The Link Between Obesity and Poverty

Obesity is commonly viewed as having three primary influences: genetics, diet, and exercise. But if future studies support recent research, a fourth factor may eventually be added to that list: economics.

In January 2004, the American Journal of Clinical Nutrition published a study that linked obesity with poverty. The study was authored by Dr. Adam Drewnowski of the University of Washington School of Public Health and Community Medicine, and Dr. S.E. Specter, a research nutrition scientist with the U.S. Department of Agriculture.

A Jan. 4, 2004, article about this study on the ScienceDaily website noted that low-income consumers are more likely to purchase high-calorie, energy-dense foods (those that are higher in fat, sugar, or salt). Foods in this category are more likely to contain "empty calories," nutrition-poor elements that the body often converts directly to fat.

"The reason healthier diets are beyond the reach of many people is that such diets cost more," Drewnowski said in the ScienceDaily article. "On a per calorie basis, diets composed of whole grains, fish, and fresh vegetables and fruit are far more expensive than refined grains, added sugars and added fats."

Studies support obesity-poverty link

Though the global obesity epidemic includes individuals of all socioeconomic levels, a series of findings that were reported in the May 6, 2008, edition of the Philadelphia Inquirer point to a higher prevalence of overweight and obesity among the world's poorer citizens. The article included the following statistics in support of the obesity-poverty connection:

• The U.S. Department of Health and Human Services has found the obesity rate among poverty-stricken women to be 50 percent higher than it is among women of higher socioeconomic status.

• According to the U.S. Centers for Disease Control and Prevention, 31 percent of women in U.S. households whose total annual income is less than $15,000 are obese. In households in which the total annual income is $50,000 or greater, the obesity rate among women is 17 percent.

• Researchers with the University of Pennsylvania, Johns Hopkins University, and other institutions determined that poor teenagers (ages 15 to 17) were 50 percent more likely to be overweight than were non-poor teens in the same age range. This study found the higher percentage of overweight was the same among male and female teens, as well as among adolescents who are white or African-American.

Along a similar line of research, an analysis of data collected by the U.S. National Health and Nutrition Examination Survey during the years 1999 to 2004 found a higher rate of overweight among children ages 2 to 19 who resided in impoverished households than among children from more financially secure households. This study, which was reported by Medscape General Medicine in May 2007, determined that impoverished children were 3 percent more likely to be overweight.

The U.S. Census Bureau determines poverty according to a household's annual income and the number of individuals who live there. In 2006, the most recent year for which statistics are available, the poverty threshold for a family of four (two adults and two children) was an annual household income of $20,444.

Experts search for explanations

Researchers and other health care experts have offered a number of hypotheses to explain the cause of the connections they have discovered between obesity and poverty. Among the most prevalent rationales are the higher price of healthier food and fewer opportunities for exercise in poor neighborhoods.

For example, one of the conclusions of the Medscape study group was that continued increases in obesity rates "likely result from the interaction of various biological and social factors in an environment that provides an overabundance of high-calorie foods with fewer opportunities for physical activity."

Academic conclusions like this are supported by first-person accounts provided by impoverished individuals.

Tianna Gaines, an obese 28-year-old woman who lives on public assistance in an economically disadvantaged area of Philadelphia, echoed the Medscape study group's finding in her comments to the Philadelphia Inquirer. In addition to noting that healthy food is more expensive and harder to find where she lives, she stated that exercise opportunities are more difficult to come by as well. "I don't have the money for Bally's fitness clubs," Gaines told Inquirer reporter Alfred Lubrano. "And I can't run here. They shoot you."

Twelve hundred miles away, single mother Tyann Taylor (a certified nursing assistant who relies on food stamps to feed herself and her five children) painted a similar picture for Minnesota Public Radio. "I would love for [my children] to have more fruit with every meal, fruit for a snack. But it's hard to do that because it's expensive," Taylor told MPR reporter Elizabeth Stawicki. "My kids are not eating healthy, because I can't afford to give them what they need."

The same article in which Taylor is featured cites the head of the Minnesota Center for Obesity, Metabolism, and Endocrinology as acknowledging the dilemma faced by less affluent shoppers. "Low-income people have the toughest decisions to make regarding what they can buy with the limited resources that they have," said Dr. Michael Gonzalez-Campoy. "Sometimes healthy food is not a part of that equation."

Prognosis appears grim

Though ongoing research and continued publicity are raising awareness of the association between poverty and obesity, economic difficulties in the United States threaten to make the problem even worse. A May report by the U.S. Department of Agriculture notes that causes as diverse as calamitous weather patterns, a weakening U.S. dollar, and a rising demand for biofuels has resulted in an unprecedented increase in the price of standard commodities such as grain and vegetable oil.

As food prices rise and household incomes stagnate, experts predict that low-income individuals will experience greater difficulties in their efforts to live a healthy lifestyle. In the opinion of at least one researcher, these difficulties will lead to higher rates of overweight and obesity among America's poor.

"Obesity is the toxic consequence of a failing economy," Drewnowski told ScienceDaily.

SOURCES
Medscape General Medicine. "Childhood overweight and family income." Posted May 3, 2007. (http://www.medscape.com/viewarticle/552148)

Minnesota Public Radio. "Poor and overweight: A connection?" Posted May 31, 2006 (http://minnesota.publicradio.org/display/web/2006/05/11/healthyeating/)

Philadelphia Inquirer. "Food costs likely to boost obesity in poor." Posted May 6, 2008. (http://www.philly.com/inquirer/home_top_stories/20080506_Food_costs_likely_to_boost_obesity_in_poor.html)

ScienceDaily. "Researcher links rising tide of obesity to food prices." Posted Jan. 5, 2004. (http://www.sciencedaily.com/releases/2004/01/040105071229.htm)

U.S. Census Bureau. "Poverty." Accessed May 19, 2008. (http://www.census.gov/hhes/www/poverty/overview.html)

U.S. Department of Agriculture. "Global Agricultural Supply and Demand: Factors Contributing to the Recent Increase in Food Commodity Prices." Updated May 1, 2008. (http://www.ers.usda.gov/Publications/WRS0801/)