Page 226 - 《社会》2021年第2期

社会决定抑或身材筛选？ 社会经济地位与肥胖的性别化因果关系

lower the likelihood of obesity； for men，the higher the SES， the more likely it is to be
obese. According to the “social determination hypothesis”，this gendered correlation
can be attributed to people’s SES，the fundamental cause of obesity. The causal relation
presents a direction from SES to obesity. On the contrary，the “health selection
hypothesis” proposes that the labor market makes discriminatory selection based on
people’s body size. As a result，the causal relation is from obesity to SES. This study
aims to examine the above mentioned gendered causal relationship between SES and
obesity. Specifically，the fixed effects model and the dynamic structural equation model
are applied to address the two major challenges of casualty establishment：confounding
bias and reciprocal/reverse causality. The analysis based on longitudinal data of the
China Family Panel Studies （CFPS） of 2010，2012，2014 and 2016 suggests a clear
gendered causal pattern：for men，the positive association between SES and obesity
results from both social determination and health selection hypotheses：higher SES
likely leads to weight gain in two years；while higher BMI is also related to SES
achievement in two years. For women，however，the negative correlation is mainly due
to the health selection process：higher BMI seems to significantly reduce individual SES
after two years.
Keywords：health inequality ， obesity ， causal relationship ， gender heterogeneity ，
cross鄄lagged panel models

一、引言

伴随着持续高速的经济增长， 我国人民在生活领域也经历了营养
转型的过程，从缺少营养、体力活动为主转变为高热量膳食为主、体力
活动减少的生活方式（ Popkin and Gordon-Larsen，2004）。 生活方式的转
变对公众健康产生了不可忽视的影响，有研究指出，2013 年，我国有 27
个省份死亡的第一大病因是心脑血管疾病（Zhou，et al.，2016）。 肥胖作
为心脑血管疾病的主要致病因素及外显信号 （ Van Gaal，et al.，2006），
在过去几十年呈明显的普及化过程。 非传染性疾病风险控制协作组织
（ NCD-RisC，2016） 对全球 200 个国家肥胖趋势的分析显示，1975 年到
2014 年，中国肥胖男性人口增加了 62 倍，肥胖女性人口增加了 27 倍，

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