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Socioeconomic status and eating disorder prevalence: at the intersections of gender identity, sexual orientation, and race/ethnicity

Published online by Cambridge University Press:  16 May 2022

Natasha L. Burke Open the ORCID record for Natasha L. Burke [Opens in a new window] ,
Vivienne M. Hazzard Open the ORCID record for Vivienne M. Hazzard [Opens in a new window] ,
Lauren M. Schaefer Open the ORCID record for Lauren M. Schaefer [Opens in a new window] ,
Melissa Simone Open the ORCID record for Melissa Simone [Opens in a new window] ,
Jennifer L. O'Flynn  and
Rachel F. Rodgers Open the ORCID record for Rachel F. Rodgers [Opens in a new window]
Natasha L. Burke*
Affiliation:
Department of Psychology, Fordham University, 441 East Fordham Road, Dealy Hall, Bronx, NY 10458, USA
Vivienne M. Hazzard
Affiliation:
Department of Psychiatry and Behavioral Science, University of Minnesota Medical School, Minneapolis, MN, USA, 55454 Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA, 55454
Lauren M. Schaefer
Affiliation:
Sanford Center for Bio-Behavioral Research, 120 Eighth Street South, Fargo, ND 58103, USA Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, 1919 Elm Street N, Fargo, ND, 58102, USA
Melissa Simone
Affiliation:
Department of Psychiatry and Behavioral Science, University of Minnesota Medical School, Minneapolis, MN, USA, 55454 Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA, 55454
Jennifer L. O'Flynn
Affiliation:
Department of Applied Psychology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, 02139, USA
Rachel F. Rodgers
Affiliation:
Department of Applied Psychology, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France
*
Author for correspondence: Natasha L. Burke, E-mail: nburke12@fordham.edu
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Abstract

Background

Longstanding biases have fostered the erroneous notion that only those of higher socioeconomic status (SES) experience eating disorders (EDs); however, EDs present across all SES strata. Considering the dearth of ED research among those of lower SES, this study examined (1) the overall association between SES and ED prevalence, and (2) ED prevalence in the context of four relevant social identities (i.e. SES, gender identity, sexual orientation, and race/ethnicity) from an intersectional perspective, as unique combinations of multiple social identities may differentially influence risk.

Methods

A sample of 120 891 undergraduate/graduate students from the Healthy Minds Study self-reported family SES with a single-item question, gender identity, sexual orientation, and race/ethnicity, and were screened for ED risk.

Results

Participants of lower SES had 1.27 (95% CI 1.25–1.30) times greater prevalence of a positive ED screen than those of higher SES. Substantial heterogeneity was observed across the four social identities beyond the association with SES. For example, positive ED screens were particularly common among lower SES, Latinx, sexual minority cisgender men and women, with 52% of bisexual men and 52% of lesbian women of Latinx ethnicity and lower SES screening positive.

Conclusions

Although positive ED screens were more common among undergraduate/graduate students of lower SES, the particularly high ED risk reported by certain groups of lower SES with multiple minority identities reinforces the importance of investigating multi-layered constructs of identity when identifying groups at disproportionate risk.

Keywords

Disparitieseating disordersgender identityintersectionalitymultiply marginalizedprevalencerace/ethnicityscreeningsexual orientationsocioeconomic status
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 9 , July 2023 , pp. 4255 - 4265
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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