Abstract
Although adult body mass index (BMI) displays considerable social patterning worldwide, the direction and strength of the relationship between BMI and socioeconomic status (SES) varies cross nationally. We examine social gradients in BMI for contemporary U.S. immigrants and evaluate whether their SES-BMI gradient patterns are shaped by underlying gradients in immigrant origin countries and whether they are further patterned by time in the United States. Data come from the New Immigrant Survey, the only nationally representative survey of contemporary immigrants. Results indicate that the inverse SES-BMI gradients observed among this population are strongest among women originating in highly developed countries. After arrival in the United States, however, inverse gradient patterns are driven largely by higher weights among low-SES individuals, particularly those from less-developed countries. We conclude that although certain immigrants appear to be uniquely protected from weight gain, poorer individuals from less-developed countries are doubly disadvantaged; this raises concerns about worsening inequalities in both diet and behavior between the rich and poor upon arrival to the United States.
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Notes
We use the term “gradient” in a broad sense to indicate “the SES patterning of BMI” (Sanchez-Vaznaugh et al. 2009).
The Human Development Index (HDI) is a composite measure used by the United Nations based on national indicators of life expectancy, educational attainment, and income.
The nearly 15 % of the sample missing on health selection is a cause for concern given that they are not missing at random and, compared with those respondents with complete data, are significantly older (42.7 years vs. 38.4 years), less educated (11.3 years vs. 13.1 years), female (55 % versus 50 %), and with more U.S. experience (6 years in the United States vs. 4 years in the United States). A sensitivity analysis that eliminated the health selection variable from the models (thereby including those respondents who were missing on health selection and not missing on any other variables) did not result in any substantive changes. Because health selection is a key hypothesis tested in this article, we have retained it in the analysis (and thereby exclude the 962 missing on health selection), but we are confident that the results would not be substantively different if they were included.
The HDI data were retrieved from a site maintained by the United Nations Development Program (http://hdr.undp.org/en/media/HDR_2010_EN_Table2_reprint.pdf).
However, using a dichotomous division may obscure differences, for example, between low- and medium-HDI countries (McLaren 2007). This may especially apply to medium-HDI countries that are often in the process of a nutrition transition, shifting the burden of obesity toward low-SES individuals (i.e., more negative SES-BMI gradients).
One possibility that we explored (as an alternative to self-identified race) was to control for skin color as a way of capturing the role of the U.S.-based racial stratification system in influencing SES-BMI gradient patterns among immigrants. Unfortunately, the NIS collected skin color only for the in-person interviews. As a result, we would lose an even larger proportion of our sample if we attempted to control for skin color than if we controlled for self-reported race.
References
Akresh, I. R. (2008). Overweight and obesity among foreign-born and U.S.-born Hispanics. Biodemography and Social Biology, 54, 183–199.
Akresh, I. R., & Frank, R. (2008). Health selection among new immigrants. American Journal of Public Health, 98, 2058–2064.
Antecol, H., & Bedard, K. (2006). Unhealthy assimilation: Why do immigrants converge to American health status levels? Demography, 43, 337–360.
Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R., & Pamuk, E. (2010). Socioeconomic disparities in health in the United States: What the patterns tell us. American Journal of Public Health, 100, S186–S196.
Buttenheim, A., Goldman, N., Pebley, A. R., Wong, R., & Chung, C. (2010). Do Mexican immigrants “import” social gradients in health to the US? Social Science & Medicine, 71, 1268–1276.
Chang, V. W., & Lauderdale, D. S. (2005). Income disparities in body mass index and obesity in the United States 1971–2002. Archives of Internal Medicine, 165, 2122–2128.
Frank, R., Akresh, I. R., & Lu, B. (2010). Latino immigrants and the U.S. racial order: How and where do they fit in? American Sociological Review, 73, 370–401.
Ganzeboom, H. B. G., DeGraaf, P. M., & Treiman, D. J. (1992). A standard international socio-economic index of occupational status. Social Science Research, 21, 1–56.
Ganzeboom, H. B. G., & Treiman, D. J. (1996). Internationally comparable measures of occupational status for the 1988 International Standard Classification of Occupations. Social Science Research, 25, 201–239.
Goldman, N., Kimbro, R. T., Turra, C. M., & Pebley, A. R. (2006). Socioeconomic gradients in health for white and Mexican-origin populations. American Journal of Public Health, 96, 2186–2193.
Gortmaker, S., Must, A., Perrin, J., Sobol, A., & Dietz, W. (1993). Social and economic consequences of overweight in adolescence and young adulthood. The New England Journal of Medicine, 329, 1008–1012.
Jasso, G., Massey, D. S., Rosenzweig, M. R., & Smith, J. P. (Forthcoming). The U.S. New Immigrant Survey: Overview and preliminary results based on the new-immigrant cohorts of 1996 and 2003. In B. Morgan & B. Nicholson (Eds.), Immigration Research and Statistics Service Workshop on Longitudinal Surveys and Cross-Cultural Survey Design Workshop Proceedings (pp. 29–46). London, UK: Crown Publishing.
Kimbro, R. T., Bzostek, S., Goldman, N., & Rodríguez, G. (2008). Race, ethnicity, and the education gradient in health. Health Affairs, 27, 361–372.
McLaren, L. (2007). Socioeconomic status and obesity. Epidemiologic Reviews, 29, 29–48.
Mokdad, A. H., Serdula, M. K., Dietz, W. H., Bowman, B. A., Marks, J. S., & Koplan, J. P. (1999). The spread of the obesity epidemic in the United States, 1991–1998. Journal of the American Medical Association, 282, 1519–1522.
Monteiro, C. A., Moura, E. C., Conde, W. L., & Popkin, B. M. (2004). Socioeconomic status and obesity in adult populations of developing countries: A review. Bulletin of the World Health Association, 82, 940–946.
Ogden, C., Lamb, M. M., Carroll, M. D., & Flegal, K. M. (2010). Obesity and socioeconomic status in adults: United States, 2005–2008 (NCHS Data Brief No. 50). Hyattsville, MD: National Center for Health Statistics.
Passel, J. S., & Cohn, D. V. (2011). Unauthorized immigrant population: National and state trends, 2010 (Pew Hispanic Center Report). Washington, DC: Pew Research Center.
Popkin, B. M. (1994). The nutrition transition in low-income countries: An emerging crisis. Nutrition Reviews, 9, 285–298.
Popkin, B. M. (1999). Urbanization, lifestyle changes, and the nutrition transition. World Development, 27, 1905–1916.
Popkin, B. M. (2001). The nutrition transition and obesity in the developing world. Journal of Nutrition, 131, 871S–873S.
Sanchez-Vaznaugh, E. V., Ichiro, K., Subramanian, S. V., Brisa, N. S., & Dolores, A.-G. (2009). Do socioeconomic gradients in body mass index vary by race/ethnicity, gender, and birthplace? American Journal of Epidemiology, 169, 1102–1112.
Singh, G. K., Kogan, M. D., & Yu, S. M. (2009). Disparities in obesity and overweight prevalence among US immigrant children and adolescents by generational status. Journal of Community Health, 34, 271–281.
Singh, G., Siahpush, M., Hiatt, R., & Timsina, L. (2011). Dramatic increases in obesity and overweight prevalence and body mass index among ethnic-immigrant and social class groups in the United States, 1976–2008. Journal of Community Health, 36, 94–110.
Sobal, J., & Stunkard, A. J. (1989). Socioeconomic status and obesity: A review of the literature. Psychological Bulletin, 105, 260–275.
Taubes, G. (1998). As obesity rates rise, experts struggle to explain why. Science, 280, 1367–1369.
Van Hook, J., & Balistreri, K. (2007). Immigrant generation, socioeconomic status and economic development of countries of origin: A longitudinal study of body mass index among children. Social Science & Medicine, 65, 976-989.
Wang, Y., & Beydoun, M. A. (2007). The obesity epidemic in the United States—Gender, age, socioeconomic, racial/ethnic and geographic characteristics: A systematic review and meta-regression analysis. Epidemiologic Reviews, 29, 6–28.
Acknowledgements
We are grateful to the editor, several anonymous reviewers, and Mauricio Avendano Pabon for their helpful comments in preparation of this manuscript. We would also like to acknowledge the support of the Institute for Population Research at the Ohio State University, supported by a grant from the Eunice Kennedy Shriver National Institute for Child Health and Development (R24 HD058484).
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Frank, R., Akresh, I.R. Social Patterning in Body Mass Index (BMI) Among Contemporary Immigrant Groups: The Emergence of a Gradient. Demography 50, 993–1012 (2013). https://doi.org/10.1007/s13524-012-0174-0
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DOI: https://doi.org/10.1007/s13524-012-0174-0