Obesity's impact on employment

Nutrition Research Newsletter, Dec, 2006

The prevalence of obesity has drastically increased in the United States during the past decade, and public health authorities have recognized this as one of the most dangerous trends contributing to morbidity and mortality. Obesity is associated with the onset of many chronic diseases such as diabetes, cardiovascular disease, cancer, asthma, and depression. Additionally, obesity has been linked with increasing medical costs, work disability, and lost wages; however, its association with employment is not well described.

Obesity may impact employment in several ways. First, obesity is associated with increased risk of physical limitations and disability at older ages. Second, poor health may change individuals' perceptions of the utility of work versus leisure by diminishing the marginal value of work and increasing the marginal value of leisure time. Third, obese individuals may face employment discrimination.

A recent investigation examined the relationship between BMI and both employment and work limitations in a US working-age population. Publicly available data from two waves of the Panel Study of Income Dynamics (PSID) was used. The PSID was designed to select a representative sample of US individuals and their families. Participants were followed longitudinally and the data collected included sociodemographic characteristics, health behaviors, and employment status of both the head of the household and his or her spouse. The self-reported height and weight information was collected for the first time in 1986 and again in 1999. The current study was restricted to those who participated in both interviews in 1986 (baseline) and 1999 (follow-up) and who were of working age. This resulted in a final study sample of 4290 respondents (1895 men and 2395 women).

The primary outcomes examined were self-reported employment status (working for pay outside of the home) and the presence of work limitations because of health (that is, any physical or nervous condition that limited the type or amount of work). The presence of obesity at baseline was the primary exposure variable of interest. Obesity status was determined using BMI. Smoking status, exercise frequency, and health status at baseline were considered as potential confounders of the relationship between obesity and employment. Sociodemographic covariates included age, race, marital status, level of education, number of children under age 18 living in the home, household wealth, and baseline employment status (or baseline work limitations for work disability analysis).

After adjusting for baseline sociodemographic characteristics, smoking status, exercise, and self-reported health, obesity was associated with reduced employment at follow-up [men: marginal effect (ME)-4.8 percentage points (pp); p < 0.05; women: ME -5.8 pp; p < 0.10]. Among employed women, being either overweight or obese was associated with an increase in self-reported work limitations when compared with normal-weight individuals (overweight: ME 3.9 pp; p < 0.01; obese: ME 12.6 pp; p < 0.01). Among men, the relationship between obesity and work limitations was not statistically significant.

This data suggests that obesity results in future productivity losses through reduced workforce participation and increased self-perceived work limitations.

K. Tunceli, K. Li, L. Keoki Williams, et al. Long-Term Effects of Obesity on Employment and Work Limitations Among US Adults, 1986 to 1999. Obesity; 14:1637-1646 (September, 2006). [Correspondence: Kaan Tunceli, One Ford Place, Suite 3A, Detroit, MI 48202. E-mail: ktuncell@hfhs.org.]