The obesity pay gap: gender, body size, and wage inequalities—a longitudinal study of Chinese adults, 1991–2011

Abstract

Sociocultural values promoting Western body-type ideals have proliferated over the past 20 years. An important question is whether the same obesity wage penalties seen in the United States, such as wage reductions for obese individuals, are emerging in China as ideals of beauty change to reflect Western ones. We hypothesize that Westernisation will exacerbate the impact of body size on wages for years to come, particularly for urban non-manual workers whose workplaces call for extensive interpersonal relations with employers, colleagues, and customers. This study examines the economic outcomes for individuals aged 18–55, focusing on 6600 female and 8488 male participants in the longitudinal 1991–2011 China Health and Nutrition Survey. Linear fixed-effects regression models estimate the net effect of body mass index (BMI) on wages, as well as the marginal effect of BMI on wages, by survey year. All analyses control for demographic backgrounds and household fixed effects, and are stratified by gender. The results show that normal-weight women with non-manual jobs in 2011 made 2.79–2.95 times more than they had in 1991, while overweight women made 2.66–2.76 times more, and obese women made only 2.57–2.63 times more. The results also indicate that women with non-manual jobs have been subject to wage disparities since 2000. Specifically, the wage disparity for heavier women living in urban areas with non-manual jobs increased significantly after 2000, while current male obesity rates may have been propelled by social acceptance of larger body sizes among men, particularly for manual workers living in rural areas.

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References

  1. Allison, P. D. (2009). Fixed effects regression models. Los Angeles, California: SAGE.

    Book  Google Scholar 

  2. Antonovics, K., & Town, R. (2004). Are all the good men married? Uncovering the sources of the marital wage premium. American Economic Review, 94(2), 317–321.

    Article  Google Scholar 

  3. Astrup, A., Dyerberg, J., Selleck, M., & Stender, S. (2008). Nutrition transition and its relationship to the development of obesity and related chronic diseases. Obesity Reviews, 9(s1), 48–52.

    Article  Google Scholar 

  4. Averett, S., & Korenman, S. (1996). The economic reality of the beauty myth. Journal of Human Resources, 31(2), 304–330.

    Article  Google Scholar 

  5. Baltagi, B. H. (2008). Econometric analysis of panel data. New York, NY: Wiley.

    Google Scholar 

  6. Baum, C. L., & Ford, W. F. (2004). The wage effects of obesity: A longitudinal study. Health Economics, 13(9), 885–899.

    Article  Google Scholar 

  7. Bell, A. C., Ge, K., & Popkin, B. M. (2002). The road to obesity or the path to prevention: Motorized transportation and obesity in China. Obesity Research, 10(4), 277–283.

    Article  Google Scholar 

  8. Carr, D., & Friedman, M. A. (2005). Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well-being in the United States. Journal of Health and Social Behavior, 46(3), 244–259.

    Article  Google Scholar 

  9. Cassidy, C. M. (1991). The good body: When big is better. Medical Anthropology, 13(3), 181–213.

    Article  Google Scholar 

  10. Cawley, J. (2004). The impact of obesity on wages. Journal of Human Resources, 39(2), 451–474.

    Article  Google Scholar 

  11. Chen, H., Gao, X., & Jackson, T. (2007). Predictive models for understanding body dissatisfaction among young males and females in China. Behaviour Research and Therapy, 45(6), 1345–1356.

    Article  Google Scholar 

  12. Chen, H., & Jackson, T. (2008). Prevalence and sociodemographic correlates of eating disorder endorsements among adolescents and young adults from China. European Eating Disorders Review, 16(5), 375–385.

    Article  Google Scholar 

  13. Conley, D., & Glauber, R. (2007). Gender, body mass, and socioeconomic status: New evidence from the PSID. Advances in Health Economics and Health Services Research, 17, 253–275.

    Article  Google Scholar 

  14. Cutler, D., Glaeser, E., & Shapiro, J. (2003). Why have Americans become more obese? Journal of Economic Perspectives, 17(3), 93–118.

    Article  Google Scholar 

  15. Davis, C., & Katzman, M. (1997). Charting new territory: Body esteem, weight satisfaction, depression, and self-esteem among Chinese males and females in Hong Kong. Sex Roles, 36(7–8), 449–459.

    Article  Google Scholar 

  16. Du, S., Lu, B., Zhai, F., & Popkin, B. M. (2002). A new stage of the nutrition transition in China. Public Health Nutrition, 5(1A), 169–174.

    Article  Google Scholar 

  17. Gates, D. M., Succop, P., Brehm, B. J., Gillespie, G. L., & Sommers, B. D. (2008). Obesity and presenteeism: The impact of body mass index on workplace productivity. Journal of Occupational and Environmental Medicine, 50(1), 39–45.

    Article  Google Scholar 

  18. Ge, K., Weisell, R., Guo, X., Cheng, L., Ma, H., Zhai, F., et al. (1994). The body mass index of Chinese adults in the 1980s. European Journal of Clinical Nutrition, 48(3), S148–S154.

    Google Scholar 

  19. Glass, C. M., Haas, S. A., & Reither, E. N. (2010). The skinny on success: Body mass, gender and occupational standing across the life course. Social Forces, 88(4), 1777–1806.

    Article  Google Scholar 

  20. Gortmaker, S. L., Must, A., Perrin, J. M., Sobol, A. M., & Dietz, W. H. (1993). Social and economic consequences of overweight in adolescence and young adulthood. New England Journal of Medicine, 329(14), 1008–1012.

    Article  Google Scholar 

  21. Gottschang, S. Z. (2001). The consuming mother: Infant feeding and feminine body in urban China. In N. N. Chen, C. D. Clark, S. Z. Gottschang, & L. Jeffery (Eds.), China urban: Ethnographies of contemporary culture (pp. 88–103). Durham: Duke University Press.

    Google Scholar 

  22. Han, M. (2003). Body image dissatisfaction and eating disturbance among Korean college female students: Relationships to media exposure, upward comparison, and perceived reality. Communication Studies, 54(1), 65–78.

    Article  Google Scholar 

  23. Han, E., Norton, E. C., & Stearns, S. C. (2009). Weight and wages: fat versus lean paychecks. Health Economics, 18(5), 535–548.

    Article  Google Scholar 

  24. Hassan, M. K., Joshi, A. V., Madhavan, S. S., & Amonkar, M. M. (2003). Obesity and health-related quality of life: a cross-sectional analysis of the US population. International Journal of Obesity, 27(10), 1227–1232.

    Article  Google Scholar 

  25. Huang, C. C., Yabiku, S. T., & Kronenfeld, J. J. (2015). The effects of household technology on body mass index among Chinese adults. Population Research and Policy Review, 34(6), 877–899.

    Article  Google Scholar 

  26. Huon, G. F., Mingyi, Q., Oliver, K., & Xiao, G. (2002). A large-scale survey of eating disorder symptomatology among female adolescents in the People’s Republic of China. International Journal of Eating Disorders, 32(2), 192–205.

    Article  Google Scholar 

  27. James, P. T., Leach, R., Kalamara, E., & Shayeghi, M. (2001). The worldwide obesity epidemic. Obesity Research, 9(S4), 228S–233S.

    Article  Google Scholar 

  28. Jia, H., & Lubetkin, E. I. (2005). The impact of obesity on health-related quality-of-life in the general adult US population. Journal of Public Health, 27(2), 156–164.

    Article  Google Scholar 

  29. Johar, M., & Katayama, H. (2012). Quantile regression analysis of body mass and wages. Health Economics, 21(5), 597–611.

    Article  Google Scholar 

  30. Jung, J., & Forbes, G. B. (2007). Body dissatisfaction and disordered eating among college women in China, South Korea, and the United States: Contrasting predictions from sociocultural and feminist theories. Psychology of Women Quarterly, 31(4), 381–393.

    Article  Google Scholar 

  31. Kline, B., & Tobias, J. L. (2008). The wages of BMI: Bayesian analysis of a skewed treatment–response model with nonparametric endogeneity. Journal of Applied Econometrics, 23(6), 767–793.

    Article  Google Scholar 

  32. Lee, S. (1999). Fat, fatigue and the feminine: The changing cultural experience of women in Hong Kong. Culture, Medicine and Psychiatry, 23(1), 51–73.

    Article  Google Scholar 

  33. Lee, S., & Lee, A. M. (2000). Disordered eating in three communities of China: A comparative study of female high school students in Hong Kong, Shenzhen, and rural Hunan. International Journal of Eating Disorders, 27(3), 317–327.

    Article  Google Scholar 

  34. Leung, F., Lam, S., & Sze, S. (2001). Cultural expectations of thinness in Chinese women. Eating Disorders, 9(4), 339–350.

    Article  Google Scholar 

  35. Luo, Y., Parish, W. L., & Laumann, E. O. (2005). A population-based study of body image concerns among urban Chinese adults. Body Image, 2(4), 333–345.

    Article  Google Scholar 

  36. Luo, X., & Wang, C. (2003). Xinshengdai nongcun liudong renkou de waichu dongyin yu xingdong xuanze [causes and choices of migration for the new generation of rural urban migrants]. Zhejiang Social Sciences, 1, 109–113.

    Google Scholar 

  37. Ma, G. S., Li, Y. P., Wu, Y. F., Zhai, F. Y., Cui, Z. H., Hu, X. Q., et al. (2005). The prevalence of body overweight and obesity and its changes among Chinese people during 1992 to 2002. Chinese Journal of Preventive Medicine, 39(5), 311–315.

    Google Scholar 

  38. Must, A., Spadano, J., Coakley, E. H., Field, A. E., Colditz, G., & Dietz, W. H. (1999). The disease burden associated with overweight and obesity. The Journal of the American Medical Association, 282(16), 1523–1529.

    Article  Google Scholar 

  39. Neovius, K., Johansson, K., Kark, M., & Neovius, M. (2009). Obesity status and sick leave: A systematic review. Obesity Reviews, 10(1), 17–27.

    Article  Google Scholar 

  40. Ng, S. W., Norton, E. C., & Popkin, B. M. (2009). Why have physical activity levels declined among Chinese adults? Findings from the 1991–2006 China health and nutrition surveys. Social Science and Medicine, 68(7), 1305–1314.

    Article  Google Scholar 

  41. Patterson, S. (2011). Obesity in China: Waistlines are expanding twice as fast as GDP 2011. Retrieved from University of South California, US-China Today website: http://www.uschina.usc.edu/w_usci/showarticle.aspx?articleID=16595&AspxAutoDetectCookieSupport=1.

  42. Pope, H., Phillips, K. A., & Olivardia, R. (2000). The adonis complex: The secret crisis of male body obsession. New York: Simon and Schuster.

    Google Scholar 

  43. Popkin, B. M., Du, S., Zhai, F., & Zhang, B. (2010). Cohort profile: The China Health and Nutrition Survey—monitoring and understanding socio-economic and health change in China, 1989–2011. International Journal of Epidemiology, 39(6), 1435–1440.

    Article  Google Scholar 

  44. Renehan, A. G., Tyson, M., Egger, M., Heller, R. F., & Zwahlen, M. (2008). Body-mass index and incidence of cancer: A systematic review and meta-analysis of prospective observational studies. The Lancet, 371(9612), 569–578.

    Article  Google Scholar 

  45. Schafer, M. H., & Ferraro, K. F. (2011). The stigma of obesity does perceived weight discrimination affect identity and physical health? Social Psychology Quarterly, 74(1), 76–97.

    Article  Google Scholar 

  46. Schmier, J. K., Jones, M. L., & Halpern, M. T. (2006). Cost of obesity in the workplace. Scandinavian Journal of Work, Environment & Health, 32(1), 5–11.

    Article  Google Scholar 

  47. Schultz, A. B., & Edington, D. W. (2007). Employee health and presenteeism: A systematic review. Journal of Occupational Rehabilitation, 17(3), 547–579.

    Article  Google Scholar 

  48. Shai, I., Jiang, R., Manson, J. E., Stampfer, M. J., Willett, W. C., Colditz, G. A., et al. (2006). Ethnicity, obesity, and risk of type 2 diabetes in women a 20-year follow-up study. Diabetes Care, 29(7), 1585–1590.

    Article  Google Scholar 

  49. Tong, J., Miao, S., Wang, J., Yang, F., Lai, H., Zhang, C., et al. (2014). A two-stage epidemiologic study on prevalence of eating disorders in female university students in Wuhan, China. Social Psychiatry and Psychiatric Epidemiology, 49(3), 499–505.

    Article  Google Scholar 

  50. Van Duijvenbode, D. C., Hoozemans, M. J. M., Van Poppel, M. N. M., & Proper, K. I. (2009). The relationship between overweight and obesity, and sick leave: A systematic review. International Journal of Obesity, 33(8), 807–816.

    Article  Google Scholar 

  51. Wang, X. (2008). An investigation into intergenerational differences between two generations of migrant workers. Social Sciences in China, 29(3), 136–156.

    Article  Google Scholar 

  52. Wang, H., Du, S., Zhai, F., & Popkin, B. M. (2006). Trends in the distribution of body mass index among Chinese adults, aged 20–45 years (1989–2000). International Journal of Obesity, 31(2), 272–278.

    Article  Google Scholar 

  53. Wen, C. P., Cheng, D. T. Y., Tsai, S. P., Chan, H. T., Hsu, H. L., Hsu, C. C., et al. (2009). “Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. Public Health Nutrition, 12(4), 497.

    Article  Google Scholar 

  54. Wooldridge, J. M. (2010). Econometric analysis of cross section and panel data. Cambridge, MA: MIT.

    Google Scholar 

  55. Wu, J., & Delong, M. (2006). Chinese perceptions of western-branded denim jeans: A Shanghai case study. Journal of Fashion Marketing and Management: An International Journal, 10(2), 238–250.

    Article  Google Scholar 

  56. Xu, X., Mellor, D., Kiehne, M., Ricciardelli, L. A., McCabe, M. P., & Xu, Y. (2010). Body dissatisfaction, engagement in body change behaviors and sociocultural influences on body image among Chinese adolescents. Body Image, 7(2), 156–164.

    Article  Google Scholar 

  57. Yang, C. F. J., Gray, P., & Pope, H. G. (2005). Male body image in Taiwan versus the West: Yanggang Zhiqi meets the adonis complex. American Journal of Psychiatry, 162(2), 263–269.

    Article  Google Scholar 

  58. Zhou, B. (2002). Cooperative Meta-Analysis Group of China Obesity task force: Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population. Zhonghua Liu Xing Bing Xue Za Zhi, 23(1), 5–10.

    Google Scholar 

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Correspondence to Chih-Chien Huang.

Appendix

Appendix

See Table 5.

Table 5 Marginal effect of BMI on log wage by occupation in 2000 and 2011 (reference = 1991)

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Huang, CC., Yabiku, S.T., Ayers, S.L. et al. The obesity pay gap: gender, body size, and wage inequalities—a longitudinal study of Chinese adults, 1991–2011. J Pop Research 33, 221–242 (2016). https://doi.org/10.1007/s12546-016-9170-3

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Keywords

  • Body mass index
  • Wage penalty
  • Obesity
  • Longitudinal study
  • China health and nutrition survey (CHNS)