Poverty and obesity

Unlike the alleged effect of food advertising, the impact of social inequalities on levels of obesity can be measured, and it is very substantial — the largest single factor that has so far been identified. Despite this, it receives scant attention in the media.

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Poverty and obesity

Coverage of obesity in the British press has doubled in the past year and threatens to become an 'epidemic' in its own right. It is almost impossible to pick up a daily or Sunday paper without being exposed to headlines featuring words such as 'time-bomb' and ill-founded assertions that the present generation of children will die before their parents. The sounds of wringing hands and admonishments to eat 'properly' have become almost deafening.

In the midst of this 'headless chicken' panic about growing girths — and especially the girths of children — government agencies appear to have given in to the food-correctness lobbyists who have sought to pin the blame for the disaster squarely on those greedy multinational purveyors of lard, sugar and salt — the culpable 'fat cats' who have, apparently, single-handedly created our fat nation. The Food Standards Agency, for example, has announced a plan to 'overhaul food promotion to children' despite the fact that in its own evidence just 2 months ago to the Commons Select Health Committee regarding advertising of food to children it conceded that:

"The conclusions that the researchers drew was that the evidence is not there to draw any conclusions on the magnitude of the effect."

In what we take to be proper science-based approaches, if the magnitude of an effect cannot be measured then it cannot be said to exist at all. Rational and evidence-based thinking clearly no longer stands in the way of appeasing the growing clamour for action on obesity, even when there is no evidence that the proposed measures will have the slightest impact. The 'let's be seen to be something, no matter how misguided' philosophy has long been a familiar response of agencies that have run out of proper ideas.

Amidst this disoriented casting around for culprits and simple solutions, driven hard by media hype, it was refreshing to read in the Observer a thoughtful article by David Smith that for once dealt with some of the real issues underlying the rise in obesity — poverty and disadvantage. It has become fashionable to believe that in the modern Blairite Britain such features of British society are no longer with us — that we are all now 'middle class' and that the old social and economic distinctions that were once an intrinsic feature of our culture have been consigned to history. Not so, sadly, for the people of Glasgow's East End where life expectancy is around 60 and falling and where the average diet is about as unhealthy as it can get. Obesity is but one of the symptoms of the impoverishment that plagues their lives.

For those directly concerned with stemming the declining health of this population the middle-class food and health philosophies generated in Westminster seem almost obscenely irrelevant. A local GP, Dr Gerry Spence, for example, comments:

"A lot of people are on benefits, living from week to week, relying on convenience foods and eating out of the chippy. Give people jobs and the ability to be masters of their own destinies and they will make healthy decisions about their lives. You bring employment into here and I guarantee the pubs will empty, the kids will stay at school and the place will flourish. You can't blame the people when they are victims of circumstances. It's not really a medical problem, it's something for the politicians to sort out. I hope the drop in life expectancy is a turning point and the politicians are called to account. They should hang their heads in shame."

Bob Holman, who quit academia to work on projects in socially deprived areas, is similarly unimpressed with current initiatives to combat obesity.

"This is not rocket science. Poor health is a well-known feature of deprivation. Mothers are not daft and they do know fat and crisps are bad for children but they can't afford the alternative. The Government has to give them the means. Initiatives are not going to change anything unless you've got the cash in your pocket. If you buy a salad at Sainsbury's, it's still very expensive."

The Observer article is, unfortunately, a rarity. Most journalists and editors seem to prefer to crank up the attacks on soft targets — the unlovable McDonald's or Coca Cola — rather than expose the dirt that has been swept under the carpet of many parts of urban Britain. The data show quite clearly that lower income families and those living in socially deprived neighbourhoods are far more at risk from becoming obese than the middle and upper classes. A report from the National Statistics office notes:

"Obesity is linked to social class, being more common among those in the routine or semi-routine occupational groups than the managerial and professional groups. The link is stronger among women. In 2001, 30 per cent of women in routine occupations were classified as obese compared with 16 per cent in higher managerial and professional occupations."

Researchers at the Department of Social Medicine at Bristol University have also concluded that:

". social origins may have a long term impact on obesity. Whether this operates through the early establishment of behavioural patterns, such as diet and exercise, or through metabolic changes associated with early deprivation, is still to be determined."

While the exact nature of the causal effect might not be clear from the Bristol study, it is evident that relative deprivation affects not only levels of childhood obesity but, perhaps even more so, obesity in later adulthood.

Unlike the alleged effect of food advertising, the impact of social inequalities on levels of obesity can be measured, and it is very substantial — the largest single factor that has so far been identified. Despite this, it receives scant attention in the media. The graph below demonstrates dramatically how little we seem to care about this issue.

Poverty and obesity

The data that are illustrated in the graph are derived from SIRC's analysis of 12,902 British national and major regional newspaper articles that focused, to some degree at least, on obesity since 1998. We can see clearly that as the frequency of such articles has risen progressively over this period of time, so too has coverage of the issue of advertising and promoting food to children and calls for stricter controls. Read just a sample of such articles and you will find that the coverage has been driven by a small group of 'food extremists' in the guise of the Food Commission, Sustain, etc.

The bottom line of the graph shows the number of articles in which attention was paid to issues of poverty, low-income families, social deprivation, etc. The graph speaks for itself. The real roots of obesity, that are conveniently hidden away from the chattering classes who wield disproportionate influence when it comes to developing 'popular' solutions to societal problems, are not things that the media wish us to read about. And because they are rarely headline news, government departments and agencies seem to have little cause to pay them much heed — especially when they are uncomfortable reminders that New Labour has not yet quite delivered the New Britain.

Peter Marsh
15 March 2004