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Feeding the Divide: How Income Influences Diet and Health Outcomes

It should come as no surprise that diet has a large impact on a person’s health and well-being. One of the largest and fastest-growing health concerns in the United States is obesity, impacting over 40% of the population, according to the Centers for Disease Control and Prevention (CDC). That’s essentially one in four Americans living with the associated health impacts obesity brings with it. In this blog, I want to explore how income plays a role in a household’s diet, particularly when it comes to nutrition. We’ll look at two different American cities with similar population sizes yet vastly different average incomes – and rates of obesity.

 

Before getting into income’s impacts on diet and health, let’s discuss the overall effect of diet on health and why a “good” diet is crucial to living a healthy life with minimal health concerns. First, let’s define what a “healthy” diet means in this context.  For the purposes of this blog, a healthy diet is one containing a variety of nutrients, vitamins, proteins, and carbohydrates and incorporates all the foods that we should have in moderation, for example, as the food pyramid shows such as whole grains, fruits and vegetables, proteins, dairy, and little but some amount of sugar. In addition, a nutritious and balanced diet would have low to negligible amounts of trans fats and cholesterol, as these fats can cause plaque deposits in one’s arteries and eventually clog them, resulting in a greater risk of heart attack. In addition, a major aspect of a nutritious diet is high levels of antioxidants, molecules that protect the cells of the body from damage, which helps prevent diseases like cancer. This diet can look many different ways when it comes to specific foods and individual needs, but the ultimate goal is to prevent malnutrition and health issues like heart attacks, strokes, diabetes, kidney stones, urinary tract diseases, and different kinds of cancer. 

 

Let’s compare two cities in the United States, Jackson, Mississippi, and Thornton, Colorado, and look at the differences in income and its impact on diet. A few things to know about Jackson, Mississippi: the population is about 140,000 with a median household income of about $35,000, and about 36.6% of the population lives with an income of about $25,000 or less. In 2017, WalletHub named Jackson the “fattest city in the United States” (note: WalletHub is a personal finance company that allows people to view their credit score and receive guidance on improving it). Today, Mississippi has an obesity rate of about 39.1%, making it one of the most obese places in the country. But is there a correlation between the lower income of the population and the high obesity rate in Jackson? The lower-income population of Jackson and similar places are more focused on feeding themselves sufficiently while managing all the other mandatory expenses, and therefore, tend to spend less money and budget in whatever areas are possible, such as groceries/food, shopping, etc., according to the video, “The 10 Poorest Cities in America.” With this thought in mind, people of this lower-income group may choose to buy more food for a cheaper price in order to save money for more important expenses. For example, in Jackson, for the price of one bag of lettuce, one can purchase 38 packs of ramen noodles, four 2-liter sodas, and a box of 25 munchkins. The latter provides many more meals than just part of a single salad! Yet, these foods are relatively unhealthy (fatty, sugary, highly calorie, etc.) compared to the lettuce in the example. After long-term consumption of these non-nutritious foods, fat begins to build up, and people begin to gain weight, eventually resulting in obesity. 

 

This study further investigates and reinforces the tendency for lower-income populations to buy unhealthy and non-nutritious food in comparison to higher-income populations. In the study, food purchase receipts were collected from 202 different income-level urban households for two weeks. The receipt data was scored using the Healthy Eating Index, or HEI. Based on the study’s findings, we can see that lower-income populations and households purchase less nutritious foods compared to higher-income households. 

 

Before I continue, I would like to make a point very clear: Although it might seem easy to do so, we shouldn’t point figures or blame anyone from a lower-income group for their obesity or other health concerns. Across the country and world, prices of products, food, gas, and more have been increasing with inflation. Therefore, people need to be mindful of their budgets. When it comes to deciding between paying the electricity bill or a recreational soccer league to stay fit, the latter can feel like an unaffordable luxury. This results in families having less opportunity to get involved in sports or other activities that come with a heavy price tag – yet these are often the activities that help keep people active and healthy.

 

Let’s move on to the city of Thornton, Colorado, which has a total population of about 145,000 people and a median household income of about $100,000 - $105,000 – that’s about three times the median income of Jackson. Colorado’s obesity rate is about 25.1%, and it makes sense given the overall higher-income population. As we saw in the study, higher-income households have the financial means to afford higher quality and more nutritious food, even though it is more expensive. Therefore, with the overall lower intake of frozen, junk, and non-nutritious food, the population overall remains at low risk for medical conditions like obesity. 

 

There is a relationship between an individual's income and the nutritiousness of their diet, and therefore, a correlation between an individual’s income and overall health and well-being. After exploring how income is an important factor affecting health, apart from factors such as genetics, environment, and more, I now comprehend the reason why many of the patients that I came across during my shadowing experience had health issues due to inadequate nutrition in their diet, which resulted in obesity, high cholesterol, urinary tract infections, and early signs of diabetes. However, there are two things I hope you took away after reading this blog. One is, of course, that income has a large effect on the diet of an individual and, therefore, their health. Two, although it might be easy to sometimes, we shouldn’t look down upon people we see with health concerns such as obesity because we really don’t know what they are going through when we’re not looking. 



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