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Year: 1 SSU: 1 Date: Mon 30/11/09 to Fri18/12/09 Student ID: 91022462

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CONSIDERING ONLY ADULTS FROM DEVELOPED COUNTRIES, WHY DOES SOCIOECONOMIC CLASS
HAVE AN EFFECT ON OBESITY?

Abstract:

The reasons behind a link between socioeconomic status and obesity were
the main focus of this literature review. It was hypothesized that weight would
be determined by socioeconomic status (SES), but this paper considers why
SES could in fact be determined by weight. Using four indicators of SES;
education, area, income and occupation; their effects, and obesity’s effects on
them, were studied.

Introduction:

The increasing frequency of obesity across the world (WHO, 1998), coupled
with greater research into its effects on health (NHS, 2008, page 20), means
the continued monitoring of the socioeconomic patterning of weight is
becoming more important than ever.

Obesity is related to socioeconomic status. A review by Sobal and Stunkard
(1989) strongly proved an inverse relationship between SES and obesity
amongst women in developed societies. This means, women of higher SES
are less likely to be obese than those of lower SES. This hypothesis is still
given much backing today. However a new and different review is now
important. It is no longer necessary to study if a relationship between status
and weight exists; it is now necessary to study why these trends are
occurring. As pointed out by McLaren (2007), there are numerous ways of
determining social status. To me it is am embodiment of many different
factors (indicators), that of education, occupation, income and area for
example. You can class someone as being of high SES if, for instance, they
were of good education, or had a high income. When each of these different
indicators is applied to statistical tests regarding a relationship between status
and weight, different results are seen.

I found the search terms ‘socioeconomic’. I will also debate whether it is these different indicators that are having an affect on obesity. This was a continuation of the work originally carried out by Sobal and Stunkard (1989) and provided analogous conclusions to other similar studies (Molarius et al. putting in my own arguments where appropriate.In this essay. This provided a wide range of results and often I would use two of the terms stated above together. For consistency. ‘employment’ and ‘occupation’ most useful for gathering the relevant information. ‘income’. but also provide insight into how the possible indicators may work. ‘education’. throughout this essay. as it is by the World Health Organization. Furthermore.. looking for a relationship between socioeconomic status and weight gain. Or. not only highlight the importance of the selection of a particular indicator. As put by Ball and Crawford (2004) during their study of 34 reviews in all. no article with a vested interest to lie was included. Method: I reviewed many articles during research for this essay. there is no longer much argument as to whether or not socioeconomic status has an influence on obesity. On top of reviewing many articles. as a body mass index of greater than 30 kg/m2. obesity having an affect on these indicators and thus if it is weight that determines SES. the differential associations of obesity with different SES. 2000). if it is in fact. Articles were excluded where it could be established from the title and abstract that the paper did not fulfill the chosen criteria. . I also drew on personal experience. thus providing a form of reference and credibility. However. and thus why SES group affects obesity. ‘social class’. I will not only be discussing which SES variable is most strongly associated with body weight. “study findings show a relatively consistent inverse association between obesity and SES”. The relationship: As stated. ‘obesity’. Using the E-library’s MetaLib. obesity will be considered. particularly in women.

that “the body (inclusive of appearance. a thinner body may be more popular and more materially viable in a society of higher socioeconomic status.Influence: Tables 1-4 (available in appendices 1-4) show the impact of choosing certain indicators of SES over others on the relationship with obesity. providing credibility. Academic qualifications. each person is an embodiment of his or her social stature. and area (52%) as indicators of SES. This idea is seen throughout this essay.3 and 4 are from the same source. or attributes that can be economical. but also can be cultural or social in nature. which are from different sources. Socioeconomic status is therefore not really just about money. Bourdieu states in his theory of class. every person has ‘capital’. simply showing different genders. a form of ‘cultural capital’ (McLaren 2007). Education: Table 5 (appendix 5) shows that as educational qualifications increase. be twinned with aspiration. This information implies that it is ones education that is most influential in determining your likelihood of obesity. where even if it does not represent economic superiority. an idea that Bourdieu calls ‘habitus’. occupation (59%). In other words. . information from these tables is in agreement with the information in table 1 and 5 (available in appendix 5). All tables considered here are results of statistical tests being applied to many number of reviews gathered surrounding this topic. it is of prestige as it is a capital that others do not possess. In other words. rather crudely. with area. Importantly negative associations were most commonly seen with education (65%). While tables 2. occupation and income being less influential as the list continues. and behavioural affinities) is a social metaphor for a person’s status”. may imply expectations for other personal achievements. there are many other factors. Education can. academic ambitions are usually combined with other senses of expectation. Within this idea. and were carried out by their authors in an attempt to see which indicator provided the most amount of negative association. A useful theme in all these factors arises in work by Bourdieu (1986). That is. style. the incidences of obesity decrease.

We must also consider the other side of the argument. Area: Continuing with Bourdieu’s theory of class. Yet simply attending higher education is a recognition and pursuit of attributes that are valued in developed societies. it not only becomes a social normality to be thin. the more someone is educated (a social norm nowadays). it is conceivable that living in a prosperous area conveys heightened exposure to and pressure for thinness. 2000). as if an area contains a strong portion of people in a high SES group (and thus thin people). Waller and J. This may be because. Schools now portray messages regarding diet and physical activity (K. preventing them from reaching the upper echelons of society. to gain information and implement it in their lifestyles. J. Parmenter. Kahmsi (2007) argues that. the more they may be influenced by other societal standards. that there is also the possibility that certain areas may be stereotypical of a particular SES group. If some members of society are thin. Wardle. While we must also consider that there are more opportunities for physical activity and easier local access to healthy foods in certain areas. it puts pressure on other people who value themselves as of equal class to compete for the ‘capital’ that is a slender body. possibly due to other indicators discussed here.whether of a general sense or specific to health and thus weight. you have a nearly 60% higher chance of sliding into this category as well”. “if a friend of yours becomes obese. then those of a lower SES group (the more obese) may be reluctant to move there. creating a link that proves educations effect on obesity. This means more educated people may demonstrate significantly better nutrition knowledge or at least be better at grasping written materials like newspaper articles and leaflets. This would mean that your postcode has not affected your weight. It is this idea of pressure again. and these include health and a thin body. . such as those of attractiveness and health. but your weight has affected postcode. and of maintaining your ‘habitus’ that comes into play. This builds on a new theory that obesity is contagious.

This is why. On the one hand. and thus could not be thin enough to avoid being penalized on wages. For example. where economists show that obese men and women receive a wage penalty (Baum and Ford. there is another side of the token. at the same time their exposure to a workplace environment that promotes these values will really compound the issue. Yet. bias and . 2004). 2009). This unfortunate connection between money and weight is accentuated by studies. However. for example. and again occupational success may be determined by your weight. there could be an affect of career success on weight. Occupation: It is possible that people high in up in their occupation may already know the symbolic value of a thin body and a healthy lifestyle (in line with their class). there is evidence of an economic gradient in diet.Income: There are two ways of viewing this section. but their obesity having an affect on their income (Baum and Ruhm. if obese people are having their wages and thus income penalized. Brownell KD (2001). According to Puhl R. This would mean that obese people could not afford the more expensive foods that could perhaps make them thinner. with their income only being lowered as a result of their obesity. A person could be obese due to a number of other factors. Although this effect is not aided by the fact that lower incomes cannot afford healthier foods. when we look at it. “in an environment with on-site exercise and shower facilities. 2004). Wealthier people may be thinner simply due to the fact that they have more economic capacity to purchase high energy. then it is not the income having an affect on their obesity. due to other indicators discussed here. and not the other way round. it is easy to imagine social norms surrounding practices such as going to the gym during lunch hour”. as McLaren (2007) writes. On the other hand. here obesity is affecting income and not the other way round. healthy foods that have been shown to be more expensive (Adam Drewnowski and SE Specter. like with area and income.

a larger body size is likely to be valued as a sign of physical dominance and prowess by men. then you will not experience living in the nicer areas. This finding is similar to Sobal and Stunkard's results. which in turn leads to the obese not being able to break into the upper SES groups of society.discrimination still exists towards the obese. reverting the patterns more commonly seen in developing countries. receiving a larger income or having a better job. unless you already possess this reduced weight. . You are less likely to be promoted. and this comes into play especially when concerning income and occupation as indicators as males are the traditional ‘wage earners’ (Power. Different ideals amongst men and women can explain this. Conclusion: Seen throughout all the indicators discussed here. or enjoy a healthy relationship with your colleagues if you are obese. where a strong direct relation is observed (high SES groups having high levels of obesity). society may now be in a state where. most of the indicator’s associations with weight are seen less when concerning men. there are two sides of the argument. ones weight could be reduced by the benefits that come with living in an affluent area. For example. On the one hand. that it could be in fact quite the other way round. Men: Interestingly. and your weight may be determining your class. having a large income or having a good job. it had always previously been assumed that it was because your class affected your weight. This throws off the normal SES-weight connection seen in developed countries. 1999). It is now however becoming a more predominant view. and this may prevent the obese getting high up in their profession. On the other. Although conclusions showing an inverse relationship between class and weight were drawn up almost 20 years ago.

Ruhm. American Journal Of Public Health 90 (2000). London: Saunders Elsevier. Age.C. 228. 1987–2010  Kumar. Ball and D. the NHS o http://www. J. The wage effects of obesity: a longitudinal study. an international perspective from the WHO MONICA Project. socioeconomic status and obesity growth. Socioeconomic status and weigh change in adults: a review. Baum and W. Clark. M (2009): Kumar & Clark's Clinical Medicine 7th ed. pp. The forms of capital. and social mobility. Specter SE. Kuh D. P. 885–899  Baum and Ruhm. (2007) 29:29–48  Obesity.  Bourdieu P. Health Economics 13 (9 (September)) (2004).Sans. Toumilehto and K. pp. relative body weight. Physical Activity and Diet. J. Kuulasmaa. Baum and C. 1260- 1268  Baum and Ford.uk/webfiles/publications/opan08/OPAD %20Jan%202008%20final%20v7%20with%20links%20and . 635–648. The information Centre. Soc Sci Med (2004) 58:1575–84  McLaren L. Epidemiologic Review. S. Crawford.ic. NY: Greenwood Press. Am J Clin Nutr (2004) 79:6–16  K. Seidell. 241–58  Drewnowski A. 2004 C.F.L. 2009 C. ed. Women's body dissatisfaction.  McLaren L. and changes in their association over 10 years. References  Molarius. In: Handbook of theory and research for the sociology of education—Richardson JH. Soc Sci Med 60 (2005). Ford. (1986) New York. Poverty and obesity: the role of energy density and energy costs.nhs. Educational level. Journal of Health Economics 28 (2009). Socioeconomic status and obesity. social class.

Waller J. 370-379. Geneva. Bias. Geneva: World Health Organization  World Health Organisation. %20buttons%20-%20NS%20logo%20removed %2020112008. Report of a WHO consultation on obesity. Obes Res (2001) 9:788–805  Roxanne Khamsi.who.pdf (last accessed on the 10th December 2009)  Parmenter K. and obesity. Health Educ Res (2000) 15:163–74  Power EM. (1998). Brownell KD. New England Journal of Medicine (vol 357. Obesity: prevention and managing the global epidemic. 3–5 June 1997.  Puhl R. Socioeconomic status and obesity: a review of the literature.J. 260–275  World Health Organization (1998) World Health Organization (WHO). Wardle J. & Stunkard (1989) J. Stunkard. discrimination. An introduction to Pierre Bourdieu's key theoretical concepts. Obesity o http://www.int/topics/obesity/en/ (last accessed on the 7th December 2009) . Psychological Bulletin 105 (1989) (2). J Study Food Soc (1999) 3:48–52. Sobal and A. Demographic variation in nutrition knowledge in England. 2007)  Sobal.

that supported study hypothesis (). Appendix 1 Table 1: Numbers of tests from methodologically stronger studies. alternative hypothesis (×). or suggested no association (0)a. Ball and Crawford (2004) .

2007) . according SES indicator and the nature of the SES-body size association (McLaren.Associations between socioeconomic status (SES) and body size among women. Appendix 2 Table 2: Adapted from .

2007) . of No. of No. according SES indicator and the nature of the SES-body size association (McLaren.Associations between socioeconomic status (SES) and body size among men. of associations associations associations associations % % % % Area 0 0 10 71 4 29 14 2 Education 4 1 220 72 81 27 305 45 Employment 7 16 17 38 21 47 45 7 Income 9 6 69 49 64 45 142 21 Occupation 2 1 100 68 44 30 146 22 Other 1 6 4 22 13 72 18 3 Overall 23 3 420 63 227 34 670 100 Table 3: Adapted from . of No. Appendix 3 NATURE OF THE SES-BODY SIZE ASSOCIATION SES POSITIVE NEGATIVE NON-SIGNIFICANT OR TOTAL INDICATOR CURVILINEAR No.

Appendix 4 Table 4: Adapted from .Associations between socioeconomic status (SES) and body size among both sexes combined. of associations associations associations associations % % % % Area 2 0 9 0 17 0 52 0 13 3 100 39 33 3 18 1 Education 14 1 2 6 126 31 65 50 114 16 33 45 254 48 50 27 Employment 0 3 0 9 1 2 13 6 28 7 88 85 33 8 6 4 Income 20 5 24 8 19 12 31 14 38 51 61 83 62 16 35 Occupation 1 7 4 6 16 49 59 39 10 70 37 56 126 27 25 15 Other 0 0 0 3 25 0 1 9 100 75 12 1 2 1 Overall 44 9 5 7 192 84 47 38 275 85 48 55 511 179 100 nature of the SES-body size association (McLaren. of No. of No. 2007) . according SES indicator and the NATURE OF THE SES-BODY SIZE ASSOCIATION SES POSITIVE NEGATIVE NON-SIGNIFICANT OR TOTAL INDICATOR CURVILINEAR No. of No.

(K. 2000) Number of % Of obese sample Educational level people taken No qualifications 431 42. Appendix 5 Table 5: A table showing the responses to a questionnaire detailing the level of education compared with the amount of obesity. J. Parmenter.5 O level/equivalent 281 27.7 A level/equivalent 169 16. Waller and J. Wardle.7 Degree/higher degree 133 13.1 .