Opportunity and Choice

Bonnie Ghosh-Dastidar and Tamara Dubowitz of the RAND Corporation posted an article yesterday examining how well the theorized link between obesity and so-called ‘food deserts’ holds up to empirical scrutiny. Though the link between obesity and distance to full-service grocers has taken on the status of stylized fact in much of the public policy literature, Ghosh-Dastidar and Dubowitz observe that “there is little rigorous evidence to support the notion that food deserts are driving the obesity epidemic.” Having grown up in low-income urban communities, I have often been at a loss for why ‘choice’ is the only explanation for eating habits not worthy of serious consideration. Sure, choice does not tell the whole story. But surely it tells us more than the literature allows. If we were examining patterns of dress for this same demographic, we might sensibly conclude that the choice of apparel—while by no means independent of income, education, age, etc.—is essentially a function of a set of aesthetic norms embedded within the cultural community which informs (but does not strictly constrain) the tastes and choices of individuals nested within the community. Let’s refer to such modes of dress as urban fashion.

Like all analogies, this one is limited. We, for example, would classify obesity as a public health problem; the same cannot be said for urban fashion. Yet urban fashion is not without consequence for an individual’s life chances. I recall as a young man learning that I would have to abandon many norms of dress to which I was accustomed and adopt sartorial norms which I found foreign. Such was required if I was to be taken seriously in the job market and in other social contexts. Adaptation is not without psychic costs, and many of my peers chose to forego these costs, considering the associated benefits remote and speculative. My point here is that while the choice of my peers adhere to their preferred patterns of dress might have hindered the achievement of other goals, we needn’t contrive a complex theoretical framework to understand the phenomena in question. It is not that hard to understand. In my case, my eating habits changed for the same reasons my style of dress changed: my values changed, and I chose.

A while back, in a critical review of the book Place Matters: Metropolitics for the Twenty-first Century, I took issue with what I viewed as a central bias of that collection of scholarly essays. I said that the authors seemed to require that the reader

be willing to discuss issues of urban decay without reference to any agency in urban dwellers themselves—urban residents come across as flat characters in a narrative that only contemplates victims and villains. The authors are dismissive of arguments or evidence that counterproductive norms and dysfunctional behavior within inner city communities contributes to the environment. They make clear that their focus is on opportunity structures and not behaviors (66). Examining structural causes is needful; declining to give way to condescending moralizing is admirable. But the authors err on the opposite extreme by romanticizing urban dwellers and leave no room for individual agency in the account of their lives. Hence, high rates of obesity are the results of parents being afraid to let their children play outside in dangerous areas and the lack of healthy food options in inner city food deserts…One wonders what the authors do with studies in the food insecurity literature which suggests that unhealthy eating habits persist even when more nutritious foods are available and even when such foods are subsidized.

Ghosh-Dastidar and Dubowitz’s research

published in the American Journal of Preventive Medicine, shows that factors other than location may have greater sway over how and where consumers shop. Store choice may reflect individual factors, such as personal food preference and income, as well as store characteristics, such as availability, quality, pricing, and point-of-sale advertising of food.

After accounting for prices of items offered at food retail outlets, distance to where residents shopped was not associated with obesity.

Imagine that: personal food preference might actually be a factor in eating habits and obesity. Opportunity matters but so do choices. It is not an either/or proposition.

A.K.

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