Poverty and Obesity: How poverty in the U.S.

is associated with higher rates of obesity

Introduction According to the U.S. Department of Agricultures Economic Research Service, food security is defined as access by all people at all times to enough food for an active, healthy life. Here arises a dilemma when considering the nutritional situation of the impoverished: how do you define what quantity and types of food are sufficient for an active and healthy life, and more importantly, what type of foods are available to those who are food secure but still experience poverty? Should the calories from a Big Mac be considered in the same way as the calories in a spinach salad? One of the key problems facing many of the 50 million Americans living in poverty is how to find foods that are nutritious and wholesome yet fall within their economic constraints. With cash crop subsidies leading to cheaper chips and sodas, and with more Americans buying these foods in bulk, the definition of food security is changing. Although low-income families, especially those receiving benefits from the Supplemental Nutrition Assistance Program (SNAP), may be food secure and receive their necessary intake of calories, what exactly are they eating and how does this affect their health? After analyzing the data the problem becomes clear: citizens experiencing poverty in the United States face a greater challenge providing themselves with nutritionally sustainable foods and are more likely to become obese, diabetic, or face other food related health issues due to various economic and social factors.

1. From Crop to Plastic Bag How food subsidies make the bad food cheap To accurately assess a possible correlation between poverty and obesity, we first have to understand the roots of the problem. Among other things, obesity is directly attributed to the over consumption of processed fatty foods and sugary drinks. For a large portion of individuals in poverty, especially those receiving SNAP benefits, being overweight or obese is a result of nutritionally wholesome foods being higher priced. These more expensive foods carry a larger impact on the family food budget driving individuals to purchase cheaper junk foods. The economic impact of food on total expenditures becomes a factor when analyzing dietary habits of poor Americans because these citizens live on very tight budgets. According to data from the Bureau of Labor Statistics, in 1992, households in the top quintile by income (mean income: $77,311/y) spent $1,997/person (2.6% of total expenditures) for food, compared with $1,249 (18.7%) spent by those in the bottom quintile (mean income: $6,669/y).i Given this disparity in the percentage of total expenditures between the wealthy and poor, it becomes easy to see how the price of food often dictates eating habits. To fully understand the reasons as to why junk foods often cost less than healthier alternatives, an analysis of the nations major crops and how they are subsidized is required. Corn and soybeans are by far the most dominant crops in the United States, each harvesting approximately 72.7 million acres per yearii. Unfortunately, Americans are not consuming sweet corn and cooked soybeans in their original harvested state. A recent U.S. PIRG report found that only about 1% of U.S. produced corn is the sweet corn that is directly eaten by humans. The other portion goes towards feeding the worlds livestock or ends up as processed ingredients such as corn syrup, high fructose corn syrup, corn starch, and soy oils. These substances represent some of the major ingredients in the nations leading junk foods.

Although it is alarming that these crops go mostly towards producing unhealthy products, it does not explain the disparity in price between junk foods using refined ingredients and other healthier options. At the root of the price problem is the subsidization of the industries related to the production of these unhealthy foods. In 2011 alone, over $1.28 billion of taxpayer money went towards subsidizing these major junk food crops, bringing the total in junk food subsidies to $18.2 billion since 1995iii. These subsidies in turn prompt producers of chips, sodas, and other foods that are high in sugars and fats to substitute natural higher costing ingredients with the cheaper subsidized corn starches and soy oils. This not only lowers the price but makes these products considerably less healthy. This may explain why the current US diet derives close to 50% of energy from added sugars and fat.iv 2. Food for the Poor How prices make bad calories cheap and readily available Having established that the subsidization of certain crops significantly reduces the production costs of junk foods, it is easy to understand why these options may be cheaper than their non-subsidized healthier counterparts. To better understand these price differences, the energy density of food (a function of the foods water content) must be considered. Whereas energy-dilute foods are heavily hydrated, energy-dense foods are dry and may also contain fat, sugar, or starch. Potato chips (23 kJ/g), chocolate (22 kJ/g), and doughnuts (18 kJ/g) are energydense foods.v Conversely, foods with a high moisture content, such as vegetables and fruit, allow the consumer to feel full on fewer calories.vi Why are those in poverty gravitating towards energy-dense foods and not the healthier energy-dilute foods? The answer lies in the previous explanation of differing food costs. There is an inverse relationship between food price and energy density, with high energy-density foods like chips being cheaper. As a general rule, energy-dense foods that utilize subsidized ingredients tend to come at a lower cost to

consumers.vii For poor families, this price drop can make all the difference between purchasing the bag of chips or the bunch of carrots. According to a recent article in the Scientific American, between 1985 and 2010 the price of beverages sweetened with high-fructose corn syrup dropped 24 percent, and by 2006 American children consumed an extra 130 calories a day from these beverages. Over the same period the price of fresh fruits and vegetables rose 39 percent.viii If the inverse relationship between the price and energy density of food continues to grow due to decreasing production costs, we can expect the issue of obesity across all demographics, not just the poor, to worsen. In addition to foods associated with obesity becoming continuously cheaper, there is also the growing issue of food deserts; areas associated with having limited access to fresh and healthy foods. It is in these predominantly low income neighborhoods that the frequency of fast food restaurants and convenience stores significantly increases and the number of organic and health food stores significantly decreases. For example, if you search organic food store Beverly Hills, Los Angeles on Google Maps and compare the list of results with organic food store Compton, Los Angeles, the disparity between the access to organic foods in these neighborhoods is alarming; there are 10 organic food stores in Beverly Hills (Area: 5.7sq. miles, per capita income: $77,627) and just one organic food store in Compton (Area: 10.2sq. miles, per capita income: $12,259)ix. The New Earth Health Food Store is the sole organic food store, as categorized by Google maps, located in the Compton area. This is just one example of the prevalence of food deserts in low income areas. All across the country, outlets providing unhealthy energy-dense foods at low prices are further complicating the nutritional plight of poor Americans.

3. Food for Thought How SNAP beneficiaries are actually meeting the nutritional standards In order to effectively put into terms how economic factors influence dietary habits and obesity rates among Americans in poverty, an analysis of the nutritional intake of SNAP beneficiaries is crucial. These Americans most accurately represent the population that struggles most with obesity and other junk food- related health issues. In a study published in the American Journal of Clinical Nutrition, a group of social scientists and nutritionists examined and compared the dietary intakes of both SNAP participants and non-participants. This is what the study found: Few low-income adults consumed recommended amounts of whole grains, fruit, vegetables, fish, and nuts/seeds/legumes. Conversely, many low-income adults exceeded recommended limits for processed meats, sweets, and bakery desserts and sugarsweetened beverages. Approximately 1322% of low-income adults did not meet any food and nutrient guidelines; virtually no adults met all of the guidelines. Compared with nonparticipants, SNAP participants consumed 39% fewer whole grains46% more red meat (95% CI: 4%, 106%), and, in women, 61% more sugar-sweetened beverages (95% CI: 3%, 152%). SNAP participants also had lower dietary quality scores than did nonparticipants, as measured by a modified Alternate Healthy Eating Indexx. Additionally, the study found that SNAP participants purchased low-cost foods with poor nutritional value and consumed far more refined grains, sugar-sweetened beverages, and red or processed meats, to maximize their food budget. These results support the belief that Americans in poverty experience obesity and other food related health problems at a greater rate than wealthier citizens. A chart illustrating this relationship between poverty and obesity was recently illustrated in an article published by the American Diabetes Association:

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4. The Cycle of Eating The seemingly endless cycle of poverty and poor nutrition Along with the economic factors contributing to poor Americans struggle with obesity and nutritional stability, there are a variety of other social and psychological factors involved. Education is a key issue when discussing poverty and its repercussions. In the study of SNAP participants, 47.2% had less than 12 years of education compared with 28.6% of nonparticipants.xii Those in poverty simply do not have the educational background crucial to achieving financial security, understanding the importance of nutrition, and bringing awareness of important policy issues such as the subsidization of junk foods. There is also the issue of convenience. Many low-wage workers dont have the time to purchase and cook nutritional meals for their families, making fast food restaurants and frozen meals a common solution. Aside from education, a psychological impact on Americans caught in the poor nutrition cycle also exists. As described by Morgan Spurlock in his famous documentary, Supersize Me, bouts of depression and headaches could only be relieved by eating more junk food, leading to an endless cycle of depression and food induced highs. It has been found that psychological

explanations have addressed inadequate nutrition knowledge, excessive vulnerability to the external environment, addictive personality, and the consumption of high-fat foods in search of comfort.xiii 5. The Costs Why we should care about obesity among poor Americans In 2008, obesity-related medical expenses cost Americans over $147 billion. These costs are expected to rise to $344 billion by 2018. Additionally, there will be an estimated 50 million work days and over $150 billion in productivity lost to obesity related health problemsxiv. These figures reiterate the importance of the issue this nation faces as more of its citizens experience poverty and poor nutrition. Obesity and its relationship with poverty is not just a social issue testing the moral obligations of the nation, but is also cutting deep into the pocket books of taxpayers as the uninsured require more emergency treatment. According to the Yale Rudd Center for Food Policy and Obesity, obesity accounts for 6 percent to 10 percent of U.S. health care spending compared with 2 percent to 3.5 percent in other Western countriesxv.

Conclusion After analyzing many of the factors contributing to obesity and other food-related health issues among Americans in poverty, it is clear that the problem lies in the subsidization of junk food ingredients, the inverse relationship between price and energy-density, the types of foods available in poorer areas, and the social and psychological issues faced by these citizens. These factors are causing a disproportionate number of poor Americans to suffer from obesity and are also having profound economic impacts on the healthcare system and productivity. To begin effectively reversing the cycle of being poor and overweight or obese, the issues of food price, availability, and an emphasis on education must be addressed to secure the future of the next

generation. This will only be achieved when public support prompts policy reform allowing those in poverty to have the opportunity to consume the same nutritious foods as wealthier Americans.
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Poverty and Obesity: The Role of Energy Density and Energy Costs (Do Healthy Diets Cost More?) Environmental Protection Agency: Major Crops Grown in the United States iii Apples to Twinkies 2012: Comparing Taxpayer Subsidies for Fresh Produce and Junk Food iv Poverty and Obesity: The Role of Energy Density and Energy Costs (High Energy Density Means Low Energy Costs) v Poverty and Obesity: The Role of Energy Density and Energy Costs (Energy Density Influences Energy Intakes) vi Poverty and Obesity: The Role of Energy Density and Energy Costs (Energy Density Influences Energy Intakes) vii Poverty and Obesity: The Role of Energy Density and Energy Costs (High Energy Density Means Low Energy Costs) viii For a Healthier Country, Overhaul Farm Subsidies ix Sperlings Best Places(www.bestplaces.net)-Economic Profiles for Beverly Hills and Compton x Dietary intake and dietary quality of low-income adults in the Supplemental Nutrition Assistance Program xi Poverty and Obesity in the U.S.-American Diabetes Association xii Dietary intake and dietary quality of low-income adults in the Supplemental Nutrition Assistance Program xiii Poverty and Obesity: The Role of Energy Density and Energy Costs xiv Poverty And Obesity: Breaking The Link xv Economic Impact of Obesity - Yale Rudd Center for Food Policy and Obesity
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