Wealth matters when it comes to obesity

In a recently published study in the Obesity Society's peer-reviewed journal, Obesity, University of Alabama at Birmingham health disparities researchers have explored how understanding inequalities in wealth is important to addressing health disparities in health and obesity.

There is a lack of research on the relationship between obesity and wealth for adults entering mid-life. During this time of life, factors of socioeconomic status (SES) like education and occupation tend to stabilize, but not wealth. This first-of-its-kind study aims to address this information gap by examining total net worth in conjunction with five components of wealth.

"We separated wealth—which is typically measured as net worth—into housing wealth, automotive vehicle value, debt, savings and investments," said Joseph Wolfe, Ph.D., associate professor in the UAB College of Arts and Sciences Department of Sociology and first author of the study. "Each of these components of wealth represent potential resources for health and health behaviors."

Associations between multiple measures of wealth and obesity for almost 7,000 respondents were investigated, using data from the National Longitudinal Survey of Youth 1979. This ongoing survey conducted by the U.S. Bureau of Labor Statistics has 40 years of information related to wealth and BMI.

The analysis revealed complex, but generally across-the-board associations between wealth and mid-life obesity. Particularly for women, net worth had a significant inverse relationship with obesity regardless of race, indicating that as net worth increased, rates of obesity decreased for black and white women. Black men were a notable exception from this inverse relationship, which is consistent with prior studies that show little evidence of an association between SES and obesity for this population.

"The exception for black men was not too surprising given the historical context of being African American in the U.S.," said Wolfe. "By undermining the ability of black men to accumulate wealth, racial discrimination is likely reducing the obesity-related advantages that wealth seems to be providing for others in the sample."

When looking at the separate components of wealth, a more nuanced understanding of the wealth-obesity relationship emerged: Among other key findings, higher home value was largely connected to lower probability of obesity for white women and men, which is consistent with existing research on property value and obesity-causing environments; women in the middle of the distribution of savings had the highest probability of obesity, demonstrating wealth may affect obesity under certain conditions, such as middle or lower-middle class status; and debt was positively associated with higher probability of obesity among black women.

"Going forward, future research should be sure to incorporate wealth so as to not miss connections between SES and health in midlife," said Wolfe.

In addition to affecting future research, the study may carry implications for social policy—programs aimed at health disparities should consider multiple sources of wealth and their relevance for different social groups. For example, policies aimed at decreasing debt and financial insecurity may be especially helpful in reducing obesity among Black women.

Assistant Professor of Sociology Elizabeth Baker, Ph.D., leader of the Obesity Health Disparities Research Center's social determinants of health core, and Division of Preventive Medicine Professor Isabel Scarinci, Ph.D., served as co-authors on the study.