Obesity and survival awareness

During the last two decades or so, obesity prevalence has increased worldwide and research on the topic has mushroomed. The effects of obesity on mortality, morbidity, disability, mental health, and quality of life, as well as its economic repercussions have been the subject of extensive study. However, perceptions of individuals about the effect of their own excessive body weight on their health and ultimately on their future survival have scarcely been investigated. This dissertation studies variability in individual perceptions and its determinants. First, I focus on the relationship between individuals' characteristics and their subjective probabilities of surviving to a target age across subgroups defined by body weight levels. The analysis uses data from the first eight waves of the Health and Retirement Study (HRS). Results suggest that on average obese individuals expect to have a shorter lifespan than normal weight ones do. This result may respond to a combination of causes, on the one hand the relationship between higher levels of BMI and subjective survival is mediated by health status. On the other hand, obesity-related diseases, which are more prevalent among obese individuals than they are among normal weight ones, have a greater impact on future survival expectations precisely among obese individuals than they have among normal weight ones. Second, I study the process that leads to updating survival expectations upon acquiring adverse health information. I use HRS data to analyze the updating process in two different periods, 1994-1996 and 2004-2006, and employ a Bayesian updating framework. Findings show that health shocks that are not obesity-related negatively influence subjective survival estimates among individuals in all body weight subgroups in the 2006 sample (only among normal weight ones in the 1996 sample). Individuals in the obese subgroup seem to assign similar importance to both obesity-related and not obesity-related health shocks. Third, I study awareness of effects of excess body weight and determinants of survival expectations in the context of one developing county, Costa Rica. I use CRELES (Costa Rican Study on Longevity and Health Aging) and show that processes are very similar to those identified in the US.

survival expectations

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