The inverse relationships between socioeconomic status (SES) and unhealthy behaviors such as tobacco use, physical inactivity, and poor nutrition have been well demonstrated empirically but encompass diverse underlying causal mechanisms. These mechanisms have special theoretical importance because disparities in health behaviors, unlike disparities in many other components of health, involve something more than the ability to use income to purchase good health. Based on a review of broad literatures in sociology, economics, and public health, we classify explanations of higher smoking, lower exercise, poorer diet, and excess weight among low-SES persons into nine broad groups that specify related but conceptually distinct mechanisms. The lack of clear support for any one explanation suggests that the literature on SES disparities in health and health behaviors can do more to design studies that better test for the importance of the varied mechanisms.

Studies of individual countries suggest that socioeconomic status (SES) and weight are positively associated in lower-income countries but negatively associated in higher-income countries. However, this reversal in the direction of the SES-weight relationship and arguments about the underlying causes of the reversal need to be tested with comparable data for a large and diverse set of nations. This study systematically tests the reversal hypothesis using individual- and aggregate-level data for 67 nations representing all regions of the world. In support of the hypothesis, we find not only that the body mass index, being overweight, and being obese rise with national product but also that the associations of SES with these outcomes shift from positive to negative. These findings fit arguments about how health-related, SES-based resources, costs, and values differ across levels of economic development. Although economic and social development can improve health, it can also lead to increasing obesity and widening SES disparities in obesity.

This article reveals race differentials in obesity as both an individual-and neighborhood-level phenomena. Using neighborhood-level data from the 1990-1994 National Health Interview Survey, we find that neighborhoods characterized by high proportions of black residents have a greater prevalence of obesity than areas in which the majority of the residents are white. Using individual-level data, we also find that residents of neighborhoods in which at least one-quarter of the residents are black face a 13 percent increase in the odds of being obese compared to residents of other communities. The association between neighborhood racial composition and obesity is completely attenuated after including statistical controls for the poverty rate and obesity prevalence of respondents' neighborhoods. These findings support the underlying assumptions of both institutional and social models of neighborhood effects.The causes of obesity, including the social relationships that mediate and moderate the relationship between various risk factors and obesity, are complex (Weinsier et al. 1998;Whitaker 2002;Bloomgarden 2002). As research consistently demonstrates that behaviors affecting health are rooted within individuals' social environments (Berkman and Kawachi 2000), it is critical to broaden the scope of inquiry such that health is understood not only as a function of individual traits, but also as related to the environments in which people live (MacIntyre and Ellaway 2003;Robert 1999). These environments include physical space as well as community attitudes and behaviors that characterize these places (Frolich, Corin, and Potvin 2001). Although literature linking residential context to health has increased sharply in recent years (see Kawachi and Berkman 2003 for an overview), little work has examined obesity as an outcome. This article contributes to the growing body of work focusing on the ecological correlates of health and makes a timely contribution to the recent focus on obesity in both academic and popular settings.It is important to fully understand obesity because obesity prevalence among U.S. adults has increased to epidemic levels; has contributed to an increased risk of disease, disability, and death; and has led to an escalation in health care costs (Allison, Zannolli, and Narayan 1999; Wang et al. 2002). Over the last 25 years, the prevalence of adult obesity has more than doubled; in 1976 only 15 percent of the adult population was obese, but by 2000 adult obesity rates surpassed 30 percent (NCHS 2003). This increase is particularly problematic because obesity is associated with an increased risk of serious health problems including type-2 diabetes, gallbladder disease, high blood pressure, and heart disease (Flegal et al. 2002;Calle et al. 2003;Kaplan 2000;Must et al. 1999). More importantly, obesity increases the risk of a number of causes of death and is believed to contribute to approximately 14 and Fontaine et al. 1999;McGinnis and Foege 1993;Rogers, Hummer, and Krueger 2003;Sturm 2002). NI...

Objective This paper addresses the relationship between suicide mortality and family structure and socioeconomic status for U.S. adult men and women. Methods We use Cox proportional hazard models and individual level, prospective data from the National Health Interview Survey Linked Mortality File (1986–2002) to examine adult suicide mortality. Results Larger families and employment are associated with lower risks of suicide for both men and women. Low levels of education or being divorced or separated, widowed, or never married are associated with increased risks of suicide among men, but not among women. Conclusions We find important sex differences in the relationship between suicide mortality and marital status and education. Future suicide research should use both aggregate and individual level data and recognize important sex differences in the relationship between risk factors and suicide mortality—a central cause of preventable death in the United States.

Although research has long documented the relevance of gender for health, studies that simultaneously incorporate the relevance of disparate sexual orientation groups are sparse. We address these shortcomings by applying an intersectional perspective to evaluate how sexual orientation and gender intersect to pattern self-rated health status among U.S. adults. Our project aggregated probability samples from the Behavioral Risk Factor Surveillance System (BRFSS) across seven U.S. states between 2005 and 2010, resulting in an analytic sample of 10,128 sexual minority (gay, lesbian, and bisexual) and 405,145 heterosexual adults. Logistic regression models and corresponding predicted probabilities examined how poor self-rated health differed across sexual orientation-by-gender groups, before and after adjustment for established health risk factors. Results reveal distinct patterns among sexual minorities. Initially, bisexual men and women reported the highest--and gay and lesbian adults reported the lowest--rates of poor self-rated health, with heterosexuals in between. Distinct socioeconomic status profiles accounted for large portions of these differences. Furthermore, in baseline and fully adjusted regression models, only among heterosexuals did women report significantly different health from men. Importantly, the findings highlight elevated rates of poor health experienced by bisexual men and women, which are partially attributable to their heightened economic, behavioral, and social disadvantages relative to other groups.

Previous research has demonstrated that behavioral variability can be modified by reinforcers contingent on it, but there has been no convincing evidence of discriminative stimulus control over such variability. We therefore rewarded 20 rats for variable response sequences in the presence of one stimulus and provided equal rewards independently of sequence variability in the presence of a second stimulus. We found that sequence variability was significantly higher during the first stimulus than during the second, with the greatest difference occurring immediately following onset of the stimuli. Removing the discriminative stimuli caused levels of variability to converge. These experiments provide strong evidence that behavioral variability can be controlled by discriminative stimuli, which may be important for general theories of operant behavior and their applications.Although variability is characteristic of all physical phenomena, a particularly adaptive form may be seen in the behavior of complex organisms. We refer to variability that is shaped and influenced by consequences-that is, operant or instrumental variability. Evidence for operant variability was obtained when rats or pigeons were reinforced for variable sequences of left (L) and right (R) responses-for example, LLRL, RRLR, and LLLL (see, e.g., Neuringer & Huntley, 1992;Page & Neuringer, 1985). For reinforcement, a sequence was required to differ from each of the previous three sequences. For example, given the just enumerated three sequences, ifthe current sequence was RLRL, it led to reinforcement, but ifit was RRLRa repetition-then reinforcement was withheld. When variability was compared to that under a yoked control procedure-in which identical reinforcement was provided but without regard to sequence variability-a consistent finding was that variability was higher when reinforced than when not (see also Blough, 1966;Bryant & Church, 1974;Holman, Goetz, & Baer, 1977;Machado, 1989Machado, , 1992Machado, , 1993Manabe, Staddon, & Cleaveland, 1997; Morgan & Neuringer, 1990;Pryor, Haag, & O'Reilly, 1969; but for different results see Schwartz, 1982aSchwartz, , 1988. This sensitivity to contingencies of reinforcement is one defining characteristic of operant behavior.Further support for the operant nature ofvariability came from the observation that pigeons' choices to vary or repeat followed the same matching function that describes This research was supported in part by grants from the National Science Foundation to A.N. Portions of these data were reported by J.D. in a Reed College undergraduate thesis. We thank Gene Olson and Chris Deiss for excellent animal care and programming assistance and Armando Machado for a helpful reading ofthe manuscript. Correspondence concerning this article should be addressed to A. Neuringer, Psychology Department, Reed College, Portland, OR 97202 (e-mail: allen_neuringer@ reed.edu).-Accepted by previous editor, Robert A. Rescorla simpler choices. Specifically, the probability of varying versus repeating was c...

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Children living in food-insecure households face myriad challenges to their well-being. The Great Recession of December 2007-June 2009 increased food insecurity to the highest levels ever measured in the United States. Using nationally representative data from the period 2010-12 for 6,300 children in the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11, with household incomes below 300 percent of the federal poverty level and a dynamic measure of food insecurity transitions, we assessed the impact of transitions into and out of household food insecurity on the academic achievement, behavioral problems, and health status of young children. We found negligible impacts of food insecurity transitions on academic achievement in first grade. However, we found consistent negative impacts of the transitions on teachers' reports of children's externalizing behaviors, self-control, and interpersonal skills and on parents' reports of children's overall health status. Taken together, our findings underline the importance of food security for children's healthy development.