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Distal and variably proximal causes: Education, obesity, and health

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  • Schafer, Markus H.
  • Ferraro, Kenneth F.

Abstract

Medical sociologists hold that social conditions generate disparities across a host of health conditions through exposure to a variety of more proximate risk factors. Though distal and proximal causes jointly influence disease, the nature of risk accumulation may differ appreciably by the link of a proximal cause to the outcome in question. This paper employs a representative sample of over 3000 American older adults to examine whether position in the educational gradient amplifies the effect of obesity on two health outcomes. Results indicate that educational inequalities amplify the effect of high body mass index on disability (unstandardized coefficients across education groups range from −.05 [ns] to .26 [p < .01] among overweight respondents yet reach .17 [ns] to .73 [p < .001] among severely obese adults), but fail to amplify the consequences of severe obesity in the case of C-reactive protein (CRP) levels. Instead, educational gradients in CRP are most pronounced at lower levels of body mass. Sex-specific analyses further clarify these patterns, as the connections between CRP and body mass are particularly strong among women. We conclude that risk accumulation processes differ based on the proximity of causes to the health outcome under examination.

Suggested Citation

  • Schafer, Markus H. & Ferraro, Kenneth F., 2011. "Distal and variably proximal causes: Education, obesity, and health," Social Science & Medicine, Elsevier, vol. 73(9), pages 1340-1348.
  • Handle: RePEc:eee:socmed:v:73:y:2011:i:9:p:1340-1348
    DOI: 10.1016/j.socscimed.2011.08.010
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    References listed on IDEAS

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    1. Lynch, J. W. & Kaplan, G. A. & Salonen, J. T., 1997. "Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse," Social Science & Medicine, Elsevier, vol. 44(6), pages 809-819, March.
    2. Marang-van de Mheen, Perla J. & Davey Smith, George & Hart, Carole L., 1999. "The health impact of smoking in manual and non-manual social class men and women: a test of the Blaxter hypothesis," Social Science & Medicine, Elsevier, vol. 48(12), pages 1851-1856, June.
    3. Hemingway, H. & Nicholson, A. & Stafford, M. & Roberts, R. & Marmot, M., 1997. "The impact of socioeconomic status on health functioning as assessed by the SF-36 questionnaire: The Whitehall II study," American Journal of Public Health, American Public Health Association, vol. 87(9), pages 1484-1490.
    4. Jennifer Karas Montez & Mark D. Hayward & Dustin C. Brown & Robert A. Hummer, 2009. "Why Is the Educational Gradient of Mortality Steeper for Men?," Journals of Gerontology: Series B, Gerontological Society of America, vol. 64(5), pages 625-634.
    5. Borg, Vilhelm & Kristensen, Tage S., 2000. "Social class and self-rated health: can the gradient be explained by differences in life style or work environment?," Social Science & Medicine, Elsevier, vol. 51(7), pages 1019-1030, October.
    6. Luis Rosero-Bixby & William H. Dow, 2009. "Surprising SES Gradients in Mortality, Health, and Biomarkers in a Latin American Population of Adults," Journals of Gerontology: Series B, Gerontological Society of America, vol. 64(1), pages 105-117.
    7. Smith, G.D. & Hart, C., 2002. "Life-course socioeconomic and behavioral influences on cardiovascular disease mortality: The collaborative study," American Journal of Public Health, American Public Health Association, vol. 92(8), pages 1295-1298.
    8. Duncan, Craig & Jones, Kelvyn & Moon, Graham, 1993. "Do places matter? A multi-level analysis of regional variations in health-related behaviour in Britain," Social Science & Medicine, Elsevier, vol. 37(6), pages 725-733, September.
    9. Ferraro, K.F. & Su, Y.-P. & Gretebeck, R.J. & Black, D.R. & Badylak, S.F., 2002. "Body mass index and disability in adulthood: A 20-year panel study," American Journal of Public Health, American Public Health Association, vol. 92(5), pages 834-840.
    10. Adriana Lleras-Muney, 2005. "The Relationship Between Education and Adult Mortality in the United States," Review of Economic Studies, Oxford University Press, vol. 72(1), pages 189-221.
    11. Sharon R. Williams & Thomas W. McDade, 2009. "The Use of Dried Blood Spot Sampling in the National Social Life, Health, and Aging Project," Journals of Gerontology: Series B, Gerontological Society of America, vol. 64(suppl_1), pages 131-136.
    12. Sharon R. Williams & Genevieve Pham-Kanter & Sara A. Leitsch, 2009. "Measures of Chronic Conditions and Diseases Associated With Aging in the National Social Life, Health, and Aging Project," Journals of Gerontology: Series B, Gerontological Society of America, vol. 64(suppl_1), pages 67-75.
    13. Kavanagh, Anne & Bentley, Rebecca J. & Turrell, Gavin & Shaw, Jonathan & Dunstan, David & Subramanian, S.V., 2010. "Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes," Social Science & Medicine, Elsevier, vol. 71(6), pages 1150-1160, September.
    14. Krueger, P.M. & Chang, V.W., 2008. "Being poor and coping with stress: Health behaviors and the risk of death," American Journal of Public Health, American Public Health Association, vol. 98(5), pages 889-896.
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    1. Schafer, Markus H. & Upenieks, Laura, 2015. "Environmental disorder and functional decline among older adults: A layered context approach," Social Science & Medicine, Elsevier, vol. 124(C), pages 152-161.

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