Running for president of the United States certainly has its advantages. Your job is to travel the country kissing babies and sampling indigenous food and beverage. You get to be on television more than all the Kardashians combined. And last, but not least, you are uniquely positioned to focus substantial national attention on the specific issues that you and your political party believe are critical for the present and future health of your country.
Any candidate’s selection of the key issues on which they will build their campaign is also a function of current events. The crippling global recession that began in 2008 dictated that the 2012 presidential campaign would be focused on the economic health of the US. With twelve million Americans unemployed as of September 2012, neither Barack Obama nor Mitt Romney need polls to tell them that the man with the most credible plan for stimulating economic growth will win the election (although that is exactly what they indicate). However, the wonkish focus of the campaign on creating domestic jobs has led to a substantial public health ramification of the economic downturn being omitted from the political discourse: the increasing risk for obesity.
Both presidential candidates have failed to recognize that an individual’s socioeconomic status is strongly associated with that person’s risk for obesity. Individuals with a low socioeconomic status bear a disproportionate risk of becoming obese. There are many possible explanations for this correlation such as a lack of nutritional education in poor areas or persistent cultural food traditions, but the most compelling explanation is based on a combination of economics and predictable human decision making mechanisms. When faced with severely constrained income, people optimize by purchasing foods based on a strong preference for satiation (the feeling of being full) and palatability (tastes good) over any consideration of a food item’s nutritional content. (See this paper from the American Journal of Clinical Nutrition for more information.)
A study has indicated that the number of unemployed Americans is positively correlated with the number of Americans who participate in the federal supplemental nutritional assistance program (SNAP). Commonly known as the food stamps program, SNAP provides financial assistance for purchasing food to low income people living in the US. According to census data, in 2010, 40.3 million Americans received assistance from SNAP, which is considerable increase from 26.3 million who received assistance just three years before. The average SNAP participant only has $133.79 per month available to be spent on food, compared to the $215.26 the average American spent on food per month in 2010.
As mentioned earlier, people with severely limited income, such Americans who rely on SNAP, make food consumption decisions based primarily on satiation. This is not a bad thing in and of itself. This human tendency becomes problem when the cheapest food items are unhealthy, high-fat, calorie-dense processed foods. The reason these foods are so relatively inexpensive is that they are composed of corn products that are artificially cheap due to large government subsidies to corn producers. The corn subsidies, which total approximately $5 billion annually, skew food prices and help to make a bag of Doritos (which is both filling and delicious) less expensive than a bag of spinach (which is clearly healthier). These altered prices distort the economic environment of low income people and lead them to consume diets that exacerbate the risk of obesity.
Thus, the missing ingredient in the 2012 campaign is an open recognition of the nexus between the federal corn subsidies, economic distress and obesity. As of now, the candidates have only been interested in talking about obesity in the context of the Affordable Care Act (Obamacare) and determining who will foot the healthcare bills associated with the disease. This approach ignores that the underlying causes of the obesity epidemic must be treated in addition to the negative health effects. A prescient presidential candidate must acknowledge that, even if they are capable of restoring the economy to its former glory, the long recession will have increased the incidence of obesity as approximately one sixth of the population will have spent some time in poverty. Any ameliorative effort must recognize the perverse effect of corn subsidies on SNAP recipients and should seek to promote public health via reform that results in competitively priced healthy food options.