Systematic Review of the Association Between Sociocultural Factors and Obesity by Socioeconomic Position in High-Income Countries
1
Research Unit of Population Health, University of Oulu, Oulu, Finland
Popul. Med. 2026;8(Supplement Supplement 1):A3059
ABSTRACT
BACKGROUND:
Sociocultural inequalities in obesity are well documented in high-income countries, yet evidence remains fragmented regarding how these inequalities are shaped by socioeconomic position (SEP). Most existing reviews examine sociocultural or socioeconomic determinants , limiting understanding of their combined effects. This systematic review synthesized quantitative evidence on sociocultural factors and obesity, explicitly evaluating SEP as an effect modifier in high-income settings.
METHODS:
PROSPERO protocol (CRD420251084190) and adhered to PRISMA 2020 guidelines. A PECO framework guided the search strategy. PubMed, Web of Science, Scopus, Cochrane Library, ProQuest, and EBSCO were searched for between 2000 and 2025. Screening was conducted using Covidence and ASReview (1), with independent review by two reviewers. Study quality was appraised using the Newcastle–Ottawa Scale for cohort studies (2) and a modified version for cross-sectional studies.
RESULTS:
Of 36,719 records identified, 47 studies were included (26 cross-sectional, 21 cohort). Most studies were conducted in the United States, with limited representation from European countries. Study populations ranged from 4 to 84 years, with children/adolescents (52.1%) and adults (47.9%) similarly represented. Both males and females were included, although sex-stratified analyses were inconsistently reported. Ethnicity and race were the most frequently examined sociocultural factors (68.1%), followed by migration-related factors (14.9%). Black/African American and Hispanic/Latino populations consistently showed higher BMI or obesity prevalence compared with White reference groups, while findings for Asian populations varied by migration status and socioeconomic context. Importantly, 87.2% of studies tested sociocultural factor × SEP interactions, and over half reported significant effect-modification, with stronger associations observed among lower socioeconomic groups. Most studies were assessed as having low to moderate risk of bias.
CONCLUSIONS:
SEP frequently operates as an effect modifier rather than merely a confounder of sociocultural influences on obesity. We need for more high-quality European studies to inform policy-relevant understanding of sociocultural inequalities in obesity.
Sociocultural inequalities in obesity are well documented in high-income countries, yet evidence remains fragmented regarding how these inequalities are shaped by socioeconomic position (SEP). Most existing reviews examine sociocultural or socioeconomic determinants , limiting understanding of their combined effects. This systematic review synthesized quantitative evidence on sociocultural factors and obesity, explicitly evaluating SEP as an effect modifier in high-income settings.
METHODS:
PROSPERO protocol (CRD420251084190) and adhered to PRISMA 2020 guidelines. A PECO framework guided the search strategy. PubMed, Web of Science, Scopus, Cochrane Library, ProQuest, and EBSCO were searched for between 2000 and 2025. Screening was conducted using Covidence and ASReview (1), with independent review by two reviewers. Study quality was appraised using the Newcastle–Ottawa Scale for cohort studies (2) and a modified version for cross-sectional studies.
RESULTS:
Of 36,719 records identified, 47 studies were included (26 cross-sectional, 21 cohort). Most studies were conducted in the United States, with limited representation from European countries. Study populations ranged from 4 to 84 years, with children/adolescents (52.1%) and adults (47.9%) similarly represented. Both males and females were included, although sex-stratified analyses were inconsistently reported. Ethnicity and race were the most frequently examined sociocultural factors (68.1%), followed by migration-related factors (14.9%). Black/African American and Hispanic/Latino populations consistently showed higher BMI or obesity prevalence compared with White reference groups, while findings for Asian populations varied by migration status and socioeconomic context. Importantly, 87.2% of studies tested sociocultural factor × SEP interactions, and over half reported significant effect-modification, with stronger associations observed among lower socioeconomic groups. Most studies were assessed as having low to moderate risk of bias.
CONCLUSIONS:
SEP frequently operates as an effect modifier rather than merely a confounder of sociocultural influences on obesity. We need for more high-quality European studies to inform policy-relevant understanding of sociocultural inequalities in obesity.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
