NCHS Data Brief ■ No. 50 ■ December 2010

u.s. department of health and human services

Centers for Disease Control and Preven

National Center for Health Statis

Obesity and Socioeconomic Status in Adults:

United States, 2005–2008

Cynthia L. Ogden, Ph.D.; Molly M. Lamb, Ph.D.; Margaret D. Ca

and Katherine M. Flegal, P

In 2007–2008 more than one-third of United States adults were obese (1). 

Obese individuals are at increased risk of diabetes mellitus, cardiovascular 

disease, hypertension, and certain cancers, among other conditions (2). 

Some studies have shown a relationship between obesity prevalence and 

socioeconomic status measured as educational level or income (3,4). This 

data brief presents the most recent national data on obesity in United States 

adults and its association with poverty income ratio (PIR) and education 

level. Results are presented by sex and race and ethnicity.

Keywords: adults • obesity • income • education

Among men, obesity prevalence is generally similar at 

all income levels, with a tendency to be slightly higher at 

higher income levels.

Key findings:

Data from the National 

Health and Nutrition 

Examination Survey, 2005–

2008

•	 Among men, obesity 

prevalence is generally similar 

at all income levels, however, 

among non-Hispanic black 

and Mexican-American men 

those with higher income are 

more likely to be obese than 

those with low income. 

•	 Higher income women are 

less likely to be obese than 

low income women, but most 

obese women are not low 

income.

•	 There is no significant trend

between obesity and education 

among men. Among women, 

however, there is a trend, those 

with college degrees are less 

likely to be obese compared 

with less educated women.

•	 Between 1988–1994 and 

2007–2008 the prevalence of 

obesity increased in adults 

at all income and education 

levels.

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NCHS Data Brief ■ No. 50 ■ December 2010

■  2  ■

Overall, almost 33% of men who live in households with income at or above 350% of the poverty 

level are obese, while 29.2% of men who live below 130% of the poverty level are obese (Figure 

1). The relationship between obesity and income in men varies by race and ethnicity. Among 

non-Hispanic black and Mexican-American men, obesity prevalence decreases as income (PIR) 

decreases; 44.5% of non-Hispanic black men with income at or above 350% of the poverty level 

are obese compared with 28.5% of those with income below 130% of the poverty level. Similarly, 

among Mexican-American men, 40.8% of those with income at or above 350% of the poverty 

level are obese compared with 29.9% of those below 130% of the poverty level. There is no 

significant difference in obesity prevalence by poverty level among non-Hispanic white men.

Among women, obesity prevalence increases as income decreases.

Overall, 29.0% of women who live in households with income at or above 350% of the poverty 

level are obese and 42.0% of those with income below 130% of the poverty level are obese 

(Figure 1). Trends are similar for non-Hispanic white, non-Hispanic black, and MexicanAmerican women, but they are only significant for non-Hispanic white women. Among nonHispanic white women with income at or above 350% of the poverty level 27.5% are obese, less 

than the 39.2% of those with income below 130% of the poverty level.

Most obese adults are not low income (below 130% of the poverty level).

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NCHS Data Brief ■ No. 50 ■ December 2010

■  3  ■

Of the approximately 72 and a half million adults who are obese, 41% (about 30 million) have 

incomes at or above 350% of the poverty level, 39% (over 28 million) have incomes between 

130% and 350% of the poverty level, and 20% (almost 15 million) have incomes below 130% of 

the poverty level. Among both men and women, most of the obese adults are non-Hispanic white 

with income at or above 130% of the poverty level. Approximately 21 million non-Hispanic white 

men and almost 21 million non-Hispanic white women who have incomes at or above 130% of 

the poverty level are obese (Figure 2).

Among men, there is no significant trend between education level and 

obesity prevalence. Among women, obesity prevalence increases as 

education decreases.

Among men, 27.4% of those with a college degree are obese compared with 32.1% of those 

with less than a high school education, although the difference is not statistically significant.

Among women, 23.4% of those with a college degree are obese, significantly less than the 42.1%

of women with less than a high school education. There is a threshold effect in both men and 

women, where the prevalence of obesity is significantly lower among those with college degrees

compared with those with some college.

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There are no significant differences in obesity prevalence by education level among non-Hispanic

black and Mexican-American men. Among non-Hispanic white men there is a threshold effect, 

the prevalence is lower among college graduates compared with those with some college. 

Among women, non-Hispanic white and Mexican-American women with college degrees are 

significantly less likely to be obese compared with those with less than a high school education.

In fact, among non-Hispanic white, non-Hispanic black, and Mexican-American women, the 

prevalence of obesity among those with a college degree is significantly lower than among

women with some college (Figure 3).
NCHS Data Brief ■ No. 50 ■ December 2010

■  4  ■

Between 1988–1994 and 2007–2008 the prevalence of obesity among adults 

increased at all income levels.

In 1988–1994 the prevalence of obesity among men with income at or above 350% of the poverty 

level was 18.0%; in 2005–2008 the prevalence of obesity had increased in this group to 32.9%. 

The corresponding figures for those with income below 130% of the poverty level were 21.1%

and 29.2%. 

Similar increases occurred among women. In 1988–1994 the obesity prevalence was 18.6% 

among those with income at or above 350% of the poverty level and in 2005–2008 the prevalence 

had increased to 29.0%. Among those with income below 130% of the poverty level, the 

prevalence of obesity increased from 34.5% to 42.0% (Figure 4). 

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NCHS Data Brief ■ No. 50 ■ December 2010

■  5  ■

Between 1988–1994 and 2007–2008 the prevalence of obesity among adults 

at all levels of education increased.

Among men with a college degree, the prevalence of obesity increased from 15.6% to 27.4% 

between 1988–1994 and 2005–2008. Among those with less than a high school diploma, the 

prevalence increased from 22.6% to 32.1%. Similar increases were seen among men with some 

college or a high school diploma. 

Among women, the prevalence increased from 15.3% to 23.4% in college graduates and from 

31.7% to 42.1% in those with less than a high school diploma. As in men, similar increases were 

seen among women with a high school diploma and among those with some college (Figure 5).

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NCHS Data Brief ■ No. 50 ■ December 2010

■  6  ■

Summary

The relationship between obesity and socioeconomic status differs by sex and race and ethnicity 

group. Among women, and specifically non-Hispanic white women, obesity prevalence increases

as income (PIR) decreases, while among non-Hispanic black and Mexican-American men obesity 

prevalence decreases as income (PIR) decreases. Although the prevalence of obesity among 

women with income below 130% of the poverty level is higher than among those with higher 

incomes, most obese women do not have incomes below 130% of the poverty level. Among men 

and women with a college degree, the prevalence of obesity is lower than among those with some 

college education. Moreover, college educated women are less likely to be obese compared with 

those with less than a high school diploma. Between 1988–1994 and 2005–2008 the prevalence 

of obesity increased in adults at all levels of income and education. 

Definitions

Obesity: Body mass index (BMI)≥ 30. BMI is calculated as weight in kilograms divided by

height in meters squared, rounded to one decimal place. Examples of obesity cut points at 

specific heights are shown in the Table.

Table. Obesity cut points for adults 5’4” and 5’9”

Height Obese weight range

5’4” 174 pounds or more

5’4” 79 kilograms or more

5’9” 203 pounds or more

5’9” 92 kilograms or more

Poverty income ratio (PIR): The ratio of household income to the poverty threshold after 

accounting for inflation and family size. In 2008, a PIR of 350% was equivalent to approximate

$77,000 for a family of four; a PIR of 130% was equivalent to approximately $29,000 for a 

family of four. In 2008, median household income was approximately $50,000 and 13.2% of the 

population lived below the poverty level (http://www.census.gov/newsroom/releases/archives/

income_wealth/cb09-141.html). The cut point for participation in the Supplemental Nutrition 

Assistance Program (SNAP) is 130% of the poverty level.

Data source and methods

The National Health and Nutrition Examination Survey (NHANES) data were used for these 

analyses. NHANES is a cross-sectional survey designed to monitor the health and nutritional 

status of the civilian, noninstitutionalized U.S. population (5). The survey consists of interviews

conducted in participants’ homes, standardized physical examinations that include measurement

of weight and height conducted in mobile examination centers, and laboratory tests utilizing

blood and urine specimens provided by participants during the physical examination. 

The NHANES sample is selected through a complex, multistage design that includes selection of 

primary sampling units (counties), household segments within the counties, and finally sample

persons from selected households. The sample design includes oversampling to obtain reliable 

estimates of health and nutritional measures for population subgroups. In 1988–1994 and 2005–

2008, African-American and Mexican-American adults were oversampled. In 1999, NHANES 

became a continuous survey, fielded on an ongoing basis. Each year of data collection is based on
NCHS Data Brief ■ No. 50 ■ December 2010

■  7  ■

a representative sample covering all ages of the civilian, noninstitutionalized population. Publicuse data files are released in 2-year cycles.

Sample weights, which account for the differential probabilities of selection, nonresponse, 

and noncoverage, were incorporated into the estimation process. The standard errors of the 

percentages were estimated using Taylor Series Linearization, a method that incorporates the

sample weights and sample design.

Estimates of the number of obese individuals were calculated using the average Current 

Population Survey (CPS) totals for 2005–2006 and 2007–2008 (http://www.cdc.gov/nchs/nhanes/

response_rates_CPS.htm).

Prevalence estimates for the total population were age adjusted to the 2000 U.S. standard 

population using three age groups, 20–39, 40–59, and aged 60 and over. Differences between 

groups were evaluated using a univariate t-statistic at the p < 0.05 significance level. Tests of

trends were done using the p < 0.05 significance level. All differences reported are statistically

significant unless otherwise indicated. Statistical analyses were conducted using the SAS System

for Windows (release 9.1; SAS Institute Inc, Cary, N.C.) and SUDAAN (release 9.0; Research 

Triangle Institute, Research Triangle Park, N.C.).

About the authors

Cynthia L. Ogden, Molly M. Lamb, and Margaret D. Carroll are with the Centers for Disease 

Control and Prevention’s National Center for Health Statistics (NCHS), Division of Health and 

Nutrition Examination Surveys. Katherine M. Flegal is with NCHS’ Office of the Director.

References 

1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among 

United States adults, 1999–2008. JAMA 303:235–41. 2010.

2. National Institutes of Health. Clinical Guidelines on the identification, evaluation,

and treatment of overweight and obesity in adults-The evidence report. Obes Res 6 Suppl 

2:51S–209S. 1998.

3. Sobal J, Stunkard AJ. Socioeconomic status and obesity: A review of the literature. Psychol 

Bull 105:260–75. 1989.

4. McLaren L. Socioeconomic status and obesity. Epidemiol Rev 29:29–48. 2007.

5. Centers for Disease Control and Prevention. National Center for Health Statistics. National 

Health and Nutrition Examination Survey. Available from: http://www.cdc.gov/nchs/nhanes/

nhanes_questionnaires.htm. Accessed November 18, 2010. 
NCHS Data Brief ■ No. 50 ■ December 2010

Suggested citation

Ogden CL, Lamb MM, Carroll MD, 

Flegal KM. Obesity and socioeconomic 

status in adults: United States 1988–1994 

and 2005–2008. NCHS data brief no 50. 

Hyattsville, MD: National Center for Health 

Statistics. 2010.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate 

 Director for Science

Division of Health and Nutrition 

Examination Surveys

Clifford L. Johnson, M.S.P.H., Director

U.S. De

Health &

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, MD 20782

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