Impact of objective and subjective social status on obesity in a biracial cohort of adolescents

Obes Res. 2003 Aug;11(8):1018-26. doi: 10.1038/oby.2003.140.


Objective: To characterize the associations between socioeconomic status (SES), two levels of subjective social status (SSS), and adolescent obesity.

Research methods and procedures: Cross-sectional study of 1491 black and white adolescents attending public school in a suburban school district in Greater Cincinnati, Ohio. BMI > or =95th percentile derived from measured height and weight defined overweight. Students rated SSS on separate 10-point scales for society and school. A parent provided information on parent education and household income for SES.

Results: Although there were no sex differences in SES, black students were more likely to come from families with less well-educated parents and lower incomes (p < 0.001). Black girls had the lowest societal SSS (p = 0.003), lowest school SSS (p = 0.046), and highest BMI (p < 0.001). Prevalence of overweight was highest among black girls (26.0%) and boys (26.2%), intermediate for white boys (17.2%), and least for white girls (11.6%). Logistic regression modeling revealed that parent education, household income, and school SSS were each associated with overweight. In a fully adjusted model, school SSS retained its association to overweight (odds ratio, 1.16; 95% CI, 1.06,1.26) independent of SES. The association of school SSS was strongest among white girls, intermediate for white and black boys, and absent for black girls.

Discussion: Perceptions of social stratification are independently associated with overweight. There were important racial and sex differences in the social status-overweight association. SSS in the more immediate, local reference group, the school, had the strongest association to overweight.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Black People*
  • Cohort Studies
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Humans
  • Income
  • Logistic Models
  • Male
  • Obesity / psychology*
  • Parents
  • Schools
  • Self Concept*
  • Social Class
  • Urban Population
  • White People*