Posted by Janet Harriett on Feb.20, 2010

©iStockPhoto.com - VMJones

Obesity, diabetes and cardiovascular disease rates are all higher among people in lower income brackets. Even with insurance and subsidized health care options through programs like Medicaid, people with lower incomes tend to get less preventative care. At the end of the day, people in the highest socioeconomic group have an average life expectancy more than 4 years higher than people in the lowest income bracket.

While the exact causes of income-related health disparities is open for study and debate, the results are clear: wealth buys health.

Nutrition

Many of the adverse health indicators that track with income level are ultimately related to the higher levels of obesity as incomes drop. It’s no secret that the foundations of good health start with a healthy diet.

Although the cheapest calories at the grocery store tend to also be the unhealthiest ones that pack calories in with refined carbohydrates and low-quality fats, a healthy diet in itself doesn’t need to be expensive. However, the calculations that show a healthy diet is also a cheap diet rely on access to stores that sell raw potatoes, fresh greens, legumes and other healthy staples. When there is no grocery store, the calculations fall apart, and that is the reality for a substantial number of people

Food deserts-areas that have limited access to healthy food, usually defined with a combination of automobile access and proximity to a supermarket-are much more likely to be in areas with below-average incomes. The new anti-childhood-obesity campaign website, www.letsmove.gov, puts the number of people living in food deserts at 43 million, including people who live in an area designated a food desert but who can drive to a market.

Clearly, this doesn’t account for all of the cases of obesity and poor health in lower income brackets, but healthy living options are severely limited for those who can’t get to a market that carries fresh fruits and vegetables, and who rely on higher-priced smaller markets and discount retailers that may have limited options, little or no fresh produce, and processed foods of dubious quality. We at GreenDivaMom.com love our green smoothies, but those require greens, and greens require either a place and time to grow them, or access to a market that sells them. We advocate many substitutions for healthier cooking, but in a neighborhood without a supermarket, the chances of finding organic agave nectar, buckwheat flour or organic raw coconut milk aren’t promising.

Activities

While middle-class suburban parents may spend weekends shuffling kids around to soccer practice or dance lessons, the fees for such activities are often out of the budgets of lower-income parents, if the programs are even accessible in their areas. Many school districts are moving to a pay-to-play system for extracurricular sports, making even school-based sports programs a middle-class-only option. This isn’t to suggest that a low annual income necessarily requires a sedentary lifestyle. Activity options are certainly available at all income levels; after all, physical activity doesn’t need to be an organized league sport.

The Wellness Privileges of the Middle Class

Even if Americans were to succeed in giving everyone access to nutritious food through grocery stores and farmer’s markets, and change farm subsidies and nutrition assistance programs to favor nutrient-dense foods instead of simply calorie-dense foods, and give people at all income levels safe places for outdoor activity, that still only goes so far in promoting holistic wellness. There is much more political and social agreement about the fairness of providing basic nutrition and fitness, but many facets of a healthy lifestyle are still considered “extras.”

Specialized Diets

With supermarket access, a healthy diet is cheap enough, but the special diets to manage particular health conditions or food sensitivities gets pricy fast. Food additives, which may be linked to several behavioral problems, are prevalent in even minimally processed foods. People with food intolerances, sensitivities and allergies may be limited to budget-busting brands or alternatives that are out of reach of people with small food budgets.

Gluten-free, casein-free diets can help many conditions, but the gluten-free, casein-free alternatives to common foods aren’t cheap. Betty Crocker recently came out with a gluten-free line of cake mixes, at about 3-4 times the price of their standard line of mixes. Even if you simply choose to eliminate glutenous grains and dairy products, gluten and casein derivatives are in many foods that don’t immediately come to mind as containing wheat or milk ingredients, like lunchmeat, baking powder, spices and instant coffee. Parents receiving WIC assistance may need to get a prescription from a doctor, incurring the expense of a doctor’s visit, to be allowed to get gluten-free cereal and milk substitutes through the WIC program, and the option isn’t always well-publicized.

Nutritional Supplements

Many physicians recommend at least a basic multivitamin to fill in the gaps that even a healthy diet can leave in nutrients, and specific vitamin and mineral supplements can benefit several conditions. However, when a family is struggling to keep the heat and lights on and the rent current, even a bottle of vitamins can quickly become a luxury item, never mind other, more expensive nutritional supplements and health-promoting super foods.

Alternative Medicine

Even the best health insurance rarely covers alternative medicine treatments, and the trend is toward less coverage, not more. Middle class families can find savings depleted pursuing complementary and alternative care for a child or family member with a chronic condition that does not respond to traditional therapies. People relying on Medicaid or emergency rooms for medical care are priced out of access to many health care options that could help manage conditions without relying on prescription drugs or other therapies. Massage, which has myriad documented health benefits, is often perceived as an upper-class luxury.

Like it or not, while basic good health is generally accessible, many features of a healthy lifestyle are still priced out of reach of struggling families.

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Posted under Alternative Treatments, Health & Fitness, Health Facts, Reading Labels.