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Background <p>This study aimed to identify unobserved subgroups of persons with similar trajectories of co-occurring behavioral health risk factors (BRFs) over 4 years in an adult general population sample and to examine their relation to education.</p> Methods <p>Data of 831 control group participants of a randomized controlled trial was analyzed. Participants aged 18–64 years who had consumed alcohol in the past 12 months were recruited at a registry office. Alcohol consumption, tobacco smoking, body mass index, and physical inactivity were assessed at baseline via self-report and 1, 3, and 4 years later. Latent class growth analysis was used to identify BRF trajectories and to test their association with school education, adjusted for sex, age, marital status, and self-rated health.</p> Results <p>Eight BRF trajectory classes were identified, with the largest class (31% of participants) being characterized by stable low-to-moderate alcohol consumption and an otherwise healthy lifestyle. Higher-educated compared to lower-educated participants were more likely in this class than in other classes, including, among others, a class combining stable alcohol consumption, tobacco smoking, and increasing excess weight (Odds ratio, OR = 7.41, <i>p</i> &lt; 0.001) and a class maintaining absence of BRFs over time (OR = 3.89, <i>p</i> &lt; 0.001).</p> Conclusions <p>This study demonstrates heterogeneity in BRF trajectories and their relation to education. Although higher-educated persons were more likely in classes with fewer BRFs and favorable BRF changes, alcohol consumption remained a common BRF in several of these trajectories. Trajectories of multiple co-occurring BRFs, particularly those involving tobacco smoking and unfavorable BRF changes, seem to disproportionately affect lower-educated persons.</p>

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Educational inequalities in trajectories of co-occurring behavioral health risk factors over four years: a latent class growth analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月2日

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  • Sophie Baumann,
  • Andreas Staudt,
  • Maria Zeiser,
  • Jennis Freyer-Adam,
  • Diana Guertler,
  • Henriette Markwart,
  • Anne Moehring,
  • Ulrich John

摘要

Background

This study aimed to identify unobserved subgroups of persons with similar trajectories of co-occurring behavioral health risk factors (BRFs) over 4 years in an adult general population sample and to examine their relation to education.

Methods

Data of 831 control group participants of a randomized controlled trial was analyzed. Participants aged 18–64 years who had consumed alcohol in the past 12 months were recruited at a registry office. Alcohol consumption, tobacco smoking, body mass index, and physical inactivity were assessed at baseline via self-report and 1, 3, and 4 years later. Latent class growth analysis was used to identify BRF trajectories and to test their association with school education, adjusted for sex, age, marital status, and self-rated health.

Results

Eight BRF trajectory classes were identified, with the largest class (31% of participants) being characterized by stable low-to-moderate alcohol consumption and an otherwise healthy lifestyle. Higher-educated compared to lower-educated participants were more likely in this class than in other classes, including, among others, a class combining stable alcohol consumption, tobacco smoking, and increasing excess weight (Odds ratio, OR = 7.41, p < 0.001) and a class maintaining absence of BRFs over time (OR = 3.89, p < 0.001).

Conclusions

This study demonstrates heterogeneity in BRF trajectories and their relation to education. Although higher-educated persons were more likely in classes with fewer BRFs and favorable BRF changes, alcohol consumption remained a common BRF in several of these trajectories. Trajectories of multiple co-occurring BRFs, particularly those involving tobacco smoking and unfavorable BRF changes, seem to disproportionately affect lower-educated persons.