investigations consider also the association with cohabitation status. Moreover, age and gender differences have not been sufficiently clarified. In addition, little is known on this matter about the Italian elderly population. The aim of this study is to examine differentials in survival with respect to marital status and cohabitation status in order to evaluate their possible predictive value on mortality of an Italian elderly cohort. This paper employs data from the Italian Longitudinal Study on Aging (ILSA), an extensive epidemiologic project on subjects aged 65-84 years. Of the 5376 individuals followed-up from 1992 to 2002, 1977 died, and 1492 were lost during follow-up period. The baseline interview was administered to 84% of the 5376 individuals and 65% of them underwent biological and instrumental examination. Relative risks of mortality for marital (married vs. non-married) and cohabitation (not living alone vs. living alone) categories are estimated through hazard ratios (HR), obtained by means of the Cox proportional hazards regression model, adjusting for age and several other potentially confounding variables. Non-married men (HR=1.25; 95% CI: 1.03-1.52) and those living alone (HR=1.42; 95% CI: 1.05-1.92) show a statistically significant increased mortality risk compared to their married or cohabiting counterparts. After age-adjustment, women's survival is influenced neither by marital status nor by cohabitation status. None of the other covariates significantly alters the observed differences in mortality, in either gender. Neither marital nor cohabitation status are independent predictors of mortality among Italian women 65+, while among men living alone is a predictor of mortality even stronger than not being married. These results suggest that Italian men benefit more than women from the protective effect of living with someone.     

Dietary and socio-economic factors associated with obesity among Kuwaiti college men

Obesity has been on the increase among people of the Arabian Gulf countries. Overweight and obesity among 18-29-year-old Kuwaiti men increased by 23.4 and 14.8% respectively, between 1980 and 1993. The objective of the present study was to explore factors associated with overweight and obesity in a sample of 515 Kuwaiti college men studied in 1997. Weight and height were measured. The index of adiposity used was the BMI, which is the weight (kg) divided by the height (m) squared (kg/m2). The men were classified as overweight (BMI > 25 kg/m2) or obese (BMI > 30 kg/m2). The associated factors obtained through questionnaires included age, marital status, governorate, number of siblings, suffering from a chronic disease, subjects' parental obesity, education and occupation, number of major meals eaten, eating between meals, family income, number of servants, number of people living at home, exercising, last dental and physical check-up, dieting, year of study, highest desired degree after college, countries preferred for visiting, and socio-economic status. The results of the study revealed that 38.5 and 11.1% of the students were overweight and obese respectively. Factors that were found to be significantly associated with overweight and obesity among the men included age, marital status, last dental check-up, exercising, subjects' parental obesity, dieting and year of study. Logistic regression analysis of significant associated factors revealed that the same factors contributed to the development of overweight and obesity.     

Marital status, delay in seeking treatment and survival from breast cancer

This study examined 10-year survival following a breast cancer diagnosis among 910 married and 351 widowed white women after adjusting for the effects of age, socio-economic status (SES), stage of disease and delay in seeking treatment for symptoms. All breast cancer patients were treated at M.D. Anderson Hospital and Tumor Institute in Houston, Texas between 1949 and 1968. Marital status, age, SES, delay and stage were all univariate predictors of survival. Widowed patients were less likely to survive than married patients. Multivariate analyses using a Cox regression technique did not detect an effect of delay on survival when stage and the other variables were included. However, marital status differences in survival remained when all the other variables were included in the model. These data suggest that marital status differences in survival cannot be accounted for by patient delay in seeking treatment for breast cancer symptoms.     

Disparities in pediatric obesity in the United States

This paper describes the disparities in the U.S. childhood obesity epidemic, mainly based on recent nationally representative data. The prevalence of overweight and obesity has increased since the late 1970s; the over time shifts (changes) in distributions of various body fatness measures indicate that U.S. children have become fatter and the obese groups gained more body fat, especially more central obesity, as indicated by waist circumference. However, considerable between-group and regional disparities exist in the prevalence, fatness measures, and over time trends. The disparities and trends are complex, which reflects the complexity and dynamics in obesity etiology. Clearly, some population groups are affected more seriously than others. Native American children have the highest prevalence of obesity, whereas Asians have the lowest rate among all ethnic groups. Preschool age children have a lower obesity prevalence than older children. Young people in some states and cities are twice more likely to be overweight or obese than those living in other regions. Low-socioeconomic status is associated with obesity only among some population groups, e.g. white children and adolescents. Vigorous, effective interventions are needed to promote healthy lifestyles among U.S. young people and to reduce disparities in obesity.     

Migration, marital status and smoking as risk determinants of cancer

To study the importance of migration to urban area, marital status and smoking as risk factors in cancer, a cohort of 4,475 Finnish men was followed up for the occurrence of cancer during the period 1964-1980. Of particular interest was the interaction of migration or marital status with smoking. For cancers at all sites, not married urbanized smoking men had the greatest risk, followed by not married native urban smokers. This pattern was mainly due to high risk of cancers of the lung and larynx among the urbanized men, with a risk peak among urbanized not married smokers. The pattern persisted even when the amount smoked was allowed for. The importance in lung cancer epidemiology of vitamin A deficiency, occupation and psychosocial stress was discussed, and some support was found for the role of psychosocial stress in both the migration and the marital status factors.     

Associations of Household Expenditure and Marital Status With Cardiovascular Risk Factors in Japanese Adults: Analysis of Nationally Representative Surveys

Background

Socioeconomic inequalities in health and social determinants of health are important issues in public health and health policy. We investigated associations of cardiovascular risk factors with household expenditure (as an indicator of socioeconomic status) and marital status in Japan.

Methods

We combined data from 2 nationally representative surveys—the Comprehensive Survey of Living Conditions and the National Health and Nutrition Survey, 2003–2007—and analyzed sex-specific associations of household expenditure quartiles and marital status with cardiovascular risk factors, including obesity, hypertension, dyslipidemia, and diabetes, among 6326 Japanese adults (2664 men and 3662 women) aged 40 to 64 years.

Results

For men, there was no statistically significant association between household expenditure and cardiovascular risk factors. For women, lower household expenditure was significantly associated with obesity, hypertension, diabetes, and the presence of multiple risk factors: the ORs for the lowest versus the highest quartile ranged from 1.39 to 1.71. In a comparison of married and unmarried participants, the prevalence of cardiovascular risk factors was higher among married women and lower among married men.

Conclusions

Lower socioeconomic status, as indicated by household expenditure, was associated with cardiovascular risk factors in Japanese women. Socioeconomic factors should be considered in health promotion and prevention of cardiovascular disease.Key words: health inequalities, socioeconomic factor, household expenditure, cardiovascular risk factor, marital status     

Family roles and smoking

This study analyzes the relationships of cigarette smoking and smoking histories to marital and parental status. Data from a large, representative sample of U.S. adults in 1985 were analyzed separately for white men, white women, black men, and black women, with controls for age, education, and marital status included in the analyses. Divorced and separated adults were the most likely to be current smokers or ever to have adopted smoking; currently married adults and widowed adults were intermediate; and never married adults were the least likely to be current smokers or ever to have adopted smoking. (There were some exceptions to these patterns for never married and widowed blacks). The differences in smoking adoption had begun during adolescence, before the usual age of marriage, which suggests that the differences in smoking, adoption were not caused by marriage or divorce. Rather, it appears that personal characteristics or early experiences influenced both the likelihood of smoking adoption and the likelihood of marriage or divorce. Currently married adults were more likely to have quit smoking than never married, divorced and separated, or widowed adults. It may be that the social support provided by marriage increases smoking cessation. In contrast to the strong relationships between marital status and smoking, relationships between parental status and smoking were relatively weak and variable. Among white women, mothers of preschoolers were less likely to be smokers than women without children. The mothers of preschoolers were more likely to have quit smoking, possibly as a result of increased smoking cessation during pregnancy.     

Gender, marital status and the social control of health behavior.

Mortality rates are lower for married individuals than they are for unmarried individuals, and marriage seems to be even more beneficial to men than women in this regard. A theoretical model of social integration and social control is developed to explain why this may occur. Drawing from this model, I hypothesize that marriage may be beneficial to health because many spouses monitor and attempt to control their spouse's health behaviors. Furthermore, the provision, receipt, and consequences of these social control efforts may vary for men and women. These hypotheses are considered with analysis of a national panel survey conducted in 1986 (N = 3617) and 1989 (N = 2867). Results show that: (1) marriage is associated with receipt of substantially more efforts to control health for men than women, (2) those who attempt to control the health of others are more likely to be female than male, (3) there is some support for the social control and health behavior hypothesis among the married, and (4) the transition from married to unmarried status is associated with an increase in negative health behavior while the transition from unmarried to married status seems to have little effect on health behavior. A theoretical explanation is developed to explain these marital status differences.