An International Comparison of Obesity in Older Adults

Effects and Risk Factors

by Tatiana Andreyeva

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Drawing from nationally representative samples of the non-institutionalized population ages 50 and above in ten European countries, this dissertation examines two issues related to obesity in older Europeans: (1) effects of excessive body weight on health, utilization of medical care, and labor force participation; (2) risk factors for obesity and environmental and societal variation across European countries. A review of strategies and approaches to prevent and manage obesity through public policy is included. Practices in different countries are compared, along with analysis of institutional structure, participants, functions, and policy actions in obesity control. Obesity is associated with significantly poorer health, medical care, and employment outcomes, with effects similar across countries. Obesity has stronger links to labor force participation among women, especially for retirement. About one-tenth of disease prevalence and ill health can be explained by obesity, which exceeds risk factors such as smoking and aging. Lack of regular physical activity is associated with higher obesity rates, especially among women. Food-related weight gain differs between European populations, depending on whether meals are eaten at home or at restaurants. Health education and health promotion as well as taxes and subsidies to regulate health are important prevention and intervention tools the government can use to improve social welfare. Policies on obesity worldwide have shifted from health education and individual awareness to the environmental impact of obesity. Further research is needed to permit government action to address the obesity problem.

Table of Contents

  • Chapter One


  • Chapter Two

    The Effects of Obesity on Health, Medical Care Use and Labor Force Participation Among Older Europeans

  • Chapter Three

    Risk Factors for Obesity in Older Europeans

  • Chapter Four

    Discussion and Policy Implications: Policy Approaches to Obesity Across Countries

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This document was submitted as a dissertation in August, 2006 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Emmett Keeler (Chair), Roland Sturm, and Neeraj Sood.

This report is part of the RAND Corporation Dissertation series. Pardee RAND dissertations are produced by graduate fellows of the Pardee RAND Graduate School, the world's leading producer of Ph.D.'s in policy analysis. The dissertations are supervised, reviewed, and approved by a Pardee RAND faculty committee overseeing each dissertation.

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