IDEAS home Printed from
   My bibliography  Save this article

Obesity, SES, and economic development: A test of the reversal hypothesis


  • Pampel, Fred C.
  • Denney, Justin T.
  • Krueger, Patrick M.


Studies of individual countries suggest that socioeconomic status (SES) and weight are positively associated in lower-income countries but negatively associated in higher-income countries. However, this reversal in the direction of the SES-weight relationship and arguments about the underlying causes of the reversal need to be tested with comparable data for a large and diverse set of nations. This study systematically tests the reversal hypothesis using individual- and aggregate-level data for 67 nations representing all regions of the world. In support of the hypothesis, we find not only that the body mass index, being overweight, and being obese rise with national product but also that the associations of SES with these outcomes shift from positive to negative. These findings fit arguments about how health-related, SES-based resources, costs, and values differ across levels of economic development. Although economic and social development can improve health, it can also lead to increasing obesity and widening SES disparities in obesity.

Suggested Citation

  • Pampel, Fred C. & Denney, Justin T. & Krueger, Patrick M., 2012. "Obesity, SES, and economic development: A test of the reversal hypothesis," Social Science & Medicine, Elsevier, vol. 74(7), pages 1073-1081.
  • Handle: RePEc:eee:socmed:v:74:y:2012:i:7:p:1073-1081 DOI: 10.1016/j.socscimed.2011.12.028

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Popkin, Barry M., 2006. "Technology, transport, globalization and the nutrition transition food policy," Food Policy, Elsevier, vol. 31(6), pages 554-569, December.
    2. David M. Cutler & Edward L. Glaeser & Jesse M. Shapiro, 2003. "Why Have Americans Become More Obese?," Journal of Economic Perspectives, American Economic Association, vol. 17(3), pages 93-118, Summer.
    3. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
    4. Ljungvall, Åsa & Gerdtham, Ulf-G., 2010. "More equal but heavier: A longitudinal analysis of income-related obesity inequalities in an adult Swedish cohort," Social Science & Medicine, Elsevier, vol. 70(2), pages 221-231, January.
    5. Chou, Shin-Yi & Grossman, Michael & Saffer, Henry, 2004. "An economic analysis of adult obesity: results from the Behavioral Risk Factor Surveillance System," Journal of Health Economics, Elsevier, vol. 23(3), pages 565-587, May.
    6. David M. Cutler & Edward L. Glaeser, 2009. "Why Do Europeans Smoke More than Americans?," NBER Chapters,in: Developments in the Economics of Aging, pages 255-282 National Bureau of Economic Research, Inc.
    7. repec:aph:ajpbhl:2000:90:8:1260-1268_9 is not listed on IDEAS
    8. Ball, Kylie & Crawford, David, 2005. "Socioeconomic status and weight change in adults: a review," Social Science & Medicine, Elsevier, vol. 60(9), pages 1987-2010, May.
    9. Kan, Kamhon & Tsai, Wei-Der, 2004. "Obesity and risk knowledge," Journal of Health Economics, Elsevier, vol. 23(5), pages 907-934, September.
    10. Tomas J. Philipson & Richard A. Posner, 2008. "Is the Obesity Epidemic a Public Health Problem? A Review of Zoltan J. Acs and Alan Lyles's Obesity, Business and Public Policy," Journal of Economic Literature, American Economic Association, vol. 46(4), pages 974-982, December.
    11. Font, Joan Costa & Fabbri, Daniele & Gil, Joan, 2010. "Decomposing cross-country differences in levels of obesity and overweight: Does the social environment matter?," Social Science & Medicine, Elsevier, vol. 70(8), pages 1185-1193, April.
    12. repec:dau:papers:123456789/9988 is not listed on IDEAS
    13. Malena Monteverde & Kenya Noronha & Alberto Palloni & Beatriz Novak, 2010. "Obesity and excess mortality among the elderly in the United States and Mexico," Demography, Springer;Population Association of America (PAA), vol. 47(1), pages 79-96, February.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Rieger, Matthias, 2015. "Risk aversion, time preference and health production: Theory and empirical evidence from Cambodia," Economics & Human Biology, Elsevier, vol. 17(C), pages 1-15.
    2. Tafreschi, Darjusch, 2015. "The income body weight gradients in the developing economy of China," Economics & Human Biology, Elsevier, vol. 16(C), pages 115-134.
    3. Bruno Linetzky & Fernando Maio & Daniel Ferrante & Jonatan Konfino & Carlos Boissonnet, 2013. "Sex-stratified socio-economic gradients in physical inactivity, obesity, and diabetes: evidence of short-term changes in Argentina," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(2), pages 277-284, April.
    4. Dang, Rui, 2015. "Explaining the body mass index gaps between Turkish immigrants and Germans in West Germany 2002-2012: A decomposition analysis of socio-economic causes," Ruhr Economic Papers 580, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    5. Otero, Gerardo & Pechlaner, Gabriela & Liberman, Giselle & Gürcan, Efe, 2015. "The neoliberal diet and inequality in the United States," Social Science & Medicine, Elsevier, vol. 142(C), pages 47-55.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:74:y:2012:i:7:p:1073-1081. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.