The relationships of income and food insecurity with overweight in women

Problem. Obesity is a health problem in the US and its prevalence is increasing. There was a 32% increase in the rate of overweight from 1980 to 1994 when 33% of adults were identified as having BMI's over the cut point. Obesity is not randomly distributed through the population. The prevalence is greatest among low socioeconomic status groups. Despite the research, scientists still do not know why this is so. While the prevalence of obesity is increasing, food insecurity is also increasing. It is assumed that authentic food insecurity is only found among the underweight. An estimated 30 million Americans experience food insecurity making it a concern to nutritionists, legislators and other policy makers.; Objectives. The two main purposes of this dissertation research are to examine the inverse relationship of income and overweight to determine why low-income groups have a higher rate of overweight and to determine if food insecurity is related to overweight.; Methods. Analyses were performed using the Continuing Survey of Intakes by Individuals (n = 4537) and the Diet and Health Knowledge Survey (n = 2720) for years 1994–1996 and included Chi Square, ANOVA (general linear model) and logistic regression. Twenty variables were defined and compiled using psychosocial. theories and Social Learning Theory.; Results. From the 450 articles reviewed for this research, 42 variables were identified that have a relationship with obesity. Of those, a small subset was shown to be related to income and or socioeconomic status (SES). Twenty of these variables are part of the analyses in this dissertation. In this dataset, Education is a more important socioeconomic variable than income in explaining the inverse relationship between SES and body weight status. In the final model, 94% of income's effect on overweight is explained by education, ethnicity, age, perceived control of body weight, TV viewing, smoking and alcohol while income is non-significant. In another analysis, overweight was found among the food insecure. The prevalence is higher among the food insecure than the food secure. Overweight is an unexpected health outcome of food insecurity. Both the negative SES/overweight and the positive food insecurity/overweight relationships were found among women. Similar relationships were not found among men. These results should be considered exploratory.; Discussion. Because of the large number of variables involved, fully understanding why low-income groups have more obesity than other groups may take years of additional research. This research would involve improved quality of existing items on national surveys and testing of variables for reliability (stability) and criterion validity. Researchers should include education as a surrogate for socioeconomic status in models studying the SES/overweight relationship. In addition, this research provides the initial step in documenting the existence of a relationship between food insecurity and overweight using a nationally representative sample of the US population. Further research to confirm these findings is recommended. Given that both the rates of obesity and food insecurity are on the rise, this is an important topic for further investigation. There are public policy implications for many of USDA's food assistance and education programs. Elaboration of both relationships, food insecurity/obesity and SES/obesity, will allow for better intervention designs and evaluations. The fact that food insecurity has unexpected and paradoxical consequences—higher obesity rates and the potential for increased incidence of obesity-related chronic diseases—needs to be addressed.