The Relationship between Socio-Economic Status through the Life Course and Adult Obesity among Older Singaporeans: Application of the ‘Accumulation of Risk’, ‘Social Mobility’, and ‘Sensitive Periods’ Frameworks

Rahul Malhotra, Duke-NUS Graduate Medical School Singapore
Chetna Malhotra, Duke-NUS Graduate Medical School Singapore
Angelique Chan, National University of Singapore
Truls Østbye, Duke University and Duke-NUS Graduate Medical School Singapore

The life course SES/adult obesity association is described among older Singaporeans by contrasting the ‘accumulation of risk’ (AR), ‘social mobility’ (SM) and ‘sensitive periods’ (SP) frameworks. Obesity (BMI> 27.5 kgm-2 (‘Asian’ criteria) was assessed for 4371 older Singaporeans. Dichotomous indicators of childhood SES (family financial status while growing up), adult SES (education) and current SES (housing type) were used to operationalize the AR (cumulative SES score), SM (eight trajectories using SES at the three life time-points) and SP (independent effect of each life time-point SES) frameworks. Both childhood and adult SES were associated with obesity, though in opposite directions (SP framework). There was no association with cumulative SES (AR framework). Those in SES states protective against obesity in childhood and adult life had lower odds of current obesity (SM framework). The three frameworks complement each other by providing different insights into the life course SES /adult obesity relationship.