The Association of Obesity and Self-Rated Health across Periods and Cohorts

Claire Altman, Rice University
Marianne M. Hillemeier, Pennsylvania State University

In recent decades, the prevalence of obesity has increased dramatically; however, individual’s ratings of their health have improved. We assess the association between individual weight status and self-rated health (SRH) across four decades (1970s-2000s) and four birth cohorts (G.I. Generation, Silent Generation, Baby Boomers, and Generation X) of NHANES data (N=30,454), while controlling for as many other health conditions as possible. We ask whether and among whom the obesity-SRH association has strengthened over time. Obesity is strongly associated with fair/poor SRH. This relationship has grown stronger among more recent birth cohorts but also weakened across time. More specifically, compared with normal weight peers, overweight and obese adults in younger cohorts are more likely to report fair/poor health than older cohorts. Simultaneously, the tendency of overweight and obese adults to report fair/poor health declined within cohorts over time. Overall, the results highlight the complex and dynamic association between SRH and obesity.