New York City has certainly missed the boat in the fight against obesity in low-income neighborhoods. How can we, as informed and responsible health care providers, be surprised by the results of this study? Given all of the challenges, health, economic, social and otherwise, faced by people struggling at or near the poverty line, using calorie labeling to combat obesity is like using a toothpick to spear an elephant.
In fact, the elephant in the room is that the fatty foods served by the fast food chains are cheap, accessible, and filling. When you have just a few dollars to spend on a meal, you choose what leaves you feeling full for as long as possible.
Healthy foods such as fresh fruits and vegetables are expensive. And many neighborhoods do not have decent grocery stores. Even so, a piece of fruit can cost close to a dollar and only qualifies as a snack, not a meal. "Five a day," the target suggested by the food pyramid, is about
five hard-earned bucks.
In Maryland, the WIC program allocates a mere $8.00 a month to "pregnant and mostly breast-feeding women" for vegetables and fruit. That's about two bags of oranges, which might last four days if you're lucky. What about the other 27 days of the month?
How can we, on the one hand, say that we're advocating for healthy, balanced diets and, on the other hand, do very little to support these expensive choices? It doesn't add up.
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