Built Enivornments and Obesity in Poor Neighborhoods
America is one of the “wealthiest countries in the world and accordingly has high obesity rates” (Levin 2667). One-third of the American population is affected by obesity (Levine 2667; Gray et al. 2; Xu and Wang 19). In addition, obesity rates are higher among the residents from low-income communities (Lovasi et al 7; Perdue 821). Obesity prevalence rates in the U.S. vary a great deal across states, which range from “21.3% in Colorado to 35.1% in Mississippi and West Virginia in 2013” (Xu and Wang 19). Obesity is “a major risk factor for heart disease, diabetes, stroke, depression, sleep apnea, osteoarthritis, and some cancers” (Xu and Wang 19). Moreover, Rahman et al. note, “Obesity is predicted to shorten life expectancy of the average American 2 to 5 years” (50). Take the case of Mississippi, which is one of the poorest and most obese states in America. Accordingly, NPR reports that with obesity rate of 42%, the average life expectancy for men in Holmes County, Mississippi is 65 years (Tackling Obesity Amid Poverty In A Mississippi County 00:00:01- 00:00:21). Thus, obesity is a precursor of different chronic illnesses that leads to decreased human life expectancy. The increasing number of obese people in poor neighborhoods is linked to the unfavorable conditions of built environment, which is understood as “human-made resources and infrastructure designed to support human activity, such as buildings, roads, parks, restaurants, grocery stores and another amenities as compared with natural environment” (Xu and Wang 19). Hence, built environments have significant effects on resident’s health based on the available resources in their surroundings. In similar fashion, Rahman et al. reveal, “Lower-socioeconomic status neighborhoods are at higher risk [of becoming obese], as these communities often have limited access to recreational facilities and food stores with healthful, affordable options” (51). Built environments encourage ‘obesogenic’ or obesity-generating behaviors among residents in poor neighborhoods; therefore, the government could help alleviate the problems of increasing number of obese people in poor neighborhoods.
Food Deserts and Obesity
Bader et al. remark, “Food deserts, or neighborhood environment with limited access to healthy and affordable food, are believed to contribute to poor diets and to elevated prevalence of obesity . . .” (411). Thus, food desert conditions that limit access to healthy and affordable food and give options of cheap yet unhealthy food contribute to growing obesity rates in poor neighborhoods. According to Sallis and Glanz, “fast-food restaurants in particular have identified as a potential contributor to a higher prevalence of obesity” (135). In addition, Rahman et al. emphasize, “A high density of fast-food restaurants, convenience stores, and bars, along with concentrated media marketing, all promote unhealthful food choices and hinder good nutrition” (51). Similarly, Xu and Wang add, “An individual with a high level of consumption of fast foods and sugar-sweetened beverages . . . has a high risk of obesity” (19). Thus, the congestion of fast food restaurants in poor neighborhoods encourage the residents to purchase and consume fast foods which are known to be ‘more’ affordable yet have low or no nutritional value. Even more, Lovasi et al. reveal, “Poor neighborhoods had less access to supermarkets but more access to small grocery and convenience stores. Compared with supermarkets, small grocery stores and convenience stores may have produce that is poorer in quality and more expensive” (9). In the same way, Perdue argues, “In the United States, small grocery stores and convenience stores tend not to stock much selection of healthier foods” (823). Likewise, Bader et al. add, “Access to convenience stores… is associated with a poorer diet and poorer weight status” (411). Furthermore, Sallis and Glanz argue, “Low-income and racial or ethnic minority communities usually have less access to supermarkets and a greater concentration of fast-food restaurants, and the quality of goods offered tends to be worse in these neighborhoods” (139). Consequently, the presence of fast-food restaurants and convenience stores in poor neighborhoods constrain the residents’ ability to access healthy food. Aside from less access to affordable healthy food, Debbie Elliot of NPR News, reports, “It's still cheaper to pick up a can of processed corn than to buy four ears of fresh picked” (Tackling Obesity Amid Poverty In A Mississippi County 00:05:15- 00:05:21). In the same way, there are several pantries that seek to support the low-income residents in filling in the gap of food access among poor residents. For example, in New Brunswick, Five Loaves of Pantry serves clients with food options ranging from frozen meat, processed meat, ready-to-eat food, canned goods, chips to some crops and produce like potatoes and bananas. Although the pantry provides food for free, the nutritional value is not guaranteed. In other words, not only the presence of more fast food restaurants and local grocery stores and convenience stores restrict residents from poor neighborhoods to access healthy food, but also the limited income of the residents and the variety of unhealthy food that is freely provided by community pantries.
Physical Inactivity and Obesity
Aside from inaccessibility of healthy food, another factor that contributes to the growing number of obese people in poor neighborhoods is physical inability. Xu and Wang define physical inability as “no leisure-time physical activity or exercise” (20). There are two major causes of physical inability among people in poor communities. First, there is less access to recreational infrastructures and exercise facilities that hinders physical activities among residents. “In one study of rural residents, the perception of a lack of place to be physically active was associated with being obese and inactive, and this association was stronger among lower-income participants” (Lovasi et al. 9). Accordingly, Lovasi et al. points out that lacking access to physical activity outside the home such as neighborhood streets, walking or biking trails, parks, or exercise facilities such as gymnasiums or pools, may discourage physical activity and promote obesity (9). Furthermore, as the most common physical activity in the United States, walking frequently occurs along neighborhood streets, making streets and sidewalks as important venues for physical activity (Lovasi et al. 9). However, Rahman et al. observe, “Communities that have low-density development patterns, poor street connectivity, and a lack of destinations within safe walking distance adversely impact health behaviors, which in turn contributes to obesity and other chronic illnesses” (52).
Not only the less access to recreational and exercise facilities, but also crime and safety-related perceptions discourage physical activities among residents. In Perdue’s view, “crime and perceptions of crimes are affected by features such as abandoned buildings, vacant lots and poor lighting, and may be significant deterrents to outdoor activity such as walking or using parks or playground” (824). Thus, the presence of these vacant lots and buildings as well as poor street lighting discourage residents to engage in physical activity such as walking or playing in the parks. Moreover, Bader et al. conclude, “There is a some evidence that fear of crime and other safety-related concerns discourage people from neighborhood walking or other forms of outdoor physical activity” (411). For example, Lovasi et al. specify, “Perceived safety from crime has been associated with physical activity for African-American women in Chicago, Illinois” (16). Therefore, in Chicago, Illinois, which also has a high rate of obesity, African-American women consider the lack ofcrime safety as a cause of not walking or doing exercise out-of-door. Similarly, Xu and Wang add, “More anxiety about neighborhood safety may deter physical activity and help explain a higher obesity rate in inner city areas” (20). Thus, the anxiety caused by the perception of crime prevents the residents to engage in physical activity. As a result of physical inactivity, the residents become obese or more obese. Thus, crime and even the fear that crime can happen discourage residents in poor neighborhoods to go out of their house to engage in outdoor physical activity and exercises.
Currently, there are government efforts to help alleviate the health problems such as obesity in poor neighborhoods. Undoubtedly, Sallis and Glanz mention that “policies are the primary mechanism for making environmental changes and include formal and informal rules, laws, and regulations. Both government and industry policies control food environments. Policies pertaining to parks and recreation, education, transportation, and planning departments in governments at multiple levels have direct responsibility for physical activity environments” (125). Therefore, government intervention includes policies, rules and regulations that seek to address the problem in healthy food access and “in order for people to be more active and have healthier diets, they need access to safe places for recreation, neighborhoods that are walkable, and local markets that offer healthful, affordable food” (Rahman et al. 55). Thus, the government make policies to control food environment and increase the access to safe places that are conducive to physical activity among residents in poor neighborhoods. For example, in California, in order to give low-income residents access to healthy foods, the Food Policy Task Force endorsed the creation of a regional food system (Rahman et al. 52). Similarly, restaurants in New York and Seattle provide calorie, fat and other nutritional information on menus (Sallis and Glanz 137). Lastly, despite being not so popular in the poor neighborhoods, there are efforts to conduct community-based education for preventive measures to promote health and wellness (Rahman et al. 50). Despite these policy interventions, Lovasi et al. stress that strategies for behavior change should be considered in line with modifying the built environment and implementing policy interventions (16). Therefore, there are several efforts to modify the built environment in poor neighborhoods in order to promote physical activity and reduce the residents’ access to unhealthy food.
In conclusion, obesity is one of the problems that is prevalent in poor neighborhoods. The number of obese people in poor neighborhoods is growing. Evidently, two major reasons contribute to this problem—lack of opportunities to access healthy and affordable food and the presence of barriers to physical activity. The prevalence of small grocery stores, convenience stores and fast food restaurants encourage low-income people to purchase and eat unhealthy food with high calories and fat. Consequently, unhealthy food consumption leads to excess weight. The low physical activity of residents in poor neighborhood is due to the lack of access to safe recreational facilities. Additionally, because of the high crime rates, people are discouraged to go out of their houses in fear of being exposed and victimized by crime-related activities. As a result, this physical inactivity leads to gaining more weight. Although there are government efforts and policies to modify the built environment, it is argued that these changes should be considered in the context of strategies of changing behavior. There is a need to make aggressive efforts to slow down this health epidemic that affects the poor neighborhoods. Therefore, strategies such as preventive programs that promote health and wellness should be encouraged in the poor neighborhoods, as the existing policies to change the built environment are being implemented.