Empty Pockets and Empty Calories

America is in the midst of an escalating obesity crisis, and this is especially true amongst low-income communities. According to a 2015 study, obesity is responsible for millions of deaths each year due to its association with a plethora of health complications including cardiovascular disease, cancer, Type 2 diabetes, stroke, and osteoarthritis. The USDA reports that caloric intake is up 20% from 1983 to 2000, and another recent study suggests that energy expenditure decreases in the workplace over the last fifty years have resulted in a significant increase in average weight amongst Americans. For this reason, it is absolutely vital that this issue be remediated. Unfortunately, the obesity epidemic seems to target populations of low socioeconomic status (SES) disproportionately. What can we do to incentivize the health and wellness of low SES populations at the systemic level of analysis?

To understand this issue in depth, let’s first address the all-too-common phenomenon of food deserts. A food desert is an area in which residents cannot easily access stores that sell affordable, healthful foods. Because people in day-to-day life tend to make their food decisions based on what’s around them, and low-income neighborhoods are more likely to be classified as a food desert according to the Department of Agriculture, it is logical to suggest that low-income populations tend to have less access to healthful options such as produce. Therefore, they tend to gravitate towards processed and calorically-dense options that you might find in liquor stores, gas stations, or vending machines. 

Adding another layer of complexity to this problem, it seems to be the case that unhealthy food simply costs less. A meta-analysis conducted by Mayuree Rao estimates that unhealthy food consumption costs people an average of $1.50 less than healthy food consumption every day. This means that a family of four might spend an annual average of over $2,100 dollars less on food by opting for unhealthy diets. This is a substantial reduction in cost when you consider that the poverty line in America for that same family of four is $26,500 (imagine saving upwards of 8% of your family income by swapping veggies for ramen).

In addition to the economic factors at play, stress from living in situations of financial insecurity can be a detrimental factor for overall health. The American Psychological Association highlights that stress occurs at higher rates among minorities and low-income populations, leading to behavior such as excessive alcohol intake which contributes to obesity. Furthermore, dietician Gabrielle Mancella points out that “elevated cortisol [stress hormone] levels can cause cravings for sweet, fatty and salty foods… as well as slow down how many calories your body burns.” Given this insight, in addition to the well-understood concept of stress eating, it is easy to understand why one’s mental state might play a massive role in their physical health.

The solution to this issue is likely twofold. The first key factor in limiting obesity in low-income areas is cultural buy-in. As it stands, the current education system does quite a poor job at health education; I find it reprehensible, for example, that I was only required to take a single semester of health class throughout the entirety of my K-12 education. In a culture of unhealthy eating, it is vital that our schools teach children and adolescents about how to attain, cook, and consume healthful foods to foster a generation that cares about their well-being and longevity. Additionally, the implementation of community-run social institutions such as urban gardening and weight loss support groups could prove useful in combating obesity.

Along with cultural remedies, local governments can introduce economic policies to minimize obesity in low SES areas. Taxes on sugary beverages, candy, etc. would drive up the price of these foodstuffs, thereby decreasing the quantity demanded in these communities. In addition, revenues from this taxation could be filtered directly into low-income neighborhoods, funding social institutions such as the ones listed above and subsidizing/distributing healthier food options in the community. Additionally, municipal governments ought to incentivize the introduction of grocery stores and affordable, healthy restaurants in their communities by offering tax breaks and streamlining the permit process. Parks and green space are also essential so that citizens have the active outdoors as an alternative to the sedentary lifestyle of modern America. 

A multifaceted approach will be required to effectively target the issue of obesity in low SES areas. Addressing the prevalence of food deserts, the lack of access to healthy foods, and the impacts of stress will take time and investment, but if we are successful then we will dramatically reduce costly and undesirable health outcomes across the country, especially in those communities which are most disadvantaged and at highest risk.

Josef Westberg ‘27 studies in the College of Arts & Sciences. He can be reached at j.r.westberg@wustl.edu.

*photo courtosey of the Lincoln Center for Family and Youth