Obesity Through a Social Lens: A Systematic Review to Deep Dive Into Determinants Affecting Adults in the United States
Author(s)
Puneet Kaushik, M. Pharmacy, Soumya Nanda, M. Pharmacy, Rupanshi Grover, M. Pharmacy, Kripi Syal, PhD, Prince Jyot Singh, M. Pharmacy.
Quantify Research, Stockholm, Sweden.
Quantify Research, Stockholm, Sweden.
OBJECTIVES: Social determinants of health (SDoH) encompass the diverse social, economic, and environmental factors that influence an individual’s health from before birth and throughout their life. With obesity affecting 40.3% of adults in the US (CDC 2023 report), these factors help shed light on the connections between community attributes and disparities in obesity rates. This systematic literature review explores how SDoH impacts obesity in adult US population, aiming to identify key social factors that drive obesity rates and health disparities.
METHODS: A systematic search following the PRISMA guidelines was conducted in Embase® and MEDLINE® using the interfaces Embase.com and PubMed. English-language articles published in the last 5 years (January 2020 - December 2024), limited to adult population, and reporting the association between SDoH burden and overweight/obesity in the US, were included.
RESULTS: A total of 1580 records were retrieved from the two biomedical databases. After deduplication, title/abstract and full-text screening, 95 publications were included. All publications adopted an observational study design with sample sizes ranging between 20 - 750,000 participants. The social and community context was the most frequently assessed domain, accounting for 30.9%, followed by economic stability at 27.6%, neighborhood and built environment at 22.7%, and access and quality of education and healthcare, each contributing 9.4%. Being home renters, Black, older, or having adverse childhood experiences had significant association with obesity prevalence. In rural women, food insecurity and lack of access to education and healthcare were associated with higher obesity. Income inequality played different roles in different racial/ethnic groups and gender. Residing in a neighborhood with a park and access to healthy food outlets decreased odds of being obese.
CONCLUSIONS: The review demonstrates the profound impact of SDoH on adult obesity in the US. Addressing these determinants could help guide effective interventions aimed at reducing obesity rates and improving health equity.
METHODS: A systematic search following the PRISMA guidelines was conducted in Embase® and MEDLINE® using the interfaces Embase.com and PubMed. English-language articles published in the last 5 years (January 2020 - December 2024), limited to adult population, and reporting the association between SDoH burden and overweight/obesity in the US, were included.
RESULTS: A total of 1580 records were retrieved from the two biomedical databases. After deduplication, title/abstract and full-text screening, 95 publications were included. All publications adopted an observational study design with sample sizes ranging between 20 - 750,000 participants. The social and community context was the most frequently assessed domain, accounting for 30.9%, followed by economic stability at 27.6%, neighborhood and built environment at 22.7%, and access and quality of education and healthcare, each contributing 9.4%. Being home renters, Black, older, or having adverse childhood experiences had significant association with obesity prevalence. In rural women, food insecurity and lack of access to education and healthcare were associated with higher obesity. Income inequality played different roles in different racial/ethnic groups and gender. Residing in a neighborhood with a park and access to healthy food outlets decreased odds of being obese.
CONCLUSIONS: The review demonstrates the profound impact of SDoH on adult obesity in the US. Addressing these determinants could help guide effective interventions aimed at reducing obesity rates and improving health equity.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
SA61
Topic
Study Approaches
Topic Subcategory
Literature Review & Synthesis
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)