Model Text: “Economics and Obesity”

Economics and Obesity^[1]

Eating healthy can be difficult for everyone. You have to figure out what is healthy and find out what diet fits your goals, then you have the struggle of actually sticking to the diet and avoiding the temptation of junk food. However, eating a nutritious diet can become even more complicated if you are poor and live in a low-income area. Healthy food is too expensive for low-income people, forcing them to buy cheaper and less healthy alternatives. People may not even have access to unprocessed foods, like fruits and vegetables, if they live in poor neighborhoods that do not have a grocery store or supermarket. The lack of access to affordable, healthy, and unprocessed foods leads to an increased rate of obesity for low-income people, and current policies and interventions are not effective and need to be changed to help decrease rates of obesity.

Obesity has been a problem in the United States for a long time. In the 1980s, the number of obese people began to increase rapidly. The percentage of obese adults went from 15.0% in 1980 to 32.9% in 2004, more than doubling (Hurt 781). Obesity can be extremely damaging to the body and can lead to other chronic diseases, such as diabetes and hypertension. It is clear and has been for a long time, that obesity is an epidemic in America, and researchers are trying to find the cause. Obesity is commonly associated with people picking food solely based on taste and not on nutritional content, leading them to choose delicious junk food over nutritious vegetables. While this is true for some, the rates of obesity were found to be higher in American counties that were poverty-dense (Levine 2667). This is not the only study to find that obesity affects the poor more than others, as a study ran by U.S. Government found that rates of obesity and diet-related chronic diseases were highest in the most impoverished populations (Story 261). Obesity is affecting those who are least able to cope with it, as obesity and related chronic diseases can have a serious economic impact on people, especially those with diabetes. People with diabetes spend around 2.3 times as much on general medical care a year than someone without diabetes, and on average a diabetic person spends about $7,900 a year just on medical expenses associated with diabetes (Yang 1033). These costs are extremely damaging to low-income people who may already have trouble getting by as it is, and it is important that the economic causes of obesity are examined so that policies and interventions can be designed to help protect public health.

Higher rates of obesity in low-income areas has been associated with a lack of access to healthy foods. Many of these low-income areas are classified as food deserts, meaning there is nowhere to buy fresh fruits, vegetables, or other unprocessed foods. The nearest grocery store or supermarket can be over a mile away, as it is for Casey Bannister a resident of East Portland, Oregon. The closest grocery store to her is a mile and a half away, which can be hard for her to walk or bike especially when she has bags of groceries (Peacher). This is a common problem for many Americans who also live in food deserts. Many people have to rely solely on nearby convenience stores for food. These stores rarely sell fresh fruits, vegetables, or unprocessed meats and have a large selection of unhealthy foods. Along with that, the convenience stores found in low-income areas were more often small, independent stores which sold food for higher prices than chain stores (Beaulac), meaning consumers in poor neighborhoods were spending more there than they would in stores found in higher-income neighborhoods.

There is an appealingly simple answer to food deserts: add a grocery store. However, merely adding a grocery store is not going to solve the obesity problem in impoverished areas, as that is only one part of the problem. According to a study run by researcher Steven Cummins, the stores added to food deserts in Philadelphia did not impact that amount of fruits and vegetables consumed. He attributed this to many causes, including the fact that the kind of stores added may not necessarily sell cheaper food (Corapi). While food deserts do contribute to obesity, the main economic cause is more likely the price of healthy, nutritious food. A healthy diet is too expensive to be accessible to low-income people and families, even if they do have access to a supermarket.

Nutritious foods like fruits and vegetables, while healthy, are low in calories. Unhealthier foods have high amounts of calories for a much lower cost, making them extremely appealing to families on a budget. These calories are made up of grains and starches as well as added fats and sugars, which have been linked to an increased risk for obesity (Drewnowski 265S). Foods like these are quite clearly unhealthy, however, health must be disregarded when it is the only thing a person can afford to eat. A study by the American Diabetes Association found that on average healthy diets cost $18.16 per thousand calories, while unhealthy diets only cost $1.76 per thousand calories (Parker-Pope). Based on a person who needs two thousand calories a day, it would cost roughly $1,089.60 a month for one person to eat a healthy diet when an unhealthy diet would cost $105.60 a month. This means that a person eating a nutritious diet would spend over ten times as much as a person eating a nutrient deficient diet. People who earn minimum wage, especially those that have more than one person to support, cannot spend this much on food a month and are forced to instead buy unhealthier options and put themselves at a higher risk for obesity.

Influences such as the convenience of unhealthy food and advertisements may also impact the rates of obesity in low-income areas and populations. It is important that they are acknowledged as well before designing new policies or interventions, so that all possible causes and factors of obesity may be addressed. Unhealthy food, for example, fast food is almost always convenient and simple, as most foods come already cooked and ready to be eaten. While healthy food is usually raw and unprocessed, meaning it has to be prepared before being served. Cooking a proper meal can take an hour or more, and many working people do not have the time. Also, cooking requires a lot of knowledge about recipes and how to prepare raw food, as well as expensive resources like pots, pans, and knives. Fast food is quick and requires no prior knowledge about cooking food or any equipment, making it an easy choice for those who are poor or busy. Food advertisements may also influence people’s choices. Most food advertisements seen on TV are for fast food and show this food as extremely desirable and a good deal. This may affect people’s choices and make them more likely to buy fast food, as it is shown as delicious and within their budget. While these influences are unlikely to be the main cause of high rates of obesity for low-income

people, it is still important that they are examined and thought of while interventions are being made.

With the obesity epidemic being so detrimental to individual’s health, people and government have been pushing for interventions and policies to help fight against obesity. Some interventions have helped bring fruits and vegetables to low-income families and neighborhoods. Food pantries have been vitally important to providing food in food deserts. Saul Orduna, another resident of East Portland, lives in a food desert and gets about half to two-thirds of his groceries from the SUN food pantry. They provide him and his two children with fresh fruits and vegetables as well as milk, eggs, and bread. It is an important service for his family, as he only has $380 a month for food (Peacher). Services like this help bring food to those who cannot afford or access it, however, they are not a good long-term solution to food insecurity. Other policies and interventions have been suggested that are likely to have more negative effects. The taxation of junk food, particularly high-calorie beverages, has been proposed to discourage people from purchasing unhealthy foods and hopefully lower obesity rates (Drewnowski 265S). Taxing unhealthy foods might be a good incentive for middle and high income people to buy healthier food. However, without lowering the price of nutritional food, policies like this will only put more of an economic burden on low-income people and make it harder for them to get any food at all.

New policies and interventions are needed, and it is necessary that they address the many different influences on the rates of obesity, including access, price, and advertising. Tax subsidies implemented on healthy foods, such as unprocessed meats, fruits, and vegetables, would encourage people to buy that instead of other options. It is important that if tax subsidies are put on healthy food that it is advertised to the public. Advertising on TV and in stores could be used alongside tax subsidies to

promote the newly affordable, healthy choices and make them seem more desirable. Putting healthy foods in the front of stores so that they are the first thing people see, rather than unhealthier options like chips and candy, would also help people choose more nutritious foods over other choices. These may seem like small changes; however, they could have a huge impact.

Education may also play an important part in lowering rates of obesity. Nutrition is extremely complicated, and there are some who may have never learned what is healthy and what is not. Others may know what is healthy, yet they do not know how to prepare and use such foods. Free community education classes could be used to teach people about health and nutrition. Along with cooking classes to teach people how to properly prepare and cook vegetables and fruits. Both of these classes would help inform people about their own health and build their confidence in choosing and preparing food. Classes may also be helpful for teaching skills other than nutrition and cooking. In an interview with the researcher Steven Cummins, he stated that “We have to think very carefully about giving people the skills to make better decisions when they’re in stores, as well as providing access to the stores in the first place” (Corapi). He brings up an important point about the importance of teaching people how to manage their money properly and how to find good deals on healthy food. A class teaching these kinds of skills could help people be more organized and deliberate in what they buy.

The obesity epidemic in low-income populations is a complex problem that has been going on for a long time. The answer sadly is not simple and is going to require involvement from the government, stores, and the communities of America. Until people are able to afford and access food themselves, it is important that people

continue to support food banks and pantries, like the Oregon Food Bank, as they provide vital assistance to those who are food-insecure. Solving the problem of obesity in impoverished areas is going to be complicated, however, the result will have more people with equal access to nutritious, healthy food and lower rates of obesity.

Works Cited

Beaulac, Julie, et al. “A Systematic Review of Food Deserts, 1966-2007.” Preventing Chronic Disease, Centers for Disease Control and Prevention, Vol. 6, No. 3, 2004, pp. 1-10, www.cdc.gov/pcd/issues/2009/Jul/pdf/08_0163.pdf.

Corapi, Sarah. “Why It Takes More than a Grocery Store to Eliminate a ‘Food Desert.’” PBS, 3 Feb. 2014, www.pbs.org/newshour/health/takes-grocery-store-eliminate-food-desert.

Drewnowski, Adam, and Nicole Darmon. “The Economics of Obesity.” The American Journal of Clinical Nutrition, vol. 82, no. 1, 2005, 265S-273S, ajcn.nutrition.org/content/82/1/265S.long.

Hurt, Ryan T., et al. “The Obesity Epidemic: Challenges, Health Initiatives, and Implications for Gastroenterologists.” Gastroenterology & Hepatology, vol. 6, no. 12, 2010, pp. 780-792. US National Library of Medicine, www.ncbi.nlm.nih.gov/pmc/articles/PMC3033553/.

Levine, James A. “Poverty and Obesity in the U.S.” Diabetes, vol. 60, no. 11, 2011, pp. 2667-2668, diabetes.diabetesjournals.org/content/60/11/2667.

Parker-Pope, Tara. “A High Price for Healthy Food.” The New York Times, well.blogs.nytimes.com/2007/12/05/a-high-price-for-healthy-food/.

Peacher, Amanda. “East Of 82nd: Raising Children In A ‘Food Desert’.” Oregon Public Broadcasting, 18 Feb. 2015, www.opb.org/news/series/east-of-82nd-a-closer-look-at-east-portland/east-of-82nd-raising-children-in-a-food-desert/.

Story, Mary, et al. “Creating Healthy Food and Eating Environments: Policy and Environmental Approaches.” Annual Review of Public Health, Annual Reviews, vol. 29, 2007, pp. 253-272, www.annualreviews.org/doi/abs/10.1146/annurev.publhealth.29.020907.090926.

Yang, Wenya, et al. “Economic Costs of Diabetes in the U.S. in 2012.” Diabetes Care, vol. 36, no. 4, 2013, pp. 1033-1046, care.diabetesjournals.org/content/36/4/1033.