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Class Struggle at the Waistline
Since 1980, the rate of union membership among U.S. workers has dropped by nearly half, from 20% to about 11% today. At the same time, the adult obesity rate has more than doubled, now standing at a little over 30%. The two trends are linked. Worker disempowerment, as indexed by union decline, is obesogenic.
Conventional public health wisdom attributes the rise in obesity to poor eating habits and lack of exercise. The solution, therefore, is supposedly education. Teach people to eat better (less fast food, more fruits and vegetables) and to make exercise a priority in their lives, and the obesity epidemic will wane.
There’s nothing wrong with urging people to eat better and exercise more. But this simple prescription ignores the root of the problem. In fact, by implicitly blaming individuals for not taking better care of their bodies, it helps to perpetuate the problem.
The obesity rate has soared not because people have lost health wisdom but because they’ve lost power over the economic conditions of their lives. Historical materialist epidemiology holds that worker health status is one indicator of the state of class struggle. What the rise in obesity rates tells us, yet again, is that capitalists are winning.
The tide of battle is evident in the thirty-year trend of rising productivity and stagnating wages. This profit-boosting dynamic has been achieved by quashing unions, offshoring manufacturing, replacing full-time jobs that offer benefits with part-time jobs that don’t, and by keeping unemployment high. What this has meant for many workers is more economic strain and less economic security.
Diet and exercise—indeed, all the things people do that matter for their health—must be understood against the background of these conditions. The stress and strain engendered by these conditions, daily and chronically, have produced fatter, less healthy bodies for reasons that are fairly well understood by social psychologists and physiologists.
We know, for instance, that high levels of stress can produce endocrine changes in the body that increase cravings for fatty and sugary foods. We also know that food is a sedative and that humans often use it to self-medicate against anxiety. It’s no wonder, then, that in a culture where fatty and sugary foods are cheap and readily available, many stressed-out people end up packing on the pounds.
Price matters, too. When wages are static and the cost of living continues to rise, it makes sense to try to get as many calories as possible for one’s dollar. Higher prices for foods labeled “organic” can also be a deterrent to buying the fruits and vegetables that health experts are always urging people to eat.
Workers in the US also work more hours, get less leisure time, and take fewer vacations than their counterparts in other industrialized countries. These time pressures, combined with the disruptions caused by shift work and erratic part-time work schedules, can make fast food and processed food, which requires less preparation and less energy to digest, more appealing for practical reasons. A frequent result is the absorption of surplus calories.
Whether calories are “surplus” or not depends of course on energy expenditure. This is the exercise side of the obesity equation. The same pattern of disempowerment that encourages eating cheap, high-calorie food discourages engagement in vigorous, calorie-burning activity.
The problem isn’t just a matter of having too little time or money to pursue physically demanding leisure. It’s often a matter of sheer fatigue. Jobs that combine high demands for responsibility with low control can be mentally exhausting, making after-work exercise, if only going for a walk, feel impossible. Vegging-out in front of the tube with a bowl of chips becomes the more realistic form of restorative therapy.
Worker disempowerment can also help us understand why rates of childhood obesity have tripled in the past thirty years. The same factors of time pressure and fatigue that have contributed to adult obesity have affected kids.
Parents who are depressed or drained by their jobs are more likely to rely on TV and video games as babysitters. Time pressures and fatigue likewise encourage parents’ reliance on fast food and processed food to feed their kids. The need for two incomes, especially if those incomes derive from multiple part-time jobs, can also make it hard to find time for active family recreation.
Relying on credit to compensate for stagnating wages has created another source of stress for many working people. Increased debt load adds to the stress load that encourages eating as a form of self-medication. Beer works as well or better (within limits), for both temporary pain relief and waist expansion.
Those who succumb to these economic forces and become obese pay for it physically and emotionally. Obesity—not just being a little overweight according to Body Mass Index (BMI) standards—is a serious risk factor for heart disease, stroke, diabetes, and osteoarthritis. There is also the stigma and shame associated with being fat in a culture that values thinness as a sign of self-control.
Obesity exacts a monetary toll as well. The CDC estimates that the average obese person spends an extra $1429 per year on medical expenses. This makes obesity not just a result of profit seeking but in turn a source of profit for a capitalist health care industry. Hucksters of diet and exercise fads win too, but they are the system’s leeches, not its principal actors.
Worker disempowerment is not the sole cause of the obesity epidemic. Other changes in the U.S. economy and in U.S. culture—suburban sprawl and the need to use motor transport to get around; a shift to service jobs that require little physical motion; austerity budgets that compel public schools to serve cheap fast food instead of healthier cooked food; aggressive marketing by the fast-food industry; ever more playtime spent, by both kids and adults, sitting in front of a computer screen—have added to the problem.
In any individual case, the causes of obesity can be complex, involving not only diet, exercise, and the strains of daily life, but also genetics, disease, personality, and psychological trauma. Owing to the dicey contingencies of personal circumstance, one can find the morbidly obese and the pathologically thin at both ends of the spectrum of political and economic power. It is the purview of clinicians to deal with individual cases.
Stepping back to look at the larger pattern, it’s possible to see the usually hidden role of class struggle in driving the obesity epidemic. As noted, this is not the whole story, but it’s certainly an essential part of it. Without considering the collective disempowerment of working people in the U.S. over the last thirty years, the obesity epidemic cannot be explained or overcome.
What might things look like if working people in the U.S. took more control of the economic conditions of their lives? Perhaps much like what we see in the social democracies of western Europe. Strong unions and national labor parties have helped working people in these countries enjoy higher wages, more and longer paid vacations, more sayso on the job, better family leave policies, and national health insurance.
Folks there are thinner and healthier, too. Whereas the adult obesity rate in the U.S. is over 30%, the average obesity rate across Austria, Denmark, Finland, Norway, and Sweden is 18.2%. In all of these countries, per capita health care costs are lower than in the U.S. and the overall health status of the population is better.
It’s fine to advise people to eat right, get more exercise, and avoid unhealthy ways of coping with stress. Education is a necessary part of protecting public health. But it’s not enough, and focusing solely on education can promote victim-blaming.
If systematic disempowerment of working people is the problem, fruits and vegetables are not the solution. There is a better prescription: by all means eat better and get exercise, but don’t forget to join or form a union. Then keep organizing until all the unwanted pounds and unneeded bosses have melted away.
Michael Schwalbe is a professor of sociology at North Carolina State University. He can be reached at MLSchwalbe@nc.rr.com.
Thanks to Joslyn Brenton for background information and helpful suggestions as this piece took shape.