178013 Does social status predict adult smoking and obesity? Results from the Mexican National Health Survey

Wednesday, October 29, 2008: 1:20 PM

Alison M. Buttenheim, PhD, MBA , Robert Wood Johnson Health & Society Scholar Program, University of Pennsylvania, Philadelphia, PA
Rebeca Wong, PhD , Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX
Noreen J. Goldman, DSc , Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ
Anne R. Pebley, PhD , Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, Los Angeles, CA
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.

Learning Objectives:
1.Describe the social gradients in smoking and obesity among Mexican adults. 2.Identify the different relationships that education and household wealth have to chronic disease risk factors. 3.Articulate public health implications for social gradients in health in Mexico

Keywords: Chronic Diseases, Social Inequalities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctorally-trained researcher with expertise in this area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.