Promoting Disparities in Health and Obesity Policies

Healthcare and policies on obesity serve people with wealth and privilege. The disparities are great in the U.S. But they exist everywhere. Just look at childhood obesity in the U.K. Consider the ten percent of children with the most social and economic deprivation. They have three times higher rates of obesity compared to the ten percent on the other end of the range. In the U.S., disparities in childhood obesity – already wide before the pandemic – have grown wider in the last year.

We are tackling obesity for the few, says Jennie Leggat in the Cambridge Journal of Science and Policy. If we continue this way, “we will be looking at both widening inequalities and an expanding obesity epidemic for years to come.”

It Starts with the Diagnosis

Dr. Butch Rosser on Racism and Weight BiasSpeaking at the YWM2021 convention yesterday, Fatima Cody Stanford explained the racial and ethnic disparities in obesity. Racial and ethnic minorities receive less care for obesity. One of the simplest reasons is that providers often skip the diagnosis in these people. So it’s tough to treat a problem that everyone is ignoring.

Access to Care Contingent on Cash

Then comes the lack of access to care. Many people must pay out of pocket for obesity care. More richly funded private insurance covers obesity care better. Public programs and basic health insurance simply carves it out in many cases. Finally, the options for care, developed mostly through studies of white women, are unsurprisingly less effective in these populations.

Dr. Butch Rosser offered a powerful lead-in to Stanford’s presentation. Systemic racism and anti-fat bias works synergistically to deny care to Black persons living with obesity, he explained.

Public Policy Must Start with the Need

Leggat has a simple proposal. Sharpen public policy by focusing where the need lies. She notes that the U.K. policy review on obesity in 2020 had plenty of talk about social factors. But the legislation alongside it did nothing to address those factors. All talk. No action.

Resources should go where the need is greatest. Without addressing social inequality, disparities in health and obesity will only get wider. Obesity will continue to grow.

Click here for the paper by Leggat, then here and here for more on racial and ethnic disparities in obesity.

Folk, sketch and study by Theodor Severin Kittelsen / WikiArt

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July 25, 2021

2 Responses to “Promoting Disparities in Health and Obesity Policies”

  1. July 25, 2021 at 9:10 am, John DiTraglia said:

    This is an important distinction:
    Are poor people more plagued by obesity because they don’t get medical care? I don’t think so since for the most part doctors can’t fix or prevent the obesity per se. (pace surgery and semaglutide)
    Instead it is probably because obese people are discriminated against in school and the work place. A different enemy.

    • July 26, 2021 at 10:00 am, Ted said:

      Most likely, as you have told me before, it’s complicated. Many issues, including the ones that you name, make it difficult for people with social and economic disadvantages to cope with an environment that promotes obesity. That includes getting adequate medical care to manage this chronic disease.