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Obesity among Poor Americans

Is Public Assistance the Problem?

Patricia K. Smith

Publication Year: 2009

Obesity costs our society billions of dollars a year in lost productivity and medical expenses, roughly half of which the federal government pays through Medicare and Medicaid. We know obesity plagues the poor more than the non-poor and poor women more than poor men. Poor women make up the majority of adult welfare recipients—coincidence or causal connection? This book investigates the controversial claim by welfare critics that public assistance programs like Food Stamps and the National School Lunch programs contribute to obesity among the poor. The author synthesizes empirical evidence from an array of disciplines—anthropology, economics, epidemiology, medicine, nutrition science, marketing, psychology, public health, sociology, and urban planning--to test this claim and to test whether other causal processes are at work. With a lucid presentation that makes it a model for applying research to questions of social policy, the book lays out the different hypotheses and the possible causal pathways within each. The four central chapters test whether “public assistance causes obesity,” “obesity causes public assistance,” “poverty causes both public assistance and obesity,” and “Factor X causes both.” The factors in the last category that may relate to both public assistance and obesity include stress, disability, and physical abuse.

Published by: Vanderbilt University Press


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Title Page

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Table of Contents

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p. ix

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pp. 1-8

Critics have argued that public assistance reduces work effort, discourages marriage, and encourages nonmarital births. Now some claim that public assistance also causes obesity. For example, Douglas Besharov, of the American Enterprise Institute, testified before a congressional committee that he thinks the Food Stamp and National School Lunch...

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1. Trends in Obesity, Poverty, and Public Assistance

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pp. 9-22

The first step toward understanding the relationship between public assistance and obesity is to quantify it. This chapter presents descriptive statistical evidence documenting the associations between poverty, public assistance, and obesity. First, I’ll present the general trends in obesity prevalence, and then I’ll disaggregate the rate of obesity by...

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2. The "Public Assistance Causes Obesity" Hypothesis

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pp. 23-48

The previous chapter documented that poor women and public assistance participants exhibit higher rates of obesity. This chapter examines the first of four possible explanations for this association, the “Public Assistance Causes Obesity” model. Public assistance is designed to help low-income families meet their fundamental needs, and the goal of the...

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3. The "Obesity Causes Public Assistance" Hypothesis

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pp. 49-69

Whereas the previous chapter considered whether public assistance leads to obesity, this chapter considers the reverse causal flow: does obesity cause people to become poor and turn to public assistance? Obesity could influence income and eligibility for public assistance programs via two pathways (Figure 3.1). First, excess body weight can impair...

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4. The "Poverty Causes Both Public Assistance and Obesity" Hypothesis

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pp. 70-114

This chapter examines the third model of the obesity–public assistance association: poverty simultaneously causes both obesity and public assistance participation. The pathway from poverty to public assistance is mechanical: to qualify a person must have sufficiently low income. For example, eligibility in the Food Stamps Program requires income...

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5. The "Factor X Causes Both Public Assistance and Obesity" Hypothesis

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pp. 115-127

Factors in addition to poverty may cause both obesity and public assistance participation. Disabling physical disorders and mental illness limit the ability to earn income and can pose barriers to physical activity and a nutritious diet. Abuse in either childhood or adulthood may lead to both physiological and psychological responses that raise the risk of...

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6. Common Threads and Conclusions

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pp. 128-138

Does public assistance cause participants to gain weight and lead to higher obesity prevalence among the poor? While the literature suggests that long-term food stamp receipt may contribute somewhat to women’s weight, a much more complex picture of obesity among the poor emerges from this investigation. Obesity contributes to lower...


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pp. 139-142


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pp. 143-187


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pp. 189-197

E-ISBN-13: 9780826516374
Print-ISBN-13: 9780826516350

Page Count: 208
Publication Year: 2009

OCLC Number: 727948506
MUSE Marc Record: Download for Obesity among Poor Americans

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Subject Headings

  • Obesity -- United States -- Etiology.
  • Poverty -- Health aspects -- United States.
  • Public welfare -- United States.
  • Obesity -- Social aspects -- United States.
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