The billionaire mayor of New York wants his city's board of health to ban super-sized servings of sodas and other sugar-packed drinks.
Some 58 percent of New Yorkers, explains mayor Michael Bloomberg, currently qualify as either overweight or obese. Their excess pounds are driving up the city's health care costs, he argues, and even putting lives at jeopardy.
"Obesity," the mayor told a national TV audience last week, "will kill more people than smoking in the next couple of years."
Maybe so, his critics counter, but no ban on super-sized sodas is going to fix that obesity. Any ban, the critics contend, would be unenforceable. And why pick on soda and not chocolate cake? Or any other "fattening food"?
This back-and-forth on Bloomberg's super soda ban will likely wax on and on, deep into the summer. The story punches too many political and media hot buttons -- think "big government" and "nanny state" -- to fade any time soon.
But this entire focus on what we stuff down our throats misses the real story behind our obesity epidemic.
If we want to get serious about fighting obesity, public health researchers would like us to understand, we need to look at the social dynamics that drive people to eat and drink more and more of what they shouldn't be eating and drinking. And the most powerful driver of that unhealthy behavior? That would be inequality.
"Wider income gaps," as British social scientist Kate Pickett and her colleagues note in one comprehensive analysis of obesity across the world's wealthiest nations, translate into "wider waistbands."
In the United States, we've had good national data on weight since the early 1960s, and the early numbers through the 1970s showed no sign of any obesity epidemic. In 1980, only 15 percent of U.S. adults counted as obese. But that rate soared to 23 percent in 1995 and then 35 percent in 2006.
Commentators had all sorts of explanations for this stunning spike. Fattening fast food has become cheaper, relative to other foods. Restaurants are super-sizing. Corporate food giants have re-engineered food products to maximize their almost addictive fat, sugar, and salt.
All these factors no doubt contribute to the growing incidence of obesity. But all these factors also operate on a national, even global, scale. They don't explain why some states in the United States have more obesity than others, or why many other developed nations show much less obesity than the United States.
But inequality does explain these differences. The states within the United States, the nations within the developed world, that sport the lowest incidence of obesity just happen to be the nations that sport the least economic inequality.
That spike in U.S. obesity that began in the 1980s? That spike matches up neatly with the spike in economic inequality we've experienced over the past 30 years.
So what's going on here? We can all easily understand how sugar water can add on the pounds. But how could inequality possibly make us fat?
Epidemiologists -- the scientists who study the health of populations -- point to two closely intertwined phenomena: social status and stress.
Levels of obesity in developed societies, the epidemiological studies show, rise as income and social status fall. On each rung of the economic ladder, people tend to be more overweight than the people on the rungs above them.
Do "lower status" people simply "choose" to be overweight and unhealthy? That's a charge you can hear all the time on talk radio. But researchers disagree. People typically practice unhealthy behaviors not because they want to be unhealthy, but because they need relief -- from social stress.
People typically respond to stress, investigators note, by increasing their intake of our society's readily available relaxants, disinhibitors, and stimulants. They smoke. They do drugs. Or they eat more "comfort foods," digestibles usually packed with sugar and fat.
The more chronic the stress, the more likely a reliance on one or another of these comforting props. And stress becomes more chronic as societies become more unequal.
Would our modern societies be healthier places if more people drank less soda? They certainly would. The health professionals striving so hard to educate people about the risks that excess pounds create are performing a vital public service.
And Mayor Bloomberg, everyone can agree, does deserve kudos for jumpstarting a national conversation on what we get when we guzzle too much Mountain Dew.
But Bloomberg would deserve far more credit -- and produce a far greater impact on our national health -- if he jumpstarted a discussion about our nation's staggeringly unequal distribution of income and wealth.
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