Income Inequality Affects Health Outcomes - Literature review Example

Income Inequality Affects Health Outcomes The types of foods a person chooses to consume affects their health. This is common knowledge. What may not be as apparent is that food choices are greatly affected by family income. Generally, healthier foods cost more which eliminates them as a choice for low-income shoppers. Its also common knowledge the income inequality, the unequal distribution of wealth in the nation, is expanding. Few in the middle or lower income level has noticed a recovery in the years following the economic crash of 2008 and the subsequent recession. (Landy, 2013). The rich have become richer while corporations have posted record profits. Those at the other end of the income spectrum is paying a terrible price for this unequal wealth distribution. Those who have the least health care options, the poor, have little choice but to eat unhealthy foods which cause them to need more health care. The added health care costs ultimately affect everyone, economically speaking, but the health outcome is catastrophic for those unfortunates at the bottom of the social ladder. Obesity, the health risk of eating poorly are long, varied and serious. Living in a poor household means having fewer choices in life. In this unfortunate circumstance, they have little choice but to live unhealthy lives. As a result of the added risk factors linked with poverty, low-income people who face food insecurity on a daily basis are particularly susceptible to being obese. An extensive nationwide study conducted in 2005 concluded that BMI (body mass index, which quantifies excessive body fat) rose more each year during the 1980s and 1990s among lower income/educated families than those in households with a higher income/education. In a national sampling of more than 6,000 adults "Wages were inversely related to BMI and obesity, meaning, those with low wages had increased BMI as well as increased chance of being obese." ("Relationship," 2010). Data collected by the CDC (Center for Disease Control) from the early 1970s through 2002 reveals the obesity rate for the poor rose five to six percent more when compared to persons earning middle and upper incomes. The obesity rate for all children aged 10 through 17 rose an astonishing 10 percent in just five years, 2003-2007 but, during this same period and age group, the obesity rate jumped 23 percent for children living in low-income circumstances. Poor kids are more than two times more likely to be overweight according to the study. A study based in 2007 involving children in this same age group found similar results. Another in 2009 tracking more than 12,000 children aged 2 to 19 discovered poor kids were close to twice as likely to be overweight. In study after study societal poverty rates were convincingly linked with higher rates of childhood obesity. ("Relationship," 2010) It may, at first glance, seem counterintuitive that people who have less money to allocate for groceries than middle and upper income earners are a greater risk of being overweight. Less money for groceries means consuming less food so why would they be heavier? Low-wage earners face similar food influences as all others such as larger portion sizes at restaurants, an increase of processed foods available at the grocery store and living increasingly less active lifestyles. The poor, which includes all who face food insecurity, are also burdened by additional and unique problems embracing healthful eating habits. Low-income communities have limited resources. This includes choices of food. Grocery stores in poor neighborhoods are seldom "supermarkets" that contain aisles of healthy foods due to the higher price tag associated with them. For example, the better neighborhoods carry several choices of sweeteners but the smaller store in an impoverished section of town likely only stocks regular, processed sugar. Their customers can better afford $2 for a bag of sugar than $7 for Stevia or similar product. Small stores dont have enough shelf space for items that dont sell. Larger stores also have a large produce section with a greater variety. The smaller store in the poor section of town probably wont stock Kiwi fruit or avocados out of season. The poor customers are less likely to have reliable transportation necessary to reach better stores nor the money to take advantage of healthier food choices anyway. "One of the most comprehensive reviews of U.S. studies examining neighborhood disparities in food access found that neighborhood residents with better access to supermarkets and limited access to convenience stores tend to have healthier diets and reduced risk for obesity." ("Why", 2010). Healthy food choices are becoming increasingly popular. Generally, these "trendy" foods are much more expensive such as in the case of sweeteners. A considerable segment of society is on a food budget that cannot include trendy, more expensive items. At least not if they want to buy food plus pay all the bills. According to the U.S. Department of Agriculture, in 2012 nearly one-fifth of U.S. households were considered "food insecure" meaning they dont always have enough money to buy groceries necessary to feed themselves. (Ferdman, 2014). This is a sobering statistic for any country and especially the U.S., widely considered one of the worlds wealthiest nations. While healthier food options are pricier, those foods with added sugars, corn syrup, fats and refined grains are usually less expensive. These foods contain higher calories, lower nutritional value, are linked to weight gain and usually the only available options in low-income neighborhood stores. When healthier foods, particularly fresh produce, is available in lower income stores its often of inferior quality than produce found at stores in the better areas of town. The less appealing fruits and vegetables does not sell as well therefore seldom reaches the dinner table in lower income households. Unsurprisingly, fast-food chain restaurants are more densely located in lower income areas and conveniently near schools. The majority of menu items in these chains are inexpensive, nutrient lacking and energy dense. "Fast food consumption is associated with a diet high in calories and low in nutrients, and frequent consumption may lead to weight gain." ("Why", 2010). In addition, fast food and other companies know their consumers eating habits and disproportionately target advertising to low-income areas. This marketing strategy exerts a great influence on food and beverage choices, especially among impressionable youths. Income inequality, the main cause of food insecurity, affects all aspects of life for those struggling to survive. People who cannot always stretch their food dollar to reach until the end of the month, at times, are involved in a seemingly endless cycle of food deprivation and over-indulgence when food finally becomes available. This cycle results in a great disparity of food intake during the month, a circumstance which is a contributing factor in weight gain. This cycle often results in an unhealthy preoccupation with food consumption in addition to physical metabolic changes which encourage the storage of bodily fat. This condition is exacerbated when combined with overeating unhealthy types of foods. In lower-income areas, these unhealthy choices are readily available thus perpetuating the cycle. This a problem most acute for parents because they will sacrifice the amount of their own food intake for the sake of their children. Add that a parents, especially maternal, obesity is a strong predictor of youth obesity. Several endless cycles of unhealthy eating habits affect others for low-income families, a circumstance that is all but impossible to escape. Low income earners also face higher levels of stress as any of us who have ever been broke, even for a short time, can readily attest. All members of low-income families usually cope with high stress levels most all the time due to living in poor housing conditions in high-crime areas, working long hours doing physically demanding work for low pay with little hope for change, inadequate health care access, food insecurity, transportation issues along with many other stress-related factors. The presence of stress alone, independent of cause, has shown to contribute to obesity. Stress-induced metabolic and hormonal changes can contribute to weight gain. "Stress, particularly chronic stress, may trigger anxiety and depression, which are both associated with child and adult obesity. ("Why", 2010). Another contributing aspect income inequality makes to the obesity epidemic in poor neighborhoods is the lack of opportunity for physical fitness. Poorer sections of town have, as mentioned, fewer resources which includes fewer recreational facilities, parks, bike paths, community swimming pools, etc. that could contribute to healthier lifestyles. Less physical activity increases the chance for more weight gain. Even if these depressed neighborhoods had adequate access to outdoor exercise facilities, the poor parts of town are never the safest parts of town. Depressed conditions in poor neighborhoods usually indicate the playground equipment, when available at all, is not safe on which to play. In addition, crime, drug traffic as well as vehicle traffic frequently discourage outdoor physical activity. Children are often encouraged stay in their house where they watch television or play video games, sedentary activities which lead to weight gain. Organized sports for children require equipment and transportation, both of which are an extra expense families who are food insecure cannot afford. According to a 2009 study by the UCLA Center to Eliminate Health Disparities, schools in poor neighborhoods are funded by a smaller tax base which limits the ability to offer physical fitness facilities equal to higher-income areas. Low-income schools are also less likely to offer recess or physical education classes. ("Why", 2010). The long list of economic hardships associated with being poor are distressing. Add to that the health consequences due to being overweight. As it relates to health conditions, being obese has been compared to being 20 years older. The obese spend more on health care related issues than smokers or heavy drinkers. (Sturm, Wells, 2002). A small sample of chronic physical conditions caused or worsened by obesity are Heart Disease, High Blood Pressure, Diabetes, damage to various internal organs, bones and joints along with a list of other grisly conditions. Obesity also affects emotional and psychological health. Depression is common among the obese, as if the poor needed additional reason to be more miserable. People who are noticeably overweight experience humiliation on a regular basis. It may be children or strangers who snicker or make unpleasant remarks, years of dieting failures, relationship issues, family disapproval, uncomfortable public seating, clothes shopping, etc. ("Obesity-Related," 2014). According to the Pew Research Center the gap in income of the nations wealthy and poor is at its largest in nearly 80 years. The banking failures and resulting housing price collapse in 2008 was due, simply put, by the wealthy inappropriately gambling the economic future of the middle and working class. The nations financial recovery has favored only the wealthy. "The financial crisis was particularly unkind to the Americas poor - inequality rose sharply across the country in its wake." (Ferdman, 2014). Income inequality causes food inequality. There exists an enormous difference with regards to the types of foods the rich and poor eat. Poverty is a considerable health risk in terms of food intake alone. The privileged eat higher quality foods therefore are healthier both mind and body. This food inequality gap continues to expand. A study by the Journal of the American Medical Association Internal Medicine examining eating habits between of Americans across a broad economic specter between 1999 and 2010 determined "socioeconomic status was associated strongly with dietary quality, and the gaps in dietary quality between higher and lower socioeconomic status widened over time." (Ferdman, 2014) The study also found the eating habits of all adults improved over this period but worsened for the poor. Those who can afford it are eating better but those who cannot are eating worse, much worse. Food, at least decent, healthy food, has become a luxury item in this country affordable to only the fortunate ones much the same as a shiny new Cadillac, home in the suburbs, quality healthcare or higher education. The health consequences of being poor affect everyone whether directly or by way of higher across the board health care costs. Its a lose, lose situation that can only be alleviated by narrowing the financial gap. If not, more of us will be drawn closer to the bottom of the income scale. As income inequality grows, fewer people will have disposable income and they shop less which ultimately lowers profits for businesses who cannot afford as many employees, at least at decent wages. Money in the hands of the poor is circulated immediately therefore stimulating the economy but the wealthy put much of their money in institutions, making money from money. This does not boost the economy. Income inequality hurts the nation but its the poor who feel it first and worst. Works Cited: Ferdman, Roberto. "America’s growing food inequality problem." The Washington Post. 2014. Web. November 12, 2014 http://www.washingtonpost.com/blogs/wonkblog/wp/2014/09/02/americas-growing-food-inequality-problem/ Landy, Benjamin. "A Tale of Two Recoveries: Wealth Inequality After the Great Recession." The Century Foundation. 2013. Web. November 12, 2014 http://tcf.org/work/workers_economic_inequality/detail/a-tale-of-two-recoveries "Obesity-Related Health Conditions." Danbury Hospital. 2014. Web. November 12, 2014 http://www.danburyhospital.org/en/Our-Services/Center-for-Weight-Loss-Surgery/Understanding-Obesity/Obesity-Related-Health-Conditions "Relationship Between Poverty and Overweight or Obesity" Food Research and Action Center. 2010. Web. November 12, 2014 http://frac.org/initiatives/hunger-and-obesity/are-low-income-people-at-greater-risk-for-overweight-or-obesity/ Roland Sturm, Kenneth B. Wells. "The Health Risks of Obesity." Rand Corporation. 2002. Web. November 12, 2014 http://www.rand.org/pubs/research_briefs/RB4549.html "Why Low-Income and Food Insecure People are Vulnerable to Overweight and Obesity." Food Research and Action Center. 2010. Web. November 12, 2014 http://frac.org/initiatives/hunger-and-obesity/why-are-low-income-and-food-insecure-people-vulnerable-to-obesity/ Read More