Highlights of Obesity and the Built Environment: Improving Public Health Through Community Design

Kristin Richardson

Disclosures

August 24, 2004

In This Article

The Economics of Food Choice

"Ensuring a healthy diet for all is the greatest challenge there is," asserted Adam Drewnowski, PhD,[3] University of Washington, Seattle, but that challenge can't be confronted without recognizing that obesity in the United States and comparable societies is largely an economic and social problem. Dr. Drewnowski emphasized the twin themes of affordability and access. Diets high in refined grains, added sugar, and added fat are cheap and easily available, while low-fat meats, fish, fruits, and vegetables are now luxury items for large segments of the US population. For many poor people, an unhealthy diet may actually be a rational economic decision.

Dr. Drewnowski presented an analysis of the availability of fast food and fresh food in Seattle, Washington, by neighborhood income level, which revealed that lower-income areas have disproportionately high numbers of fast food outlets and disproportionately low numbers of grocery stores selling fresh foods. He concluded by reminding the audience that "When we talk about unhealthy foods, we talk about glycemic index, energy density, empty calories, and trans fats. And this is true. When we talk about healthy foods we talk about antioxidants, vitamins, and minerals, and this is also true. What we never focus on is the huge disparity in cost." If we are to ensure a healthy diet for all, the economic underpinnings of food choice must be addressed.

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