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Obesity ignores social status

Many public health experts agree that those with higher education and greater wealth tend to lead healthier lifestyles. But a study utilizing a special protein suggests that obesity ignores the benefit of social status and affects all populations equally.

Cathy Bykowski, a health psychology researcher at USF, used a national data set to determine the relationship between health, obesity and socioeconomic status (SES), the representation of overall income and education of an individual or population.

Bykowski and fellow researcher Kristi White work from the assumption that a low SES causes a stressful lifestyle.

“There is a lot of research focusing on stress and health, and a lot of research focusing on obesity and health, but not a lot putting the two together,” White said.

Bykowski used the level of C-reactive protein (CRP) to measure the general health of individuals in the study. CRP is an inflammatory marker related to cardiovascular disease.

“Studies have shown that it is actually better at predicting cardiovascular disease than cholesterol,” she said.

Low SES populations are more stressed, less healthy and generally have higher CRP levels, the study revealed. The link between low economic standing and poor health has been a focus of public health for years.

“Poverty is huge when it comes to affecting someone’s health status,” said Laura Rusnak, instructor at USF’s College of Public Health.

Many factors contribute to the reduced health status of the poor, she said. Impoverished areas usually have reduced access to health care. They are home to dangerous environmental factors such as crime, unsafe housing and poorly lit streets. The cheapest food is usually the least healthy, and minimum-wage workers often lack time, opportunity and motivation to exercise.

Because of this, low SES individuals are disadvantaged in nearly every aspect of health, Rusnak said.

However, Bykowski thinks obesity is the one factor that crosses both social boundaries. While CRP levels and poor health generally increase at lower income levels, they also greatly increase in obese and overweight individuals regardless of economic status.

“The relationship between SES and CRP was dependent on body weight,” Bykowski said.

The health of people with low body weight was greatly affected by their economic status, while obese individuals had high CRP levels and poor health regardless of SES, Bykowski said.

This puts most obese people on the same level of health regardless of factors that would normally give high SES populations an advantage.

“You think you are protected against bad things because you have higher income or education, but if your weight is too high then those benefits will be diminished,” Bykowski said.

She said the wealth and education of a person could influence their stress levels. If this holds true, the study shows an important correlation.

“If you are overweight, lowering your stress won’t make much of a difference,” she said.

Bykowski recently traveled to Baltimore where she presented her findings at the American Psychosomatic Society Conference. Her research suggests obesity has become the critical issue in health care – a point that public health educators have strongly advocated.

“(Obesity) is the fastest-growing threat to public and individual health,” Rusnak said.

While C-reactive protein levels measure cardiovascular health, there is no way to quantify all of the detriments obesity causes.

Bykowski’s research must be followed by an experimental study to draw stronger conclusions or show causation among health, stress and obesity. Until then, the results are only convincing enough to suggest practical applications in health.

“It really stresses the importance of weight management, even over stress management, as a way to reduce health risks,” she said.