Obesity is a Social Inequality & Health Problem

Sociology: I like it more the further removed it is from the task, explicit or de facto, of  proposing the manners required to grease or otherwise optimize capital accumulation.

I appreciate that feminists feel under siege and martyred. Don’t we all these days. But sometimes, due to  un-nuanced, anti-authoritarian alliances with capital, some kinds of feminists permit feminism to be reduced to a wretched, reactionary tool. Certainly, liberal feminism is commonly used in the contemporary era as a tool by political elites to persecute political opponents, as for example where Swedish courts are currently abusing pseudo-feminist sex deviance charges to persecute Wikipedia’s Julian Assange (Sweden has an established weakness for allowing conservatives to use liberal feminism to attack progressive policy, as in immigration).

We appear to have arrived at an epochal juncture where, while global oil-finance-war capitalist machines and working class Enlightenment fighters clash in the streets, postmodernism appears to consist of poorly-paid, impassioned liberal (sometimes self-identifying as radical) feminists, as they are tossed out of the crumbling offices of dying Women & Gender Studies departments in dying humanities schools in overpriced colleges and universities, grasping desperately at the last, remnant, potentially-fundable liberal reform cause: Obeausity liberation (sponsored by Pepsico).

In obesity advocacy, liberal feminism and radical social constructionism are tools used to claim that obesity has no known association with disease. For example, on the environmental website Grist, obesity advocates opposed environmentalists’ pro-bicycling infrastructure campaign on the grounds that it is an affront to obese women. This the last great liberal cause exhorts us to liberate the maligned fat girls from their oppression at the hands of the elite of society: the mean girls, the bicyclists, men who aren’t attracted to fat, and the unsupportive medical doctors of course. In academia, an obese Canadian OISE academic claims that obesity-as-public-health-issue is nothing more than a mean social construction. Presumably to her the function of recognizing a relationship between obesity and disease would simply be to make her feel like she’s in the 7th grade again. Solipsism and careerism charade as a justice campaign.

In a 2010 article from this expanding academic subfield, the UCLA authors Saguy, Grys and Gong reduce the terrain of the issue to a random fight between two groups they reify as moralists v. sociologists. Essentially these are Sneetches with Stars, an unsociological group of people who, presumably out of sheer meanness, choose to understand obesity as a sin behavior “like smoking,” versus Sneetches without Stars, presumably more sociologically-sophisticated people who understand obesity as an “ascribed characteristic like race.”

You know, I enjoy a critique of rampant sociological illiteracy and individualistic moralism as much as anyone; but always take a step back and look around, when social science devolves into simple, de-contextualized barbarity policing/scolding, and social scientists are reduced to professional, secularized nuns. At this point in history, it is a discovery every day for 18 year olds, that race is ascribed. That doesn’t mean that at this point in history, the problem is that doctors got bitchy and called Americans fat.

Fat’s significance is not as a phenomenon of a collective 7th-grader imagination. That would be an EZ problem to solve–for example, with the good old ruler to the knuckles, basically the implied suggestion. No, fat’s significance is that it is created in the physical world outside of our heads, by unequal social relations, which hurt our bodies and minds in other ways as well. People are not being barbaric to oppose this, and it is cheap sophistry to conflate their opposition to these relations with incivility to fat women.  Because it is so myopic, X-treme, fetishized social constructionism can be such a reactionary and careerist tool. Cheap sophistry and toolery are endemic hazards of post-modernism, or any phenomenological dogma. Post-modernism’s proliferation of contextually-naive sophistry and its susceptibility to serving as a political tool for better-organized, hegemonic conservatives (centres of social domination) enable brute power to dictate the terms of reality, and that is why critical realism is required for science, human knowledge, to proceed. (Anarchist post-modernists  argue back that science is nothing more than a tool of the state. That is a debate I will take on more fully elsewhere, but some aspects of my case are embedded in this post.)

Liberal feminist social constructionism dully, dutifully black-boxes why various experts and institutions are identifying obesity as a public health problem, and what their different goals are (eg. social epidemiological efforts to improve public infrastructure v. drug company efforts to sell diet pills). Thus, to the extent that such work –similar to climate change deniers– simply ignores the changing incidence of obesity, its infrastructural, economic and policy roots, its costs to, variously, individuals, families, communities, insurance firm profits, and state health care budgets, and efforts to rectify the roots of obesity that avoid stigmatizing the obese, they are intellectually lazy. But worse, they are dissimulating;* there is in fact solid scientific consensus on the material relationship between fatness and disease.

The Causes of Mass Obesity and the Costs of Obesogenic Societies

This post is not refuting the psychological and physical struggles fat and obese people can experience. Here is a relatable article on how hard it is for a person, once she becomes fat or obese, to lose weight. John Cheese avoids pseudo-altruistic academic bullshit and gives it straight, why poor people in the West are obese, and why they stay that way: They can’t afford real food, and even if they run into money, their tastebuds have already learned that quasifood is exclusively what you stick in your piehole. “Man grows used to everything, the scoundrel.”
In her book Bossypants, Tina Fey declares that we should avoid being mean to people about their weight. I agree. Generally, I am all for being nice. I like it when people are nice to me, though I notice that in a world of 7 billion people, privatized, concentrated means of production and consequent rampant over-competition within the labor market, and very little equality and repair, this doesn’t happen as frequently as obesity advocates assume is normative. The reliable exception to this niceness rule is in paid, underpaid, or free, professional academic and political argumentation. So without further ado, let me tell you why fatness and obesity are themselves social and health problems determined by systemic social problems.

The increase in rates of obesity in the soaring-inequality Anglosphere is alarming. In the past 10 years, the incidence of obesity has risen 50% in the UK. The British National Health Service (NHS) observes that childhood obesity is increasing most drastically. Since 1980, the incidence of obesity (as based on BMI) has increased from 25% of the American population to over 1/3. The Centers for Disease Control and Prevention in the US, along with the British Department of Health, have classified American and British societies as “obesogenic,” meaning these societies promote increased food intake, nonhealthful foods, and physical inactivity. Although more conservative public health experts avoid specifying the well-demonstrated social epidemiological relationship between growing inequality and declining non-elite health, an obesogenic environment is nonetheless seen as the root cause of the increase in fatness and obesity in a population.

“The problems we are now seeing are to do with changes in society – the levels of car ownership, availability of convenience food,” Dr. Tim Crayford of the Association of Public Directors of Health advises. “We need to make it easier for people to make healthier choices, for example, that means having better cycling and walking networks.”

“Dr Susan Jebb of the Medical Research Council said that in this (obesogenic British) environment, it was surprising that anyone was able to remain thin, and so the notion of obesity simply being a product of personal over-indulgence had to be abandoned for good,” reported the BBC following a 2007 UK study of the impacts of obesity, conducted by 250 clinicians and backed by the British government.

Fatness-associated risk for the chronic diseases listed below can be (and has been) measured in health care costs associated with fatness. Depending on the methodology, 1998 US costs associated with fatness totaled between $51 billion – $79 billion, for example. In 2002, those who were overweight or obese cost the UK nearly £7bn in treatment, state benefits and indirect costs such as loss of earnings and reduced productivity. These costs spur both capitalist and government interest in decreasing fatness and obesity in some societies. As well, these costs to societies are private profits for many businesses, which produce and support pro-obesity commodities and infrastructure, including pro-obesity hegemonic work.

Fatness is a Risk Factor for Chronic Diseases

Some of the medical and health research establishment classifies obesity as a “metabolic disorder.” That classification facilitates lucrative medical interventions into the symptoms of the public health problem. There have also been successful efforts to designate obesity as a disease, in order to promote drug treatment. That is obviously profit-scrounging behavior, especially as it ignores and distracts from the roots of rising obesity in the population. You are on firmer ground regarding obesity as a “known risk factor for chronic diseases.”

UK studies have shown that 9,000 premature deaths/year in the UK are directly attributable to obesity. Obesity decreases a person’s lifespan on average by 9 years. Severe obesity reduces the lifespan by 13 years.

Fatness significantly increases the risk of the following ten (broad)
diseases (the evidence for the association is rated “convincing” by
the CDC):

Coronary heart disease
Type 2 diabetes
Cancers (endometrial, breast, and colon)
Hypertension (high blood pressure)
Dyslipidemia (for example, high total cholesterol or high levels of
triglycerides)
Stroke
Liver and Gallbladder disease
Sleep apnea and respiratory problems
Osteoarthritis (a degeneration of cartilage and its underlying bone
within a joint)
Gynecological problems (abnormal menses, infertility)

Fatness Taxes the Heart

According to the American Heart Association, fatness is associated
with a number of comorbidities, including several forms of heart
disease. Comorbidity means that no direct physical relationship has
been established between the main “disease,” (here considered fatness)
and the diseases it tends to occur with. So technically, many of the
diseases associated with fatness are not as far as we know caused directly by
the “disease” of fatness.

However, some heart diseases are caused by fatness, including
hypertrophy of the left heart ventricle. Weight is directly positively
related to blood pressure. Fatness tends to cause systemic
hypertension. People with severe obesity are likely to die suddenly of
dilated cardiomyopathies, featuring concomitant cardiac arrhythmias.

When the left ventricle hypertrophies, this causes the right ventricle
to also hypertrophy. This causes obstructive sleep apnea and the
obesity hypoventilation syndrome, which produce pulmonary
hypertension, dilatation, progressive dysfunction, and finally
failure.

The most valid way to diagnose obesity is via hip-waist ratio. Because
insurance companies (eg. Met Life) have traditionally used BMI to
successfully predict risk of disease, we know that BMI is a valid
predictor of heart disease for people who are not of the following
ethnic backgrounds: Pima Indians, Hispanics, and African-American
women.

Fatness Causes Diabetes Type II

Obesity causes impaired glucose tolerance or non–insulin-dependent diabetes mellitus, which leads to insulin resistance and accompanying hyperinsulinemia.

With insulin resistance, muscles no longer respond well to insulin, and do not pull sugar (or, more technically, glucose) out of the bloodstream efficiently. Both insulin resistance and fat-marbled muscles (storing extra fat within and between muscle cells) are metabolically unhealthy conditions that can be precursors of diabetes.

The BBC regularly reports on government-sponsored studies of the obesity epidemic in the UK. See:

BBC. 2007. “Obesity not individuals’ fault.” October 17.

Triggle, Nick. 2007. “Why the NHS struggles with obesity.” BBC, September 11.
Also fun: The CDC’s Global Cancer Atlas Online and the US cancer map site. The CDC’s site has mapped data on obesity as it relates to cancer.

Social-constructionist feminists are not the only accomplices in the reactionary coalition to block needed social infrastructure reform in sclerotic, anti-egalitarian, stress-fueling, health-depleting, crisis-plagued late-capitalist societies. Accepting the data on obesity’s relationship to disease, one rising Canadian star of neoclassical freakonomics has used her mathematical skills to argue that obesity is caused by cigarette taxation–which encourages individuals to give up smoking. Her view is that individuals smoke instead of eating; and so in order to stay thin, people must smoke.

So if you’re of the Panglossian pro-inequality persuasion, and yet somehow you don’t subscribe to the solipsi-feminists’ anti-empiricist flat denial of obesity and disease research findings, you have the option of embracing the conservative economists’ contention that there is a second E-Z policy approach (Besides sassily labeling obese people “Real Women” and scolding thin people and family practitioners.) to obesity: discourage taxation and encourage smoking!
Yes, this neoliberal junk social science is what painstakingly-educated people get paid and/or lauded to come up with and flog. They’re just like everyone else when it comes to scratching for their meat. It’s a wicked life, but what the hell. Everybody’s got to eat.

*To be perfectly accurate, they are radical social constructionists, and not critical realists. So they don’t recognize differences among epistemologies’ relationships to ontology. This is what allows them to join with conservatives to deny scientific consensus on changing conditions.

Infrastructural Contributors to Obesity

I) Pollutants Contribute to Obesity and Diabetes:


II) Social Inequality Contributes to Obesity via Stress


III) Capitalism Contributes to Obesity via Class Inequality in Consumption: The Consumption and Lifestyle Decision Paths of Workers and Consumers with Little Effective Demand Are Unhealthily Constrained

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Corruption in the US at the 21st Century

Transparency International (TI), the international community’s foremost corruption watchdog, compiles a global Corruption Perception Index every year wherein a variety of “yes-no” questions are posed to respondents from 180 different countries. The results are telling, and they lead to TI’s overall corruption rank for each state…

TI’s corruption barometer found that in Europe, Latin America and sub-Saharan Africa, political parties are perceived to be most conducive to corruption. In Asia, the Middle East, North Africa and the Western Balkans, suspicions lie with the civil service. And in North America, it is the parliament or legislature.

Most police officers in America do not require greased palms for their services. But if one wishes to attend a chicken cordon bleu dinner with Sen. Max Baucus of Montana, it will cost him $10,000 (fly fishing and camping in Big Sky Montana with the same gentleman only costs a quarter of that though). Congressman Joe Crowley’s company, however, may be purchased for a piffling $100, including karaoke—unless one wishes to buy in bulk and also attend a “VIP After Party,” in which case the bill rises to $1,000.

The going rate for lunch with Congresswoman Suzanne Kosmas seems to be around $500, as is also the price for a savory “Taste of Michigan” luncheon with Congressman Bart Stupak. And for those who feel like splurging, a seat at the “Healthcare Community Dinner Honoring Pete Stark” will set one back a modest $2,500.

Charlie Palmer steaks and health-care talk with Republican Sens. Chuck Grassley, Mike Enzi and Richard Burr costs either $2,000 or $5,000, depending on one’s desired propinquity to the head of the table…

Has the $787,641 to Max Baucus’ coffers (and, to be fair, he is but one of 535) from the health professionals industry since 2005 played any role in his shaping health-care reform legislation? …

Such is also the case for conservative Blue Dog Democrats in the House, such as Mike Ross of Arkansas, who just days after voicing his criticism of the progressively minded health-care bills was wooed with extravagant fundraisers by health-care industry lobbyists. (The Blue Dogs received) 25 percent more in contributions from the health-care and insurance industries.”

Excerpted from Whatley, Stuart. 2009. “American Plutocracy.” The Huffington Post, July 31.

US per capita expenditures

What do Americans spend their money on, besides disposable consumer trinkets, interest, and overblown mortgages?

They are currently involuntarily donating:

$2238/capita/annum to military expenditures,
$39,000/capita in wealth redistributions (recent bailouts) to finance capitalists, and
over $6000/capita/annum to the private insurance-lobbyist-pharma-and gross-inequality-lovin’-physicians-run US medical complex!

Such a lucky slave-peoples.

Everyone Does Better with Equality


“Americans think that it’s healthcare that produces health, when there really is very little evidence for that.

What turns out to be really important is the nature of caring and sharing in society. And the best factor that really impacts that is the degree of inequality. Where societies are more unequal, people don’t look out for one another, they look out for themselves. Where societies are more equal—and economic equality is the thing that is most important in this—people look after each other, society looks after each other, and pretty well everyone does better.

There’s almost nothing that is better in a society that tolerates the extreme levels of inequality.”

Dr. Stephen Bezruchka, Senior Lecturer at the University of Washington’s School of Public Health, interviewed by Amy Goodman on Democracy Now! March 30, 2009.

"Nonprofit" Corruption

A revealing article, dubbed wonkishly enough “The Pennsylvania Community Health Reinvestment Agreement”: http://www.statecoverage.net/pdf/monograph0806.pdf

This article provides an overview of one of the many, many problems with a private health care system. Here we see the many opportunities for corruption available to the insurers that enjoy non-profit status, Blue Cross/Blue Shield.

The historical roots of Blue Cross/Blue Shield are in the efforts of the AMA to maintain “provider sovereignty”–that is, to prevent the majority of Americans from access to health care, so that the health care market would be calibrated to the incomes/wealth of the most affluent Americans, thus maintaining medical doctors’ financial elitism in addition to their elite status.

It should be made clear to non-Americans that Blue Cross/Blue Shield do not primarily service needy populations.

These insurers’ unregulated status makes public accountability impossible, as this article demonstrates.

Blue Cross/Blue Shield provide an excellent case of the widespread corruption and inefficiency that dominates US businesses via “creative” accounting. They went from no reserves to pay claims in the 1980s and 1990s–when they poured insurance income into outrageous golf junkets and Paris headquarters–to a new amassing of massive wealth at the public and social expense. While companies and individuals paying for health insurance fork over ever higher premiums for the “confidential” ends of the private healthcare insurers, this wealth has been dedicated to ridiculously high executive salaries, the retention of armies of ridiculously overpaid legal firms, and political lobbying.

In exchange for minimal and insecure commitments to low-income health insurance subsidization (covering 100,000 people), the Pennsylvania Agreement effectively relieves these unaccountable companies and their for-profit subsidiaries from contributing to the public welfare through taxation. Crazily enough, the PA Community Investment Agreement appears to be the very best the privatized US health care system can do to provide health care coverage. It is hailed as a cutting-edge model for states hoping to cope with the devastating health care crisis. For in most states, governments have no ability to regulate these “nonprofit” monsters.

And by regulate, I mean to say: Governments have no ability to determine whether a nonprofit is acting in any “benevolent” (as opposed to bilking) manner whatsoever. They have no access to information about rates and expenditures. This brings into question the whole point of even having a “nonprofit” category in public governance. Since its a capitalist country, why assume that any private business is “benevolent” at all? Blue Cross/Blue Shield themselves deny it! Here is the reason for the “nonprofit” category in the US: It’s an avenue for graft.

Blue Cross/Blue Shield are a clear cut case that privatized health care is socially inefficient and socially damaging.

No Child Left Behind: Critical Blog

Want to know the effects of education policy thats main purpose is to remove adult human decision-making power from educators?

Here is a source on No Child Left Behind (NCLB):

http://susanohanian.org/index.html

The Road to Perdition: Charter Schools

The state of Minnesota used to have a good education system. Then the Baptists organized working class voters to vote for those most holy baby-savers, the Republicans, whereupon the Republicans set about destroying public education, among other collective assets of the working class. Sound familiar? The way they destroyed public education was through Charter schools.

How do Charter schools destroy public education, in order to wipe out an organized middle class of teachers, channel (public and private) education dollars to rich kids, and create a big low-educated/low-skill serf population for the local businessmen to use?

(1) Charter schools don’t take enough high-cost students. Students with little human capital, struggling families, or disabilities cost more to educate. The public schools educate them. Charter schools don’t; it’s not financially advantageous for them. This means that there is built-in misallocation of funding in a system with Charter schools. It’s a system designed for failure–to ultimately convince working people that, unlike the rich, they have no collective assets, they’re isolated and powerless sitting ducks. As missionary David Paszkiewicz explained to his missionary subjects in a high school in Kearny, New Jersey, “The purpose of public school is to provide free education for people that can’t afford education. What it’s become is social engineering” (Harper’s Magazine, July 2007: 27).

(2) Charter schools take too much money out of the public trough for wasteful reasons, spending it profligately on lower-needs students. For example, in Minneapolis, all Charter school students are bussed on the public dime. But if a child goes to a public school, she has to walk to school if she lives within a mile of it. Because many Americans are chronically terrified by racist and classist right-wing fear mongering, and also cleave to an obesity lifestyle, families will send their children to Charter schools–if they can–just to avoid having the child walk to school or walking the child to school. That’s only one drop in the misallocation bucket.

(3) Most Charter School teachers are not unionized. This means (a) that “people” (read: women) who are interested in educating are expected to invest in expensive higher education in order to teach, and then squander that investment on insecure, low-status, low-pay temp jobs. Although we always expect women to work for “love” (AKA free), it’s not an economically rational system; it is designed to fail. And (b) the decline of a unionized middle class sector–educators–means that public policy formation is left to the remaining regional actors with organizational power–businessmen, Republican political organizers, and doctors. If you want to know what rapacious class warfare is, I suggest you study the politics of these men.

Interlude
State Politics Run By Local and National Wealthy Elites Alone: The AMA

For instance, the only non-despotic medical organization is Medecins sans Frontiers. The AMA (American Medical Association), on the other hand, is one of the most regressive, cruel, self-serving cabals that has plagued the American political scene. My study of Oregon state neoconservative politics since 1970 was where I discovered what a bunch of jackals the AMA is. The virulent history of AMA politics is recorded in a number of studies, including Jill Quadagno’s “One Nation Uninsured: Why the US Has No National Health Insurance,” Colin Gordon’s “Dead on Arrival,” and Bartlett & Steele’s “Critical Condition.”

Remember, even though it’s convenient to cloak themselves in a fine veneer of noblesse oblige, most people really become doctors for one reason only: to get rich. To be a doctor you usually have to make plans and follow an education protocol in your teenage years. If that’s not steered by status-conscious mom and dad, then look at t.v. and consider what kinds of “noble” things inspire most young people: tennis club memberships, expensive cars, big houses. The hunger for social advantage doesn’t stop at the examination room door. The AMA is always there to fight competitively against the welfare of the working class. Inequality = poor health = profit.

Back to our Regularly-scheduled Treatise on Charter Schools:

Look, everybody thinks they can do a better job than other working class (AKA “middle” class) people. That’s how you’re *supposed* to think as a non-capitalist in a capitalist system. You’re supposed to compete with others of your lowly station, so that owners might bargain down your price. So it is not unusual to harbor the illusion that all you have to do to get a better education for children is to replace teachers with yourself. My experience is this: the people most likely to decide that they should have or control someone else’s work are the people who are both ignorant and contemptuous of what that work involves. Yes, some people are not great at their jobs. However, if you want to improve education, and you think you’re the gal for the job, then at first, just get a degree in teaching, and teach, and join a union. And then tell us about your ideas for reform, which doubtlessly feature some version of forcing teachers to tapdance while students, lawmakers, and Chamber of Commerce-types throw pennies and vegetables at them.