Obesity in the context of migration and socio-economic risk factors - a multivariate epidemiologic analysis

Pia Jäger; Katharina Beyer; Kevin Claassen

doi:10.1016/j.annepidem.2022.09.008

Obesity in the context of migration and socio-economic risk factors - a multivariate epidemiologic analysis

Ann Epidemiol. 2022 Dec:76:108-113. doi: 10.1016/j.annepidem.2022.09.008. Epub 2022 Oct 14.

Authors

Pia Jäger¹, Katharina Beyer², Kevin Claassen³

Affiliations

¹ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Berlin, Germany. Electronic address: pia.jaeger@charite.de.
² Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Berlin, Germany.
³ Cancer Registry of North Rhine-Westphalia, Gesundheitscampus 10, 44801 Bochum, Germany; Witten/Herdecke University, Faculty of Health, School of Medicine, Health Services Research, Alfred-Herrenhausen-Strasse 50, 58448 Witten, Germany.

PMID: 36252892
DOI: 10.1016/j.annepidem.2022.09.008

Abstract

Purpose: While the existence of a healthy migrant effect remains controversial, overweight and obesity are considered a global pandemic. Migrants seem to be affected more often, however most of the few existing studies did not differentiate a first-generation from a second-generation migration background and/or did not control common socio-demographic confounders. This study aims at examining the influence of first- and second-generation migration on body mass index (BMI) and obesity in Germany.

Subjects and methods: We conducted a controlled observational study based on a survey of n = 64,089 participants of the German Socio-Economic-Panel. Missing values were multivariate imputed via chained equations (MICE). The influence of migration on BMI and obesity was assessed by comparing first-generation, second-generation and non-migrants to each other. Pairwise statistical testing was done by t tests and Fisher's exact tests. For the multivariate analysis, OLS and logistic regression models and its coefficients (beta, odds ratio) were used. Targeting multiple testing, Holm-correction was utilized.

Results: Within the bivariate analysis, all three group-specific mean BMI-values differ significantly from each other (P < .001). The pairwise differences regarding the obesity risk are also significant (P < .001). Within the multivariate analysis, only second-generation migration reveals an influence on BMI compared to first-generation migration (ß = 0.297; 97.5% CI: 0.127-0.467) and non-migrants (ß = 0.366; 98.33% CI: 0.103-0.628). This is equivalent to its influence on obesity versus first-generation (odds ratios = 1.220; 98.33% CI: 1.045-1.423) and non-migrants (odds ratios = 1.134; 97.5% CI: 1.018-1.262).

Conclusions: After controlling socio-demographic confounders, a second-generation migration background but not a first-generation migration background is associated with a higher BMI and obesity.

Keywords: Adjusted risk analysis; First- and second-generation migration background; Healthy-migrant effect; Migration background; Obesity risk.

Publication types

Observational Study

MeSH terms

Humans
Multivariate Analysis
Obesity / epidemiology
Risk Factors
Socioeconomic Factors
Transients and Migrants*