Commentary: Closing the disparity gaps in obesity

Extract

The two big challenges that obesity presents us with are how to reduce its overall burden and how to reduce its associated disparities—especially the disparities by socio-economic position (SEP) and ethnicity. The paper by Clarke et al.¹ in this issue elegantly highlights the epidemiology of the obesity epidemic in relation to the changing patterns in the USA across gender, ethnicity, SEP, age and cohort. As shown in this and other US studies in adults and children,^2–4 the inter-relationships between these factors are complex and changing over time. Sophisticated studies, such as this analysis of the Monitoring the Future Study (MTS), are needed to help untangle the various contributions of these determinants to the prevalence and, more importantly, the trends in obesity. For example, the findings that the ethnic and SEP disparities in body mass index (BMI) seem to increase over the life course of the population (longitudinal analyses) but decrease over time (serial cross-sectional analyses) is subtle but important—the gaps between Whites and Blacks or between advantaged and disadvantaged are greater for older age groups but are overall less now than they used to be.