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Obesity and socioeconomic status:A framework for examiningrelationships between physical andsocial variablesJeffery Sobal aa Associate Professor in the Division of Nutritional Sciences,Cornell University, Ithaca, NY, 14853Version of record first published: 12 May 2010.

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Obesity and Socioeconomic Status:A Framework for Examining RelationshipsBetween Physical and Social VariablesJeffery Sobal

Fatness and obesity are body characteristics which are both ascribed and achieved for adults.Socioeconomic status (SES) is the ranking of individuals within complex societies. In traditionalsocieties a direct relationship between SES and fatness exists, while in modern societies there isan inverse association between SES and obesity for adult women but mixed patterns for otherage/sex groups. A framework recognizing the difference between variables on the physical andsocial level of analysis needs to be used to examine the relationship between fatness (a physicalvariable) and SES (a social variable). Different mechanisms are involved in the causal pathwayswhere SES influences obesity and obesity influences SES. SES influences obesity by education,income, and occupation causing variations in behaviors which change energy consumption,energy expenditure and metabolism. Obesity influences SES when the perception of obesity isinterpreted through prejudiced beliefs, with subsequent stigmatization and discriminationlimiting access to higher SES roles.

INTRODUCTION

Human body sizes vary widely, and preferred body size is often linked to aperson's rank in society. Two important body dimensions related to social positionare stature and volume. Stature, as height, is directly associated with sodal statusin most societies (Messer 1989, Roberts and Herman 1986). However, stature islargely exempt from personal control for most adults, having been already deter-mined by genetics, nutrition and other influences during growth. Therefore, forthe individual, stature can be viewed as an ascribed characteristic of body size.Ascribed attributes are largely beyond personal control, in contrast to achievedcharacteristics which individuals can influence (Vander Zanden 1979).

Adult body volume, in contrast to stature, is partially ascribed for adults throughgenetics, metabolism, and growth, but also partially achieved through diet andactivity. Personal, social, and cultural control can be exercised to effect variations inbody volume. Because body volume is more malleable than stature, it is adimension of body size which can receive greater cultural and social attention andmanipulation.

Body volume varies with both fat stores and the size of muscle and skeletal mass.Fat stores can be manipulated more extensively than muscle mass, and skeletal

JEFFERY SOBAL is an Associate Professor in the Division of Nutritional Sciences, Cornell University, Ithaca NY14853. His interests include nutritional sociology, nutritional ethics, the study of health beliefs and behaviors, andresearch methodology.

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mass is not usually substantially changed by adults. However, it is notable that inmodern societies some groups, such as weight lifters and body builders, createlarge changes in their body volume by increasing their muscle tissue with focusedexercise.

Fatness, the amount of stored body fat, is an object of social attention in mostsocieties either because of insufficiencies or excesses. Adiposity is the amount offatness of an individual. This paper will focus on modern societies and obesity,which is the condition of having very high adiposity. Traditional societies will bediscussed as further examples.

Socioeconomic status (SES) is a ranking or stratification system existing incomplex societies. Dominant values of society are often reflected in socioeconomicstatus, and societies that value particular body shapes exhibit preferences for thatbody type among members of their higher social strata. Body volume is related tosocial rank or position in many societies (Brown and Konner 1987; Messer 1989). Ifcultural values support bigness as being better, individuals of higher SES are morelikely to be bigger. Bigger individuals are also more likely to move upward in socialstatus. For societies with values supporting thinness, the reverse will be true.Different values may exist for men and women, with various patterns of fatnessamong social strata existing for the two sexes.

SES in developed societies is a complex, multidimensional attribute, based onseveral major components, including an individual's education, income, occupa-tional prestige, and family background. SES can be considered as a global charac-teristic, but theoretical analysis of mechanisms relating SES to obesity requires thatwe consider the individual components of SES separately to see whether theyoperate in different ways.

LEVELS OF ANALYSIS IN THE EXAMINATION OF SES AND OBESITY

An essential consideration in examining the SES-obesity relationship is that obe-sity is a physiological characteristic, while SES is a sociological characteristic. Amethodological problem exists in examining this relationship because knowledgeabout the two variables is conceptualized from two different frames of reference.Obesity is most frequently studied by applying perspectives from the life sciences,while socioeconomic status is studied using a social science perspective.

A complete examination of obesity will use perspectives involving multiplelevels of analysis, including linking concepts from both the social and life sciences.One commonly used framework for moving beyond the purely biological modelmost frequently used to examine obesity is the Biopsychosocial Model (Engel 1977,1980). Engel proposed that the traditional biomédical model needs to be expandedto incorporate psychological and social variables. While the biopsychosocial modelincorporates the family, community, and other social systems, it fails to considerthe existence of fundamental differences between physical and social variablesand has less explanatory power as a result.

Obesity and socioeconomic status are on two separate levels of analysis, the

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Obesity and Socioeconomic Status 233

physical and social, which operate using very different conceptual systems. Forexample, concepts such as energy and units of measurement such as joules can beapplied to biological and chemical processes but cannot be translated to culturalor social processes. Similarly, the concepts of roles or personality are used byanthropologists, sociologists, and psychologists, but cannot be usefully translatedor measured in the work of chemists or physicists. The dualism of physical versussocial levels was described by Descartes, considered by later thinkers such as Kant,applied by pioneering social scientists such as Durkheim, and discussed as atheoretical issue by Klausner (1970,1971,1972). Failure to recognize that social andphysical levels of analysis are incommensurate and not mutually translatabledetracts from the validity of analyses and prevents complete explication of relation-ships of variables on different levels of analysis, such as socioeconomic status andobesity.

A useful theoretical framework that provides a model for considering both thephysical and social levels of analysis is action theory (Parsons 1966,1978). Figure 1presents a systems model of action theory. Systems on the social level of analysisinclude the cultural, social, and personality systems. All of these systems have acommon frame of reference, with many shared concepts such as identities, norms,values, etc. By contrast, the physical level of analysis shares a common frame ofreference, which examines phenomena in the organism system and the environ-mental system, which are studied by the life sciences and physical sciences. Theenvironmental system is not a subsystem of action. It is involved with, but not in,human action. The physical level of analysis measures phenomena in time andspace units and includes biological, physical, and chemical processes. Commonconcepts are shared on the physical level of analysis, such as energy, mass, etc.

Concepts from the physical and social levels of analysis are not directly translat-able from one to the other level, and can only be discussed as metaphors andanalogies. Thus energy in an organism is not the same concept as energy in a socialsystem, personality has no meaning for ecosystems, and digestion is not meaning-ful for societies. The interface between social and physical levels of analysisbecomes problematic when examining relationships between social factors such asSES and physical factors such as fatness.

Translation across the two levels of analysis demands careful examination of themechanisms operating between variables on the two levels. This is important inexamining relationships between SES and obesity, especially if influence or causal-ity may operate in both directions. SES influences obesity in the following manner.On the social level of analysis, higher income leads to an increased ability to buyadditional food within the economic system. This is then translated into thephysical level of analysis by the behavior of ingesting more kilocalories leading togreater stored energy in fat cells and an increased prevalence of obesity. The degreeof obesity can also determine an individuals socioeconomic status. In this case, atthe physical level of analysis the presence of large amounts of energy stored asbody fat is translated to the social level of analysis by the perception amongindividuals holding the values of a modern cultural system of excess fat as beingunattractive. This valuation would then lead to actions which result in a lowerplacement of the obese person on the local social hierarchy. The principle of

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234 J. Sobal

Personality

System

Hierarchy

of Control

Physical

Level of

Analysis

Hierarchy of

Determination/

Environmental

System— • —

Figure 1. Levels of analysis and systems in Parsonian action theory.

translation between the social and physical levels of analyses always needs to beconsidered when evaluating relationships among these mechanisms.

Parsons (1966, 1978) also provided a framework for examining the types ofinfluence exerted by the physical and social levels of analysis, which presents twohierarchies for the five systems: a hierarchy of determination and a hierarchy ofcontrol. The physical level of analysis operates through a hierarchy of determina-tion, which acts through a process of conditionality or limitation. For example, anecological system with limited carrying capacity will have difficulty providingsufficient energy to produce obese organisms, and cultural values determined by

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Obesity and Socioeconomic Status 235

this may encourage the storage of as much fat as possible as a hedge againstenvironmental exigencies. By contrast, the social level of analysis influences thehierarchy by control, rather than determination. For example, the values of acultural system control the social status given to obese individuals. This will theninfluence individual behavior. For example, if high social status is bestowed onobesity, then individuals will strive to increase calorie intake, while they willendeavor to limit calorie intake if obesity has low social status.

Within the social level of analysis, the cultural system exerts control over socialand personality systems. Thus, moving down the hierarchy of control, culturalvalues about fatness determine the social organization of individuals with respectto obesity, and the motivations of personalities to achieve preferred levels offatness. Moving up the hierarchy of determination, a scant supply of food from theenvironment may prohibit an organism from storing fat; genetic attributes of theorganism influence ability to store fat, and these may be perceived by an individualpersonality as undesirable in light of that person's position in the social structurewithin the system of cultural values. Determination establishes limits withinwhich action can occur, as opposed to control which defines the specific forms thataction may take. Physical limits of determination, such as access to food in theenvironment or genetic aspects of an organism, place constraints on the controlexercised by the systems on the social level of analysis.

Various schools of thought may emphasize one of the two hierarchies at theexpense of the other. Materialism emphasizes determination by environments andthe importance of extraction of energy from an environment as a cause of socialfactors, such as obesity. This materialistic analysis is seen in the perspective ofanthropologists such as Harris (1977, 1979). Such focusing on the hierarchy ofdetermination may be criticized as reductionist because of the emphasis on thephysical level of analysis. Symbolic perspectives of other anthropologists empha-size the existence of values which control the preference of body shape that leadpeople to modify eating and activity to fit the controlling cultural values. Suchsymbolic work is seen in structuralism (Douglas 1966, Murcott 1988). Symbolicapproaches may be criticized as unappreciative of determination from physicalfactors. Both materialistic and symbolic perspectives offer valid but sometimesconflicting points of view. Understanding differences between these perspectivescan be considered by seeing them as taking vantage points from either physicalor social levels of analysis.

PATTERNS OF SOCIOECONOMIC STATUS AND OBESITY

Differential patterns of fatness exist by SES. Over 30 years ago anthropologistsproposed that women in higher social classes are thinner but men in those classesare fatter (Powdermaker, 1960), but specific quantitative studies of SES and obesitywere not conducted until the early 1960s (Goldblatt, Moore, and Stunkard 1965;Moore, Stunkard, and Srole 1962). The literature on the topic has recently beensystematically reviewed and integrated (Sobal and Stunkard 1989) and the findingsof this exhaustive review are summarized in Table I. In traditional and developing

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TABLE I. Existing studies of sodoeconomic status and obesity*.

Group

Men

Women

Boys

Girls

Association

directinversenonedirect

inversenonedirect

inversenonedirect

inversenone

DevelopedSocieties

2034111

4679

11148

1311

DevelopingSocieties

1202

1001

1302

1402

•From: Sobal and Stunkard (1989)

societies there is a universal direct relationship of SES and fatness for all age andsex groups. Extreme examples of the link between excess fatness and high statusoccur for women in some societies, as seen in the fattening huts in several Africancultures which develop extreme corpulence in young women to increase theirbeauty, status, and marital value (Brink 1989). Labelling of corpulence as obesity inmodern societies has been questioned by Ritenbaugh (1982a) in discussing obesityas a culture-bound syndrome.

Modern developed societies have a pattern of SES and obesity that is specific forage and sex groups. Among adult women there is a consistent inverse relationshipbetween SES and fatness. This is exemplified in the extreme in the high prevalenceof anorexia nervosa in women of higher social classes (Gordon 1990; Kendall et al.1973) and in the frequently quoted quip that "No woman can be too rich or toothin" (Garn 1986; Gordon 1990). For other age and sex groups in developedsocieties, the findings about obesity and SES are inconsistent, with no clearrelationships predominating. Fatness is seen as better by almost everyone indeveloping societies, but is not seen as better among women in developedsocieties.

The mechanisms for the relationship between SES and obesity need to beconsidered in light of the possibilities that 1) SES influences obesity, and 2) obesityinfluences SES. For SES to influence obesity, fatness needs to be recognized as aphysical condition and any social causes must ultimately operate through thephysiological mechanisms of the energy balance equation. Thus energy intake andexpenditure must be influenced by SES for causality to operate in that direction. Bycontrast, influences of obesity upon SES must involve causal mechanisms workingthrough psychological, social and cultural factors. Both of these directions ofinfluence will be examined in the following sections to show the differences indescribing mechanisms that operate in opposite directions across the two levels ofanalysis.

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Obesity and Socioeconomic Status 237

THE INFLUENCE OF SOCIOECONOMIC STATUS UPON OBESITY

The components of SES are on the social level of analysis, but can cause obesityonly through mechanisms on the physical level of analysis by behaviors whichcontrol energy intake, energy expenditure and metabolism (Figure 2). The threemajor SES components which need to be examined as possible determinants ofobesity are education, income, and occupation, with family background beinganother less important factor.

Education

SocialLevel ofAnalysis

Occupation

Eating Exercise

PhysicalLevel ofAnalysis

EnergyIntake

Metabolism EnergyExpenditure

ObesityFigure 2. Mechanisms for the influence of SES upon obesity.

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Education is a component of SES that is related to obesity primarily throughknowledge and beliefs. People with higher education are likely to be more aware ofthe health issues their society associates with obesity (Kushi et al. 1988). Highereducational attainment may include training in health and nutrition, but alsoprovides intellectual resources for acquiring information about eating and activitywhich can influence obesity. People with higher educational levels are more likelyto participate in sports and active recreational activities than their counterparts(Wilson 1980).

Income is related to obesity primarily through access to resources. Individualswith higher personal and family incomes have more options in food access andfood choices, although actual caloric intake does not necessarily vary by income(Kushi et al. 1988). Wealthier people also have greater financial resources to engagein voluntary energy expenditure to change their fatness levels. To the extent thatdieting and exercise are limited weight loss resources in our society, people withhigher incomes have greater access to the means of reduction than those withlower incomes.

Occupation is related to obesity primarily through lifestyle, with only relativelysmall differences between occupations in post-industrial societies in the amount ofphysical labor performed on the job. Shifting of economies of modern societiesfrom manufacturing to service industries has reduced the expenditure of energy atwork for most individuals. Mechanization of the workplace has decreased the gapsin energy expenditure between higher status and lower status occupations, with onlya small minority of occupations now requiring heavy physical activity on the job.

People in lower prestige occupations have reduced autonomy and flexibility intheir work. They cannot control their work time and scheduling as freely as those inhigher prestige occupations. This limits their participation in voluntary exerciseactivities and reduces their choice of food intake. Lifestyle also includes the sharingof values about appropriate body shape. Reference groups of people in higherprestige occupations may place greater emphasis upon appearance than for peopleworking in lower prestige jobs, which also influences weight gain and loss amongthose individuals.

It is difficult to assess the role family background plays in the SES-obesityrelationship than the more easily measured and conceptualized components ofeducation, income and occupation. As far back as the late 1800s (Veblen 1899),ideals of the thin women in feminine beauty have been seen as symbols of anemerging leisure class. By the turn of the century, upper-class women were usingdietary restraint to distance themselves from the working classes (Brumberg 1988).By contrast, lower-class subcultures in the U.S. are often more accepting and evendesiring of obesity in women, so that what has been described as a subculture ofpoverty (Lewis 1966; Valentine 1968) may also be a "subculture of adiposity."Clearly the reference groups associated with social strata provide values whichcan encourage or inhibit obesity.

Relationships between SES and obesity vary in connection to several importantdemographic variables, especially sex/gender and race/ethnicity. The theoreticalframework developed here provides a perspective for thinking about the role ofthese other factors by differentiating physical and social levels of analysis anddelineating hierarchies of determination and control.

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Obesity and Socioeconomic Status 239

Sex is seen as a biological characteristic with associated genetic and physiologi-cal attributes, while gender is a social characteristic with cultural, sociological andpsychological attributes. The physical attributes of sex strongly determinewomens' fatness through genetics and metabolism, as seen in an evolutionaryperspective by Beller (1977). By contrast, cultural values about fatness control thelevels of body fat within the boundaries determined by mechanisms on thephysical level of analysis. The direct relationship between SES and fatness intraditional cultures (Brown and Konner, 1987) suggests that biocultural factors areconsistent in those cultures in relationship with fatness and SES. However, theexistence of an inverse relationship primarily among women in modern societiessuggests an incongruity between biological and cultural factors. Several historicalanalyses consider the unique focus on fatness among women in modern societies(Brumberg 1988; Schwartz 1986). Gordon (1990) suggests that the modern transi-tion in womens' roles makes them especially vulnerable to focusing attention ontheir bodies, which leads to an emphasis upon slimness in this era of change inwomens' social positions and identities. Gender is an important factor in obesity(Rodin, Silberstein, and Streigel-Moore 1985), and needs to be considered in therelationship between SES and fatness.

Race is a physical characteristic with genetic and physiological attributes, whileethnicity is a social characteristic with cultural, social and psychological attributes.Genetic characteristics of various racial groups determine levels and distribution ofbody fat. An example is steatopygia, which is storage of very high amounts of fat inthe buttocks of some racial groups. Consideration of race as a physical factor inrelationships between SES and obesity needs to examine how racial attributesdetermine obesity and this consequently influences SES. Ethnic patterns in obesityhave been documented among both European ethnic groups (Goldblatt, Moore,and Stunkard 1965) and African Americans (Kumanyika 1987). The SES-obesityrelationship is influenced by the interplay of ethnic food and activity patterns withboth SES and obesity.

A number of other mediating variables exist in considerations of influences ofSES upon obesity, and their confounding effects have not been well examined inexisting studies. Smoking is more frequent among lower SES individuals (Pierce etal. 1989) and clearly effects metabolism so that smokers are thinner than non-smokers (Fehily, Phillips, and Yarnell 1984; Klesges et al. 1989) SES, as an attributeof social structure, influences the behavior of smoking which has direct metabolicconsequences for obesity. Other examples of mediating variables include numberof children, area of residence, and marriage, and future research needs to examinetheir role in the SES-obesity relationship.

THE INFLUENCE OF OBESITY UPON SOCIOECONOMIC STATUS

Obesity is a factor on the physical level of analysis that must influence SES throughmechanisms on the social level of analysis. This occurs in the way obesity isperceived, interpreted, and acted upon in the social system (Figure 3). The majorcomponents which need to be examined in this relationship are values, prejudice

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SES

Education Income Occupation

Stigma Behaviors Discrimination

Bias Values Prejudice

SocialLevel ofAnalysis

IPerceptionof Obesity

PhysicalLevel ofAnalysis Obesity

Figure 3. Mechanisms for the influence of obesity upon SES.

and stigmatization, and actual discrimination which influence the components ofSES (education, income and occupation).

Values about the appropriateness of fatness and thinness vary between andwithin societies. In traditional societies, the preponderance of evidence suggeststhat fat body shapes are often highly valued (Messer 1989). Brown and Konner(1987) found that 81% of the 58 traditional cultures which have data about valuesand fatness in the Human Relations Area Files (HRAF) view "plumpness" as an

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Obesity and Socioeconomic Status 241

ideal of feminine beauty. Fat stores are viewed as a sign of health and viability, andindividuals with greater adiposity are more likely to attain positions of power andprestige. By contrast, people who are thin are viewed more negatively and notgranted access to social positions available to their fatter counterparts. This isespecially true of women, to the extent that women are considered as social objectsand possessions by men in a culture.

In modern, developed societies there has been a relatively recent development ofvalues which see thinness rather than fatness as desirable. Especially since 1960,ideal body shapes for women have emphasized extreme thinness as the mostdesirable body shape (Garner and Garfinkle 1980; Silverstein, Peterson, andPerdue 1986). This has led to a consistent inverse relationship between socio-economic status and obesity among women, with the probability that at least someof the causal influence occurred because fatness influenced socioeconomic status.Despite these values favoring an increasingly slimmer female body shape, therehas been an increase in the fatness of young women over the past two decades,with no change in men (Flegal, Harlan, and Landis 1988a, 1988b).

The negative evaluation of obese people has led to prejudice against them, moreso for women than men. Weil (1977:183) notes ". . . the greatest hazards of excessadiposity are psychologic and social." The negative assessment of obesity results ina stigma existing for people who are visibly obese, with behavioral consequenceswhich can affect social status. The stigmatization of obesity is described by anumber of analysts (Allon 1973, 1981; Cahnman 1968; Dejong 1980; Jarvie et al.1983; Kaiisch 1972; Sobal 1984b, 1991; Tobias and Gordon 1980). Exceptions to therelationship between SES and obesity exist, with the image of physical and socialpower associated with bigness leading some people to maintain larger sizes(Ritenbaugh 1982b).

Prejudicial attitudes against the obese can lead to discriminatory behavior,which is the next step in the mechanism of influence whereby obesity causes SES.A number of studies have documented discrimination against obese people inaccess to college education (Canning and Mayer 1966), employment (Larkin andPines 1979; Matusewitch 1983; Benson et al. 1980), earnings (McClean and Moon1980), job promotions (Hinkle et al. 1968) and housing (Karris 1977). Weightdiscrimination is emerging as an issue of sufficient importance to be discussed inthe legal literature (Baker 1984). The existence of a physical condition of obesity andnegative interpretation of that condition can lead to social behaviors by otherswhich influence socioeconomic status.

Several studies document that physicians hold negative attitudes toward theobese (Maddox, Bach and Liederman 1968; Maddox and Liederman 1969; Maimanet al. 1979; Price et al. 1979; Najman and Munro 1982). Negative attitudes towardthe obese exist among medical students (Blumberg and Mellis 1985) and medicalresidents (Brotman, Stern, and Herzog 1984). Obesity influences the clinicalactivities of health professionals (Young and Powell 1985; Franks, Culpepper, andDickinson 1982). Rehabilitation counselors negatively evaluated therapeutic poten-tial of obese patients (Kaplan 1982; Kaplan and Thomas 1981). These investigationssuggest that stigmatization of the obese by medical professionals occurs from theirgeneral public values, not necessarily from training or experience in their profes-sional roles. Discrimination against obese people by health professionals can deny

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242 }. Sobal

employment in higher status jobs through employment physicals or other mecha-nisms where medical power limits a persons entry into a job or progress towardshigher status jobs.

Social status can result from ascribed as well as achieved influences. Familybackground is certainly ascribed, and income, occupation, and education may bedetermined rather than attained. In societies which do not have rigid barriersbetween socioeconomic groups, achievement of SES becomes a major issue, largelythrough education, occupation, and resultant income. Social mobility is the keyfactor in the SES-obesity relationships in these cases.

Social mobility has traditionally occurred through education, occupation, andmarriage for family background. Traditionally education and occupation have beenmore important for men, and marriage more important for women, but thatdistinction has recently been diminishing. Attracting marital partners is related atleast in part to physical attractiveness, moreso for the working classes than middleclasses, for whom education becomes more important (Elder 1969). Marriage isrelated to obesity and socioeconomic status through upwardly mobile individualsmarrying into a higher prestige family background (Sobal 1984a). Garn, Sullivan,and Hawthorne (1989a, 1989b) present data describing how assortative matingresults in thinner women marrying up in SES and fatter women marrying down inSES. This shows how obesity plays a role in SES attainment because of success inattracting mates.

The mechanisms whereby prejudice and discrimination against the obese influ-ence social mobility include preventing access to opportunities for mobility andslowing progress towards mobility. Keeping individuals from educational andtraining opportunities because they are obese denies them future opportunities torise in social status. Individuals who are obese whose progression in careers isslowed because of their obesity take longer to move upward in the social systemand therefore cannot attain the same maximum social position as their thinnercounterparts. Gatekeepers in the social stratification system may limit the ability ofobese individuals to move upward in SES, exercising sanctions against thembecause of their body weight.

CONCLUSION

Understanding the mechanisms of relationships between obesity and socio-economic status requires the use of a framework which considers that obesity isa variable on the physical level of analysis and socioeconomic status is on thesocial level of analysis, with each level of analysis using a frame of referencenot translatable into the other. This permits analysis of how socioeconomic statusinfluences obesity, and also of how causality also can operate in the reversedirection, with obesity influencing socioeconomic status.

In the United States there is currently a strong emphasis on the value of thinness,more so for women than men (Gordon 1990). Social pressures to become andremain thin often create stress because of physiological pressures for bodies tostore fat. Culture and physiology collide, creating a discrepancy between culturaldesires and biological imperatives. The great interest and attention to weight loss in

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Obesity and Soáoeconomic Status 243

modern societies is a manifestation of the competition between the hierarchy ofcontrol which is driven by values emphasizing slimness, and the hierarchy ofdetermination which is driven by thousands of years of evolution that producedthrifty genes which store fat (Neell962,1982). Socioeconomic status comes into thepicture as it plays a role in the influence of both determination and control in bodyfatness.

Socioeconomic status is a concept of primary importance in the social sciences.As an important determinant of social activities, socioeconomic status is relatedto obesity, plus many other nutritional variables such as iron deficiency anemia(Lopez and Habicht 1987). The conceptual framework presented here can beapplied to the examination of socioeconomic status and other nutritional variables.The key point is that mechanisms of translation need to be specified for relation-ships between variables on the social and the physical levels of analysis. Thesemechanisms are often behaviors for influences of social variables upon physicalvariables and perceptions for influences of physical variables on social variables,although other translating mechanisms also operate.

Fatness is related to socioeconomic status, but in different ways in differentcultures. Traditional, developing societies believe that bigness, as body fatness, isbetter than thinness. However, modern, developed societies believe that thinnessis better, with those values most salient for women. Theoretical frameworks forthinking about how socioeconomic status and obesity are related can be useful inproviding ways of thinking about whether bigness is better.

ACKNOWLEDGMENTS

This project was partially supported by funding from New York State Hatch Project NY(C)-399404 toinvestigate Socioeconomic Status and Obesity. The author thanks Claire M. Cassidy, Samuel Z.Klausner, Albert J. Stunkard, and Frank Young for helpful comments and suggestions.

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