Obesity Higher Among Long-Term Unemployed

Gallup released the results of a survey based on interviews in 2013 of 5,000 long-term unemployed and 13,000 short-term unemployed.* Gallup highlighted that obesity is higher among the long-term unemployed:

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The long-term unemployed are also twice as likely to say they have high cholesterol and high blood pressure. However, the pollster warns against jumping to the conclusion that high unemployment led directly to worse health. Indeed, the short-term unemployed report a lower incidence of these two ailments by virtue of being young: average age of the short-term unemployed is 33.6 years versus 42.6 for the worker pool overall.

It’s appealing to assume that correlation means causation. It isn’t hard to imagine that someone who is unemployed will wind up gaining weight due to the ready proximity of the fridge and to shifting their diet to cheaper foods, which are often higher fat and/or higher simple carbohydrates. Gallup points out that people who are in worse overall health may find it harder to land a job. Curiously, they don’t mention the most obvious reason that the long-term unemployed have higher rates of obesity: that the obese are discriminated against. For instance, at Harvard Business School, the student that the school chose as its graduation speaker for the class of 2013, Brooke Boyarsky, began her talk by stating: “I entered H.B.S. as a truly ‘untraditional applicant’: morbidly obese.” And what was her self-described act of courage at the school? Not graduating as a Baker Scholar, but losing 100 pounds during her second year of study.

Gallup points out that either unemployment itself or poor health can lead to a self-reinforcing downward spiral:

Unemployment may cause some people to engage in behaviors that lead to health problems, while pre-existing health conditions may make it harder for others to find and keep work. For many individuals, both dynamics may be at work, perpetuating a negative cycle of declining job prospects and worsening health.

Jobless Americans may be more likely to fall into such a cycle if a higher incidence of health problems hinders their efforts to find a good job.

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Over the longer term, one of the most worrisome implications of these relationships is that many of those who have been unemployed for a prolonged period may suffer chronic health problems even if they successfully re-enter the workforce. A 2009 study of Pennsylvania workers laid off in the 1970s and 1980s found that even 20 years later, these workers were 10% to 15% more likely to die in a given year than those who had not suffered a job loss.

This is yet another reminder of the high social cost of inequality and lack of access to decently paid work is a big part of the problem. As we wrote in 2010:

Severe financial crises result in a permanent decline in the standard of living. For some citizens, that has come through contracts being reneged, in particular, pension cuts. Other people see their savings in tatters and have no realistic prospect for being able to fund their retirement. And for many of these individuals, the odds of finding continuing, reasonably paid work are low. Even before unemployment soared, people over 40 face poor job prospects. The idea that the middle aged cohort can earn back losses to their nest eggs is wishful thinking. And the young are not much better off. New graduates also face a hostile job market. Worse, students often went into debt to finance their education, believing the mantra that it was an investment.

And many of the societies suffering these financial shocks have already suffered a great deal of erosion of their underlying support structures. Even before the crisis, in the US and other advanced economies, social bonds have eroded in a remarkably short period of time, roughly a generation and a half. Job tenures are short; employees and employers have little loyalty to each other. Ties to communities are weak. Many families have two working parents, so career and parenting demands leave little time to participate in local organizations. Advanced technology frequently offers an easier leisure outlet than trying to coordinate schedules with time (or financially) stressed friends. But marriage and families are also not the haven they once were, given high divorce rates.

One oft unrecognized factor is that alienation and social stress are directly related to income inequality. This is hardly a new finding, but it seldom gets media coverage in the plutocratic US. And it has concrete, measurable costs. As Michael Prowse explained in the Financial Times:

…..if you look for differences between countries, the relationship between income and health largely disintegrates. Rich Americans, for instance, are healthier on average than poor Americans, as measured by life expectancy. But, although the US is a much richer country than, say, Greece, Americans on average have a lower life expectancy than Greeks. More income, it seems, gives you a health advantage with respect to your fellow citizens, but not with respect to people living in other countries….

Once a floor standard of living is attained, people tend to be healthier when three conditions hold: they are valued and respected by others; they feel ‘in control’ in their work and home lives; and they enjoy a dense network of social contacts. Economically unequal societies tend to do poorly in all three respects: they tend to be characterised by big status differences, by big differences in people’s sense of control and by low levels of civic participation….

Unequal societies, in other words, will remain unhealthy societies – and also unhappy societies – no matter how wealthy they become. Their advocates – those who see no reason whatever to curb ever-widening income differentials – have a lot of explaining to do.

Yves here. If you look at broader indicators of social well being, you see the same finding: greater income inequality is associated with worse outcomes. From a presentation by Kate Pickett, Senior lecturer at the University of York and author of The Spirit Level, at the INET conference in April:

Picture 52

Note in particular where Japan sits on the chart. Some readers have argued that the US has little to fear from deflation and a protracted period of near-zero growth, since Japan is orderly and prosperous-looking, despite its relative decline. But Japan was and is the most socially equal major economy, and during its crisis, it observed the [Simon] Schama prescription of sharing the pain. The US, the UK, and to a lesser degree, Europe, have done the exact reverse, with both the bank rescues and austerity measures effectively a transfer from ordinary citizens to financiers.

Back to the current post. In a society driven by an ideology of selfishness and short-sightedness, many at the top find it easy to rationalize business and social policies that increase the ranks of the unemployed and leave them and other lower-income people with inadequate health care as pro-efficiency, or worse, somehow virtuous. The irony is that the rich pay for inequality through the toll on their own health and longevity.

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* The Bureau of Labor Statistics sets the boundary for long v. short term unemployment at 27 weeks. Empirically, there’s a lot of evidence that those who can’t find a job within six months face greatly reduced odds of ever finding employment again.

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25 comments

  1. jcee

    “The irony is that the rich pay for inequality through the toll on their own health and longevity.”
    Large bonuses will help to off-set the pain.

  2. Skeptic

    “In a society driven by an ideology of selfishness and short-sightedness….”

    What about the flip side of this? That is what are the health effects on those who are employed? It is not just obesity that is a health problem. Those who are employed may engage in many destructive behaviours because they are employed and have the means to do so. Having more means possibly the more destructive behaviours may be. Such destructive behaviours may include Shopping, Drug Addiction (including alcoholism), Internet/Electronic Addiction, Food Addiction, Gambling, Sportz, etc. I suspect that well over half of Americans are addicts in one way or another. And maybe as one moves up the employed food chain, the behaviours become even more destructive.
    It is not only the unemployed/obese who are unhealthy.

    1. jrs

      Yea employed people engage in a lot of unhealthy behaviours out of stress and time pressures, but as bad and as stressful as the American workplace is for most workers (and it IS), unemployment is usually an even worse experience.

  3. DakotabornKansan

    If only poor people understood nutrition! The poor eat badly. That is why their health tends to be poorer! This “tidy solution that not only absolves financial and economic guilt, but, as a bonus, allows richer, more-edumacated people to assume the role of benevolent experts,” writes The Fat Nutritionist.

    http://www.fatnutritionist.com/index.php/if-only-poor-people-understood-nutrition/

    From the report “Still Too Fat to Fight” by a group of retired military leaders:

    “Finding ways to reverse our epidemic of obesity is crucial because the U.S. Department of Defense alone spends an estimated $1 billion per year for medical care associated with weight-related health problems. In a dramatic move to address this problem, the military is bringing healthier foods to its schools, dining facilities, and vending machines, but it cannot win this fight alone. The civilian sector needs to do its part.”

    http://www.rwjf.org/en/research-publications/find-rwjf-research/2012/09/still-too-fat-to-fight.html

    J. Eric Oliver, Fat Politics: The Real Story Behind America’s Obesity Epidemic, set out to write his book believing that “obesity” is a real problem in America. However, “What I thought was an epidemic began to look like a politically orchestrated campaign to capitalize on America’s growing weight.” The “heath-industrial” complex profits once we label fat people as “sick.”

    Fatness is not a disease. Oliver says it “is a protective mechanism that evolved to survive fluctuations in our food supply. Judging someone’s health by how much they weigh is like judging a camel by how much water it has in its hump — in conditions of privation, our extra weight, just like the water, may be exactly what we need to survive. Our weight is merely an expression of this adaptive mechanism at work.”

    “The only way we are going to “solve” the problem of obesity is to stop making fatness a scapegoat for all our ills. This means that public health officials and doctors need to stop making weight a barometer of health and issuing so many alarmist claims about the obesity epidemic. This also means that the rest of us need to stop judging others and ourselves by our size.”

    Obesity, according to Oliver, is a symptom, not a cause of, the nation’s health problems. Proclamations of an “obesity epidemic” are built upon shoddy science and marketing campaigns developed and promoted by those who either sell purported “solutions” to the “problem,” or whose funding depends on belief that they’re researching or fighting a terrible disease.

    “Our body weight is not the cause of our ill health but merely the expression of metabolic processes that are meant to protect us in times of privation. In other words, our fatness is like our body hair or the shape of our ears — it is a natural part of our physicality that has a specific function. The real health problems that are associated with being heavy, including heart disease and diabetes, are not coming from our weight but from the same metabolic processes that determine our weight levels, such as our appetites and insulin levels.”

    “Instead of convening task forces to figure out ways to combat obesity, state and federal government should simply be telling health agencies to find better measures of health than weight. They should make rules on the conflicts of interest between obesity researchers, weight-loss doctors, and the diet and pharmaceutical industries. And they should develop programs to combat the stigma and prejudice that fat people must face and institute laws, such as those in San Francisco and Michigan, that protect people against size discrimination. In short, they should work on changing all the harmful perceptions we have about weight. This would do far more to improve the health and well-being of the American population than making us so worried about our weight.” – Eric Oliver, Fat Politics: The Real Story Behind America’s Obesity Epidemic

    1. Klassy

      Thank you!
      Fat Politics has a useful discussion of how the “obesity epidemic” came to be. Very eye opening.

    2. Yves Smith Post author

      The entire country has gotten fatter since the 1980s. This is not a matter of poverty per se. It’s a matter of more time stress, so people either eat out more (and for the poor, fast food is still affordable) or eat more prepared foods. Aside from their content (often too many starches and sugars), standard portion sizes in the US are large. We’ve normalized overeating. And time stressed people find it hard to find time to exercise.

      Fat has become a class marker, so upper income people make sure to stay trim, or at least not fat.

      1. Randy

        The whole world has become increasingly obese. I heard some shocker lately like 30% of the global population is obese. Mind blown.

  4. Ben Johannson

    Couple this with the research on happiness and personal income level, where the former ceases to climb after roughly $75,000. Turns out wealth really can’t buy happiness, or much of anything else that really matters.

  5. Steve H.

    “Where we, the USDA nutritionists, called for a base of 5-9 servings of fresh fruits and vegetables a day, it was replaced with a paltry 2-3 servings (changed to 5-7 servings a couple of years later because an anti-cancer campaign by another government agency, the National Cancer Institute, forced the USDA to adopt the higher standard). Our recommendation of 3-4 daily servings of whole-grain breads and cereals was changed to a whopping 6-11 servings forming the base of the Food Pyramid as a concession to the processed wheat and corn industries.”

    -former USDA director of dietary guidance Luise Light

  6. LAS

    The obesity, health and social context are really difficult to study in epidemiology because of the many pathways from one to the other. A person’s weight is believed not only causal of poor health, but it is an outcome/symptom of poor health. If health cannot sustain an exercise program you may gain weight; if you have cancer, depression or other disease you may be losing weight. The social context in its turn can be both a cause and a consequence, as well. In certain neighborhoods, healthier people are congregated, while in other neighborhoods sicker people. How did they get there? Were they poor first? Or sick first and then became poor? Without highly controlled and potentially unethical research designs, it is very hard to separate the effects.

    National borders sometimes lead to semi-experimental conditions due to policy differences (but genetic / racial and cultural differences may yet confound these conclusions). I remember seeing in one epi paper a discussion about how sanctions and embargoes against Cuba by the USA caused the whole population of Cuba to lose some weight over the years the sanctions were in place. Some persons in Cuba got healthier (middle age adults) and specifically the incidence of diabetes declined, but some people got worse health and higher mortality (infants, elderly. those with low immunity).

    Conversely, there are many papers from CDC that show the median BMI of Americans has grown over the last 40 years. Today, overweight (BMI ~ 27) is healthy in the USA because the average citizen is overweight in that range. Overweight is the new norm and deviants from the norm have higher probably of being in poor health – so it appears in observational studies that the average overweight is the most healthy weight. It probably isn’t because the population is also experiencing an epidemic of diabetes and this would only be recognized in cross-country, temporal comparisons and ecological studies.

    I think the USA is conflicted over health. The feds have these dietary standards Michelle Obama speaks of but at the same time other federal agencies promote higher use of fatty cheese to appease the Dairy Industry. Don’t you ever wonder who thought of putting cheese into pizza crust or offering triple cheese toppings, etc.? Was the population truly demanding this extra fat?

    1. readerOfTeaLeaves

      New research links obesity pretty firmly to ‘obesogens’, which are chemicals that interfere with hormone function. Add onto that global exposure to toxins, and to chemicals that interfere with hormone function, and you have a growing global obesity problem.

      The annual market for insulin and related products is in the billions – and that doesn’t add in the food products catering to ‘low cal’ or ‘low sugar’. Basically, obesity and weight loss are HUGE markets, and depressingly profitable.

      Wikipedia has a good intro to ‘obesogens’.
      http://en.wikipedia.org/wiki/Obesogens
      If you read this with care, you can probably think of linkages to the recent problem of ‘feminized frogs’, in which chemicals have interfered with the sex hormones of frogs. The biological processes that are related to obesity also interfere with production of testosterone and estrogen; in many instances, the chemical processes involved in producing sex hormones are ‘overridden’ and the body instead makes far too much cortisol — a stress hormone good over the short term, but toxic when in constant production.

      Obesity is a huge global problem, and these nasty obesogen chemicals are now in soils and waters around the globe. Being moralistic about what – and how much – people eat is not only self-defeating, it is preventing more researchers from unearthing the links between certain chemicals and hormone interference as the basis for a lot of obesity.

      Obesity has other effects, including general tiredness and exhaustion, because the body is not properly metabolizing nutrients. This, in turn, leads to cravings for quick energy (i.e., simple carbs). So it’s a negative feedback loop that intensifies over time.

      There are two excellent books written by doctors that are aimed at the general reader. One is “The Complete Idiot’s Guide to Hormone Weight Loss”, by Alicia Stanton, M.D.
      http://www.amazon.com/Complete-Idiots-Guide-Hormone-Weight/dp/1615641025

      The other is quite recent and I know several people who are raving about it: “The Metabolic Storm”, by Emily Cooper, M.D.
      http://www.amazon.com/Metabolic-Storm-Science-Metabolism-Making/dp/0989690210/ref=sr_1_1?s=books&ie=UTF8&qid=1403194813&sr=1-1&keywords=metabolic+storm

      Both books explain some basic biology for the general reader, and both are quite easy to follow. They are both recent and use the latest available science to explain health problems.

      If I were a health insurance exec:
      (1) I’d be making sure that I emptied my home, car, and offices of ALL toxic cleaners, etc. Also, that I’d be very careful about what shampoos, lotions, etc, I use – because all those products enter the body and if they contain obesogens, they trigger a sequence of nasty chemical processes that result in obesity. And I’d share this info widely with every single member of my company, as well as all people covered by the insurance plans.
      (2) I’d be reading every single thing that I could about the most recent research into obesity, because that problem is becoming so huge that it is going to have severe impacts on the health care systems,
      (3) I’d be strongly and loudly advocating for far better, far tougher environmental regs — because the number of chemicals even in the US that have not been tested over time, or not tested in good studies, is an absolute scandal. Until the links between certain chemicals and obesity becomes widely shared public knowledge, polluters and off-the-shelf personal products will continue to make people sick without their realizing what’s happening.

      When Bill Maher said that Americans are at greater risk from Doritos than we are from terrorists, he was not too far off. We’re at even greater risk from environmental toxins and obesogens.

      There is so much money involved in health care, and particularly in obesity and diabetes (“diabestity”) that there are some very smart, smart people looking into the way that hormones almost certainly are a critical piece of the obesity puzzle.

      Obesity tends to be higher in poor communities; those communities also are associated with higher levels of industrial waste and toxins. But everyone is at risk from the problems of increasing numbers of obesogens in the environment.

      1. LAS

        I’m aware of some of these, and think there is something to the theory of epigenetics or genetic response to environmental variables on human populations. There also seems to be an association with low birth weight and eventual obesity. But virtually all the studies are flawed and limited because it is very, very hard to control for events that are environmental hormone disrupters to infants, for genetics, for social and demographic factors and so much more over the time it takes for the outcomes to appear. And virtually none of the studies are randomized control trials. There is always reasons why the findings are not conclusive. Probably laboratory studies of animals are going to be the best evidence.

  7. Cocomaan

    / dons tinfoil hat

    I don’t think it’s a big secret that the current US health system feasts on the abysmal health of Americans. It has no connection to wellness or holism, just profits and medications. This blog has established that over and over again.

    Increasing obesity means worse health outcomes, and means more medical billing, more doctor visits, more chronic health problems. As long as these folks can afford Obamacare, everyone makes money off of their terrible lifestyle.

    / takes off tinfoil hat

  8. RUKidding

    I’ve had a very part-time job in the weight loss field for several decades. Speaking anecdotally, it has been astounding to witness the vast increase in weights over the years. One big reason for this, I feel, has been the introduction of high fructose corn syrup into a lot of “foods,” in particular sodas. Growing up in the ’50s, soda was a treat doled out sparingly & in small amounts, usually at parties and the holidays. I lived overseas for 8 years in the late 70s/early 80s, and I was quite honestly shocked when I returned to note the giant sodas that people drank daily – and often more than one per day.

    High fructose corn syrup sodas have contributed a lot to weight gain, along with all the pre-packaged “foods” and fast “foods” that USians consume. Well most here know all this, but all I can say is that amount of people coming in our weight-loss doors who weighed 400 pounds or more has increased a lot over the past few decades. Used to be that we only saw such obesity infrequently; now it’s sadly very common.

    Problem is that when someone weighs 300+ pounds, it becomes increasingly difficult to lose & keep off that weight. I don’t have all the scientific facts behind this, but part of the reason is that such obesity usually precludes people from being able to move much. Without some level of exercise, losing weight becomes much harder. When 300+ people come in our doors, my heart sinks. I feel so badly for them because, believe me, they’re not happy, but I know (but don’t say) that it’s going to be super tough for them to be successful. Just a fact.

    When Sarah Palin (a couple of years ago) dissed NYC Mayor Bloomberg (not my favorite, but still) for trying to limit the size of sodas & stood up her grafter hind legs with a giant Big Gulp, I really saw “red.” Well we all know that Palin’s a tool and in it for the money, but given what I deal with every week, it really pissed me off.

    US Agriculture & “Food” industries want people addicted to crappy “foods.” That movie “SuperSize Me” proved how addictive CrapDonald’s “food” is and how incredibly deleterious it is for your health. But addicted people spend money on their “fix” of choice, and for some, it’s crappy “food.”

    And yes, then, the “Health Care” industry makes out like bandits from dealing with the outcomes of such sh*tty eating HABITS.

  9. washunate

    Great read. The root problem is extreme inequality. More does not solve that problem. But hey, it’s good for business if you have a cushy job in the healthcare industry!

    Public health is a complicated matter, yet the principles are fairly straightforward when we compare to other countries. The US is more car dependent than other nations, the US has this bizarre linkage between employment and health insurance, the US has a much more authoritarian workplace culture where employees have little power or influence and work many more hours than other industrialized nations, the US has embraced fossil fuel/GMO/IP protected agribusiness more than anywhere else on the planet, and the US has embraced drug usage as a criminal matter rather than a public health matter.

    1. kareninca

      Yeah, no kidding. The “Paxil 20.” If you see the pharmaceutical company studies, they say that people gain 3-6 pounds on (e.g.) Paxil. Then if you go to askapatient.com (a great site), you will find that it’s typically 20-25. When I quit taking it I dropped 20+ pounds promptly. Too bad I’m depressed again; those extra pounds are looking not so bad!!!

      1. RUKidding

        Again from the trenches of working in the weight loss field, I have worked with a number of people on anti-depressants. I don’t what kind. Many put on weight, and no matter how hard they try, they cannot take it off while on medication. Some nearly starve themselves (not recommended), but still the pounds roll on. Unsure why some meds cause this type of weight gain, but I’ve seen it myself. And I do believe the people I worked with were really trying hard to eat correctly, smaller amounts, as well as exercising.

        It can be a real nightmare for some, who are heavy to begin with. Unsure of any solutions. Good luck to all concerned.

  10. Peter Pan

    Linking back to the original Gallup article, I’m surprised there’s no mention that the short term unemployed have “better health” (high blood pressure/ high cholesterol) than any of those categorized as being employed. But is it really true that this is because the short term unemployed are more youthful or could it be that being employed creates stress that leads to unhealthy situations?

    1. Yves Smith Post author

      A ten+ average age difference is a study of this size is a HUGE difference. I would not underestimate the impact of that.

      1. run75441

        Big stuff coming out of 7th District COA on Scott Walker investigation. Easterbrook released ~250 pages of information.

  11. impermanence

    Large societies produce tremendous dys-function due to the tendency of individuals of abuse the power and wealth contained in the group structure. On the one hand you have the elite [group leaders] and their minions preaching the gospel of how to live a functional life, while on the other, taking away much of that which individuals need to pursue the very same.

    The best you can hope for is to allow people to break free of these pernicious groups so they can figure out how to take care of themselves. Once people regain functionality, perhaps it will be worth another shot at socialization [although I doubt it].

  12. mellon

    People should be aware that fairly recently it was discovered that a great many toxic “endocrine disruptors” like Bisphenol A (there are many others) are also “obesogens” – The body stores them in fat to get them out of the bloodstream. They are extremely disruptive to the body because they mimic sex hormones. Many plastics contain these “obesogens”..

    http://en.wikipedia.org/wiki/Obesogen

    http://ehp.niehs.nih.gov/july-podcast/

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279464/

  13. John

    This is by design.
    Genocide on the unemployed.
    That way the elite don’t need to worry about off shoring millions of job and flooding this country with millions and millions of foreigners to take jobs from Americans who can’t support themselves.
    Kill them off is their policy and get richer doing it

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