Obesity is one of the deadliest diseases in the U.S.. With a prevalence of 39.

8% in
the American adult population (Morbidity and Mortality Weekly Report (MMWR)) and
the source of health complications ranging from diabetes to cancer, obesity is quoted as
the second biggest killer in the country (Schneider, 237). More than ethnicity, race or age
the most shocking disparity is that caused by socioeconomic status with the prevalence
of obesity for low-income individuals at 39% and higher income individuals - 32%
(Morbidity and Mortality Weekly Report (MMWR)). I will argue that the U.S. creates a
structurally violent environment where both micro and macro-level factors lead to
increased obesity rates among people of low socioeconomic status.
Looking through the spectrum of the Braveman model of social determinants of
health, the high risk of obesity among low-income people is not necessarily caused by
personal choice, but rather by upstream factors such as residential segregation.
Residential income segregation doubled in the last thirty years (Massey), which
contributes to obesity in two ways. Firstly, low-income neighborhoods attract mainly
fast-food restaurants, resulting in the creation of the food deserts (Schneider, 245). With
no proximity of sources of fresh food, people have no choice but to consume
high-calorie products. Secondly, low-income neighbourhoods are usually higher in crime
and usually lack parks or athletic facilities, creating an environment preventing people
from physical activity. This is only aggravated by downstream factors such as the lack of
disposable income for gym memberships. The imbalance between increased calorie
intake and decreased physical activity then leads to obesity.
Another significant upstream factor is the lack of access to education. College
graduates have significantly lower obesity prevalence (at 27.8%) than those without a
degree (about 40%, varying with years of education) (Morbidity and Mortality Weekly
Report (MMWR)). Low-income individuals have less access to quality education, due to
schools in poorer areas being underfunded and low-income students excluded from
resources available to their wealthier counterparts. Low-income individuals therefore
have decreased access to knowledge of health and will lack the understanding of
consequences of an unhealthy lifestyle, leading to higher levels of obesity (Devaux).
The final factor leading to higher levels of obesity is the exposure to stress, which
is significantly higher among low-income individuals (Brondolo). Psychological stress has
been repeatedly linked to obesity, due to its effect on the distribution of adipose tissues
(Scott). People of low income face increased stress ranging from midstream factors
(living in more violent communities) to downstream factors (lack of sleep due to working
many shifts or worry for the provision of one’s family). Such disproportionate exposure
therefore significantly affects the rate of obesity in the disparity.
Although the above factors are true at the end it is also worth noting that their
effects will vary across disparities, due to the intersectionality of the issue. For example,
whilst the inverse relationship between weight and income is true for women this
relationship is not so clear cut for men (Morbidity and Mortality Weekly Report
(MMWR)). For men the prevalence of obesity between income groups varies
significantly less (Morbidity and Mortality Weekly Report (MMWR)), possibly due to
differences in societal expectations and consciousness of body-size between genders,
inviting for further exploration of the topic.
Sources:

Brondolo, Elizabeth. “Higher Stress Among Minority and Low-Income Populations Can
Lead to Health Disparities.” American Psychological Association, American
Psychological Association,
www.apa.org/news/press/releases/2018/01/stress-minority-income.aspx.

Devaux, Marion, et al. “Exploring the Relationship Between Education and Obesity.”
OECD Journal: Economic Studies, vol. 2011, no. 1, Sept. 2011, pp. 1–40.,
doi:10.1787/eco_studies-2011-5kg5825v1k23.

Massey, Douglas S., et al. The Annals of the American Academy of Political and Social
Science, U.S. National Library of Medicine, 1 Nov. 2009,
www.ncbi.nlm.nih.gov/pmc/articles/PMC3844132/.

“Morbidity and Mortality Weekly Report (MMWR).” Centers for Disease Control and
Prevention, Centers for Disease Control and Prevention, 26 Feb. 2018,
www.cdc.gov/mmwr/volumes/66/wr/mm6650a1.htm?s_cid=mm6650a1_w.

Schneider, Mary-Jane, and Henry S. Schneider. Introduction to Public Health. 5th ed.,
Jones & Bartlett Learning, 2017.

Scott, Karen A., et al. “Effects of Chronic Social Stress on Obesity.” Current Obesity
Reports, vol. 1, no. 1, Nov. 2012, pp. 16–25., doi:10.1007/s13679-011-0006-3.