Does social status predict adult smoking and obesity? Results from the Mexican National Health Survey

Background. Socioeconomic status is generally associated with better health, but recent evidence suggests that this “social gradient” in health is not universal. For example, the SES-health relationship among Mexican-origin populations in the United States is weaker than for native-born groups. This study examines whether social gradients in smoking and in obesity in Mexico—a country undergoing rapid socioeconomic change—conform to, or diverge from, results for richer countries like the U.S.

Methods. Using a nationally-representative sample of 39,129 Mexican adults, we calculated the odds of smoking and of being obese by educational attainment and by household wealth. We then calculated the effects of each SES dimension net of the other dimension. Analyses were stratified by gender and urban residence.

Results. Higher education is associated with less smoking among men but more smoking among women. Household assets are also associated with more smoking for women and for rural men. Increased education is associated with lower obesity for urban women, while obesity among rural women is highest at the middle of the education distribution. There is no relationship between education and obesity for men. Household wealth is associated with increased obesity for all groups except urban women.

Conclusions. Determinants of smoking and obesity in Mexico are complex and vary by gender and urban residence. While some gradients are flat, others show strong positive or negative slopes. As household incomes, education, and urbanization continue to increase in Mexico, these patterns suggest potential targets for public health intervention now and in the future.