One third of America is obese, but they never harm anyone except themselves, so it’s never been anyone’s business as far as social issues go. That’s changed. We now know that this third, that’s 70+ million obese Americans, affect our economic well being directly when they clog our health care system by spending 42% more than normal weight Americans. Obese people are eating America into the poor house.
Are Obese Americans the cause of all of our economic problems? Of course not, dumb home buyers, greedy real estate players, credit default swaps and a pendulum-like two party system had something to do with it too, but if you take a step back you may see a common theme here. The American consumer buys what they can’t afford, the American businessman works unethically to make more money and our leaders focus more on feeding their political coffers and exploiting factionalism to further their careers rather than solving the country’s long term problems … and all of us eat more food than we need for nourishment, some of us to the clear detriment of our health.
Don’t get me wrong, America is the greatest country on Earth and I believe that with all my heart, but there has to be a downside to our success and freedom. Here it is. Let’s look at it. Our narcissism, pride and love of American violence and power can be left for another post, but American gluttony goes deep to the root of our problems and should be explored.
First let’s play devil’s advocate for a moment. There are several systemic factors that lead to America’s obesity, such as unhealthy food being the cheapest to acquire. Try buying two hundred calories of preserved junk food and then buy two hundred calories of fresh healthy food and compare the price for each. This might let you in on why so many obese Americans come from the ranks of lower income families as well as to how much choice they have in their diet, but my defense ends there (although you should watch the film “Food Inc.” to explore an expansive issue). Many families purchase relatively healthy food with little money and keep their children from eating too much while maintaining an active healthy lifestyle, so the “bad food is cheap” argument only goes so far.
The assumption that educational and/or income levels correspond to rates of obesity seems inadequate. An extremely informative dual analysis from Daruis Lakdawalla and Carol Graham published by the Wall Street Journal shows why. Obesity simply crosses too many social boundaries for an educational or income based explanation to hold all the water. According to Lakdawalla, Obesity rates from 1976 to 2001 doubled among high school dropouts, but the same rate tripled among college graduates, leaving more than one out of six college graduates obese.
Graham then goes on to show the irregular differences in obesity among socioeconomic and racial groups highlighting that women of all racial groups and socioeconomic levels have a higher incidence of obesity than men who have obesity rates more evenly distributed among these distinctions. At one point, she frustratingly asks why black men are the thinnest group and black women are the most obese. Graham also notes that the problem varies among other countries, showing that rich Russians are more obese than poor Russians, which used to be the case with the United States one hundred years ago.
This brings her argument to focus on social norms and their role in obesity in America. However, both come to the conclusion that rich American’s still generally have the best outcomes for weight maintenance due to their social norms and incentives for success and continued affluence through better health while many lower income families have a bleak outlook on their futures and, therefore, a limited desire to plan for their future health as well. This illuminating article waters down potential tactics for change to incentives versus social norms. Lakdawalla is a clear proponent of utilizing incentives to affect concrete and measurable change while Graham agrees, but is hesitant to dismiss to role that social norms play in this quandary.
So, where does this leave us? We still have a large drain on American medical resources and there is no way to address this problem without infringing, even slightly, on the individual rights of American’s. An incentive based approach, which can be more easily manipulated by policy makers, could involve positive incentives such as employers providing a lower insurance deductable for non-obese non-smokers, but people with difficult genetic weight problems would have a harder time taking advantage of this. More likely are disincentives such as the one proposed by Clarian Health Partners, an Indiana-based hospital chain, which charges employees up to $30 every two weeks unless they meet weight, cholesterol and blood pressure guidelines the company deems healthy.
We can find an example of what it’s like trying to change social norms in the case of Michelle Lombardo, a consultant funded by Kellogg, who had children at a school in Kissimmee, Florida recite a pledge to eat low fat, high fiber, drink lots of water and exercise, but the downside came quick when one parent soon complained their child refuse to eat any of the food they had because it was unhealthy. Mom couldn’t afford to throw away her food and buy the more expensive stuff just because this Lombardo woman got an idea in her head for somebody else’s children.
As we can see from both incentives and the intentional altering of social norms that this would create a health care system that many will liken to a police state. This is hard to argue with, but let’s try.
Take another example of the effects of American gluttony, airline seats. Airlines are beginning to charge obese individuals for two seats and some think this is wrong, but break that down to brass tacks and we can learn something. When you ship something in the mail, you are charged by weight for simple reasons of practicality involving the weight capacity of transport, but why is this not the case with airline seats? Every airplane can only take a certain amount of weight, but still you’ll see a 120 pound passenger get charged for luggage just over 50 pounds, while a 250 pound passenger is charged nothing because they packed a 45 pound suitcase. The first passenger is bringing about 170+ lbs onboard, but that second passenger is walking onto the plane with almost 300 lbs of weight.
We’re talking survival here, so we shouldn’t feel bad when we damage the obese passenger’s ego by charging them for two seats, because now they’re paying for the weight they brought onto the plane. Look on the bright side, our theoretical obese passenger can bring twice as much luggage and would be entitled to two meals. Think of this country as a big airplane and if we don’t keep ourselves honest about how much everybody weighs, we’re all gonna crash.
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