The effects of socioeconomi̇c vari̇ables on obesi̇ty i̇n Turkey and inequality

Obesity is an important public health problem for both developed and developing countries. Obesity has rapidly been increasing in all age and socioeconomic groups particularly since 1980s. The World Health Organization (WHO) reported that there were approximately 1.4 billion overweight adults and 500 million obese adults in the world as of 2008. The numbers of obese adults projected to reach 2.3 billion and 700 million respectively in 2015. The Health Survey conducted by TurkStat reported that the obesity ratio is 16.2% in 2008 and 18.8% in 2010. Similar to the worldwide situation, prevalence of obesity among female and prevalence of overweight among men are higher than their counterparts in Turkey. According to the TurkStat Health Survey 2008, 49.1% of adult populations were overweight and obese. This ratio increased to 52.1% in 2010. As national average, the rate of obese and overweight was measured as 46.9 % for females and 51.2% for males in 2008. These rates increased to 51% and 53.2% respectively in 2010. Obesity has an effect on the quality of people's life and health as well as a negative effect on country economy. Obesity incurs direct and indirect costs to the country's economy. Declining food prices in real terms, increasing real per capita income, technological development, social and environmental factors, socio-demographic factors, working conditions demanding less physical activity and females participation to labor force have influenced individual's food consumption and energy balance. Consequently, obesity prevalance has increased. In international literature, the number of empirical studies based on microeconomic theory which focused on the economic causes of obesity and its consequences, the cost of obesity, the effects of obesity on income or wage levels, socioeconomics inequality on obesity, has rapidly increased in recent years. But, almost all the studies on obesity in Turkey has been conducted by health scientist/researchers. Unfortunately, empirical studies based on economic theory has not been done yet in the country. As a result, empirical findings are inadequate to contribute anti obesity policy design. The main determining factors on obesity, socioeconomic inequality on obesity and to determine the factors causing inequality are important for intervention policies. This research x aim to contribute literature in the national context and to identify appropriate economic tools to fight against obesity. TurkStat 2008 and 2010 Health Survey data are used in the empirical analysis. The empirical section of this study consists of two parts. In the first part, current status of body mass index (BMI) by socioeconomic and demographic segments are presented using 2008 and 2010 survey data. Then, a Probit model is estimated to measure whether socioeconomic and demographic variables such as gender, age, location, level of education, marital status, income level, general health status, individual habits and consumption of fruit, have as significant impact on obesity and overweight/obesity, using both 2008 and 2010 survey data. In the second part, concentration index is calculated to determine impact of socioeconomic and demographic variables on inequality in obesity and to determine degree and direction of the inequalities. According to results obtained from the model, as in other devoping countries, probability of being obese and overweight/obese is higher at higher income group and low education level in Turkey, results are not significantly different for both the models estimated by using 2008 and 2010 survey data. Moreover, probability of being obese and overweight/obese is found to be higher at urban area than rural area. But probability of reducing to being obese and overweight/obese is higher at rural area relative to urban as a unit increase of logaritmic income of person. Total inequality of obesity and overweight/obesity concentrated at low socioeconomics status group both in 2008 and 2010. This evidence indicates a pro-rich inequality in obesity in Turkey. Furthermore, obese people who are illiterate, have primary school, higher education degree are concentrated at low socioeconomic status. Obese people with diabet and hypertansion health status is also concentrated at the low socioeconomics status. The rate of disease are higher and the frequency of consumption of fruits and vegetables are lower at low socioeconomic status. In the ligth of the results, total inequality of being obese and overweight/obese at society takes root from inequality in education levels and income distribution. Therefore, it can be said that reducing inequality in education and income will be effective intervantion policy for obesity in Turkey. Key Words: Obesity in Turkey, Inequality of Obesity, Factors Influencing Obesity, Empirical Analysis of Obesity