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Inequality of obesity

Ta-Nehisi Coates explains why he's been blogging so much about the intersection of obesity, class and race:

It's the world I live in. The buses in Harlem heave under the weight of wrecked bodies. New York will not super-size itself, so you'll see whole rows in which one person is taking up two seats and aisles in which people strain to squeeze past each other. And then there are the middle-age amputees in wheelchairs who've lost a leg or two way before their time. When I lived in Brooklyn, the most depressing aspect of my day was the commute back home. The deeper the five train wended into Brooklyn, the blacker it became, and the blacker it became, the fatter it got.

I was there among them -- the blacker and fatter -- and filled with a sort of shameful self-loathing at myself and my greater selves around me. One of the hardest thing about being black is coming up dead last in almost anything that matters. As a child, and a young adult, I was lucky. Segregation was a cocoon brimming with all the lovely variety of black life. But out in the world you come to see, in the words of Peggy Olson, that they have it all -- and so much of it. Working on the richest island in the world, then training through Brooklyn, or watching the buses slog down 125th has become a kind of corporeal metaphor -- the achievement gap of our failing bodies, a slow sickness as the racial chasm.

The so-called "food movement" has been stereotyped as a bunch of yuppies trying to impose their preference for heirloom tomatoes on the rest of America. At times, it does veer into that territory, though it's often because the spokespeople tend to be well-intentioned chefs who are used to talking about food rather than well-intentioned policy people who are used to talking to the political media.

But at its base, obesity is one of the most important social justice issues in America today. Just as the wage gap matters, and the disparities in health-care coverage matter, so too does the disparity in health matter, particularly when the primary culprits are diseases like obesity and diabetes that we know -- know -- are related to the environments we live in and the choices we have.

By Ezra Klein  |  October 20, 2009; 4:06 PM ET
Categories:  Health  
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Comments

everyone knows that obesity levels in minorities are higher than everyone else. The question is HOW do you reduce the obesity levels in them as well as the rest of America. Get that problem solved and over time the healthcare reform issue becomes much easier and less costly.

Posted by: visionbrkr | October 20, 2009 4:35 PM | Report abuse

I frequent a supermarket used by the affluent (in many cases, the outright wealthy; my town's an upscale retirement magnet). The customers tend to be fairly slender and in reasonably good shape, even during daylight hours when the retirees are out and about. The Walmart on the other side of town seems to have different sets of customers at different times of day, or week. Everything from fit-looking ranch hands and citrus grove workers to blob people, lots of them, looking disabled and perhaps not long for this world.

So obesity looks like a class issue to me. (Disclosure: I've always had a weight problem, increasingly serious as I've grown older. My sympathies are with those trapped in the burden of fat).

Posted by: DaveoftheCoonties | October 20, 2009 5:28 PM | Report abuse

If this were a more nurturing society, obesity would be less of a problem. And as Coates says, society is perhaps least nourishing to the darkest-skinned people.

Solve that problem and you'll solve poverty as well as health care and obesity.

Posted by: Mimikatz | October 20, 2009 5:38 PM | Report abuse

No, no, no...it's not yuppies trying to impose their heirlooms on people. It's yuppies trying to save people! We're not telling people what to eat and shaming those who disagree to make ourselves feel better! That's just a happy side effect. We're here to save people! The stupid people who really need us! So get out of the way and let us control your lives!

See also:
We're not telling you what TV you can't own, we're helping you decide by making some illegal!

We're not imposing our foie gras views on you, we're saving you from yourselves!

We're not telling you what car you can drive, we're just getting rid of some choices!

We're not imposing our smoking habits on you, we're just making your viewpoint illegal!

Posted by: kenobi1 | October 20, 2009 5:49 PM | Report abuse

"We're not imposing our smoking habits on you, we're just making your viewpoint illegal"

Fascinating, secondhand smoke is now a point of view. I wonder if relieving myself on your carpet would also be a "viewpoint." Stop imposing your bathroom habits on me! I have a different viewpoint! Why do you hate freedom?

I think it's a crime against humanity that while we are in the middle of an obesity epidemic, we are cutting gym out of our schools. And I don't think anyone has taught a cooking class since 1978, which is tragic. Home ec could not possibly be more important than it is when 1 in 3 adults are obese.

We are valuing stupid things over our children's futures. Coke is not, in fact, holy water. It's not a crime to say "hey, our kids are DYING here. How's about we pull the sugar water out of the schools? And lay a huge tax on them to bring back gym and home ec?"

Posted by: theorajones1 | October 20, 2009 6:09 PM | Report abuse

So, Kenobi1, people have the right to do what they want without being lectured by moralists? I'll remember that the next time the gay marriage issue comes up, hmm?

Posted by: tomemos | October 20, 2009 6:11 PM | Report abuse

Our industrialized system of agriculture burns more calories of stored energy (petroleum) than it delivers to the plate, and yields are getting lower as the accumulation of pesticide and fertilizer depletes the soil.

Meanwhile what we get for this system is corn for a food base instead of grass.

The cheaper the food is the more unhealthy it is. And labeling is still very, very deceptive - it's easy to eat wrong even thinking it's right, and even paying top dollar.

It costs money to shop for the healthier products currently, but alternately what can trump this is knowledge/education about sustainable local farm shopping - CSA, community supported agriculture. Even in NY this must be happening.

But in your quote I was very touched by this line: "One of the hardest thing about being black is coming up dead last in almost anything that matters."

Brilliant writing, so sad.

And for collateral to my assertions above, read Michael Pollan or Paul Hawken.

Posted by: rosshunter | October 20, 2009 6:12 PM | Report abuse

Thank you! Thank you for helping draw attention to this important intersection in social justice.

Posted by: zoya371 | October 20, 2009 6:12 PM | Report abuse

oh and by the way, Milwaukee is at least getting closer to NY than Texas where I am, but see this initiative in urban farming created by a black farmer.

That's URBAN farming, and it can be done.

See growingpower.org if this youtube link doesn't get you there:

http://www.youtube.com/watch?v=3EpTWQWx1MQ

Posted by: rosshunter | October 20, 2009 6:18 PM | Report abuse

Ezra, I find it sad that you continue to write about fatness in the most stereotypical way possible. Well-meaning, yes, but paternalistic and devoid of knowledge of actual fat people that are fat, due to a variety of causation. Yes, there are unhealthy fat people who eat crappy and don't excercise, the same goes for thin people. There are fat people who do eat healthy and excericse just like thin people. And the science on this is not as conclusive as you make it out to be, there is plenty of reseach that shows that fat in itself, is nowhere near as deadly as the current "obesity epidemic" meme makes it out to be.

I wish you would shows some knowledge of other people out there that are studying analysing, and looking at the research regarding fatnes and coming up with different conclusions than you, such as Gina Kolata, Paul Campos, J. Eric Oliver, or Michael Gard and Jan Wright, or Glenn Gaesser or Sandy Szwarc. And if you think they are full of it, say why, and have a criticial evaluative post about fatness as opposed to the standard party line that "fat is gonna kill you no matter what, no matter how fat, or what the circumstances are."

I never thought I'd say this but - perhaps you should listen to Megan McArdle about this issue.

Posted by: silentbeep | October 20, 2009 6:56 PM | Report abuse

Write more about crime and poverty and food deserts, things that limit mobility and the opportunity to seek other food options, and maybe people will take the "food movement" seriously. Otherwise it IS just about heirloom tomatoes and lifestyle.

Go to your local discount supermarket by public transportation and then carry healthy groceries home for a household living at poverty level. Don't get the subsized 20 pack of cheap polish sausage for $5 either, get the $1.69 pack of dry white beans, beans you'll have to soak and cook when you get home from the bus ride to the grocery store. Then imagine that's the absolute BEST you can do for your family at that level of income. Do that and maybe people would have more respect for the social justice aspects of the food movement. Or keep shoveling the Style section BS and calling it food policy.

Posted by: jamusco | October 20, 2009 7:10 PM | Report abuse

If this were a more nurturing society, obesity would be less of a problem. And as Coates says, society is perhaps least nourishing to the darkest-skinned people.

Solve that problem and you'll solve poverty as well as health care and obesity.

Posted by: Mimikatz | October 20, 2009 5:38 PM | Report abuse

I'm sorry but this is almost complete BS.

Check below for stats:

http://www.nationmaster.com/graph/hea_obe-health-obesity


So the koreans are much more nurturing than the US? I'd believe that a small part of it has to deal with psychological factors but much more has to do with energy consumption vs energy output. The US has become a lazy society. We don't do much in the way of physical labor anymore. Most of us sit in front of computers all day long (GUILTY) and get very little exercise. Then some eat like crap and watch the fat pile on. I went to a high school reunion a couple weeks back and I was really disgusted about how fat my fellow classmates were only 20 years after graduation.


oh and my daughter's middle school has home ec in one of her semesters. They also still teach health (and focus on diet in a part of it) in my daughter's elementary school. Again many may be dropping them (which they shouldn't) but many still have it.

Posted by: visionbrkr | October 20, 2009 8:46 PM | Report abuse

oh and there is a good part of it that is genetic that we need to look into further to determine the causes of it to resolve it. Also I wonder how much people think they can let themselves go and get bariatric surgery to "fix it".

Posted by: visionbrkr | October 20, 2009 8:47 PM | Report abuse

*Also I wonder how much people think they can let themselves go and get bariatric surgery to "fix it".*

This is by far one of the craziest things you've said, visionbrkr. Even crazier because you have nothing to back up your assertion, just a "I wonder how much people do this?" kind of thing, much like wondering how much people decide to fake immobility to get the free electric mobility scooter.

Posted by: constans | October 20, 2009 8:58 PM | Report abuse

"Fascinating, secondhand smoke is now a point of view. I wonder if relieving myself on your carpet would also be a "viewpoint." Stop imposing your bathroom habits on me! I have a different viewpoint! Why do you hate freedom? "

No, silly. You choose to go to a bar that allows smoking, because the owner has decided to allow smoking, you decide for yourself to be exposed to second hand smoke. You decide for everyone that they're not allowed to smoke "because we just want to help the children" then you're a member of the young fascists. (I think you know your peeing on my carpet "analogy" isn't worth responding to.)

"So, Kenobi1, people have the right to do what they want without being lectured by moralists? I'll remember that the next time the gay marriage issue comes up, hmm?"

Please do. It's a strong argument. I have no time for people telling me what laws we should have because God wants them or Gaia wants them. The latest motivation I see for this nonsense is "social justice." Please.

It's a measure of how hard our forbears worked to ensure our freedom that people now have so much time to whine.

Posted by: kenobi1 | October 20, 2009 9:01 PM | Report abuse

about two weeks ago, i took the train cross-country. always a remarkable experience...traversing sixteen states...this time, in blazing autumnal color.
i spent part of a day in union station, in chicago, waiting for the capital limited train.
long distance train travel has a different group of folks, than airplane travel.
the people, for the most part, are poorer.
almost everyone i spoke with on the train, was laid off, or in serious financial trouble. three people on the return train, were coming from michigan and chicago, to find work in the southwest, with little more than the shirts on their backs.
but in union station waiting room, i never saw so many obese, poor and sick people in one room.
so many of the people in the room were gigantic... and so many with walkers and oxygen tubes....others looking so worn down and so poor.
old and young alike.
the man in front of me, when we lined up to get on the train, was british. he was a translator.
we engaged in conversation, and he said that the united states now looked to him like it was just filled with sick, poor and immensely overweight people.
looking around that room, it was hard to disagree.
when i got into union station in washington, with its boutiques selling pashmina stoles, victoria's secret, fine leather goods and swarovski crystal in the arcade....it was a different world...thin and handsome, well dressed people rushing for the acela express....but i can tell you, going cross country...through the midwest....the cities looked run down and hard scrabble.
the main streets all have two stores now on them....a cash advance store, and a ninety-nine cent store.
steel mining foundries, shuttered. small towns with once cute clapboard houses are in disrepair....
i suggest that anyone who wants to see "the rest of america," from coast to coast...take the train.
and by the way, i kid not.
from california to washington, dc.....i saw three buildings under construction. one in california, one in kansas city and one in washington,dc. i saw not one tract community going in from one end of the country to the other.

Posted by: jkaren | October 20, 2009 10:16 PM | Report abuse

Um.
Perhaps you didn't see anything being built because people don't build by train tracks?

I live in Chicago. Things are definitely sucking. People are hurting. But we are not all fat. There is still building going on. Your observations speak more to your lack of exposure to the "rest of the country" than anything about the midwest. It hasn't changed much in 30 years.

What's that about the relationship between anecdote and data?

Posted by: kenobi1 | October 20, 2009 10:36 PM | Report abuse

kenobl1


i think you see a great deal when you cross through 16 states on a train. and you actually traverse many, many main streets in small towns across the country from needles, california to dodge city, kansas to elkhart, indiana....
you are incorrect....as many small towns are built right next to train stations, and many of the shuttered industrial towns were built next to traintracks, just as the coke ovens of the once booming coalmining towns of pennsylvania.
i have been taking this very same train ride for fifteen years, and i have gotten to see a tremendous amount of natural beauty, such as pronghorn antelope and golden cottonwoods in eastern colorado, but i have gotten to see infrastructure of american cities and industrial towns that deteriorates more and more with each passing year.
i dont think that the people in the beautiful condos in chicago are fat, or in the "whole foods market" near union station....but take yourself down to the terminals for the long distance train travel, and see how some of the poorer folks are looking.
you go and have a look and see if obesity doesnt look like a disease of the poor now. if the people dont look unhealthy and worn down.
and if you think the midwest hasnt changed much in thirty years, then i suggest you take a traintrip across country.
looking out of the window as you roll through small towns, and ghost towns where industrial plants used to be humming, you might think that things are looking a whole lot different.

Posted by: jkaren | October 20, 2009 10:49 PM | Report abuse

"What's that about the relationship between anecdote and data?"


i dont think that date and bar graphs tell the whole story on human beings.
i think using your eyes and looking around you in train stations, out of windows...talking to a cross section of people that enter and exit in iowa, california, new mexico, west virginia....gives you another kind of human sense of what is going on in people's lives and communities.
the people on the train and in the stations make up the bar graphs.
sometimes, i actually think we get so wrapped up in data, and "opinion polls" and studies....that we forget that the real story is in individual human beings, that make up neighborhoods and cities and a country.
i learn alot on my traintrips cross country. i learn a lot about the human and social condition of the country....and i get to see lots of things firsthand.
i get to talk to pennsylvania dutch families going to hutchinson, kansas...and to a cattle rancher from la junta, colorado....and a young native american mechanic from las vegas, new mexico. they make up the little colorful bars on the graph...

Posted by: jkaren | October 20, 2009 10:57 PM | Report abuse

well.
not a whole foods shopper. can't speak to it. don't deny poor people ride the train out of chicago cross country. don't deny being and obesity can go hand in hand. just not clear on what your point is, other than a vague comment on the fat, poor midwesterners that rankled my feathers more than it probably should have.

but seriously. midwesterners aren't stupid. we really don't build things by train tracks. thus the "main streets" you see from your window have been deserted. sometimes it speaks to a closing of a local steel mill. sometimes it just means we don't like living by loud trains. but by all means, extrapolate away.

i can play this game, too. i just got back from philadelphia. every worker i met with in the airport was lazy and disinterested. they even lost my bag. thus, philadelphians are lazy and mean.

Posted by: kenobi1 | October 20, 2009 11:05 PM | Report abuse

sorry...i meant "data" and not "date" in first sentence above.

i could write a book about the conversations i had, just listening to folks.
and many of the stories were similar.
a young woman with two children, leaving michigan with two children to live with her sister in new mexico, as she couldnt find a job....
a young car mechanic taking two days off from work, to take the train to help repair his sister's car in albequerque, because she has no money to get it fixed and cant lose any more days at work.
a young latino man who moved his family out of los angeles, as the crime was bad, to live in las vegas, new mexico, so they could grow up under blue skies, even if he made less money.
you learn a whole lot from listening to people's stories....
and there are themes that emerge about peoples shared concerns.
i heard so many heart touching stories after taking the six trains from one end of the country and back again, that i felt i got a very interesting and good picture of how people are working through these difficult times.

Posted by: jkaren | October 20, 2009 11:09 PM | Report abuse

"but seriously. midwesterners aren't stupid. we really don't build things by train tracks."

trains skirt through all kinds of areas....but the one thing you do see is alot of the american infrastructure that is withering away, a lot of once-humming areas that are all but forsaken, and a country that looks like its standard of living is rapidly falling.
there are wealthy areas outside of chicago that have been built by traintracks. and for a few years, each year, i have been seeing new contstruction....but that has stopped.
i trust my observations, as i compare things, over the years.
do you know the old saying,
"believe half of what you see, and nothing that you hear?"

Posted by: jkaren | October 20, 2009 11:19 PM | Report abuse

"american infrastructure that is withering away, a lot of once-humming areas that are all but forsaken, and a country that looks like its standard of living is rapidly falling."

i grew up near the train you're talking about. i've lived in chicago almost all of my life. i can tell you with great certainty that your train through the suburbs of chicago passes through some of the wealthiest cities and small towns in all of the midwest. wealthy people do not want to live in the 1950's and 1960's downtown areas of these small towns they've settled in. the infrastructure is not withering away.

"there are wealthy areas outside of chicago that have been built by traintracks. and for a few years, each year, i have been seeing new contstruction....but that has stopped."

chicago definitely had a glut of new construction. that has slowed. but maybe...just maybe...they actually built some new homes beyond the area you can see from the train? possibly?

Posted by: kenobi1 | October 20, 2009 11:38 PM | Report abuse

".they actually built some new homes beyond the area you can see from the train? possibly? "

i didnt see areas beyond the train, and i know the world isnt flat beyond the train stations....but over the thousands of miles i went through in california, arizona, new mexico, colorado, kansas, missouri, iowa, illinois, indiana, ohio, pennsylvania,maryland, west virginia and washington, dc...i did get to see something.

Posted by: jkaren | October 20, 2009 11:55 PM | Report abuse

"i didnt see areas beyond the train"

finally, something we can agree on!


and with that, i bid you good night.

Posted by: kenobi1 | October 21, 2009 12:02 AM | Report abuse

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Posted by: whwalterhansen03 | October 21, 2009 12:41 AM | Report abuse

i agree with silentbeep.

it's lazy to point to a symptom (size) and call IT the disease.

obese folks can be healthier than thinner folks. the real issues are activity and healthy food options. how people become the sizes they are is really irrelevant to the state of health they are currently in.

i'm not saying that ezra or coates are wrong or malicious, but the language is sloppy.

obesity and unhealthiness are NOT coterminous. they're just as coterminous as thinness and unhealthiness. but people don't seem to make that mistake.

check out some of the writers silentbeep suggests. i also suggest reading the should-be-satirical article "The Fat and Short of It" in October 18, 2009's New York Times. it sounds crazy when you say these things about short people--because they can't "help" it!--but we accept them when said about people of size. it's sick.

thanks!

Posted by: birdgirl3 | October 21, 2009 3:28 AM | Report abuse

constans,


you see the difference between you and me is that i can admit when I'm wrong or even slightly misguided by my experiences. the next time you admit your error (remember the $500k figure from the other day's restaurant example) will be the first.

my words were guided by my experiences. I've had two clients (admittedly an extremely small sample size) come to me and ask if bariatric surgery was covered. One time it was although it was inadvertently taken out when it shouldn't have been during a renewal process. When she thought it wasn't covered she basically said to me then well, I'll go see a nutritionist and maybe try to get my weight down that way. Once we realized it was dropped incorrectly from the renewal due to human error from our rep (this company's benefits weren't supposed to change at renewal but they changed "platforms") she then jumped right back on and had the surgery.

Again I'm not saying this is prevalent or even happens more than this one instance but if you don't think its possible, don't think it could happen, don't think it DOES happen then you're being naive. You really need to think more about the human nature of some people and the "what can i get them to pay for me" mentality.

Again I admit, I may be wrong or may have phrased it wrong.

How's your admission coming??

Posted by: visionbrkr | October 21, 2009 7:53 AM | Report abuse

The declaring of a "problem", a national problem that "WE" have to solve is one of the major tactics of the present regime. Obesity used to be one's own business. So in the new spirit of it now being everyone's business, you force me to mention once again the obese who are on the front lines of remaking the country and, entirely coincidentally, profiting mightly in the process: press secretary Gibbs, Debbie Stabenow, Axelrod (though he has undergone some kind of a makeover lately), Barney Frank.

Posted by: truck1 | October 21, 2009 11:08 AM | Report abuse

It is a huge social justice issue. We've been working to empower community members to make changes in their families and schools. Our work with parents in Latino communities in Chicago show how engagement can really get people to make changes - not by telling them what to do, but by getting people to see the disparities and realize that something has to change.

http://healthyschoolscampaign.org/?parents

Posted by: marklbishop1 | October 22, 2009 6:49 AM | Report abuse

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