THE “WEIGHT” OF SOCIO-ECONOMIC STATUS, RACE/ETHNICITY, AND GENDER: A SYSTEMATIC EXAMINATION OF OBESITY AND ITS CO-MORBIDITIES

Abstract

OF THE DISSERTATION THE “WEIGHT” OF SOCIO-ECONOMIC STATUS, RACE/ETHNICITY, AND GENDER: A SYSTEMATIC EXAMINATION OF OBESITY AND ITS COMORBIDITIES Although extensive research exists on the association between SES and obesity and its patterning across separate gender and racial/ethnic groups, critical gaps remain. In particular, the majority of studies on the SES-BMI association have examined it in additive models without simultaneously considering the influence of gender and race/ethnicity. An additional limitation of the current obesity scholarship concerns the lack of scholarship addressing the interplay between social factors, such as SES, race/ethnicity, gender, and proximate health risk factors, such as BMI, in shaping obesityrelated chronic health outcomes, especially considering that health outcomes may vary in the extent to which they may be controlled by individual behavior. By utilizing the 2011-2014 cycle of the National Health and Nutrition Examination Survey (NHANES) (N=19,931), this dissertation addresses key gaps in the literature on the social patterning of obesity and certain obesity co-morbidities – arthritis and indicators of cardiovascular health, namely blood pressure, plasma fasting glucose and HDL cholesterol – across diverse social groups. This research project has been situated in the fundamental social causes of disease (FSCD) theoretical framework, which situates individual risk factors within the larger socio-cultural structures, making this broader context the key mechanism explaining disparities in health outcomes. Research findings uncovered stark gendered racial disparities in overweight and obesity that were not attenuated by high income and education, placing Black American women at an increased risk of having a higher BMI. In addition, results reveal that the influence of different indicators of social status vary across health outcomes. Specifically, social factors did not modify the BMI-arthritis relationship, while the effect of BMI on blood pressure was amplified for Hispanic adults. Further, with respect to fasting plasma glucose and HDL cholesterol, the negative effect of BMI was amplified for White adults. In addition, the effect of BMI on HDL cholesterol was also amplified for individuals with higher educational attainment and household income. Overall, the results from this dissertation provide novel insights on the ways distal social factors interact simultaneously with each other and with more proximal health risk factors to produce variations in individual weight and weight-related health disparities. KEYWORKDS: Obesity, Obesity Co-morbidities, Socioeconomic Status (SES), Race/Ethnicity, Gender, Fundamental Social Causes of Disease (FSCD) Gabriele Ciciurkaite