AN ABSTRACT OF THE THESIS OF Amber D. Lacy for the degree of Master of Arts in Interdisciplinary Studies in Philosophy, Philosophy, and Nutrition and Food Management presented on November 27, 2006. Title: Estranged Eating. Abstract approved: ______________________________________________________ Lani Roberts The “fat-hunger paradox” is a relatively recent phenomenon in the United States in which people of low socioeconomic status are disproportionately overweight or obese, and yet frequently lack access to adequate food and nutrition. Research indicates additional disparities in the prevalence of overweight and obesity amongst most racial and ethnic minorities, women, and female Food Stamp Program participants in the U.S. when compared to other low-income demographics. Although the body of literature investigating the fat-hunger paradox has increased over the past several years, efforts to offer insight into this problem remain hypothetical, nonetheless, and many questions are left unanswered. I argue that the Marxist concept of “estrangement” can help explain both the fat-hunger paradox and its disproportional effects on various low-income populations. Marx contends that the proletariat, analogous to the working poor today, experiences estrangement which leads one to seek temporary solace in base human functions, such as eating, drinking, sleeping, procreation, and passive forms of entertainment. I expand upon Marx’s theory using the work of critical social theorists, multicultural theorists, and Socialist Feminist theorists to demonstrate that, in addition to class, welfare, race/ethnicity, and gender are bases of estrangement in the United States. Among the means through which Marx proposes temporary solace may be sought and obtained, I argue that eating is the most readily available and socially acceptable source of such comfort for low-income people. Moreover, the types of foods that low-income people can afford and which are associated with comfort are typically the very sort that promote obesity but provide little in terms of nutritional value. My thesis about “Estranged Eating” is not intended to supplant other hypotheses or analyses. Rather, I contend that my theory adds significantly to our collective understanding of the fat-hunger paradox in general, and its disparate manifestations observed within low socioeconomic demographics in particular. Estranged Eating by Amber D. Lacy A THESIS submitted to Oregon State University in partial fulfillment of the requirements for the degree of Master of Arts in Interdisciplinary Studies Presented November 27, 2006 Commencement June 2007 ACKNOWLEDGEMENTS The author expresses sincere appreciation to each of her committee members. First, I wish to thank Dr. Lani Roberts, my first and only adulthood hero and the chair of my committee. Dr. Roberts has always been a strong advocate for my centeredness while teaching me what it means to reach beyond myself and my fears. I wish to thank Dr. Joseph Orosco for his excellent courses and teaching abilities, which sparked my interest in Marxism and critical social theory. I could not have begun this work without the intellectual foundation he provided. Also, many thanks to Dr. Mary Cluskey, who noticed early on in my undergraduate studies the ways in which my personality did not conform to the conventional dietetics career tract. Dr. Cluskey embraced who I was anyway and encouraged me to find my own path, which has mattered a great deal throughout my life. Furthermore, I wish to express my appreciation to Dr. Anthony Wilcox, who has remained patient and present throughout this entire process. Thank you all. I am likewise eternally grateful to my family. Their unwavering support and love went a long way to keeping me in one piece. Thanks especially to my son, Michael, for literally growing up with me over the years. Michael always believed I would finish my thesis, and his amazing resilience allowed me the peace of mind to do so, as I have needed to spend an immense amount of time on campus instead of at home over the past several months. I also wish to thank my partner, Daniel, who has been thoroughly supportive of my goals and who has loved me no matter what. My mother has been an incredible support to me, as well, and to my family in my absence while I worked. Finally, I wish to thank my dad, whose influence during my childhood still lives on. On the many occasions when I thought I would break, I could renew my willpower by listening to the echo of his words, “No one ever said it was gonna be easy, Amber Dawn.” Dad, how right you were. TABLE OF CONTENTS Page Chapter One ……………………… 1 Chapter Two ……………………... 20 Chapter Three ……………………. 48 Chapter Four ……………………... 73 Bibliography ……………………... 93 ESTRANGED EATING Obesity and poverty, once conceived as contradictory conditions, are dual realities experienced by many disadvantaged members of American society today. Numerous studies have shown that obesity rates are highest among low socioeconomic status and minority groups in the United States (Zhang and Wang 1623). In other words, the prevalence of obesity is greatest in populations with the lowest incomes and education levels (Drewnowski and Specter 6). The inverse relationship observed between obesity and socioeconomic status is particularly strong among women, but less consistent for men and children (Sobal and Strunkard 260). Research also indicates that households with incomes below the poverty line are at higher risk of experiencing food insecurity and hunger than more affluent households (Parker 54). While it makes intuitive sense that poverty and one’s ability to obtain adequate food would be connected, another finding is quite paradoxical: within individuals and households, food insecurity and hunger can and do occur in conjunction with being overweight or obese (Center on Hunger and Poverty 1). The term “fat-hunger paradox,” albeit rather imprecise, refers to the association of overweight and obesity with poverty in the United States. This relationship may, but does not necessarily, include experiences of food insecurity or hunger (Drewnowski and Specter 7). 2 Explaining the fat-hunger paradox presents something of a puzzle. The coexistent states of obesity and poverty involved in the fat-hunger paradox are historically and conceptually unprecedented, and the problem of obesity has not always been one that particularly afflicts the poor. Earlier in our nation’s history, higher rates of obesity were observed in people of high socioeconomic status, especially men and children. In the later part of the 20th century, however, a complete reversal of this trend occurred with higher obesity rates existing in adults of low socioeconomic status, particularly women (Crawford 63). Conceptually, too, common sense dictates that poverty-induced hunger and obesity should be mutually exclusive conditions. Malnourishment and over-nourishment, the presumable correlates of hunger and obesity, appear at first glance to mark opposite extremes along a continuum of food intake. Presence of the first state, it seems, would logically preclude formation of the latter. Yet for many low-income individuals and families in the United States, the burden of poverty has – quite literally – grown heavier. Although empirical studies focusing on the relationship between socioeconomic status and obesity date back to the 1960s, educational level, not income, has the been the criterion used most frequently as a proxy for socioeconomic status in such research (Olson 75). Measuring socioeconomic status solely in terms of educational level can be a shortcoming, especially when assessing trends from one period to the next, because “the social significance and monetary return for set educational categories (e.g., high school graduate) have changed quite 3 markedly with time, limiting the utility of education relative to income…” (Chang and Lauderdale 2123). The National Health and Nutrition Examination Survey (NHANES) III, conducted from 1988 to 1994, was the first to my knowledge to explicitly identify income-based disparities in the prevalence of overweight on a national scale. This government-funded survey, which involved nearly 40,000 participants over six years, identified low-income groups as disproportionately overweight (National Center for Health Statistics 156, 395). The association between being low-income and overweight or obese was strongest among women, while evidence for such a relationship among men was minimal (116). Within the lowest income categories for all races, NHANES III researchers found the percentage of overweight women to be significantly greater than the percentage of overweight men (117, 156). NHANES III revealed additional disparities along the lines of race. Analysis of its results showed that within the “poor” income category, members of the largest racial and ethnic groups in the United States, Blacks and Mexican Americans, have higher incidences of overweight/obesity in comparison to whites of similar economic status (National Center for Health Statistics 117, 156). The sample size of other minority groups surveyed in NHANES III, such as American Indians, Alaskan Natives, and Pacific Islanders, was insufficient to reliably tabulate the prevalence of overweight/obesity in these populations according to socioeconomic status (139). Smaller population-specific studies, however, have found high rates of overweight and obesity in most racial-ethnic minority groups overall, with the 4 exception of Asian Americans (National Institutes of Health 9). Current research indicates that the disparate prevalence of overweight and obesity among minority groups “persists at broadly equivalent levels of income, suggesting that race discrepancies are not reducible to income effects” (Chang and Lauderdale 2127, emphasis mine). In other words, comparative differences in overweight status between racial/ethnic minorities and whites continue to exist at the low socioeconomic level, as well as at higher socioeconomic levels (Zhang and Wang 1626-27). Based on a recent article by Drewnowski and Specter published in the American Journal of Clinical Nutrition in 2004, it appears that the income- and weight-related disparities I have described thus far remain accurate today: There is no question that the rates of obesity and type 2 diabetes in the United States follow a socioeconomic gradient, such that the burden of disease falls disproportionately on people with limited resources, racial-ethnic minorities, and the poor. Among women, higher obesity rates tend to be associated with low incomes and low educational levels. The association of obesity with low socioeconomic status (SES) is less consistent among men. Minority populations (except for Asian Americans) have higher rates of obesity and overweight than do US whites (6). Although obesity rates have increased steadily in both sexes, at all ages, in all races, and at all educational levels, the highest rates occur among the most disadvantaged groups (7, emphasis mine). As Drewnowski and Specter point out, American waistlines have grown substantially, indeed, within all demographic groups, at every income level, and in every state. The majority of these increases have occurred over the past two and a half decades (U.S. Department of Health and Human Services 11). More than sixty-