Poor Americans Are the Most Obese, and We Have No Help for Them

The high-risk one that needs to be targeted for intervention would be the inner-city youth that Michelle Obama is reaching out to.
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If living were a thing that money could buy
Then the rich would live and the poor would die

- Joan Baez, "All My Trials, Lord"

We know Americans eat too much and are overweight. That's more true of poor Americans. The higher your income and education in America, the less likely you are to be obese. Hispanic, Native American and African American youths are far more likely to be overweight than their Caucasian cohorts.

And the differences are growing worse. A recent study of Californians found that obesity has leveled off for teens since 2005, except among Native American and African American girls, where it continues to increase. Eighty percent of African American women are now overweight.

The standard explanation is that poor Americans live in neighborhoods where fresh fruit and vegetables are hard to obtain, but where fast foods are abundant. Meanwhile, rich people can afford to shop at Whole Foods, work out and hire personal trainers.

That's a partial answer. Here is more data to consider when drawing conclusions about social class and health. Poorer, less educated people smoke more. And they drink less often. People cite the latter statistic as a way of showing that each social group has its own advantages -- and poor, less educated people are better off because they very often (in two-thirds of cases) abstain from alcohol.

But that's not true. First, a greater percentage of those in lower socioeconomic groups who do drink, drink abusively. Moreover, moderate drinking is associated with lower rates of heart disease, diabetes and death.

Ironically, skeptics about the benefits of alcohol cite the fact that the people who are most likely to drink moderately also have better diets, exercise more and are less likely to smoke, which then may account for their superior health. But studies that control for additional healthy habits nonetheless find moderate drinkers to have less heart disease and to live longer.

But, let's accept that all of these habits -- moderate drinking, not smoking, exercising, good diet and weight level -- occur together in one package. What's that about?

"Morning Joe" took their (particularly Mika Brzezinski's) health crusade to Washington, where Joe Scaborough, Willie Geist and Mika walked and talked about health with politicians and media figures. A quick glance told viewers that some (e.g., Massachusetts Senator Scott Brown) were in better shape than others (Pennsylvania Governor Ed Rendell).

But this group as a whole is not the high-risk one that needs to be targeted for intervention. That would be the inner-city youth that Michelle Obama is reaching out to. But the "Morning Joe" hosts interviewed no adolescents, none of DC's inner-city residents and certainly no inner-city teens. How could they -- none of these groups travel in Scarborough's, Brzezinski's and Geist's social circles. That's not a put-down of anyone -- that's the way life works.

The difference between the people "Morning Joe" did interview and the people in the worst shape is a matter of life outlook and life situation. Which is why Mrs. Obama will fail -- because she doesn't have the means at her disposal to change the outlooks and lives of teens or those in inner cities.

That requires real social change.

Want to bet that in 5-10 years more American teens, and especially poorer and minority teens, are obese and in worse health, no matter how many television specials warn people to watch their weight, eat healthy foods and exercise?

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