January 15, 2012
It’s become conventional to blame fast food for the epidemic of obesity afflicting the poorest Americans. But, as GOOD reports, a UC Davis study of thousands of adults found that McDonalds, Burger King, et al. are shoveling the fat higher up the income chain…
The relationship between fast-food eating and income looks less like a negative linear relationship—where the lower one’s income, the more fast food they eat—and more like an “inverted U.” Patronage of fast-food restaurants increases as families move out of the low-income bracket, peaks in the lower regions of the middle-income population, then declines after families begin to earn more than $60,000 annually.
From a commercial point of view, it makes perfect sense for the fast food establishment to target the middle class: they tend to operate under a perpetual time-and-money crunch– less free time + more children + shrinking disposable income = more Drive-Thru. Besides, most fast food restaurants don’t accept food stamps.
America’s poorest are, of course, even more income constrained. For too many of them, a friend in the grocery business explained, “it’s all about getting as many calories as you can for your dollar.” That’s a competition that processed foods essentially always win… and so obesity and its evil children (Type Two Diabetes, et al.) are rampant.
At least some of America’s poorest have Medicaid coverage; so treating the expensive chronic ailments that result from horrible diets is possible– albeit a burden on the national treasury.
But for America’s middle class, the situation is the opposite: the wounds are self-funded– they pay their Arby’s tabs with their own money. And the consequences– the costs of dealing with chronic illness, or the pain of not being able to afford to– are also (increasingly) borne directly. A Robert Wood Johnson Foundation report (pdf here) notes that the number of middle-class Americans covered by health insurance has dropped over the last decade far faster than that of any other income cohort; only 66% of middle-class Americans are covered by employer health plans; very few by individual plans.
Indeed, obesity-driven health problems can all too often be a family’s ticket from the middle class down into poverty: A study published in the American Journal of Medicine (pdf here) reports that 62% of all U.S. household bankruptcies were driven by medical debts; most of those in middle class households with inadequate or no insurance. And, of course, many of those cases were obesity-related.
The obesity epidemic is costing America dearly. Leaving aside the human costs to focus simply on economics, its drag on Medicaid is unnecessarily expensive at a time when the nation can ill afford it. But its evisceration of middle class income and savings is even more damaging at a time when the country is struggling to turn itself around in a way that depends on a resurgent middle class.
The debate rages over the appropriate role for government to play in addressing the issue. But surely one thing is clear: Americans “deserve a break today”– a break from the fast food habit.