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Consider the following data on the relationship between depression 1 and obesity

ID: 3221792 • Letter: C

Question

Consider the following data on the relationship between depression1 and obesity2 from a hypothetical case-control study.

Obesity2

Depression1

Obese

Non-obese

Totals

Overall

Yes

12,241

29,155

41,396

No

55,947

190,419

246,366

Males

Yes

6,211

18,851

25,062

No

25,110

88,082

113,192

Females

Yes

6,030

10,304

16,334

No

30,837

102,337

133,174

1Depression was measured with the Center for Epidemiologic Studies Depression Scale (CES-D); scores of 16 or higher were used to indicate probable depression.
2Obesity was defined as body mass index scores (BMI) 30; non-obese were defined as BMI scores < 30.

Is gender a confounder, effect modifier or mediator of the relationship between depression and obesity? Please discuss each possibility and calculate and interpret all relevant measures of association to support your conclusion.

Obesity2

Depression1

Obese

Non-obese

Totals

Overall

Yes

12,241

29,155

41,396

No

55,947

190,419

246,366

Males

Yes

6,211

18,851

25,062

No

25,110

88,082

113,192

Females

Yes

6,030

10,304

16,334

No

30,837

102,337

133,174

Explanation / Answer

Chi-Square Test: Obese, Non-obese

Expected counts are printed below observed counts
Chi-Square contributions are printed below expected counts

Obese Non-obese Total
1 12241 29155 41396
9809.18 31586.82
602.877 187.221

2 55947 190419 246366
58378.82 187987.18
101.299 31.458

Total 68188 219574 287762

Chi-Sq = 922.855, DF = 1, P-Value = 0.000

There is significant association between depression and obesity at the overall level.

the highest impact is observed between obsese and depressed person. The difference between observed and expected count is significantly different.

FOR MALE

Chi-Square Test: Obese, Non-obese

Expected counts are printed below observed counts
Chi-Square contributions are printed below expected counts

Obese Non-obese Total
1 6211 18851 25062
5677.72 19384.28
50.089 14.671

2 25110 88082 113192
25643.28 87548.72
11.090 3.248

Total 31321 106933 138254

Chi-Sq = 79.099, DF = 1, P-Value = 0.000

There is significant association between depression and obesity for Male category.

the highest impact is observed between obsese and depressed person. The difference between observed and expected count is significantly different.

FOR FEMALE

Chi-Square Test: Obese, Non-obese

Expected counts are printed below observed counts
Chi-Square contributions are printed below expected counts

Obese Non-obese Total
1 6030 10304 16334
4027.78 12306.22
995.307 325.760

2 30837 102337 133174
32839.22 100334.78
122.076 39.955

Total 36867 112641 149508

Chi-Sq = 1483.098, DF = 1, P-Value = 0.000

There is significant association between depression and obesity for Female category.

the highest impact is observed between obsese and depressed person. The difference between observed and expected count is significantly different.

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