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Federal report cites income, education as affecting obesity in some women

This article first appeared in the St. Louis Beacon, May 17, 2012 - Education and wealth influence whether some women become overweight, but these variables don't seem to have much impact on the prevalence of obesity among men.

That's one of the major highlights in the latest federal report on health in America. Released Wednesday by the Centers for Disease Control and Prevention and compiled by the National Center for Health Statistics, the study includes a special section on socio-economic status and health. It makes these points:

  • Between 39 percent and 43 percent of women aged 25 and older without a  bachelor's degree were obese. The rate was 25 percent for women with at least a bachelor's degree. But the prevalence of obesity among adult men did not vary consistently with education. Among black and Hispanic men, the higher the income, the greater the odds of being obese.
  • Between 2007 and 2010, higher levels of education among household heads resulted in lower rates of obesity among children between 2 and 19. In cases where the head of the household had less than a high school education, 24 percent of boys and 22 percent of girls were obese. For children in households headed by someone with at least a bachelor's degree, the prevalence of obesity was 11 percent for boys and 7 percent for girls.

The statistics offer only a snapshot of the nation's well-being and offer no explanations of the factors that might cause the disparity in obesity between men and women or between women and minorities.
Among those who study such socioeconomic factors and are least surprised by the data is Jason Q. Purnell, an assistant professor in the Brown School of Social Work at Washington University. 

"What this is saying is that people with high levels of education have access to resources and information and have the ability to make choices," Purnell says of the data on children. "Because the (parents) have higher incomes, they can make choices that can provide the kinds of environments for their children where you see less obesity."

Purnell acknowledges the data can be tricky when it comes to applying the conclusions to various groups based on gender and race. But as for health and well-being and the prevalence of obesity among children, Purnell says more affluent parents tend to make a difference. They are likely to have more access to useful information about health and to make healthier choices -- to "add fruits and vegetables to their diets, cut out sugary drinks and give them milk and water instead."

Higher-income parents are also more likely to "have the time and resources to give children enrichment, like gymnastics and ballet, and choose to live in neighborhoods where parents feel more confident that their children will be able to go out and place and be safe."

Beyond obesity, he says, education and wealth also give people access to better medical care and to "social support in times of stress in ways" that might be unavailable to "people who have less social capital."

Purnell says the St. Louis region tends to have "siloed conversations" about socio-economic issues without realizing the health components in each of them. When the region talks about economic development, for example, he says that conversation "should include thought of how that is going to impact health. When we talk about educational attainment and the dropout crisis, that should also be about health and economic intervention.  We can't just think about these at the individual level and neighborhood level; it has to be a regional response."

Among the study's other highlights:

  • In 2010, smoking was prevalent among 31 percent of adults between the ages of 25 and 64 with a high school diploma or less. The rate was 24 percent among adults with some college and 9 percent of adults with a bachelor's degree or higher.
  • Between 1996 and 2006, the gap in life expectancy between those with less than a high school education and those with a bachelor's degree or more increased by 1.9 years for men and 2.8 years for women.

"If I had to highlight one thing here, that would be the one," Purnell says of the data on longevity. "They are dying two to three years earlier than people who have a bachelor's degree. But we don't really often think of education interventions and economic inteventions as health interventions."
A big part of the conversation the St. Louis region needs to have, he argues, should be on health problems that hinder children from being educated in a timely way.

"Educators are some of the right people to talk to," he says, but adds that the issue is much bigger than the school since malnutrition, mental health and chronic illnesses, such as diabetes, can adversely affect learning.

"We probably need to do a better job of emphasizing health and healthy behaviors within schools early on and not waiting until people have chronic diseases," Purnell concluded.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.

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