Does Social Class Explain the Connection
Between Weight and Health?
Adiposity is strongly related to socioeconomic status (SES) in modern Western societies (Sobal, 1991; Sobal & Stunkard, 1989). SES is usually measured by household income or years of education, although these two measures are clearly different and have many limitations as indices of social standing. In their seminal review in 1989, Sobal and Stunkard showed strong links between low social status and high body weight. This relationship only applied consistently to adult women in developed nations. For adult men, half the surveys showed the same trend as for women, but the remainder showed no relationship between SES and weight; in fact, some demonstrated the opposite relation, with high status males being heavier. Sobol and Stunkard offered one explanation for this gender difference: smoking. Tobacco consumption falls with rising SES, especially for men, and body weight is lower for smokers. But higher rates of smoking among low status males are probably not enough to explain such a fundamental difference, as Sobol and Stunkard admit. Reevaluating their summary of previous studies, there is a striking trend over time toward stronger links between SES and weight in men. For surveys dating from 1949 to 1967, five linked high SES with high weight and only one linked poverty to fatness. For surveys between 1968 and 1988, twenty-one linked poverty to fatness in men, whereas only three linked high SES with high weight. More recent surveys have shown increasingly strong relationships of poverty to high body weight (Banks, Marmot, Oldfield, & Smith, 2006). Thus, the link between adiposity and poverty, always strong for women, has been getting progressively stronger for men since the 1960s.
Surveys of children and adolescents did not show a consistent relationship between their body weight and the social status of their parents, at least in the seventy published reports that existed in 1988 (Sobal & Stunkard, 1989). This was true for both girls and boys. Sobol and Stunkard concluded that whatever process links fatness and SES must begin in early adulthood. Their conclusion, however, must now be