Obesity, SES, and Economic Development: A Test of the Reversal Hypothesis

Fred C. Pampel, University of Colorado at Boulder
Justin T. Denney, Rice University
Patrick M. Krueger, University of Colorado at Denver and Health Sciences Center

Studies of individual countries suggest that SES and weight are positively associated in lower-income countries but negatively associated in higher-income countries. However, this reversal in the direction of the SES-weight relationship and arguments about the underlying causes need to be tested with comparable data for a large and diverse set of nations. This study systematically tests the reversal hypothesis using individual- and aggregate-level data for 67 nations representing all regions of the world. In support of the hypothesis, it finds not only that the body mass index, being overweight, and being obese rise with economic and social development but also that the effects of SES on these outcomes shift from positive to negative. These findings fit arguments about how health-related, SES-based resources, costs, and values change with economic development. Although economic and social development can improve health, it can also lead to increasing obesity and widening SES disparities in obesity.