Obesity and health care

McCardle is right that the government should not be in the business of hectoring people to lose weight, and I still affirm that "being fat" is one of the last vestiges of culturally and legally accepted discrimination. But I can tell you that she's wrong that "making vegetables available" doesn't work. I lived for several years above 120th Street in Manhattan and finding decent food to prepare and eat was a major chore. Far easier to go pick up something salty in a can down the corner at the bodega. And Ambinder's thoughtful rejoinder in exactly right. The whole thing is worth reading, but here's a snippet.

Labling obesity a "problem" isn't a behavioral intervention: it's a social structure intervention. And here's where the individual model really breaks down, even for those who don't blame obese people, per se, for their obesity. Obesity is highly correlated with socioeconomic status. And it is a most acute problem among young minorities: African American women, Mexican-American boys, and Native American children have much higher rates of obesity than white children do. Poor kids tend to be more obese than wealthier or middle class children. The reason for these disparities are both obvious and counterintuitive: in general, people tend to eat what they can, which means that they're buy the food they have access to. Wealthier people and people living in suburbs have access. Geographic location often correlates with lifestyle; history and social norms tend to be different, too, among ethnic groups.

McArdle is right that it it's not fair for government to lecture people about weight loss and exercise, but she's right for the wrong reason: policy choices -- ag subsidies, zoning laws, education and budget priorities -- create a flow that, absent any intervention, are sweeping many young kids, particularly poorer kids of color, into obesity. Government's role isn't to scold; it's to make better policy choices. She's wrong about the interventions, too: some, like a physical education project in Somerville, Mass., seem to be working. Taking fast food vending machines out of schools and weighing children at least once a year has arrested the obesity growth rate in Arkansas. Nationally, the obesity growth rate also seems to be be slowing.