Essays on the Economics of Obesity

Abstract

This thesis comprises five chapters in total, starting with a general introduction that raises the issue of obesity as well as a brief description of the basic research questions of the dissertation, three main chapters involving the analysis of the Body Mass Index (BMI) with a view to investigate the social, economic, cultural and environmental factors driving and sustaining health disparities in obesity in Spain and a chapter of concluding remarks stemming from the analysis made. In particular, the second chapter examines the evolution of obesity as well as the incomerelated inequality in obesity over the past two decades in Spain, splitting by gender. It also evaluates income inequality in obesity (measured by distribution sensitive measures) by breaking it down to its main contributors. The results indicate that obesity prevalence rates have been increasing over the last twenty years among the Spanish population, as in most developed countries, however income-related inequality in obesity status, depth and severity has a declining trend mainly among women. These findings may imply a switch in the basic determinants of obesity across the income distribution; that is, BMI status might not be linked only to individual attributes, but changes in environmental influences across income groups may be important as well. This is inextricably linked to the third chapter, where we seek to understand the basic determinants of individual body weight and obesity risk, by concurrently examining individual and regional characteristics within a multilevel approach, to conclude that not only personal attributes but also environmental characteristics (i.e., criminality and lack of green spaces) affect positively individual and women s BMI and obesity. Driven by the spatial pattern of BMI that is observed in this third chapter, according to which southern regions of Spain tend to exhibit higher BMI levels than the northern ones, we proceed with chapter four. In this fourth chapter we aim to contribute to the North to South health divide in Spain, using decomposition techniques to analyse the main contributors of the BMI gap between the North and the South of Spain. Our findings indicate that North to South differences are significant only for women and that the largest share of this gap is attributed to differences in endowments (mainly education) to the detriment of women living in the South.