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A new study led by Distinguished Professor Luisa N. Borrell found significant inequities in body mass index (BMI) among adults in Spain, driven by age, sex, immigration status, and education.
The research, which used data from the 2014 and 2020 European Health Interview Surveys and the 2017 Spanish National Health Survey revealed that older adults, immigrants, and people with lower educational attainment generally had higher BMI, while women showed lower averages.
While most inequities were explained by age, sex, immigration status, and education, there were interaction effects among these factors with some groups with BMI means departing from the predicted by the main effects. The latter highlights the need for universal public health interventions with a proportionate targeting to groups with social identities associated with high BMI, i.e., immigrant women—especially those aged 55–64 with middle or high education.
Dr. Borrell and her team used an intersectional framework with multilevel analyses and focused on how social identities intersect to affect BMI. Age, sex, immigration status, and education explained the majority of BMI differences, with interaction effects explaining inequities for certain groups—including immigrant women—whose BMI exceeded predicted levels based on these factors.
Results suggest universal health measures may need adjustment to address the unique needs of such higher-risk groups.
“The complex interplay of social factors in BMI risk shows the importance of intersectional approaches in health policy and intervention design,” says Dr. Borrell. “We urge policymakers to consider these patterns to improve effectiveness in obesity prevention and treatment strategies across Spain.”
