Relationship Between Poverty and Obesity

One of the common myths that exists is that all or virtually all low-income people are far more likely to be obese.

Overall, the research for a greater risk of obesity is more consistent for women and children (especially White women and children) of low-income or low-SES than for men.

While all segments of the U.S. population are affected by obesity, one of the common myths that exists is that all or virtually all low-income people are far more likely to be obese. In this generalization, two facts commonly are overlooked: (1) the relationship between income and weight can vary by gender, race-ethnicity, or age and (2) disparities by income seem to be weakening with time.

The studies below highlight some of the more recent research on the complicated relationship between obesity and poverty. Overall, the research for a greater risk of obesity is more consistent for women and children (especially White women and children) of low-income or low-SES than for men. In addition, there is evidence that where there are gaps between high- and low-income groups, they have been closing with time as those with higher incomes become more obese.

Note that other sections of the FRAC website describe the relationship between food insecurity and obesity (see the section on the Relationship Between Hunger and Obesity) as well as potential explanations for the relationship between low-income, food insecurity, and obesity (see the section on Why Low-Income and Food Insecure People are Vulnerable to Obesity).

Adult Poverty and Obesity

The Relationship Based on General Trends

  • Based on a large national study, body mass index (or BMI, an indicator of excess body fat) was higher every year between 1986 and 2002 among adults in the lowest income group and the lowest education group than among those in the highest income and education groups, respectively (Truong & Sturm, 2005).
  • Wages were inversely related to BMI and obesity in a nationally representative sample of more than 6,000 adults – meaning, those with low wages had increased BMI as well as increased chance of being obese (Kim & Leigh, 2010).

How the Relationship Varies by Gender and Race-Ethnicity

  • In a recent review of the scientific literature published between 1988 and 2004, 63 percent of reviewed studies of women in industrialized countries found that women with lower SES were more likely to have a larger body size (McLaren, 2007). Such a relationship was less consistent for men.
  • A national study using 1999-2004 data also observed higher obesity rates at lower income levels among all women and White women, but higher obesity rates at higher income levels among Mexican-American men (Ogden et al., 2007). No significant trends emerged among all men, Black women, or other gender-racial sub-groups.
  • According to 2005-2008 national data, obesity rates tended to increase with decreased income among women, but this trend was only significant for White women (not Black or Mexican-American women) (Freedman, 2011; Ogden et al., 2010a). Among men, obesity rates were fairly similar across income groups or tended to be higher at higher levels of income. In fact, among Black and Mexican-American men, those with higher income were significantly more likely to be obese than those with low-income.
  • Pooling national data from more than 30 years, White and Black women consistently experienced higher BMI at lower income levels, although this association was more modest at some time points than others (Chang & Lauderdale, 2005). In recent years, and in contrast to women and White men, Black and Mexican-American men experienced higher BMI’s with higher incomes.

How the Relationship Has Changed Over Time

  • In one of the first national studies to examine SES (based on educational level) and obesity disparities over time (1971 to 2000), the association between higher BMI and lower SES – as well as greater obesity and lower SES – weakened over three decades among most gender and ethnic groups, especially among women, even though overall obesity prevalence increased substantially (Zhang & Wang, 2004). In addition, across gender-racial categories, the high-SES group experienced the highest rates of increase in obesity over time.
  • National data indicate that obesity rates increased at all income levels between 1971 and 2002, but the poor did not necessarily experience the largest increases during this time period (Chang & Lauderdale, 2005).
  • According to one recent nationally representative sample, obesity prevalence was higher in lower income and education groups, but the rate of increase in obesity over two decades was faster for higher income and education groups (Singh et al., 2011). For instance, between 1992 and 2008, obesity prevalence increased by 42.3 percent for the lower income group compared to 88.5 percent for the higher income group.
  • NHANES data from 1971 to 2002 indicate that rates of obesity increased among both the poor and non-poor over a 30 year period, and those rates of obesity were 5.1 to 6.5 percentage points higher among the poor compared to the non-poor (Jollife, 2011). However, this relationship between obesity and poverty “appears to no longer exist” as more recent NHANES data (2003 to 2006) suggest no difference in obesity rates between the two groups. In addition, rates of obesity increased by 62 percent among the poor and by 155 percent among the non-poor from 1971 to 2006.

Childhood Poverty and Obesity

The Relationship Based on General Trends

  • Obesity rates increased by 10 percent for all U.S. children 10- to 17-years old between 2003 and 2007, but by 23 percent during the same time period for low-income children (Singh et al., 2010a). This national study of more than 40,000 children also found that in 2007, children from lower income households had more than two times higher odds of being obese than children from higher income households.
  • Rates of severe obesity were approximately 1.7 times higher among poor children and adolescents in a nationally representative sample of more than 12,000 children aged 2 to 19 years (Skelton et al., 2009).
  • In California, higher community poverty rates were strongly associated with higher childhood overweight rates (Drewnowski et al., 2009).

How the Relationship Varies by Gender, Race-Ethnicity, and Age

  • Using NHANES data from 1999-2004, one study of children 6 to 19 years of age found greater obesity at lower family income levels among White and Mexican-American children, but greater obesity with higher family income levels among Black children that was most evident among Black girls (Freedman et al., 2007). Using different analyses with NHANES 1999-2004 data in another study, researchers found no significant trends for income and obesity among children except for a strong inverse trend (i.e., greater obesity at lower income levels) among White girls (Ogden et al., 2007).
  • Obesity rates significantly increased with decreased income among White boys and girls in analyses of NHANES 2005-2008 data, but no significant trends with income emerged among Black or Mexican-American boys and girls (Freedman, 2011; Ogden et al., 2010b).
  • Obesity rates did not differ significantly by poverty status for 12- to 14-year old adolescents based on a large national survey from 1999-2004, but rates were over 50 percent higher among 15- to 17-year-old adolescents in poor families compared to non-poor families (Miech et al., 2006).
  • National data from 1999-2002 revealed that only one significant association emerged between SES (based on the poverty income ratio) and obesity rates among 10- to 18-year olds when examining associations by gender and gender-ethnicity (Wang & Zhang, 2006). The one significant association: Black adolescent girls with a high SES were twice as likely to be obese as their counterparts with a medium SES.

How the Relationship Has Changed Over Time

  • National data from over 3 decades (1971 to 2002) suggests a weakening association between SES (based on the poverty income ratio) and child obesity over time, especially among adolescents (Wang & Zhang, 2006).