Taxing the Fat is Taxing the Poor

Over at the Huffington Post, John Ridley, a writer for Esquire and Time magazines, has written an article on the problem of obesity and the spiraling healthcare costs associated with obesity. He writes:

Obese people in America now outnumber the merely fat. The National Center for Health Statistics reported this year that more than 34 percent of Americans are obese, compared to 32.7 percent who are "just" overweight. Just under 6 percent are "extremely" obese. The bottom line is that we're a slovenly lot and getting more so by the year.

The financial hit on health care is pretty staggering. A study by the Center for Disease Control released at their first ever "Fat Summit" in July finds:

The prevalence of obesity rose 37% between 1998 and 2006, and medical costs climbed to about 9.1% of all U.S. medical costs.

Obese people spent 42% more than people of normal weight on medical costs in 2006.

With all the talk -- and screaming and gun-toting -- that's going on around the health care reform debate, maybe the answer as to how to pay for it is orbiting our ever-expanding guts.

A tax on the fat. If you're out of shape, you've got to carry your weight, so to speak.

He goes on to declare obesity a "lifestyle choice." Perhaps that's the case if poverty is a lifestyle choice for obesity in the United States (and elsewhere) is highly correlated with poverty. To tax the fat, as Mr. Ridley suggests, is to tax the poor. The suggestion is moronic and speaks to a profound detachment from if not ignorance of the plight of the poor and our widening social inequality.

While obesity rates are climbing among all ages, races and incomes, evidence compiled by the Center for Disease Control (CDC) shows that the poor are more likely to be overweight or obese than wealthier Americans.

In Seattle nearly 22 percent of adults living in households with incomes of less than $15,000 a year are obese, compared with almost 15 percent in homes pulling in $50,000 a year or more, according to an analysis by Public Health - Seattle & King County of survey data from the Centers for Disease Control and Prevention.

Solving the obesity problem in the United States requires a redressing of our corn policy. The United States is the world's largest producer and exporter of corn, accounting for more than 40 percent of global production and nearly 60 percent of all exports. And corn is highly subsidized. Between 1995 and 2003, federal corn subsidies totaled $37.3 billion averaging $4.6 billion per annum. Since then, the annual corn subsidy has doubled to $9.0 billion. These government subsidies are creating a corn monoculture that is imperiling our health. As Michael Pollan, author of The Omnivore's Dilemma, so bluntly put it: "We’re subsidizing obesity."

Mr. Pollen noted:

Government farm programs, once designed to limit production and support prices (and therefore farmers), were quietly rejiggered to increase production and drive down prices. Put another way, instead of supporting farmers, during the Nixon administration the government began supporting corn at the expense of farmers. Corn, already the recipient of a biological subsidy in the form of synthetic nitrogen, would now receive an economic subsidy too, ensuring its final triumph over the land and the food system.

The effect of all this cheap corn is simply this: the annual per-capita consumption of caloric sweeteners has increased by 40 pounds in the last 40 years, and high fructose corn syrup (HFCS) accounts for 81% of the 83 additional calories the average American consumes each day from sweeteners alone.

But a concurrent problem in tackling obesity is social inequality. It is not a coincidence that obesity rates began to rise as real wages began to stagnate. Between 1985 and 2000, the cost of fruits and vegetables shot up nearly 120 percent, while the price tags on soft drinks, fats, sugars and sweets increased by less than 50 percent, according to the U.S. Department of Agriculture. Simply put a healthy diet is increasingly beyond the reach of the poor.

From a Deseret News article published in May 2008:

"The food crisis will make obesity and attendant diabetes even more rampant," said University of Washington epidemiologist Adam Drewnowski. "Fruits, vegetables and fish are becoming luxury goods completely out of reach of many people. Consumption of cheap food will only grow.

"Obesity is the toxic consequence of a failing economy."

While more people from every economic background are becoming obese around the world, the poor are still outpacing the better-off.

A recent U.S. Department of Health and Human Services study found that women in poverty were roughly 50 percent more likely to be obese than those with higher socioeconomic status.

In U.S. households making less than $15,000 a year, 31 percent of the women are obese, according to the federal Centers for Disease Control and Prevention. In households with more than $50,000 annually, 17 percent are obese.

University of Pennsylvania epidemiologist Shiriki Kumanyika and other investigators found that poor 15- to 17-year-olds -- black or white, male or female -- were 50 percent more likely to carry excessive poundage than nonpoor teens.

And a study by Drewnowski last year showed that obesity rates in poor Seattle neighborhoods were 600 percent greater than in rich areas.

Poor people frequently live in "food deserts" -- neighborhoods with few supermarkets. They rely on corner stores and convenience marts for groceries, said Carey Morgan, director of the Greater Philadelphia Coalition Against Hunger.

These are great places to buy chips and soda, not so good for asparagus.

Concentrating on filling their stomachs, poor, hungry people go for high-fat, high-sugar foods. "They're not thinking about health -- just getting through the day," said Mariana Chilton, a hunger expert at the Drexel University School of Public Health, and principal investigator for the Philadelphia GROW Project, which deals with nutrition and physical development among poor children.

Derek Felton, a community organizer with the Coalition Against Hunger and a former poor, obese person, agreed.

"I was the oldest of seven, with a lifetime of no breakfasts to eat," said Felton, who is 5-foot-9 and went from 247 pounds to 185. "When we had the chance to eat, we ate white bread to feel full."

All that corner-store processed food is relatively inexpensive -- artificially so. Researchers say that many junk foods contain high-fructose corn syrup, made from government-subsidized corn crops. Federal help keeps the cost of syrup-containing foods such as sodas, fries and even burgers down. Drewnowski said that healthful, unsubsidized foods like spinach cost five times more per calorie to produce, thus driving up the price.

Food stamps are supposed to help. But Chilton's research shows that the allotments families in Philadelphia receive are not accounting for higher food prices.

As a result, families often run out of food stamps by the second or third week of the month, Chilton said.

The hunger can be excruciating, said Gaines, who lets her three children under age 4 eat whatever food is left after the stamps are gone.

It makes her all the more voracious at the beginning of each month, when the new stamps arrive.

"You go without eating, then gorge," Gaines said. "Then you go to sleep with a full stomach. That's how the weight picks up."

It works that way for lots of people. And with the current food inflation, even cheap foods are getting more expensive.

"What choices can poor people afford now?" asked Stella Volpe, a nutritionist at the University of Pennsylvania's School of Nursing. "Will their diets get even worse, and will hard times contribute to more obesity?"

There is a correlation between poverty and obesity in the United States. Fixing the latter means tackling the former.

Tags: Obesity, US Food Policy, US Tax Policy (all tags)



Re: Taxing the Fat is Taxing the Poor

As I've stated many times here and elsewhere--our public policy is to subsidize sweeteners, refined carbs, and animal fats.  We do not subsidize (and in many cases we tax) most fruits and vegetables.  This is our public policy and has been for 60 years.

We could chop the Medicare budget by $100 billion per year just by ending or changing the structure of our Ag subsidy system.  If we had a policy of producing topsoil rather than eroding it we could drive CO2 levels in the atmosphere down to where they were 100 years ago.  Wondering how we can afford UHC?  There's your answer.

The solution is simple.  End the subsidies on crap.  That alone improves the situation.  Replace them with subsidies on good stuff, if you can't do without them.

by SuperCameron 2009-09-12 08:40PM | 0 recs
don't disagree

but don't see any path for this to happen. The next farm bill won't be passed until 2014, and (assuming Collin Peterson and Blanche Lincoln are still around then) the leaders of the House and Senate agriculture committees will never agree to an overhaul of our ag subsidies system.

by desmoinesdem 2009-09-13 04:04AM | 0 recs
Re: don't disagree

Apart from the annual budget, no piece of legislation is as important as the Farm Bill but few people pay attention to it. It affects every American and it is subsidy rich.

I'm not sure what the path is but I think it important to get more people to pay attention to what goes into the bill and who gets what.

The corn subsidy is really a gift to Archer Daniels Midland. Hence this quote from ADM Chairman Dwayne Andreas:

"There isn't one grain of anything in the world that is sold in a free market. Not one! The only place you see a free market is in the speeches of politicians. People who are not in the Midwest do not understand that this is a socialist country."

That moment of zen came in 1995. We have socialism in the US. Socialism for corporations.

by Charles Lemos 2009-09-13 04:23PM | 0 recs
Re: don't disagree

There are so many issues where the Republican and Democratic parties have conservatives and liberals trained to be at each others throats, when in reality it should be the people -vs- corporate influenced big government. This is one of those issues (among many). The power changes in Washington, but the results are the same.

Can't remember where I saw it, but there is a google map showing green circles where the farm subsidies are distributed across the coountry and Manhattan was densely covered. Makes absolutely no sense at all.

by tpeichel 2009-09-14 01:33PM | 0 recs
Re: Taxing the Fat is Taxing the Poor

You're right, but this is true of all "sin" taxes - on cigarettes, alcohol and the like.  I'm just wondering if there's a standard you can follow where you can use sales taxes to discourage behavior but not in others.

btw I'm aware that my sig line mocks these kinds of questions, but pffft.

by Jess81 2009-09-13 05:04AM | 0 recs
Re: Taxing the Fat is Taxing the Poor

First of all I think cigs should be taxed to high heaven because they do not simply affect the health of those who smoke, but everyone around them as well...and as to these things being a tax on the poor; I don't know many poor people who are ordering $10 martinis, and if you walk by any major office building you will see legions of the suit and tie crowd outside smoking...

The obesity question, to me, is a tougher one and I think neither side is quite right. Obesity, quite simply, can be a lifestyle choice. That being said it certainly is harder to eat healthily the smaller your budget is, and food does become one of the few creature comforts the poor can, occasionally, turn to.

All of that being said, I think that in terms of policy we need to find a careful balance in how we approach all of these things. There needs to be a change in how we approach subsidies (not that it will ever happen,) and we need to incentivise healthier living... and banning smoking would be fine with me too...again though, that will never happen.

by JDF 2009-09-13 10:48AM | 0 recs
Re: Taxing the Wankers is Taxing

Shy Romantics

by QTG 2009-09-13 05:25AM | 0 recs
Taxing sugar drinks is helping the Poor

A  tax on sugar laden soft drinks could make a significant difference. The income from such a tax could be used to subsidize the cost of artificial sweetners. There is really no good reason to use sugar to make soft drinks and that includes taste.

by eddieb 2009-09-13 06:38AM | 0 recs
Re: Taxing sugar drinks is helping the Poor

There is no good reason to drink soft drinks either, but they are so ingrained ou society that they are not going anywhere.

by JDF 2009-09-13 10:49AM | 0 recs
Re: Taxing sugar drinks is helping the Poor

That is a massive tax on the poor.  I'm sleepy but I can't think of any junk food that divides along class lines more than the soda/bottled water divide.

by Jess81 2009-09-13 02:33PM | 0 recs
Re: Taxing sugar drinks is helping the Poor

Unfortunately there's considerable evidence that artificial sweeteners in addition to being unhealhful, stimulate the appetite and lead to more weight gain.

I think a large part of the problem is the public health establishment's demonization of fatty and high cholesterol foods - foods that do not lead to heart disease.  Eggs are inexpensive and wonderfully healthy, and such foods as butter and cheese are nutritious and filling. As long as the choice is between vegetables and processed grains, processed grains will continue to prevail.

For those who are skeptical of the benefits of fat in combatting obesity read Good Calories, Bad Calories by Gary Taubes. It documents the falsity of the fatty food phobia that dominates informed opinion.

by oderb 2009-09-13 05:46PM | 0 recs
Re: Taxing the Fat is Taxing the Poor

I may be wrong in my assumption, but I would venture to say that a lot of the foods purchased by low income people, besides soft drinks, is starch laden - hamburger helper, macaroni & cheese, cheese (the government giveaways), breakfast foods (sugar and starch), spaghetti etc. And, it's because they are on the cheaper side of foods, and they last go further to feed a family (of any size). Also, the sedentary lifestyle of most people in the US leads to obesity. So, who gets hit with any sales tax increase - the lower income families. One could do some rationing (I know, that's a bad word), where people on food stamps or other government handouts (assistance) are restricted in how much "unhealthy" food can be purchased, with rewards for purchasing "healthy" foods. However, who decides what's healthy / unhealthy - more government control over the individual. Of course, those on public assistance have already turned control of their lives over to the government.

by BeanerECMO 2009-09-13 09:51AM | 0 recs
Re: Taxing the Fat is Taxing the Poor

I would be fine with stricter controls being placed on what sort of food can be purchased on public assistance. As you said, these people have already turned over control of their lives to some extent and putting rules in place that will help them to make healthier choices only increases the liklihood that they improves their lives in the long run.

by JDF 2009-09-13 10:51AM | 0 recs
Re: Taxing the Fat is Taxing the Poor

That idea makes the libertarian in me flee in horror, but even if you think it's a good idea in isolation, it sets a horrible precedent.

by Jess81 2009-09-13 02:35PM | 0 recs
Obese people spent 42% more than people of normal
The issue that Ridley doesn't understand is that most of the medical spending on the obese is unnecessary. Unfortunately, the medical & pharmaceutical community has "medicalized" obesity and targeted these people for all varieties of treatments including weightloss programs, statins, oral hypoglycemics, and anti-hypertensives, all under the rubric of metabolic syndrome. While some at the extremes of obesity are candidates for some medical intervention, the risks associated with the elements of metabolic syndrome are log-linear, not linear, and there is little, if any evidence, for all the pharmaceuticals we are prescribing for these unfortunate people.
I am a physician, board-certified in preventive medicine. For a more detailed discussion of this issue, I would refer the reader to Dr. Nortin Hadler's exellent book, "Worried Sick." Hadler is a graduate of Harvard Medical School and is Professor of Medicine at UNC School of Medicine.  
by amadon 2009-09-13 03:36PM | 0 recs
Re: Obese people spent 42%

Interesting. Thanks.

by Charles Lemos 2009-09-13 05:50PM | 0 recs
Re: Obese people spent 42%


The issue of how to deliver health care is a far bigger issue than how to pay for it. No payment system, not single payer (of which I am a strong proponent) or even completely socialized medicine will rescue us from the burden of health care costs unless we reform the health care delivery system itself. Marcia Angell, MD wrote an excellent piece dealing with this issue on Huffington Post last week. Her book about the drug companies and Hadler's book are excellent companion pieces for understanding this issue.

by amadon 2009-09-13 11:09PM | 0 recs

for obesity has a clear genetic origin.

A tax on fat people is in some ways a tax on one's genetics.

by fladem 2009-09-14 06:34AM | 0 recs


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