Social Theory, Environment & Prevention
Social Theory, Environment & Prevention
The Centers for Disease Control and Prevention (CDC) reported that over the last three decades obesity has nearly tripled in among adults(Control., 2015). Nearly 30% of adults are either overweight and obese adults(Statistics, 2014) Researchers posit that obesity is typically due to sedentary lifestyles and unhealthy eating both of which are influenced by socioeconomic climate(Vamosi, Heitmann, & Kyvik, 2010). Consequentially, obesity disproportionately affects minority, low-income populations(Ogden & Carroll, 2010)See Figure 1.
Figure 1: Racial And Ethnic Disparities In Obesity (Ogden & Carroll, 2010)
Diet-related diseases are one of the leading causes of death in the United States(Keith, Fontaine, Pajewski, Mehta, & Allison, 2011). Such diseases include heart disease, cancer, and stroke, as well as contributing conditions, particularly obesity and diabetes(Keith et al., 2011). Additional health conditions that are associated with overweight/obese adults include sleep apnea, gallbladder disease, elevated liver enzymes, polycystic ovarian disease, and orthopedic problems(LeBlanc, O'Connor, Whitlock, Patnode, & Kapka, 2011). The majority of diet-related diseases disproportionately affect urban, low-income, and minority youth populations, further compromising their well-being (Ogden & Carroll, 2010).
Unhealthy dietary habits and obesity are significantly correlated, but are not causal; both can be considered independent ramifications of decreased access to healthy food or the adverse psychosocial stresses of poverty(Frieden, 2010). Neighborhood characteristics have shown to be linked to both a one’s weight and health behaviors(Lachowycz & Jones, 2011; Leahey, LaRose, Fava, & Wing, 2011)These findings suggest that the socioeconomic environment contributes to unhealthy behaviors. Affluence and environmental settings are the most significant environmental factors that are responsible for rising overweight and obese adults ((Lachowycz & Jones, 2011; Leahey et al., 2011). Low-income neighborhoods lack safe spaces to participate in physical exercise((Lachowycz & Jones, 2011; Leahey et al., 2011). Among immigrant communities over 85% do not reach the federally recommended amount of physical activity(Booth et al., 2013).
Underserved communities have a decreased access to healthy food options (See Figure 2), making it nearly impossible to maintain a health diet to prevent obesity and related illnesses (Carroll-Scott et al., 2013; Brief, 2012; Rendall et al., 2012; Van Hulst et al. 2013). Low-income, urban neighborhood food settings mostly include fast foods, processed foods, and other unhealthy convenience items(Lachowycz & Jones, 2011; Leahey et al., 2011). Prior research has found in some instances that such settings are associated with unhealthy dietary patterns (Lachowycz & Jones, 2011; Leahey et al., 2011). Therefore suggesting that socioeconomic factors(Rendall, Weden, Fernandes, & Vaynman, 2012) interact and determine the structure of neighborhood settings, thus may be the most significant social-environmental factor that influences the rising rates of overweight and obese children & adults(Carroll-Scott et al., 2013; Leahey et al., 2011; Van Hulst, Gauvin, Kestens, & Barnett, 2013).
Figure 2: Lack of Access to Healthy Food Options Low vs. High Income Neighborhoods (Brown, 2012)
The socioecological model pertaining the to health among disadvantaged populations emphasize the importance of external social factors that contribute to obesity. Such factors include the decreased access to fresh food as the items are featured in local convenience stores, which are more common than supermarkets in lower-income neighborhoods(Fiechtner et al., 2015; Lachowycz & Jones, 2011). Thus, this environment encourages unhealthy diets of all members of low-income families.
Social Theory & Obesity: Contributors and Prevention
Durkheim’s concept of “social facts” (Durkheim, 1982)is extremely useful when attempting to make sense of the current Obesity Epidemic. Just like suicide, obesity is frequently perceived as a personal problem resulting from the inability to effectively monitor what one eats. More recently, obesity has often been understood in terms of a medical condition that increases one’s risk to heart disease, cancer and diabetes. However, a Durkheimian examination of obesity rates, rather than individual cases, reveals the social dimensions of the Obesity Epidemic. Obesity rates is largely a result of the changing social structure, which encourages overeating and sedentary lifestyles(Barnett, 2012)..
Durkheim defines a “social fact” as any social value or behavior that functions externally to an individual, but at the same time is internalized into each individual to the point in which society and the individual can not be separated. (Durkheim, 1982) He argues that the specific characteristics of society are distinct from the summation of the individuals among the population(Durkheim, 1982). The particular value systems of a society may be influenced by those individuals part of that society, but more importantly the social structure and values in a given society also shape personal behavior(Barnett, 2012). Durkheim argues that “social facts” shape the behaviors of individuals(Durkheim, 1982).Furthermore, an examination of “social facts” lends itself to an analysis at the level of social organization, which independently functions externally to the individual. In turn, this analytic approach sheds light on what is distinctly “social”. Thus, to understand the dramatic rise in obesity rates, on must examine the “social facts” that impact one’s inclination to becoming obese. A biological explanation is suited for the understanding of the increase in weight of an individual, but the rise in obesity rates requires an examination of weight gain through the analysis of “social facts”. Given this, obesity rates can be understood in terms of “social facts” (Durkheim, 1982).
As Durkheim argued, to understand changes on a social level in terms of changes in rates one must examine the structural changes or differences that influence the society at large(Durkheim, 1982). With concern to obesity rates, a Durkheimian perspective is often overlooked because of the biological and genetic characteristics associated with obesity. However, the increase in weight gain at the societal level illustrates that genes alone cannot explain such a dramatic increase(Durkheim, 1982). Thus, to explain obesity rates one must examine the ways in which the social structure impacts individual weight gain on a mass scale.
The economic system has also changed; manual labor has decreased and service jobs, which require little to no physical activity, have increased(Schlosser, 2012). The economic climate also encourages individuals to work longer hours in order to earn a decent living. Thus, cooking healthy home cooked meals are extremely difficult, especially for the working poor. In lower income areas, unhealthy fast food options are more widely available than
healthier food options(Schlosser, 2012). The overabundance of unhealthy food choices in combination with the lack of access to safe environments to engage in physical activity leads to higher rates of obesity, disproportionally affecting the working poor(Schlosser, 2012).
These are just a few of many structural changes that have reorganized society and in turn have impacted the behavior of individuals. The macro changes have impacted micro changes such as working more, eating more and exercising less, which all play a role in the prevalence of obesity(Schlosser, 2012). It is important to mention that it is the Durkheimian analysis of obesity rates rather than individual cases that bring these social aspects of obesity to light. Efforts have recently been made in some States to address this health epidemic among underprivileged groups by opening local community centers that offer free or low-cost exercise activities and classes. Given this, a heightened attention of public health official should be made to societal & community-level factors that foster health disparities among vulnerable populations. To effectively address this problem the public health policy surrounding childhood and adolescent obesity must address the underlying societal, cultural and environmental factors that influence one's ability to maintain healthy lifestyles.
References:
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