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Misreporting and misclassification: implications for socioeconomic disparities in body-mass index and obesity.

Ljungvall, Åsa LU ; Gerdtham, Ulf LU and Lindblad, Ulf LU (2015) In European Journal of Health Economics 16(1). p.5-20
Abstract
Body-mass index (BMI) has become the standard proxy for obesity in social science research. This study deals with the potential problems related to, first, relying on self-reported weight and height to calculate BMI (misreporting), and, second, the concern that BMI is a deficient measure of body fat (misclassification). Using a regional Swedish sample, we analyze whether socioeconomic disparities in BMI are biased because of misreporting, and whether socioeconomic disparities in the risk of obesity are sensitive to whether BMI or waist circumference is used to define obesity. Education and income are used as socioeconomic indicators. The overall conclusion is that misreporting and misclassification may indeed matter for estimated... (More)
Body-mass index (BMI) has become the standard proxy for obesity in social science research. This study deals with the potential problems related to, first, relying on self-reported weight and height to calculate BMI (misreporting), and, second, the concern that BMI is a deficient measure of body fat (misclassification). Using a regional Swedish sample, we analyze whether socioeconomic disparities in BMI are biased because of misreporting, and whether socioeconomic disparities in the risk of obesity are sensitive to whether BMI or waist circumference is used to define obesity. Education and income are used as socioeconomic indicators. The overall conclusion is that misreporting and misclassification may indeed matter for estimated educational and income disparities in BMI and obesity. In the misreporting part we find that women with higher education misreport less than those with lower education, leading to underestimation of the education disparity when using self-reported information. In the misclassification part we find that the probability of being misclassified decreases with income, for both men and women. Among women, the consequence is a steeper income gradient when obesity is defined using waist circumference instead of BMI. Among men the income gradient is statistically insignificant irrespective of how obesity is defined, but when estimating the probability of obesity defined by waist circumference, an educational gradient, which is not present when classifying men using BMI, arises. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Health Economics
volume
16
issue
1
pages
5 - 20
publisher
Springer
external identifiers
  • pmid:24363175
  • wos:000348983500002
  • scopus:84890326561
ISSN
1618-7601
DOI
10.1007/s10198-013-0545-5
language
English
LU publication?
yes
id
9dd4ffc2-5ae2-4474-b39c-5ebc47ad7a40 (old id 4223141)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24363175?dopt=Abstract
date added to LUP
2014-01-05 23:37:35
date last changed
2017-01-01 04:06:50
@article{9dd4ffc2-5ae2-4474-b39c-5ebc47ad7a40,
  abstract     = {Body-mass index (BMI) has become the standard proxy for obesity in social science research. This study deals with the potential problems related to, first, relying on self-reported weight and height to calculate BMI (misreporting), and, second, the concern that BMI is a deficient measure of body fat (misclassification). Using a regional Swedish sample, we analyze whether socioeconomic disparities in BMI are biased because of misreporting, and whether socioeconomic disparities in the risk of obesity are sensitive to whether BMI or waist circumference is used to define obesity. Education and income are used as socioeconomic indicators. The overall conclusion is that misreporting and misclassification may indeed matter for estimated educational and income disparities in BMI and obesity. In the misreporting part we find that women with higher education misreport less than those with lower education, leading to underestimation of the education disparity when using self-reported information. In the misclassification part we find that the probability of being misclassified decreases with income, for both men and women. Among women, the consequence is a steeper income gradient when obesity is defined using waist circumference instead of BMI. Among men the income gradient is statistically insignificant irrespective of how obesity is defined, but when estimating the probability of obesity defined by waist circumference, an educational gradient, which is not present when classifying men using BMI, arises.},
  author       = {Ljungvall, Åsa and Gerdtham, Ulf and Lindblad, Ulf},
  issn         = {1618-7601},
  language     = {eng},
  number       = {1},
  pages        = {5--20},
  publisher    = {Springer},
  series       = {European Journal of Health Economics},
  title        = {Misreporting and misclassification: implications for socioeconomic disparities in body-mass index and obesity.},
  url          = {http://dx.doi.org/10.1007/s10198-013-0545-5},
  volume       = {16},
  year         = {2015},
}