Human Rights Facts (47): Poverty and Obesity, Ctd.

Evolution of Obesity

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In a previous post, I mentioned that poor people in the U.S. are more likely to be obese, and that they risk finding themselves in a poverty trap as a result: their poverty causes health problems, which in turn make them more poor (healthcare is obviously expensive, especially when you’re uninsured* and when your illness causes you to be absent from work or to lose your job altogether). Why does poverty cause health problems? For many reasons, but the one we’re focusing on here is obesity. It seems that poverty shifts

choices toward an energy-dense, highly palatable diet that provides maximum calories per the least volume and the least cost. The hypothesis [is] that healthier diets may indeed cost more. Adam Drewnowski and SE Specter (source)

A large body of epidemiologic data show that diet quality follows a socioeconomic gradient. Whereas higher-quality diets are associated with greater affluence, energy-dense diets that are nutrient-poor are preferentially consumed by persons of lower socioeconomic status (SES) and of more limited economic means. As this review demonstrates, whole grains, lean meats, fish, low-fat dairy products, and fresh vegetables and fruit are more likely to be consumed by groups of higher SES. In contrast, the consumption of refined grains and added fats has been associated with lower SES. … The observed associations between SES variables and diet-quality measures can be explained by a variety of potentially causal mechanisms. The disparity in energy costs ($/MJ) between energy-dense and nutrient-dense foods is one such mechanism; easy physical access to low-cost energy-dense foods is another. If higher SES is a causal determinant of diet quality, then the reported associations between diet quality and better health, found in so many epidemiologic studies, may have been confounded by unobserved indexes of social class. Conversely, if limited economic resources are causally linked to low-quality diets, some current strategies for health promotion, based on recommending high-cost foods to low-income people, may prove to be wholly ineffective. Nicole Darmon and Adam Drewnowski (source)

Poverty causes obesity, obesity causes ill health, and ill health causes poverty. And both ill health and poverty are human rights violations (see here and here respectively). So plenty of reasons to link obesity and human rights.

The reasons why poverty causes obesity and shifts diets towards low quality foods are diverse, and not limited to the relatively high cost of high quality food. There’s also something called

an “obesogenic” environment. Food options in poor neighborhoods are severely limited: It’s a lot easier to find quarter waters and pork rinds on the corner than fresh fruit and vegetables. Low-income workers may also have less time to cook their own meals, less money to join sports clubs, and less opportunity to exercise outdoors. (source)

poverty and obesity cartoon by David Fitzsimmons

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So obesity is one thing which pushes people into a vicious circle of poverty and ill health (unhealthy work, inadequate sanitation, inadequate shelter etc. also contribute to this vicious circle).  But obesity and poverty can create a vicious circle of their own. If poverty leads to obesity, obesity can also be impoverishing:

Women who are two standard deviations overweight (that’s 64 pounds above normal) make 9 percent less money. … Obese women are also half as likely to attend college as their peers and 20 percent less likely to get married. (Marriage seems to help alleviate poverty.) (source)

More about the relationship between poverty and health here and here.

* Among the 46 million people in America who lack medical insurance, about two-thirds earn less than twice the poverty level (source, source).

Update:

Contrary to conventional wisdom, … the poor have never had a statistically significant higher prevalence of overweight status at any time in the last 35 years. Despite this empirical evidence, the view that the poor are less healthy in terms of excess accumulation of fat persists. (source)