IB Psychology HLTopic 1 — Health ProblemsPaper 1 & 2Sociocultural approach~9 min read
Why Obesity Rates Differ Between Cultures
Eating looks like the most personal thing in the world. You decide what goes on your plate. But who you eat with, what counts as a proper meal, and whether skipping the family dinner is even an option — none of that is decided by you. That is what a cultural explanation of obesity is really about.
📘 What you need to know
Hofstede surveyed over 60,000 IBM employees in 50+ countries in the early 1970s and identified cultural dimensions.
The dimension used here is individualism vs collectivism.
In individualist cultures, eating is framed as personal choice, so convenience and preference can outweigh health advice.
In collectivist cultures, food follows group norms — shared meals, traditional dishes — which builds cohesion but can also lock in habits.
Obesity prevalence is measured with BMI: the proportion of a population classed as obese over a set period.
Masood et al. (2019) studied 156,192 adults across 53 countries and found participants from individualist countries had higher average BMI.
Globalisation is changing the picture fast, with rising rates in countries that historically had very few cases.
Two routes to the same outcome
The two chains reach obesity by different mechanisms, which matters for policy: an individual education campaign fits one culture far better than the other.
The strongest sentence you can write on this topic: in an individualist culture the pressure comes from the freedom to choose, and in a collectivist culture it comes from the difficulty of choosing differently from the group. Same outcome, opposite mechanism.
Research support: Masood et al. (2019)
Aim: to investigate the relationship between individualism versus collectivism and BMI.
Participants: 156,192 adults from 53 countries, covering both individualist and collectivist cultures.
Procedure: data were collected on each participant’s BMI, gender, age, marital status, education, occupation, socioeconomic status and whether they lived in a rural or urban area.
Results: participants from individualist countries such as the USA had higher BMI on average than those from collectivist cultures such as Vietnam.
Conclusion: national culture has a significant relationship with BMI, which helps explain cross-cultural patterns in obesity prevalence.
Notice what else they measured. Education, occupation, income and rural or urban living were all recorded. Those are exactly the variables most likely to explain a BMI difference on their own. A correlation with “culture” is only convincing once you have shown it survives those, so ask how much of the effect is culture and how much is wealth.
Evaluation
Strengths
Enormous sample across 53 countries. That gives strong statistical power and high external validity, so the findings generalise well.
A standardised measure. BMI is calculated the same way everywhere, which makes the study reliable and easy to replicate.
Hofstede’s dimensions are regularly reviewed and updated, which reduces the risk of the framework becoming out of date.
Limitations
BMI is simplistic. It captures weight against height, not cultural attitudes to food, body image or portion size — the very things the study claims to be about.
The dimensions are reductionist. Sorting 53 countries into two categories flattens huge variation within each one.
Hofstede’s original sample was biased. IBM employees, mostly from the USA and other developed countries, are not a fair sample of world cultures.
Correlation only. Nothing was manipulated, so culture cannot be shown to cause the BMI difference.
Replication would be very expensive on that scale, which limits how often the finding can be checked.
EXAM QUESTION
Discuss the role of culture in one health problem. [22]
Step 1: define cultural dimensions and where they came fromHofstede, 60,000+ employees, 50+ countries, individualism vs collectivism.Step 2: give the mechanism for each culture typePersonal-choice framing vs group norms and expectations. Two routes, one outcome.Step 3: bring in Masood with numbers156,192 adults, 53 countries, higher average BMI in individualist countries.Step 4: evaluate the measure, the framework and the designBMI validity, reductionist categories, Hofstede’s sample, correlation not cause, socioeconomic confounds.Finish with globalisation as evidence that cultures are not fixed
Link to concepts
Responsibility
Obesity research is socially sensitive, and results comparing whole nations can very easily be turned into a stereotype. Researchers need to report carefully and practise reflexivity — being open about how their own cultural background shaped the questions and the interpretation.
Change
Prevalence is shifting with globalisation. Cheap processed food is now widely available in countries such as India, where obesity was historically uncommon. This is the clearest evidence that the cultural patterns described here are not permanent traits but responses to a food environment that is changing.
💡 Exam tip
Give the mechanism, not just the correlation. “Individualist cultures have higher BMI” is a fact; explaining how the norm reaches the plate is an answer.
Use the socioeconomic confound. It is a much sharper criticism than “correlation is not causation” on its own.
Hofstede’s 1970s IBM sample is reusable across three pages of this topic. Learn it once.
Globalisation is your change point and it also doubles as a limitation of the original research.
Do not moralise about food. Describe norms and environments, not good and bad eating.
If the question says “one health problem”, pick obesity and stay with it. Do not drift into smoking.
⚠ Common mix-up
Saying collectivist cultures are healthier. The study found lower average BMI, which is not the same as healthier, and rates are rising.
Assuming everyone in a country shares its cultural label. These are population averages.
Treating BMI as a measure of diet. It measures neither what people eat nor why.
Forgetting that Hofstede did not study health. His dimensions were borrowed afterwards.
Ignoring the confounds Masood measured. They are listed in the study, so use them.
Confusing a huge sample with a representative one. Size fixes statistical power, not sampling bias.
Up next: Why Smoking Rates Differ Between Cultures — same dimension, a different behaviour, and one study whose results do not do what you expect.
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