Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): socio-occupational class as an effect modifier for the relationship between adiposity measures and self-rated health

Abstract

Abstract Background Little is known about the role of social class in the association between adiposity measures and self-rated health, and several studies have evaluated its influence as a confounder. The aim of the study is to investigate whether social class is an effect modifier in the association between adiposity measures and self-rated health in participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Method Cross-sectional design, including 6453 men and 7686 women. Body mass index (kg/m2) and waist circumference (cms) were assessed. Self-rated health was categorized as good, fair and poor. Socio-occupational class was based on the participants’ occupation, education and per capita income. Multicovariate ordinal logistic model was used to evaluate the association between adiposity measures and self-rated health. Results For women, the low and medium socio-occupational class effects were higher for those with waist circumference between 80 and 88 cm or overweight. For men, the low and medium socio-occupational class effects were higher for those with adequate waist circumference or normal body mass index. Conclusions Social class is an effect modifier in the association between body mass index or waist circumference and self-rated health.

Keywords

• Body mass index
• Waist circumference
• Self-rated health
• Occupational social class
• Social stratification
• Effect modification