What makes thin people have more money?


John DiTraglia, M.D.



DiTraglia

DiTraglia


It is widely known that obesity is bad for your bottom line. But why is that? Another worldwide phenomena is that in rich countries, poor people are fatter. But in poor countries, rich people are fatter. Recent reports add some granularity to this phenomena that may help explain it. (1,2)

Using data from the National Health and Nutrition Examination Survey (NHANES) in 2011-14, statisticians at the Center for Disease control (CDC) found that the prevalence of obesity was just over 36% in adults and 17% in youth. The prevalence of obesity was higher in women (38.3%) than in men (34.3%). Among all youth, no difference was seen by sex. Delving deeper, 31% of people in the highest income bracket — $83,000 and above for a family of four in 2014 — were obese, but the obesity rate was 40% for people with family incomes below that level. Looking at sex, this became even more marked. Women’s obesity levels fell precipitously as income rose from about 45 percent for women at the poverty line to about 43 percent for women in the middle-income group, and then to under 30 percent for women at the higher level of income.

Furthermore, the trend seemed specific to white women. For black women, obesity rates remained roughly the same, regardless of income. There was no similar trend for men. In fact, the highest obesity rate for American men was in the middle-income group, at 38.5 percent. That’s compared to men who were either at the poverty line (a 31.5 percent obesity rate) or in the higher income bracket (32.6 percent). Another anomaly in the statistics: black men. The research showed that their rates of obesity actually rose as their incomes got higher. Forty-three percent of black men were obese in the highest income group and 34% in their lowest income group. Higher education also seems to help keep American waistlines trim. Regarding education overall, the findings showed that while about 40 percent of people who had a high school diploma or less were obese, that number dropped to just under 28 percent for college graduates.

Korea is another first-world developed country with an obesity epidemic, and the interactions among income, education and sex are also very complicated or more like mind boggling. Using data from their 5th Korea NHANES (2) and statistical models for all men, the highest level of formal education was associated with an increase in their probability of being obese by as much as 26%.

So what does this mean? I puzzled and puzzled till my puzzler was sore. Then I thought of something I hadn’t before. Maybe obesity discrimination in education and jobs, especially against women, is the cause. You puzzle it for awhile. Do the Blacks and Koreans fit this explanation?

I can simplify this, though. When it comes to socioeconomics, it’s all social. There’s nothing biological here, unless you think that obesity is somehow connected to IQ. So that’s what these complicated statistics are showing, and the solutions have to be social, too.

DiTraglia
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John DiTraglia, M.D.

1. Ogden CL et al. Prevalence of Obesity Among Adults and Youth: United States, 2011–2014. NCHS data brief, no 219. Hyattsville, MD: National Center for Health Statistics. 2015. Morbidity and Mortality Weekly Report. Dec. 22, 2017.

2. Woojin Chung et al. Gender-specific interactions between education and income in relation to obesity: a cross-sectional analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V) BMJ, http://dx.doi.org/10.1136/bmjopen-2016-014276

1. Ogden CL et al. Prevalence of Obesity Among Adults and Youth: United States, 2011–2014. NCHS data brief, no 219. Hyattsville, MD: National Center for Health Statistics. 2015. Morbidity and Mortality Weekly Report. Dec. 22, 2017.

2. Woojin Chung et al. Gender-specific interactions between education and income in relation to obesity: a cross-sectional analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V) BMJ, http://dx.doi.org/10.1136/bmjopen-2016-014276