Poverty, obesity and malnutrition: myth vs. reality

Unless you’ve been living in a cave, you are familiar with first lady Michelle Obama’s Let’s Move program to combat childhood obesity. You are probably also aware of the flak she has received from conservative pundits, who claim that the program is an effort by the government to tell Americans what to eat. With an epidemic of obesity in the U.S., it is difficult for most of us to believe that low-income people often suffer from malnutrition despite the relative low cost of food compared to other countries.

I’ll use the St. Louis area, where I live, as an example. But what I’m describing could probably apply to many American urban areas.

Anyone who has driven through parts of the city of St. Louis has noticed the neglected and dilapidated homes; the abundance of fast food restaurants, chop suey joints, and liquor stores; and the lack of full-service grocery stores within walking distance of residential neighborhoods.  Even with this reminder of class and social status, many St. Louisans have difficulty understanding that in our community, people suffer from hunger and malnutrition.

Cynthia Davis (R), former state representative from St. Charles, Missouri says, People who are struggling with lack of food usually do not have an obesity problem.” An informal poll taken by this author recently showed that ten out of eleven respondents have heard the following statement spoken by acquaintances:I don’t believe that poor people are really malnourished, because so many of them are overweight.”  This attitude seems to be a pervasive myth particularly among political conservatives.


Most people, when they hear the word “hunger,” form a mental picture of a skin-and-bones person living in Sudan or India. Perhaps a more precise term to use would be “malnutrition.” As defined by Merriam-Webster, malnutrition means “faulty nutrition due to inadequate or unbalanced intake of nutrients or their impaired assimilation or utilization.”  By this criteria, a person can be well-fed calorically, yet suffer from malnutrition because of what he eats, rather than how much he eats.

Research has shown that malnourishment causes a host of physical ailments, and can predispose one to infections like tuberculosis.   A common form of malnutrition, called “overnutrition,” is often seen in countries where there is an abundance of rich, fatty foods — like those found on a typical American fast food menu.  Metabolic syndrome, the increasing inability to process glucose, leads to the onset of Type II (adult-onset) diabetes and is closely associated with the consumption of sugars such as corn syrup, the largest ingredient in soft drinks like Coke.  Such a diet can lead to hypertension, coronary artery disease, and stroke. Overnutrition frequently causes obesity.


According to a 2010 report, Missouri is  the 12th most obese state in the country. The state’s adult obesity rate is 29.3 percent, and in Missouri. men are more obese than women, at 29.9 percent. More than two-thirds of states have adult obesity rates above 25 percent.

The same report states that Mississippi leads the nation in obesity, at 33.8%.  Mississippi also has the highest poverty rate in the United States at 21.3%, according to U.S. Census data.

In contrast, St. Louis City has a 26% poverty rate, per the most recent available data from 2010.  Obesity, poor nutrition, and the resulting diseases carry a high cost both to the individual and to the individual’s society as a whole, in increased utilization of scarce medical resources, morbidity, and mortality.

A dangerous combination

How can obesity, malnutrition/over-nutrition, and poverty possibly be related? The answers are many.  It begins with education and knowledge of nutrition. Children in the St. Louis City school district have only a 60% graduation rate (2011 statistics). High school is typically when students take health classes and learn about nutrition. A lack of knowledge about nutrition often leads to poor dietary choices. Parents of these children often do not understand nutritional labels on foods and thus are unable to teach them how to choose between a high-calorie, low-value food and one that provides essential vitamins and minerals at a lower calorie cost. Recent data shows that the rate of diabetes in the U.S. is directly proportional to both the educational and income level of the population.

Access to affordable food supermarkets offering healthy food choices is essential. There are few large chain grocery stores in low-income city areas. These stores offer a wide variety of healthy food selections such as fruits, vegetables, low-fat dairy products and meats, and alternatives to high-sodium and high-fat snacks.  Most grocery stores available to residents in these regions carry few perishables and instead rely upon prepared and frozen foods with low nutritional value.  Most of these stores accept food stamps for what is considered by health experts to be “junk food.”

The few restaurants in these areas typically tend to be of the fast-food type, which feature high-fat and high-calorie choices.  Even the ubiquitous Chinese take-out places feature breaded and fried meats with heavy sauces and high sodium content – rather than the vegetables and plain rice that the Asians themselves eat—because this is what Americans demand.

St. Louis has many fine food pantries that distribute, for free, canned and packaged goods to low-income citizens. Unfortunately, the food pantries often have limited storage space for perishables such as fresh produce and meats, so are unable to offer them to their clients.

Breaking the cycle

All of society has a stake in providing every one of its citizens with the tools to maintain a healthy lifestyle. It does no good to provide food vouchers and food stamps if the low-income residents have no access to quality food sources.  Politicians must find ways to provide incentives, perhaps in the form of lowered taxes, to induce large chain grocery stores like Schnucks or Shop-and-Save to locate more facilities in low-income residential neighborhoods.

Further, education on nutrition must be provided to both younger children and to their parents.  Schools can play an important part both by offering nutritious meals on campus, and by teaching students how to make wise choices.  These measures are far less expensive, in the long run, than treating the diseases caused by modern malnutrition. Closing the national dialogue on the topic by stating nonsense such as, “What she is telling us is she cannot trust parents to make decisions for their own children, for their own families in what we should eat…” (Sarah Palin, 2010) does no one a favor.