Weighing in on Inequality: Obesity among Low and High SES Children.

摘要

Over the last four decades obesity rates have steadily increased among adults and children in the United States. Similar to other health conditions, low SES groups experience a disproportionate burden of obesity prevalence. However, recent evidence suggests the gap between low and high SES groups is narrowing, challenging the basic tenet of fundamental cause theory that higher SES groups are able to protect themselves from preventable diseases over time. Using a mixed methodological approach, this dissertation conducts an in-depth investigation on the relationship between SES and obesity, seeking to uncover structural explanations for rising prevalence among both low and high SES children. Among low SES children, the extant literature mainly focuses on the role of family income in evaluating the SES-obesity relationship, but the role of parental education has been largely unexplored. In addition, the "black-box" of mechanisms mediating the SES-obesity relationship remain elusive. Using data from the Early Childhood Longitudinal Series --- Birth Cohort (ECLS-B) data, I find that mother's education is the primary indicator driving the SES-obesity relationship among young children. Qualitative interviews suggest that SES operates through at least three "stressor pathways" to impact obesity among low SES children --- the presence of food insecurity in the household, the internalization of stress among mothers and children, and the quality of neighborhood resources. ECLS-B data was also used to identify structural factors associated with obesity among high SES children. I find that mother's labor force participation plays a significant role in the higher SES group, with children who have mothers working full-time significantly more likely to be obese than those with mothers who are not in the labor force. Overall, the findings for both low and high SES children suggest that structural changes that have occurred alongside trends in childhood obesity have severely limited the resources and time of families to overcome the social ecological changes that have increased Americans' opportunity to engage in unhealthy behaviors. Efforts to reduce childhood obesity, therefore, will have limited success if major structural barriers are not overcome first.