Can Money Buy a Community Less Obesity?

Some time ago, the Beatles told us that money can’t buy us love. Now a new study from Molly Martin at Penn State suggests that it also may not buy a community less obesity. Martin is a researcher with a keen interest in social inequality, families, and child well-being. Her research examines data from a natural experiment. Money from Marcellus Shale gas extraction generated new wealth in rural Pennsylvania in a short time.  She tells us the influx of money did not help with childhood obesity:

“This paper demonstrates that giving disadvantaged families in Pennsylvania more money is not the solution, but that should not distract us from the inequities in obesity or dissuade us from trying to eliminate them.”

Outcomes in a Four Year Timespan

In the communities Martin studied, the Marcellus Shale boom came between 2008 and 2010. So she looked at baseline data in 2007 and outcomes data from 2011. Martin used data from professional measurements of child height and weight in public schools to assess youth obesity prevalence. To analyze the causal effect of money flowing into the community, she used regression models, fixed effects models, and instrumental variable models in a difference-in-difference framework.

She had not been expecting to see a big effect:

“Although I was largely skeptical that income was a large contributor to disparities in youth obesity, I thought it could play a small role given the multiple reasons to expect it to matter. The true direction of that association, though, was unclear. Some evidence suggests that greater income increases obesity risks. In sum, I expected income to have a very small, but causal effect on obesity, but in this particular case there is no causal effect.”

The Importance of Digging into a Correlation

This study illustrates perfectly the importance of digging into a correlation. Income and obesity rates clearly correlate with each other. But the relationship is complex. Income disparities fuel other disparities that matter. So simply pouring money on the problem will not erase all of those disparities in a short time.

Martin points to other factors in rural communities that may be playing a role. Those factors might relate to wealth in the community, but they don’t change overnight. Thus, they could blunt any positive effects of additional income.

It’s worth noting that others have looked at this question and found different answers. Brett Watson et al found that a universal income payments had a helpful effect in Alaska. Of course, those payments have been ongoing for 35 years. So that context was very different.

The bottom line here is that context matters. Complex systems are interacting to produce more obesity in some communities than others. We need sufficient curiosity and commitment to figuring it out. It’s easy to say that “social determinants of health” are in play. It’s more challenging to find strategies that will make for effective change.

Click here for Martin’s paper, here and here for further perspective.

Equality (Money), painting by František Kupka / WikiArt

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March 20, 2021