Link between Poverty and Obesity

Image credit: Washington Times

New column published in the Washington Times.

by James A. Bacon

A while back, I attended the homecoming game between Collegiate and St. Christopher’s, two prep schools in the Richmond, Va., area. For the most part, the parents in the football stands were well-to-do professionals, executives and business owners who could afford to pay stiff private school tuition. Midway through the game, my daughter articulated a thought that had been coalescing in my own head: “It’s amazing. There aren’t any fat people here.”

I had quite a different impression a few years ago when, on a lark, I attended a World Wrestling Federation event, a form of entertainment favored by the working class. I was stunned. I’d never seen so many morbidly overweight people before. I felt as if I’d been teleported to the Brookhaven Clinic.

Obesity has reached epidemic proportions in the United States, surging from 13 percent of the population in 1960 to 34 percent in 2006 and contributing to epidemics of hypertension, diabetes and other chronic diseases. Treating those maladies costs an estimated $117 billion annually, half of which is financed by Medicare and Medicaid.

While everyone laments the trend, there is no consensus on what causes it. The rise of obesity coincides with the falling price of groceries over the long term and the proliferation of fast food outlets, making food more affordable and more accessible to all segments of society. But that’s not a sufficient explanation. If the means to purchase more food and patronize restaurants were what made people fat, wealthy people would be the butterballs, not poor people. But the opposite is the case. It is well-documented in countries across the developed world that obesity is correlated with lower socioeconomic status.

Why would that be? One explanation blames forces beyond poor peoples’ control. “Low-income and food-insecure people are especially vulnerable due to the additional risk factors associated with poverty, including limited resources, limited access to healthy and affordable foods, and limited opportunities for physical activity,” asserts the Food Research and Action Center. “Households with limited resources … often try to stretch their food budgets by purchasing cheap, energy-dense foods that are filling – meaning that they try to maximize their calories per dollar in order to stave off hunger.”

So, the prodigious appetite for potato chips and cheese puffs is driven by “food insecurity.” Yeah, right. Here’s an alternate explanation: People buy junk food because it tastes good, it gives them a brief sensation of pleasure, and they don’t care about the consequences – not because they are trying to “maximize their calories per dollar.”

Three economists, Charles J. Courtemanche, Garth Heutel and Patrick McAlvanah, have just written a paper, published by the National Bureau of Economic Research, exploring the influence of “time preference” – the value that people place upon present consumption versus future consumption – upon dietary choices. Some people are impatient, the authors observe. They have less impulse control. They are less willing to defer gratification.

Drawing upon the 2006 National Longitudinal Survey of Youth, which includes a wealth of personal data, including Body Mass Index (BMI) as well as answers to questions regarding hypothetical time-related trade-offs, the scholars conclude: “As economic factors lower the opportunity cost of food consumption, impatient individuals gain weight while the most patient individuals do not. BMI therefore rises, but the rise is concentrated among a subset of the population.”

Translation: As food has gotten more affordable over the years, some people have gotten fatter because they are more impulsive and shortsighted and prefer to eat food that gives them a quick sugar rush over healthier foods that don’t.

Many lower-income people are like children from more affluent families who also suffer from impulse-control issues. My eighth-grade son, left to his own devices, would happily subsist on Cheerios, Klondike bars and macaroni and cheese. The reason he doesn’t is that my wife and I strip the house bare of candy, cookies, ice cream, potato chips, Twinkies, Fritos, Cheetos, sugared soft drinks and other cheap carbs. In a grueling battle of wills, we compel him (with varying degrees of success) to work broccoli, fruit and garden salads into his diet. We subject him to lectures on how his eating habits today will affect his health and physical appearance in the far distant future – like when he’s in high school.

The difference is culture. To achieve success in the United States requires a willingness to excel at school, forgo income while spending years in college, subject oneself to the strictures of the workplace and live within one’s means – in sum, to stifle impulse and embrace the boring bourgeois virtues. The willingness to defer gratification is the same trait it takes to maintain disciplined eating and exercise habits over decades. That’s a big reason the preppy moms and dads of Richmond have plump wallets but lean derrieres while many of the working stiffs across town are wheezing and overweight.