Food injustice and obesity: the other pandemics
The coronavirus pandemic has cracked open and exposed the perils of deeply ingrained inequities on many fronts: economic, social, educational, judicial and medical. We see the impact of these inequities in a variety of ways, including through the growth of obesity rates and rising food insecurity. As confirmed cases of COVID-19 in the U.S. approaches 4.3 million and deaths approach 150,000 and disproportionately affect people of color, and as protests against systemic racism roil our nation, we must demand food justice as an essential element of health and wellness.
Food injustice and its impact on our growing obesity problem represent the other raging pandemics we should be fighting. We lack a just, fair and equitable food system. According to a recent Feeding America Study, food insecurity in Connecticut as a result of the pandemic could increase by 44%.
Food and nutrition security form the foundation of both individual and public health. Lack of access to healthy food and nutrition has created dire health consequences for impoverished citizens, especially families of color, in our inner cities and poor communities. People who live in food deserts and food swamps awash in fast food establishments and convenience stores have more ready access to cheap, energy dense foods that tend to promote unhealthy eating than they do to healthier choices. Food insecurity particularly affects children and interferes with their ability to learn and grow.
The costs of obesity, both monetary and on health and quality of life, are substantial, and the need to address the root causes are urgent. Healthy nutrition is integral to good health and the prevention of disease, and we as a society are failing to meet this most basic of human needs in a significant portion of our population. Poor diet, whether it is found in the form of excessive consumption of fast foods or highly processed foods, sugar sweetened beverages, or lack of access to nutritious and affordable wholesome foods, is predisposing much of our population to poor health, especially in economically challenged communities and communities of color.
Food resource scarcities that result in poor nutrition are major determinants leading to chronic diseases such as obesity and its associated medical complications, including diabetes, heart disease, high blood pressure and liver disease. Minority populations have a heavier burden of these chronic diseases. COVID-19 has shone a light on these disparities. The Center for Disease Control and Prevention (CDC) lists obesity as a strong risk factor for severe COVID-19 disease with resulting poor outcomes, and also reports disproportionately higher death rates from COVID-19 infection in Black and Latino patients than in white and Asian patients.
Data from the CDC show that 42% of adults in the United States are obese, as well as 18.5% of children ages 2-19. Black (22%) and Latino (26%) children have higher rates of obesity than their white and Asian counterparts. A recent study out of Harvard projected that nearly half of Americans will be obese by the year 2030, and nearly one in 4\four will be severely so.
As we reimagine what a post-COVID and racially just society could look like, food justice and obesity prevention and fair and equitable access to and affordability of healthy food choices for all of our citizens must be a part of the dialogue.
We will not be able to address either the obesity pandemic or the high rates of food insecurity without major changes to our food system. There are strategic actions that we as a society can take and should demand.
- First, we must address the deeply entrenched and interconnected underlying causes of food insecurity: poverty, unemployment and underemployment, and inconsistent access to adequate healthy food. We must broaden the nutrition safety net to meet the needs of all of our citizens.
- Second, we must reevaluate our food system to promote equitable and sustainable food sources and demand that the food and beverage industries reformulate products with healthier ingredients. They should stop predatory advertising to children and socially disadvantaged communities. Their profit is our peril.
- Third, we must implement policies and system changes that promote good nutrition. A study reported in Health Affairs in 2015 showed sugar-sweetened beverage excise taxes to be one of the most cost efficient ways to decrease childhood obesity.
- Fourth, we need a major public health campaign to promote healthy eating and active living.
It is unconscionable that the richest country in the world cannot ensure nutritious food for all of its people. Food justice is essential to health equity. We must end these other pandemics by making food justice and obesity prevention top priorities.
Nancy Trout, MD, MPH is a primary care pediatrician at Connecticut Children’s and co-director of Kohl’s Start Childhood Off Right, which is a childhood obesity prevention initiative of Connecticut Children’s Office for Community Child Health.
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