Thoughts on Childhood Obesity and Poverty

Between working as research assistant on a cancer-risk study and a social work intern at the University of Chicago Hospital—I’ve been thinking a lot lately about the intersection between poverty and obesity-related diseases.

While America’s obesity problem is often blamed on a cultural addiction to television and fast food—I believe firmly that our eating habits are not shaped by culture and individual proclivities alone. This is especially true for America’s poor.

From my experiences teaching in urban neighborhoods and serving poor clients at the University of Chicago Hospital—I have deduced a few major problems that increase the likelihood that poor, urban children will suffer from obesity-related diseases.

Safety & Exercise.

One respondent I interviewed as a part of a cancer study, informed me that she did not exercise because it was not safe to walk around her neighborhood and she could not afford to join a health club. I realized afterward that my students in Englewood had often commented that the number of shootings in their communities forced them to stay inside the house as much as possible. When neighborhood streets and parks are not safe places for children to play —it is only logical to assume that they will not receive regular exercise.

Children in poor neighborhoods may also be pressured to work or to care for younger siblings after school. This makes it less likely that poor children will participate in after school sports programs. Furthermore, due to the demands of the No Child Left Behind Act, many schools have slashed recess and elective courses (such as gym class) in order to accommodate for extra test preparation.

School Lunches.

School lunches across the country are notoriously unhealthy. A recent Chicago Tribune article revealed that nachos submerged in a puddle of cheese are regularly served for lunch in Chicago Public Schools. Since that article’s publication CPS pledged to make their menu healthier by using whole wheat tortilla chips. (I’m sorry but whole wheat or not any meal drowned in fake cheese does not qualify as nutritious).

While most middle class children have the option of packing a healthier lunch from home, the majorities of poor children qualify for free or reduced price lunch and breakfast. Poor parents cannot afford to buy breakfast and lunch for their children—so poor children have no choice but to eat the high fat, low-nutrient meals at school. Is it any wonder that poor children suffer disproportionately from diabetes?

Grocery Deserts.

There are no grocery stores in the vast majority of inner-city neighborhoods. This means families who do not own cars will most likely be forced to buy their food at gas stations or fast food establishments. This means that many poor families are subsisting almost entirely on highly processed packaged foods with little nutritional value.

……………………………….

Between the French fries and pizza served at school and the packaged foods that stock the shelves at gas stations—most inner city children are likely to go through the day without ever consuming a fruit or vegetable item. As I consider the realities  discussed above, the issue of poor nutrition among America’s low-income children strikes me not only as a serious public health concern but also as a human rights issue.

It is proven fact that poor diet and the lack of exercise can lead to obesity, diabetes, heart disease and cancer. If this is true—shouldn’t all citizens have access to healthy foods and safe places to exercise? It seems to me that all Americans should have the right to practice good health. For poor, inner-city residents this choice is non-existent.

Currently many preventative health care programs in schools focus on educating students about the value of exercise and eating healthy. Such educational programs are valuable, but only when children have access healthy foods and safe places to play, walk, or ride bicycles. As long as structural inequalities that deny poor children the option of choosing healthy foods persist, preventative health care education will never accomplish much change.

Our government pumps billions of dollars into expensive medical procedures to treat obesity related diseases and has invested billions in medical research to discover more effective treatments. Why not invest more money in preventative care? There are a few steps I believe our government could take to greatly reduce the prevalence of obesity related diseases among our nation’s poor.

  • Give subsidies and other monetary incentives to low-income families in order that they can afford to buy produce and other healthy food items.
  • Invest money in improving school lunches
  • Provide incentives for grocery stores to move into low-income neighborhoods
  • Make parks and other public spaces safer places for children to play
  • More funding urban gardening programs and non-profit organizations (such as Girls on the Run) that bring exercise programming to schools
  • Mount an intensive public health campaign against the food served at fast food chains (similar to public health campaigns waged against smoking)

I am convinced that leading a healthy lifestyle is as important as access to good doctors and high quality medical care. If our government undertook some of the simple and relatively cheap suggestions above  (compare the cost of a heart transplant to the yearly cost of a healthier school lunch for one pupil)I believe we could radically improve the health outcomes of  many children. The real question is whether our nation will ever decide with sincerity that the health and well-being of poor, minority children matters.

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    • Catherine
    • August 22nd, 2010

    This is so true, Kathryn. You make a lot of good points. I can’t tell you how many times kids in my classes in Chicago referred to fruit snacks, vegetable chips, and other “fruit flavored” items as healthy. They didn’t even know that there was a difference between these foods and fresh fruits and vegetables.

    • Catie
    • August 26th, 2010

    This is a huge issue. I’m on a pediatric rotation right now, and I can’t tell you how many times this has come up. One of the doctors I’m working with had to get a note from her son’s pediatrician so she could opt out of the snack they serve at his daycare. She didn’t want him drinking the juice (basically empty calories), but they required the doctor’s note because this counted as the “fruit” serving for the snack/meal.

    Another doctor was talking about a community garden that he started at a local elementary school. He was teaching the kids about all the different vegetables, and asking them what kinds of foods had the vegetables in them. When he held up a potato a large number of them didn’t know what it was, and couldn’t tell him that French fries are made from potatoes. There’s something seriously wrong with the system when kids can’t even identify common fresh foods.

    Enough people have trouble motivating themselves to eat healthily or live a healthy lifestyle. It’s really sad when kids who might want improve their diets can’t because of what’s offered at school.

    • Catie thanks for your comment! It’s so interesting to hear your perspective on this issue– you have a lot more insight as a medical student. The example you gave about the nursery school lunch is really depressing. There just isn’t enough awareness about this problem.

        • Catie
        • September 8th, 2010

        I was talking about this with my family this past weekend. Two issues came up that you touched on in this article:

        1) Healthy foods are way too expensive. When you have to budget your grocery expenses, the calories per dollar value of a Twinkie is much higher than that of a carrot. Even if access to healthy foods wasn’t an issue, until these foods are affordable, obesity and its related health problems are still going to disproportionately affect lower socioeconomic classes.

        2) My brother-in-law felt that if there was a greater demand for grocery stores/produce in inner cities, those types of stores would open in those areas. I don’t know if this is entirely true, but I guess education on nutrition and healthy living couldn’t hurt. Still, the issue of the price of produce poses an obstacle to solving this problem.

        Anyway, I just thought I’d follow up because this came up in conversation again.

        I’ve really enjoyed reading your blog. Keep it up!

    • Brian Byers
    • September 2nd, 2010

    Enjoyed reading your article. Recently I’ve been thinking a lot about food and how the Western Diet is taking over the world. Living in Doha, I see all of the American fast food chains starting to cause the same obesity/health problems that America faces.

    I recently read Michael Pollan’s new book, “In Defense of Food”, and it is definitely worth a read. His main idea is just eat real food. Food has to have a symbiotic relationship with the people eating it for both species to survive. In today modern world, real food has cessed to exist with all the processed foods marketing to the hyperawareness of what is health.

    I think you’d enjoy reading it.

    • thanks, Brian. I’m always curious to hear about these things from someone who has an international perspective since my experience is pretty limited to the U.S. I’ve actually read “In Defense of Food” and loved it. I think Michael Pollan is one of the best journalists out there.

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