This week the World Health Organization released a press statement on the carcinogenicity of the consumption of red meat and processed meat. The statement, which elicited media headlines comparing eating hot dogs to smoking cigarettes, reported findings from a group of 22 global experts examining more than 800 studies to evaluate the association between cancer and consumption of red meat and processed meat. Unlike the frenzied headlines that misunderstand cancer risk and classification, the actual WHO statement reported on carcinogenic (potential cancer causing) classifications, not the magnitude of risk. Specifically, they classified processed meat as carcinogenic to humans (Group 1) because of the numerous studies with similar findings linking consumption to colorectal cancer.
Because processed meat is now classified alongside cigarette smoking in Group 1, the inevitable confusion results with people assuming that smoking cigarettes is comparable to eating sandwich meat. But, again, the classification is only referring to the amount of studies with the same results. This is why the association between red meat and cancer (largely colorectal but also pancreatic and prostate) earned a weaker categorization of probably carcinogenic to humans (Group 2A) based on more limited evidence (fewer studies). Researchers pointed out that individual risk of developing colorectal cancer with eating processed meat “remains small,” but increases with the quantity consumed. What is important to keep in mind is that public health considerations must always assess and balance risks and benefits.
Meat, unlike cigarettes, has nutritional value and to make flippant comparisons between the two is not helpful, but in fact adds confusion to dietary recommendations. The research supports much of what has been already stated about limiting meat consumption, but it does not point to radically altering people’s diets based on this information. Yet, one question remains. What does this mean for those living in poverty?
In 2014, over 14% of Americans were living in poverty. When you isolate for age, you discover that over 20% of children are living at or below the poverty line. Much has been said about food insecurity among those who are living in impoverished conditions, but more needs to be said about the quality of foods accessible to those living in these conditions.
When money is scarce, many families eat inexpensive foods that are either processed or high in preservatives. Low-income neighborhoods usually lack grocery stores and farmers markets where fresh fruits and vegetables are readily available. Further, if these neighborhoods do, indeed, have full service grocery stores or farmers markets, healthy food is more expensive. According to the Food Research and Action Center:
Households with limited resources to buy enough food often try to stretch their food budgets by purchasing cheap, energy-dense foods that are filling – that is, they try to maximize their calories per dollar in order to stave off hunger. While less expensive, energy-dense foods typically have lower nutritional quality and, because of overconsumption of calories, have been linked to obesity
This means that many families living at or below the poverty line have a higher risk of being obese and/or developing type-2 diabetes. We’ve known this for quite some time. Now there is growing concern surrounding poverty and cancer.
It was common knowledge that there is a correlation between the consumption of processed foods and cancer, but now the WHO announcement concretized that correlation by using language that talks about these foods in ways similar to how they discuss cigarettes. To be sure, those living in poverty are not the only ones that consume bacon, ham, and other processed meats. However, if you are poor, there is a higher chance that you will. This should create a crisis of conscious among those concerned about poverty in this country. Instead it inspired moralizing on the part of vegans and vegetarians.
Instead of going on social media and pontificating from a position of middle to upper-middle class privilege, social justice advocates need to take a hard look at barriers to health among those living in poverty. 16 million children are at or below the poverty line in America. That’s more than 1 in 5. What the poor among us need are social changes and governmental policies that give them access to high quality foods—not sermonizing or self-congratulatory behavior on the part of vegans, vegetarians, pescatarians, and petite bourgeois foodies. Whether it’s about cigarette smoking or eating meat, moral prescriptions for health that shame rather than understand individuals is never a good public health approach. Even the images used to communicate the cancerous potentiality of the meat was grounded in classism; pictures of ‘poor people food’ like hot dogs and greasy dollar menu hamburgers were used to warn the general populace. Simply google “processed meats and cancer” to view the images associated with this warning.
The media’s focus on comparing (both visually and verbally) the eating of processed meat to smoking cigarettes is even more questionable when the comparison to another Group 1 carcinogen, alcohol, seems like a more accurate comparison. According to the American Cancer Society (ACS), seven (and possibly 8) types of cancer are linked to alcohol consumption, and for each of these cancers, just as with the consumption of processed meats, the risk increases with the amount consumed. Decreasing alcohol consumption is often recommended, for example, to reduce women’s risk of breast cancer, but halting alcohol consumption altogether is not typically suggested. The same recommendation is made for processed meat consumption.
Cigarette smoking, on the other hand, is not only linked to 14 types of cancer, according to the ACS, but there are no recommended levels for “safe” or less risky consumption. As the ACS website notes, “even smoking as few as 1 to 4 cigarettes a day can lead to serious health outcomes.” The ACS website points out that no levels of cigarette smoking are safe due to the addictive qualities of nicotine.
So why do media outlets compare the consumption of processed meats and cigarette smoking as Group 1 carcinogens when alcohol consumption might be a more logical comparison? Again, because moralizing health around class based behaviors is a common practice both within public health and in the broader media. We must be careful about how we discuss and represent health messages to avoid embedding our societal biases into prescriptions for health.
We have a health crisis in this country. Obesity, diabetes and cancer are ravishing disadvantaged communities. Too often this crisis is centered in personal responsibility, but we must also look at systemic conditions lest we blame the victims of poverty without equipping them with the tools necessary for positive health outcomes.