International Journal of Epidemiology, Vol 26, 860-866, Copyright © 1997 by International Epidemiological Association
G Bostrom and F Diderichsen
BACKGROUND: The purpose of this study was to analyse misclassification of
height, weight and body mass index (BMI), derived from mail questionnaires,
and its dependency on socioeconomic factors. METHODS: A random sample of
4442 adults aged 18-84 years, living in Stockholm county, Sweden, were in
1984-1985 asked about their height and weight. A few months later 3208 of
these adults participated in a health examination that included measures of
height and weight. In this study we have used occupational class as the
socioeconomic indicator. We have used sensitivity as a measure of
misclassification of height, weight and BMI. RESULTS: The difference in
mean measured height between socioeconomic groups I and III was 2.7 cm for
men and 2.0 cm for women. The mean difference in measured height between
socioeconomic groups I and III was higher for men than for women in all age
groups. The mean difference between self-reported and measured height was
0.6 cm for men and 0.79 cm for women. For weight, the corresponding
difference was - 0.74 kg for men and -1.64 kg for women. Women's BMI was
more underestimated than men's (-0.85 for women, -0.40 for men). When using
self-reported height and weight for calculating BMI, 81% of the men and 78%
of the women were classified correctly, but only 61% of the obese men and
55% of the obese women were identified. The BMI was underestimated in all
socioeconomic groups. Manual workers had a lower proportion of underweight,
compared to professionals and intermediate non-manual workers, while the
objective measure showed the inverse relationship. The prevalence of
overweight and obesity in men was 42% higher in socioeconomic group III
compared with group I with self- reported data compared with 28% when
measured. Underestimation of BMI was highest among women, the obese, the
elderly, and male non-manual workers and female manual workers.
CONCLUSIONS: Our study shows that socioeconomic differences in height, when
using self-reported information, involve an underestimation. This means
that the height differences between socioeconomic groups in Sweden may
actually be higher than that reported by individuals in surveys. The
socioeconomic differences in underweight tend to be underestimated for men,
as well as obesity for women, when using self-reported information. The
socioeconomic differences in overweight and obesity are shown to be
overestimated for men.
ARTICLES
Socioeconomic differentials in misclassification of height, weight and body mass index based on questionnaire data
Karolinska Institute, Department of Public Health Sciences, Sundbyberg, Sweden.
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