Social class stigma and poorer health behaviors: Evidence from the eating in America study

Although the association between objective markers of low socioeconomic status (SES) and poor health is well established, one underexamined possibility is that over and above objective SES, social class stigma—experiences and anticipation of discrimination based on social class—might undermine people's ability to engage in healthy behaviors. Participants (N = 2022) were recruited between December 2019 and January 2020 via a national Qualtrics panel that was census-matched to the U.S. population in age, gender, income, race/ethnicity, and census region. Participants completed measures of class stigma, alcohol use, disordered eating, comfort eating, sleep disturbance, physical activity, and demographics. Controlling for objective SES and demographics, generalized linear regression models indicated that class stigma was associated with significantly greater alcohol use, disordered eating, greater comfort eating, and sleep disturbance but not less physical activity. Class stigma was not associated with health behaviors after full adjustment for weight/racial discrimination and psychological factors. Results from this investigation suggest that beyond one's objective SES, the stigma associated with having low class may also contribute to poorer health behaviors. •Social class stigma may contribute to poorer health behaviors in addition to SES.•Regression models tested for an association between class stigma and health behaviors.•Focal models controlled for objective indicators of SES and demographics.•Class stigma was uniquely associated with poorer health behaviors in the focal model.•Class stigma was not associated with health behaviors in fully adjusted models.