The shifting income-obesity relationship: Conditioning effects from economic development and globalization

The literature has long been debating whether it is high-income or low-income individuals who face higher risks of obesity. In this study I contend that this mixed record about the income-obesity relationship is the result of a failure to account fully for macro-level social contexts. The income-obesity relationship is not uniform in all societies but is conditioned by macro-level social contexts including the society's economic development and involvement in globalization. The 2011 Module on Health and Health Care of the International Social Survey Programme (ISSP) provides an ideal opportunity for testing the complex income-obesity relationship in a cross-country setting. Employing multilevel models with cross-level interactions, this study finds that the shift in the effect of income from obesity-promoting to obesity-depressing is facilitated by both economic development and globalization. Under the combined forces of economic development and globalization, obesity increasingly becomes a burden of the poor in a society and the social distribution of obesity increasingly mirrors existing social inequality. Nevertheless, the economic development and globalization thresholds for shifting into a significant obesity-depressing effect of income are high.