The inequality of obesity
Mon Apr 28, 12:20 AM ET
For Americans used to a steady rise in life expectancy, a new study last week came as a shocker. While overall life expectancy increased more than seven years for men and more than six years for women from 1960 to 2000 (to 74 and 80), the good news didn’t reach all parts of the country.
Life expectancy dropped — yes, dropped — in some areas, particularly parts of the South and Appalachia. Four percent of men and almost one in five women there experienced either declines or stagnation in life expectancy beginning in the 1980s.
“This is a story about smoking, blood pressure and obesity,” summed up Majid Ezzati, a co-author of the study by the Harvard Initiative for Global Health.
It is, above all, a wake-up call on obesity. The male-female discrepancy is likely due to the fact that women did not start smoking in large numbers until the 1970s. So the gap might be shrinking. But that’s the only glimmer of hope. What the study most reinforces is that obesity is on the rise, particularly among the poor.
Last week, even an upbeat report about better children’s health and mortality rates noted one dark cloud: the prevalence of overweight children, raising the risk of childhood diseases and health problems later in life. Since the late 1970s, the number of overweight children has grown from 5% to 13.9% for ages 2-5, soared from 6.5% to 18.8% for 6-11, and from 5% to 17.4% for 12- to 19-year-olds. Adult obesity has more than doubled to one in three, with a further one in three overweight.
Even those who aren’t obese pay for this through insurance. Health care spending on obesity-related diseases — diabetes, high blood pressure, cardiovascular problems, some types of cancer and more — has exploded at least tenfold in the past two decades.
Everyone knows how to lose weight: exercise more and eat less, fatty foods in particular. But fast food, eaten on the run and in vast quantities, has too often replaced the leisurely sit-down dinners with healthier foods of years past. Further, obesity is increasing worldwide, and among the poor more than the affluent. Broad social changes underlie the trend, and so it will not be easily reversed. But where it is worst, among the poor, better access to preventive health care plainly is part of the answer.
A century ago, poorer Americans were more likely to have their lives shortened by hunger and malnutrition. It would be a tragic irony if the obesity epidemic has a similarly devastating and unequal impact.