The determinants of body mass in Greece: Evidence from the National Health Survey

Daouli, Joan and Davillas, Apostolos and Demoussis, Michael and Giannakopoulos, Nicholas (2013): The determinants of body mass in Greece: Evidence from the National Health Survey.

Abstract

In this study we explore the determinants of body-weight in Greece utilizing information at the individual level from the National Health Survey of 2009. BMI has been treated as both, a cardinal and an ordinal measure of body-weight, while different estimation techniques were applied (OLS, ordered probit and unconditional quantile regression). In our attempt to identify the major determinants of BMI outcomes in Greece we employed a wide range of demographic, socio-economic, lifestyle, health-related and regional characteristics. The unconditional quantile estimates uncovered differences in the estimated impact of several correlates across the BMI distribution, highlighting their superiority vis-a-vis the simple mean-based linear models of BMI. Examining the entire BMI distribution and targeting specific segments of the Greek population can render public health policies against obesity more efficient and prolific.

• Item Type: MPRA Paper
• Language: English
• Keywords: Body mass index, obesity, ordered probit, unconditional quantile regression, Greece.
• Subjects: C - Mathematical and Quantitative Methods > C2 - Single Equation Models ; Single Variables > C21 - Cross-Sectional Models ; Spatial Models ; Treatment Effect Models ; Quantile Regressions; I - Health, Education, and Welfare > I1 - Health > I10 - General; I - Health, Education, and Welfare > I1 - Health > I12 - Health Behavior

References

Averett, S.L., Argys, L.M., Kohn J.L.: Immigration, obesity and labor market outcomes in the UK. IZA Journal of Migration 1(1), 1-19 (2012).

Baum, C.L., Ruhm, C.J.: Age, socioeconomic status and obesity growth. Journal of Health Economics 28, 635–648 (2009).

Brunello, G., Fabbri, D., Fort, M.: The causal effect of education on body mass: Evidence from Europe. Journal of Labor Economics 31(1), 195-233 (2013)

Burkhauser, R.V., Cawley, J., 2008. Beyond BMI: the value of more accurate measures of fatness and obesity in social science research. Journal of Health Economics 27, 519–529.

Cawley, J.: An economic framework for understanding physical activity and eating behaviors. American Journal of Preventive Medicine 23, 117–125 (2004a)

Cawley, J. The impact of obesity on wages. Journal of Human Resources 39(2), 451-474 (2004b)

Chou, S.Y., Grossman, M., Saffer, H.: An economic analysis of adult obesity: results from the Behavioral Risk Factor Surveillance System. Journal of Health Economics 23(3), 565-87 (2004)

Chung S, Domino ME, Stearns SC. The effect of retirement on weight. Journal of Gerontology: Social Sciences 64B(5), 656-665 (2009)

Costa-Font, J, Fabbri, D, Gil, J. 2009.: Decomposing body mass index gaps between mediterranean countries: a counterfactual quantile regression analysis. Economics of Economics and Human Biology 7 (3), 351-365 (2009)

Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Medicine and Science in Sports Exercise 35:1381–95 (2003).

Cutler, D., Glaeser, E., Shapiro, J.: Why Have Americans Become More Obese? Journal of Economic Perspectives 17(3), 93-118 (2003)

Finkelstein, E.A., Trogdon, J.G., Cohen J.W., Dietz, W.: Annual medical spending attributable to obesity: payer-and service-specific estimates. Health affairs 28(5), w822-w831 (2009)

Firpo, S., Fortin M.N., Lemieux, T.: Unconditional Quantile Regressions, Econometrica 77(3): 953-973 (2009)

Flegal, K.M., Graubard, B.I., Williamson, D.F., Gail, M.H.: Excess deaths associated with underweight, overweight, and obesity. JAMA 293(15), 1861-1867 (2005)

Freedman, David, Khan, Laura, Serdula, Mary, Galuska, Deborah and Dietz, William. Trends and Correlates of Class Obesity in the United States from 1990 through 2000. Journal of the American Medical Association 288(14): 1758-1761 (2002)

Fry, J., Finley., W.: The prevalence and costs of obesity in the EU. Proceedings of the Nutrition Society 64(3), 359-362 (2005)

García Villar, J., Quintana-Domeque, C.: Income and body mass index in Europe. Economics & Human Biology 7(1), 73-83 (2009)

Gomis-Porqueras, P., Mitnik, O.A., Peralta-Alva, A., Schmeiser, M.D.: The Effects of female labor force participation on obesity. IZA Discussion Paper 6071 (2001)

Grossman, M., Mocan N.: Economic Aspects of Obesity. Chicago and London: University of Chicago Press (2011)

Heineck, G.: Height and weight in Germany, evidence from the German Socio-Economic Panel, 2002. Economics and Human Biology 4, 359-382 (2006)

Jolliffe, D.: Overweight and Poor? On the Relationship between Income and the Body Mass Index, Economics and Human Biology 9(3), 342-55 (2011)

Kan, K., Tsai, W.: Obesity and risk knowledge. Journal of Health Economics, 23, 907–934 (2004)

Kapantais, E., Tzotzas, T., Ioannidis, I., Mortoglou, A., Bakatselos, S., Kaklamanou, M., Lanaras, L., Kaklamanos, I.: First national epidemiological survey on the prevalence of obesity and abdominal fat distribution in Greek adults. Annals of Nutrition & Metabolism 50, 330–8 (2006)

Knai, C., Suhrcke, M., Lobstein, T.: Obesity in Eastern Europe: an overview of its health and economic implications. Economics & Human Biology 5(3), 392-408 (2007)

Koenker, R.W., Bassett, G., Jr. Regression Quantiles, Econometrica 46:33-50 (1978)

Kuczmarski MF, Kuczmarski RJ, Najjar M. Effects of age on validity of self-reported height, weight, and body mass index: findings from the Third National Health and Nutrition Examination Survey, 1988–1994. Journal of American Dietetic Association 101 (1), 28–34 (2001)

Lakdawalla, D., Philipson, T.: The growth of obesity and technological change. Economics & Human Biology 7(3), 283–293 (2009)

Manios, Y., Panagiotakos, D.B., Pitsavos, C., Polychronopoulos, E., Stefanidis, C.: Implication of socio-economic status on the prevalence of overweight and obesity in Greek adults: the ATTICA study. Health Policy 74(2), 224-32 (2005)

Michaud, P.C., van Soest, A.H.O., Andreyeva, T.: Cross-country variation in obesity patters among older Americans and Europeans. Forum for Health Economics & Policy 10, 1–30 (2007)

Mokdad, A.H., Ford, E.S., Bowman, B.A., Dietz, W.H., Vinicor, F., Bales, V.S., Marks, J.S.: Prevalence of obesity, diabetes, and obesity-related health risk factors. Journal of American Medical Association 289, 76-79 (2003)

Morris S. The impact of obesity on employment. Labour Economics 14, 413–33 (2007)

Must, A., Spadano, J., Coakley, E., Field, A., Colditz, G., Dietz, W.: The disease burden associated with overweight and obesity. JAMA 282 (16), 1523-1529 (1999)

Nakamura, R., Siciliani, L.: Education and Body Mass Index: Evidence from ECHP. Discussion paper 10/04, Department of Economics, University of York (2010)

Ng, S.W., Norton, E.C., Guilkey D.K., Popkin B.M.: Estimation of a dynamic model of weight. Empirical Economics 42, 413–443 (2012)

Norton, E.C, Han, E.: Genetic information, obesity, and labour market outcomes. Health Economics 17, 1089–104 (2008)

Power, C., Lake, J.K., Cole, T.J.: Body mass index and height from childhood to adulthood in the 1958 British born cohort. American Journal of Clinical Nutrition 66(5), 1094-1101 (1997)

Philipson, T., 2001. The world-wide growth in obesity: an economic research agenda. Health Economics 10, 1–7.

Rashad, I.: Structural Estimation of Caloric Intake, Exercise, Smoking, and Obesity. Quarterly Review of Economics and Finance 46(2), 268-83 (2006)

Sanchez-Vaznaugh, E.V., Kawachi, I., Subramanian, S.V., Sanchez, B., Acevedo-Garcia, D.: Differential effect of birthplace and length of residence on body mass index (BMI) by education, gender and race/ethnicity. Social Science and Medicine 67(8), 1300–1310 (2008)

Sanz-de-Galdeano, A.: The Obesity Epidemic in Europe. IZA Paper No.1814 (2005)

Stifel, D.C., Averett, S.L.: Childhood overweight in the United States: a quantile regression approach. Economics and Human Biology 7 (3), 387–397 (2009)

Tzotzas, T., Kapantais, E., Tziomalos, K., Ioannidis, I., Mortoglou, A., Bakatselos, S., Kaklamanou, M., Lanaras, L., Kaklamanos., I.: Epidemiological survey for the prevalence of overweight and abdominal obesity in Greek adolescents. Obesity 16(7), 1718-1722 (2008)

Tzotzas, T., Konstantinidis, T., Bougoulia, M., Krassas, G. E.: Factors associated with body mass index in adults from Northern Greece. Hormones 3(2), 111-119 (2004). WHO.: Physical status: the use and interpretation of anthropometry. World Health Organization, Geneva (1995)

Wandell, P.E., Ponzer, S., Johansson, E., Sundquist, K., Sundquist, J.: Country of Birth and Body Mass Index: A National Study of 2000 Immigrants in Sweden. European Journal of Epidemiology 19(11), 1005–1010 (2004)

Willett, W.C., Dietz, W.H., Colditz, G.A.: Guidelines for healthy weight. New England Journal of Medicine 341 (6), 427–434 (1999).

Yen, S.T., Chen, Z., Eastwood, D.B.: Lifestyles, demographics, dietary behavior, and obesity: a switching regression analysis. Health Services Research 44(4), 1345–1369 (2009)