Tae Jun Kim|Olaf von dem Knesebeck
Income and obesity: what is the direction of the relationship? A systematic review and meta-analysis
University Medical Center Hamburg-Eppendorf|Universität Hamburg|University Medical Center Hamburg-Eppendorf|Universität Hamburg
repeatedly shown lower income associated higher risks subsequent obesity however perspective potential reverse causality often neglected obesity considered cause lower income obese people drift lowerincome jobs due labourmarket discrimination public stigmatisation review performed explore direction relation income obesity specifically assessing importance social causation reverse causalitysystematic review metaanalysisa systematic literature search conducted january 2017 databases medline psycinfo sociological abstracts international bibliography social sciences sociological index screened identify prospective cohort studies quantitative data relation income obesity metaanalytic methods applied using randomeffect models quality studies assessed newcastleottawa scalein total 21 studies eligible metaanalysis included studies originated either usa n16 uk n3 canada n2 14 studies causation 7 studies reverse causality found metaanalyses revealed lower income associated subsequent obesity 127 95 ci 110 147 risk ratio 152 95 ci 108 213 though statistical significance vanished adjusted publication bias studies reverse causality indicated consistent relation obesity subsequent income even taking publication bias account standardised mean difference 015 95 ci 030 001 sensitivity analyses implied association influenced obesity measurement gender length observation study qualityfindings suggest consistent evidence reverse causality therefore need examine reverse causality processes detail understand relation income obesity42016041296