The Income and Obesity Relationship in the United States

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Obesity is a problem of increasing concern and incidence in the US. There is a growing awareness that many prevalent health problems such as heart disease, stroke, diabetes and perhaps even certain types of cancer, can be traced to the over-consumption of certain kinds of food. At the same time, health practitioners have argued that the incidence rates of such diseases can be reduced with the observance of a proper diet. Similarly, at a time when health care costs are spiraling, much more emphasis is being placed on the link between lifestyle factors, which can be modified, and illness. This paper will look at the relationship between income and obesity. It will seek to determine which income groups are most implicated in what is being called the obesity epidemic.

This paper will be divided into four sections. The first section is the current introductory section. Section two will discuss the problem of obesity in the US. Section three will present data showing the relationship between income and obesity. Section four will be the final summary and conclusion of the paper.

Obesity in the United States

Obesity is a biological problem caused by excessive weight gain in the body. This weight can be evenly distributed throughout the body or it can accumulate in the midsection. Obesity is believed to be caused by a sedentary lifestyle combined with heavy and regular consumption of foods high in trans-fats, sugars, and sodium. Obesity is defined as a body mass index (BMI) that is greater than or equal to 30 (Nestle & Jacobson, 2000). Long-term obesity can cause serious and life-threatening health problems including heart disease, stroke, diabetes and certain types of cancer. According to published reports as many as 44 million Americans are obese.

This problem is particularly serious where children are concerned. For instance, a 2007 survey of New York State high school students found that 62 percent didn’t meet the recommended guidelines for physical activity and 87 percent didn’t attend any school-related physical education (“Preventing and Reducing” 2008). Most students didn’t consume the recommended five servings of fresh produce per day. Bad habits tend to start very early in life and become a permanent part of an individual's lifestyle as an adult. For instance, an overweight adolescent has a 70 percent chance of being overweight in adulthood. This chance increases to 80 percent if one of the parents is also obese, leading some to conclude that parents are to blame for their children's' obesity (“Preventing and Reducing” 2008). Also, costs related to treating obesity-related diseases have reached $12 billion in New York State alone (“Soaring Health Care” 2012). Nationally, the incidence of obesity is also a recognized problem. According to Ogden, Lamb, Carroll, Flegal (2010, 1) nearly 17 percent of all children and adolescents aged 2-19 years were obese.

Obesity and Income

In recent years much attention has turned to the relationship between obesity and income. A number of studies have reported that obesity is a greater problem in low-income groups than for individuals with higher incomes (Ogden, Lamb, Carroll, Flegal 2010, 1). Figure 1 presents data that shows the incidence of obesity among children and adolescents in the aforementioned age range. This data is also disaggregated in regards to race, gender, and poverty income ratio (PIR). The data are from the National Health and Nutrition Examination Survey, 2005-2008.

The PIR thresholds are ranked at 130 percent, 350 percent and between 130 percent and 350 percent of the poverty rate. The poverty data are for 2008. Thus 130 percent of the poverty rate is roughly $29,000 for a family of four. Also, 350 percent of the poverty rate is equivalent to about $77,000 for a family of four. Median household income was $50,000 and about 19 percent of all children below the age of 18 lived below the federally defined poverty level (Ogden, Lamb, Carroll, Flegal 2010, 6).

(Figure 1 omitted for preview. Available via download)

The data in the above table show that obesity incidence increases when one moves from the higher end of the income distribution to the lower end. But the pattern is not seen consistently across racial groups. Indeed, the inverse relationship between obesity and income is most consistently seen in the white American population. However, among the black and Mexican-American groups no consistent pattern emerges. For example, among black boys, the inverse relationship in the poverty rate appears to reverse when one moves from the middle of the PIR distribution to the lower end. A similar pattern is also observable among Mexican-American boys.

Among white American girls, the data show the expected pattern of the reverse income-obesity relationship. That is, as one moves down the income distribution the incidence of obesity increases. However, the data for black American girls show an elevated incidence of obesity at the 350 percent PIR level. It should be noted, the black female incidence is nearly twice that of the black male incidence for the same PIR level. There is a significant gender difference in obesity incidence between members of the black American group. It notably appears only at the higher and lower extremes of the data, not in the middle of the distribution. Observing the obesity incidence for black girls only, when moving from the top to the bottom of the PIR distribution, obesity incidence among black girls fluctuates. It decreases at the middle PIR level and increases again at the lowest PIR level. It also doesn't appear that the rate of obesity among black girls changes with any significance, in terms of income group, as is observed in the data for white American girls.

The data for Mexican-American boys follows the same pattern for black American boys. However, for Mexican-American girls the data only show slight differences between the top and middle PIR groups then the obesity incidence actually declines noticeably when it reaches the bottom of the income distribution.

The authors make the observation that most US children and adolescents (again between ages 2-19) are not low-income. As a reminder, for this study low income is a family four at or below 130 percent of the federally defined poverty level. The authors note that only 38 percent of obese children live below the poverty threshold (Ogden, Lamb, Carroll, Flegal 2010, 2). Conversely this means that 62 percent of the obese are not living in poverty. Unfortunately what the authors did not disclose is the proportion of the population at which the low-income is represented. As reported above, about 19 percent of all children live below the poverty level. However, these low-income children represent 38 percent of all of childhood obesity. This seems to indicate that obesity affects low-income children disproportionately in comparison with members of other income groups.

Another salient point the authors mention is that obesity incidence has increased among all races and income groups. This increase was observed in NHANES data between the periods 1988-1994 and 2005-2008. Thus while obesity rates may be relatively lower in certain racial and gender groups they are increasing for all segments of the population (Ogden, Lamb, Carroll, Flegal 2010, 5).

Finally, it is important to note that while this paper has focused on income and obesity that other variables are of note. One that is pertinent to mention is the role of education. Similar to obesity, education rates scale with the PIR distribution. Those families where the head of household held a college degree have significantly lower rates of obesity than those families where the household head never finished high school. This applies another layer of justification for the income-obesity relationship. That is, it shows that higher-income individuals are also better educated. Thus they make much better dietary choices for themselves and their families than lower-income household heads.


In sum, this paper examined the issue of obesity in the United States. It reported that obesity is a problem that exacts significant health and monetary cost to the nation. It also found that income and obesity have a notable inverse relationship when one looks at the total data. However, when the data are disaggregated by race and gender important differences are observed. It appears that the white American group has the strongest classic inverse relationship between income and obesity. It also appears that black American females have the weakest such relationship. The paper also found that, while obesity is a problem affecting all segments of the population, it is most critically a problem for the poor. The data show that obesity disproportionately affects those at the lower end of the income scale. This suggests even deeper issues are also at work because the poor are also the least likely to see a physician or seek treatment when serious health problems occur. As such public policymakers should consider messages specially targeted on the poor with reminders about the benefits of good nutrition and regular medical checkups.

Works Cited

Nestle, Marion, Jacobson, Michael F. (2000, Jan.-Feb.). Obesity. In Public Health Reports, vol. 115. Retrieved from

Ogden, Cynthia L., Lamb, Molly M., Carroll, Margaret D., and Flegal, Katherine, M. "Obesity and Socioeconomic Status in Children and Adolescents: United States, 2005–2008." NCHS Data Brief, no. 51, Dec. 2010. Web. Accessed Oct. 7, 2013.

Preventing and reducing childhood obesity in New York. (2008, Oct.). Office of the State Comptroller. Retrieved from

Soaring health care costs highlight need to address childhood obesity. (2012, Oct.). Office of the State Comptroller. Retrieved from