Obesity and its associated cardiovascular complications are increasingly serious health problems in the U.S., where there are significant socioeconomic disparities in the distribution of weight status. Persons of lower socioeconomic status (SES) are more likely to be obese, especially among women. This finding can be considered in the context of a more general literature on social disparities in health, where many argue that disparities are predominantly due to the causal effects of SES on health. The causal effects of health on SES - typically termed selection effects - have received less attention. In the case of weight status, however, we have strong reasons to believe that the selection effects play an important role. Unlike many illness states, obesity is an immediately visible attribute and carries a severe social stigma. Moreover, people can actively invest in their weight status not only for health reasons, but for the purposes of social mobility. This project integrates nationally representative longitudinal data to investigate both processes in dynamic perspective: how SES affects weight status and how weight status affects SES. Furthermore, we examine these processes not only over the individual life course but also between generations. We have four specific aims. First, we estimate a reciprocal relationship between weight-and SES over time, considering the relative contribution of each causal arm. Second, we investigate how these relationships vary at different stages of the lifecycle. Is there a process of accumulating disadvantage with age or do disparities observed at younger ages eventually taper off? Third, we study how weight and SES cycle across generations. For example, to what extent does weight status contribute to the inheritance of socioeconomic factors, and to what extent does SES contribute the inheritance of weigh status? Fourth, we relate weight status to social mobility and job displacement as specific types of change in SES. Together, these aims allow us to determine how relationships between weight status and SES over the life course and between generations may contribute to social inequalities in health. Research of this kind provides a deeper understanding of both the social production of illness and the role of health in mediating social stratification. Furthermore, we move beyond the mere description of static correlations between social factors and health to how inequality is produced and reproduced overtime and across generations, ultimately providing a more powerful lever for health policy and social change, especially in regard to this important risk factor for cardiovascular disease.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Social Sciences and Population Studies Study Section (SSPS)
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Arteaga, Sonia M
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University of Pennsylvania
Internal Medicine/Medicine
Schools of Medicine
United States
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Krueger, Patrick M; Saint Onge, Jarron M; Chang, Virginia W (2011) Race/ethnic differences in adult mortality: the role of perceived stress and health behaviors. Soc Sci Med 73:1312-22