Income Inequality As Obesity Villain


Given everything we know about how multi-factorial the obesity epidemic is, we should be able to accept one thing as a cause without demoting another thing, which is probably also at cause. A doctoral candidate in sociology at Stanford University Priya Fielding-Singh wrote:

Over the past decade, study after study has shown that differences in access to healthy food can’t fully explain why wealthy Americans consume a healthier diet than poor Americans.

That is sad information, but maybe the apparent irrelevance of the food-desert hypothesis did not need to be emphasized. Look at history. A few years back, when one metric, in one demographic, improved by a couple of percentage points, people were going around declaring that childhood obesity was over.

When an authority says that food deserts “don’t drive nutritional disparities in the United States the way we thought,” this too could send an erroneous message. Many people who live in food deserts believe they they exist, and that should be enough.

Fielding-Singh has done the research in this area, where health and sociology meet. She worked with more than 150 individuals (members of 73 families) to extract some truths about the meaning of food. Her bio states:

I use interviews, observations, and surveys to examine how families’ socioeconomic circumstances shape their diets. My work not only shows how families across the socioeconomic spectrum think about, purchase, and consume food — it lays bare the implications of these consumption disparities for parents’ and children’s health.

Well, it sounds like the Nag Factor is winning. The author describes parents, both indigent and affluent, as “constantly bombarded with requests for junk food.” The kids want sugar, salt and fat… All the things that legislation often aims to protect them from.

Supposedly, the wealthier parents say no to junk food more often. High-income parents generally have had more education, says Fielding-Singh, and are more apt to have standards around the lofty ideal of responsible parenting. They see themselves as instilling healthy dietary habits, discipline, self-denial, and willpower — and it is just all-round easier for them to wave the banner of righteous parenting, and say no to junk food. Of course, when affluent parents are completely aware that their kids have money and, often, cars to take them to where the junk food is, how much is a “no” worth?

The bottom line

Not surprisingly, economically-stressed parents are more likely to say “yes” to junk food, because the ability to approve more expensive purchases and grant more complicated wishes is not within their power. When it comes to a small, everyday purchase like a bag of chips or an ice-cream bar, it’s easy for a parent to rationalize, and figure that one small indulgence won’t hurt. A parent being importuned by a whiny kid is not inclined to calculate how many pounds will be added to a child’s weight by just one can of soda per day.

The stressed-out parent will probably not consider how habits and customs carry through to the future. Thirty years from now, that kid will still be consuming junk food for emotional support purposes, because it was the currency of parental love.

In either case, emotional issues are in play. A parent who is strapped for cash can’t show love by buying a jet ski, but a pizza? That’s doable. A wealthy parent may realize, on some level, that the best way to really show love would be to make the kid find a job and get his hands dirty. But since that is probably not going to happen, the wealthy parent can convince herself that serving kale smoothies instead of birthday cake is a meaningful gesture.

This quote from Fielding-Singh should be carved in stone:

Tackling nutritional inequality will require more than putting supermarkets in low-income neighborhoods. These interventions won’t change what food means to the poor families I met. But lifting them out of poverty could. If low-income parents had the resources to consistently meet their kids’ desires, maybe a bag of Doritos would be just a bag of Doritos, rather than a uniquely potent symbol of parental love and care.

Your responses and feedback are welcome!

Source: “Why do poor Americans eat so unhealthfully? Because junk food is the only indulgence they can afford,”, 02/09/18
Source: “Priya Fielding-Singh,”, undated
Photo credit: Reuel Mark Delez (kamalayan) on Visualhunt/CC BY

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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