Abstract
Global obesity as a major public health problem has increased at pandemic rate, with men often outpacing women. Survey data show that the overall prevalence of obesity is higher among women than men, yet in high-income developed countries, the prevalence of overweight is higher among men than women. The differential impact of different economic stages has prompted research in transition economies such as China. Using an instrumental variable approach based on a sample of 13,574 individuals from nine provinces in the Chinese Household Income Project (CHIP), we find a 7% excess-weight premium in wages for overweight men and a 4.6% penalty for overweight women, compared to their healthy-weight peers. We also find an inverse u-shaped association between the body mass index (BMI) and logarithm of monthly income for men, with an implied optimum above the threshold of obesity, while women are better off the slimmer they are. The excess-weight premium in wages for Chinese urban men might be associated with entrenched business practices of excessive dining and drinking associated with senior positions. Policies aimed at reducing obesity in China must be adapted to its unique sociocultural context in order to have gender-differentiated effects.
Highlights
Global obesity as a major public health problem has increased at pandemic rate, with age-standardized prevalence of obesity more than tripling in men and doubling in women between 1975 and 2014 [1]
In developed countries, where most occupational roles have been sedentary for the past half century with little gender difference, dietary intake rather than physical activities is responsible for gender disparities in overweight and obesity
Despite volumes of research in other parts of the world, only a few have examined the causal relationship from excess weight to employment settings in China, including Shimokawa’s finding of a wage penalty for very heavy and thin persons among both men and women but the penalty was more pronounced for men [73], and Pan, Qin and Liu’s finding of an inverse u-shaped effect of body size on the probability of being employed [75]
Summary
Global obesity as a major public health problem has increased at pandemic rate, with age-standardized prevalence of obesity more than tripling in men (from 3.2% to 10.8%) and doubling in women (from 6.4% to 14.9%) between 1975 and 2014 [1]. In the decade 2004-2014 alone, the prevalence of obesity in China more than tripled, reaching an overall prevalence of obesity at 14% for men and. Global survey data show that the overall prevalence of obesity is higher among women than men, yet in high-income developed countries, the prevalence of overweight is higher among men than women [3,4,5]. In developed countries, where most occupational roles have been sedentary for the past half century with little gender difference, dietary intake rather than physical activities is responsible for gender disparities in overweight and obesity. With the dramatic changes in the economic landscape, China’s obesity
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