It's Not Just Food

- by Stacey Prince

Among the most common New Year's resolutions are those having to do with eating better, exercising and losing weight.  This year I have heard from friends (or stated myself) various food-related goals including eating healthier, more vegetables, less fat, less sugar, less red meat, going vegan, more protein, and keeping it local.  Have you ever thought about what a privilege it is to even be able to state these as deliberate (and attainable) goals?  Two recent articles made me think just that, and caused me to reflect on the ways that social inequities play out in the foods we eat - with subsequent consequences for things as far reaching as health, obesity, mortality risk, and school performance.

The first article, entitled Divided We Eat, appeared in Newsweek in late November, right before Thanksgiving.  This fascinating article describes the various ways that class impacts nutrition, and maintains that food has become one of the most salient representations of "the great divide" between rich and poor.  Trends such as being "foodies," "health food nuts," "locavores," and eating "organic" are a privilege and a luxury, out of reach for many.  According to data released by the US Department of Agriculture, 17 percent of Americans (more than 50 million people) live in households that are categorized as "food insecure," meaning they sometimes run out of money to purchase food, or run out of food before they can get more money.  Food insecurity is most severe in the South and in large urban areas.  Food insecurity co-varies with other indices of economic stability such as housing and employment, so it's no surprise that the biggest surge in food insecurity since the measure was established in 1995 occurred between 2007 and 2008, at the beginning of the economic downturn.

It's not just the availability or scarcity of food, but what people eat, that has more and more become a marker of social status in America.  Even ignoring the truly luxury items that only a privileged few can afford, simply buying and eating fresh and nutritious foods has become a luxury out of reach to many American families.  The food insecure are more likely to subsist on high fat, high calorie, highly processed foods such as pizza and take-out.  A 2009 study by the US Department of Agriculture looked at "food deserts," areas where supermarkets are not within walking distance and cars are not readily available.  This map shows the incidence of food deserts in America.  The areas with a higher incidence of food deserts don't correspond exactly with food insecure areas (likely because large cities have a higher density and accessibility of supermarkets) but according to the study 2.3 million American households live more than one mile from a grocery store and do not have access to a car.  Families living in these food deserts are more likely to rely on convenience stores and processed foods.  In larger urban areas where supermarkets may be more readily available tend to be characterized by racial/ethnic disparities, so despite the increased availability, many families still cannot afford to purchase adequate amounts of healthy foods.

It comes as no surprise that decreased access to healthy foods, whether through geography or income level, is related to obesity.  While being obese used to be an indicator of prosperity, it is now a marker of poverty.  Obesity rates are highest in countries with the greatest income disparities (the US being one), and higher among low income individuals than those in the middle or upper class.  Research indicates that this is due not to poor knowledge of nutrition (which some have incorrectly maintained) but because the foods that comprise a healthy diet are beyond the reach of many lower income American families.  You can read the Newsweek article for all the details, but the point is clear: low income families eat sugary, fattening, processed foods because they are cheap and taste good, not because these families don't understand good nutrition.  One researcher sums it up as follows: "In America, food has become the premier marker of social distinctions, that is to say--social class."  While I don't know if I agree with this sweeping conclusion (surely other measures such as having stable housing and healthcare are equally prominent markers of social class) it is clear that healthy food has become a  luxury and that taking it for granted is a privilege.

So, what does all of this have to do with psychotherapy and healing?  A lot.  Obesity has been related to teasing and bullying in schools, a range of health risks in adults, and increased mortality rates.  Poor nutrition can result in decreased attention and concentration, leading to reduced school and job performance, leading to curtailed job and earning opportunities... and the list goes on.  The  middle/owning class's obsession with weight, weight loss and body image is starkly seen as a luxury, and and an unnecessary source of suffering, in light of the fact that so many don't have enough sustenance to survive at a basic level.  For all of us, our relationship to food and our bodies is not only a class issue, but one that is impacted by a complex range of cultural and historic variables, including both personal and cultural history of trauma, scarcity, and starvation.  It's critical for therapists, healers and healthcare professionals to consider all of these variables when assessing clients' statements about food, weight, and body image.  In addition to this analysis, we can all think about how to work together toward increased food justice.  See the call to action at the bottom of the blog for one such idea, a "food justice" event taking place later this month.