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Weighing In: Toward a New Era of Obesity Reform

Recent reports from the CDC and Trust for America’s Health have heralded a decline in obesity. Although still high, the obesity rate has lowered, particularly among children aged 2-5, across multiple states. However, two statistics remain troubling: obesity rates stayed higher for racial/ethnic minorities, and obesity rates remained high in socioeconomically disadvantaged communities. From an intervention perspective, the problem lies in (1) the reductionist belief that obesity is a modifiable condition that rests on the individual’s responsibility to change, and (2) the assumption that fixing one component of a community will fix all place-based inequities. Once we have debunked these prevailing thoughts, we will see dramatic declines in obesity across all communities.

Most obesity research has focused on individual-level explanations: biology, food culture, health knowledge, activity engagement, and child rearing practices are just a few of many mechanisms that researchers have used to frame the problem of, and solution to, obesity. This body of work has led to many individual-level interventions, such as Michelle Obama’s Let’s Move campaign, the NFL’s Play 60 campaign, and the Children’s Healthcare Stop Sugarcoating advertising campaign. The messaging of the problem is clear: Americans need more awareness of the problem and behavioral modifications to curb obesity. It is a compelling, visual message.

However, these interventions fail to illuminate the structural conditions that perpetuate health inequalities. For instance, it is incredibly challenging for the working poor to afford healthy foods, since they make just enough to disqualify for food assistance. Or, it is difficult to be motivated to exercise after working long hours at multiple places of employment. The larger structural injustices present in the labor market, as well as in other dynamics such as immigration policy and racial discrimination, play a role in determining who can engage in active lifestyles, which perpetuate a poorer and heavier underclass.

How we deal with spatial challenges to obesity is even more concerning. My research has demonstrated that place matters, particularly for obesity, diabetes, and cardiovascular illness. Indeed, my recent research suggests that one’s residential environment is shaped by larger social inequalities, perpetuated by local elites who continually funnel resources into some areas, but not others. This uneven development has created stark social class differences, and in some cities, these differences can be seen simply by crossing the street. However, in combating obesity, interventions such as increased supermarket access and building recreation centers have been deemed appropriate – despite some evidence that obesity rates may not vary significantly among individuals who live close to or far from these amenities.

However, the absence of these structures is telling of a larger concern: strategic public investment needs to occur in low-income areas to increase geographic health equity. The “build it and they will come” philosophy has helped lower obesity in some communities, but the larger structural conditions of capital flows/investments that create socioeconomically disadvantaged neighborhoods will continue to stifle any progress of eliminating health disparities.

So, while we have some exciting news on the obesity front, our continued progress in achieving health equity is contingent upon reframing the problem as less about the individual, and more about the larger social forces that shape behavior. Similarly, instead of dealing with geographic inequities in a piecemeal fashion, we need to end the cycle of non-investment in poor and underserved areas, so that “place” is no longer tied to large socioeconomic and health disparities.

 

Antwan Jones, Ph.D. is an assistant professor in the Department of Sociology at The George Washington University. He received his B.A. in Sociology and African & African-American Studies from Duke University and his Ph.D. in Sociology from Bowling Green State University. Dr. Jones is trained as a social demographer, and his research examines various intersections in the areas of race/ethnicity, socioeconomic status, and health. As an urban sociologist, he is particularly concerned with how socio-environmental processes affect the health and well-being of children and adults.

Author: Antwan Jones

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  1. This is a great synopsis of our American issue around obesity. I do believe it is a community issue. Environments have proven to be one of the most effective strategies to address issues. Empowering communities to celebrate and become enthused with healthy living practices will influence many to become more attentive to their personal health and take the necessary action steps to work on themselves/ourselves. I loved this.

  2. This is a fantastic structural analysis of obesity. Too often, we look to individuals to solve the problems that our institutions have created. Your research shows how short-sighted that is. I echo the call for strategic public investment! Thank you for sharing your work.

  3. This was a very informative post and brought out some points that I hadn’t thought about before. I find it interesting that while your financial situation doesn’t directly affect your weight, it does have inadvertent results. Like you said, who has the energy to go to the gym when simultaneously working two jobs? There are only so many hours in the day, and earning a living has to be a priority.

  4. I agree with the last commenter, but I also think the type of job you choose has a lot of bearing on your physical condition – driving a bus for instance, or sitting behind a desk all day gives you more of a chance of obesity than being a janitor or a dockworker. While I realize some people don’t have a lot of choice in their employment options, when you do, it’s healthier to go with more active opportunities. All in all this is a very complex issue, but you’ve written an intelligent article and made some good points. Thanks.

  5. Very insightful article. The challenge to ending any sort of inequality,whether in health, schools, or housing, is getting people to understand that inequality is a product of structures and systems and not about individual failings. This article is a great contribution to that effort.

  6. It’s so nice to read a well-written and informative post about a subject that I have strong opinions on! It makes me feel smart :)
    As a teacher, I have seen the differences in social class & diet and it’s disheartening to see. I have always thought that social class and obesity were linked because in order to maintain a diet of highly nutritional food one has to spend a lot of money. Budget friendly food items are often (always) cheaper and more appealing to people who just can’t spend a lot of their income on food. This just doesn’t seem right.

  7. It’s interesting that this article coincides with National Public Health Week – very timely. We should all try to do something for our bodies this week. Maybe one step in the right direction will lead to a lot more. Walking is a great solution for those who are unable to make it to the gym. Inexpensive and simple, it can be a social activity and is one of the healthiest things you can do for your physical and mental well being. As you can probably tell I’m a great fan of hoofing it.

  8. Very good read. Like you, I am happy to see that the obesity rate is starting to come down, but it is still discouraging to see that obesity is maintaining it’s hold within certain groups.
    I love that we are seeing a lot more emphasis on “getting out” and getting fit in the media. You mentioned the Play 60 program, and as a parent whose son has benefited from this, I can tell you that it definitely energizes these kids – many of whom would rather play a sports themed video game than play an actual sport. This is a great sign of what could be on the way in the near future!

  9. I can attest to the fact that many neighborhoods that are made up of a predominantly minority population are targeted by food chains and stores that offer a menu of foods that are unhealthy to say the least. Where I grew up, there were no whole food stores being built. There were no Jamba Juice franchises moving into town. Instead, we would see one fast food place after another moving in. It definitely seems to me that the link between social class and health should be obvious to everyone, but I guess sometimes you have to live through something in order to see it for what it really is.
    Great article. Well written and thought provoking.

  10. Wow. Very, very good article to read. I am going to share this with my class next week, and use it as a springboard to a class conversation. So, thank you for helping me with my teaching material!
    The entire article was very well-written, but it was the last paragraph that really touched me. You’re 100% right. Until we see a “buy-in” that involves educating & caring for our communities instead of one individual at a time, we will continue to see large socioeconomic and health disparities.

  11. I believe that you’re right. There are absolutely connections between socioeconomic stature and health. More must be done to ensure that all of our communities are taken care of, and that none of us are left behind – concerning our health – simply because of where we come from & who we are.
    As a whole, the country has got to start in the schools. School lunches these days are actually causing a lot of kids (who often depend on a full meal at school as their only true meal of the day) to go hungry. Like it or not, it all starts with investing in our children, regardless of where they live.
    An investment in the quality of food our children get in school can lead to a huge pay off in the overall health of our nation.

  12. In your excellent article you state, “Strategic public investment needs to occur in low-income areas to increase geographic health equity.” Well that’s an understatement if ever I heard one. It also needs to occur to increase educational equity, job equity, income equity, etc. While you focus here on one aspect of this huge societal problem, you draw attention to an age old issue. Lower income equals a lower quality of life. What’s to be done?

  13. I completely agree that supermarkets and facilities to exercise or join in physically healthy activities is lacking in poorer economic neighborhoods. I believe also that those towns and cities that are building these “get up and move” amenities are also putting some unnecessary “red tape” on memberships and such. Some offer a substantial discount only if you are an in town resident and not necessarily if you live within the city. I’d love to see the government funnel their money more proportionately because I have seen the “other side of the rail road” scenario in towns way too much. But there always seems a Catch-22 clause.
    However, I am not all together sold out on Catch-22 scenarios. I believe the focus should be on the obesity itself regardless of race or economic standing. I absolutely hands down would advocate for a food assistance program where a certain amount of money was given to obese citizens (still based on income) for raw food only purchases. The federal food assistant program still regulates rather you can buy hot or cold food via the barcode and I do believe the raw fruit and vegetables could be regulated as well. People in Raleigh, NC have to take a budgeting class on how to buy groceries so why not one on nutrition (since you already have their attention).
    Yes, I completely agree. The government has a hand in our food already so why not help those who are literally dying over it.

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