If left untreated, depression can exacerbate the risk of poor nutrition and obesity among low-income people who live in food deserts — neighborhoods with limited access to healthy food and fresh produce — a recent study has confirmed.
Researchers followed more than 600 participants in a Pittsburgh food assistance program who bought food for their families. They found a strong correlation between depression, poor nutrition, and high body mass index — the estimate of the body fat based on the height and weight. The study, however, didn’t explicitly show that depression caused unhealthy eating habits.
“This study focuses on a group that is of particular importance: low-income, primarily African-American residents of urban food deserts,” lead investigator Karen Florez, an associate social scientist at the Rand Corp., said in a journal news release. “This group is at particularly high risk of obesity and poor nutrition. Thus, the finding that depression is associated with even higher risk within this already high-risk group suggests a potential avenue for intervention is a focus on mental health.”
While Florez acknowledged the need for additional research to determine if weight control and a balanced diet could reduce the risk of mental illness among poor people, public health experts have long contended that the treatment of one ailment could help in mitigating the other. Researchers have confirmed that linkages exist, though it may not be clear which condition precedes the other. On one hand, depressed people show a greater likelihood of overeating and avoiding physical activity. On the other, those struggling with obesity have low self-esteem and may go into isolation where their depressive state worsens.
Whatever the case may be, life in a low-income area magnifies the impact of depression and obesity, especially when you take into account ongoing disparities in access to mental and physical health care. The rate of obesity among low-income women is 10 percentage points higher than that of their counterparts who live above the poverty line. Representatives of the Food Research and Action Center say that poor people stand a greater chance of gaining excess weight because of food insecurity, a sedentary lifestyle, and obstacles to fitness that other groups don’t face — including high crime, lack of green space, and unsafe playground equipment.
The physical and emotional stress of meeting financial obligations with few resources can also take a toll on a person living in a low-income community, increasing the likelihood that they will gain excess weight. Before the implementation of the Affordable Care Act, poor people had little access to preventative health care that could help them mitigate the mental trauma of life in unhealthy environments. Even with free preventative care, poor people may not take advantage of these offerings due in part to their distrust of the medical profession, an entity they have deemed as commercialized and exploitative.
“Research shows that African-American women’s use of mental health services may also be influenced by barriers including, poor quality of health care, (limited access to clinicians that are culturally competent), and cultural matching (limited access to work with minority clinicians),’” Nia Hamm, producer of digital news at CNBC, wrote in the Huffington Post last year. “A history of trauma and victimization experienced by African-Americans has also helped foster a cultural mistrust toward the U.S. health care system. Events like the Tuskegee Experiments are hypothesized to contribute to many black people’s negative attitudes about health care.”
While the national food stamp program has more than doubled in size since the Recession, critics say that the additional dollars have done little to change the eating habits of low-income Americans. Factors that impede their ability to purchase fruits and vegetables include the lack of such amenities in their neighborhoods. If food stamp recipients do live near a fully stocked grocery store, their food stamp dollars may not suffice for expensive produce. Program benefits are based on national average food prices, which often place families living in areas with above average food prices at a disadvantage.
With insufficient funds, families have little choice but to buy cheaper, high-sugar, high-salt foods. The poor diets lead to high rates of obesity and cancer deaths among poor people, ultimately costing the United States government more than $20 million.
This ongoing conundrum has forced many in the public health field to ponder how to create a healthier environment for poor people, an issue that intersects health, economics, and justice. While experts say that affordable housing, access to education, public safety, and availability of healthy could improve one’s quality of life, poor people — particularly African Americans — haven’t been able to attain those services, due in part to a system of institutionalized residential segregation that still detaches communities of color from vital social and economic opportunities decades after the Civil Rights Movement.
That’s why the researchers studying low-income communities in Pittsburgh said that figuring out how to address mental health issues could be yet another piece to that puzzle. They suggest that it’s important to conduct further research into the risk of depression among food stamp recipients.