Obesity is a growing epidemic in the United Kingdom. An important contributor to cardiovascular disease, obesity is responsible for a growing proportion of morbidity and mortality in England, and poses a sizable burden on the UK's National Health Service. Ethnic minority and socioeconomically disadvantaged populations have been shown to have higher risk for obesity compared to whites and socioeconomically privileged populations. However, little is known about intervention strategies that can curb the epidemic and decrease inequalities in obesity. Currently, the literature about obesity and its unequal burden has relied on traditional epidemiologic regression techniques, which may not be equipped to unravel the complex social causes of obesity in ethnically and socioeconomically diverse contexts. Rather, systems approaches, such as agent-based modelling, may be well poised for studying health in a complex, heterogeneous population that features changing and adaptive behaviors and interactions between individuals and between individuals and their environments. I used agent-based modelling to shed light on the aetiology of obesity and its inequalities in England in hopes of educating strategies for intervention against this epidemic. After I systematically reviewed the literatures about ethnic and socioeconomic inequalities in obesity in the United Kingdom, I reviewed and synthesized the literature about the use of systems approaches, including social network analysis and agent-based modelling, in social epidemiology. I then developed, constructed, and implemented the Obesagent model, an agent-based model of obesity in England. Using this model, I first showed that life course trajectories in obesity produced by the model were comparable to those from real data. I then assessed life course trajectories in ethnic and socioeconomic inequalities in obesity and demonstrated that higher obesity rates among Blacks may arise during childhood. Second, I explored the effectiveness of various curative and preventive intervention strategies against obesity in this context. Third, I demonstrated that given their relatively small effect relative to other exposures in the aetiology of obesity, targeting social networks in anti-obesity interventions is not likely to improve their efficacy. Fourth, I used the model to demonstrate that interventions against neighbourhood and social segregation may not substantially decrease ethnic inequalities in obesity in England. I conclude with a synthesis of this work, a discussion of its implications for anti-obesity policy in England, and suggested directions for future research.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:556476 |
| Date | January 2011 |
| Creators | El-Sayed, Abdulrahman M. |
| Publisher | University of Oxford |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
Page generated in 0.0014 seconds