Things that make me go asldkjdlfkgjdlkfjasdlkj: When health experts ignore structural inequality and blame fat people instead

November 30, 2023

Kill me now.

I listened to this story this morning on NPR and promptly lost my goddamn mind. If you don’t want to listen (I can’t find a transcript) the gist is:

1. Covid lowered life expectancy in the US by a lot.
2. It’s gone back up.
3. But life expectancy in the US is still low compared to other wealthy nations.
4. The title of the article is about suicide rates.
5. The guest expert (a correspondent, not a scientist) does not go into the causes of or solutions to increasing suicides; he just notes that it exists.
6. He instead glosses over addiction and gun violence and then pivots to chronic illness because, wait for it……
7. Obesity. Yes, the problem is because we’re fat.

THIS IS NOT THE PROBLEM

FUCK MY LIFE

People cannot fucking get away from blaming fat people for anything shitty that happens to them. This ignores all the chronic illness that affects non-fat people. And all the fat people who don’t have chronic illness. And people with disabilities who can’t get decent medical care, housing, education, or jobs because states like Texas routinely ignore their civil rights.

Do you know what is different in the US from other wealthy countries? Economic inequality. Lack of access to health care. Chronic stress, because any of us could end up homeless from getting cancer. Vast disparities in housing, education, and access to food. Gun violence.

But no, this fucking Chad is like, “You know what is different in the US? All the fat people.” Not unsubsidized healthcare. Not food deserts. Not housing shortages and homelessness. Not a criminally high maternal mortality rate that overwhelmingly affects black women. Not medical racism and misogyny and fatphobia (which is, in fact, one of the most significant health risks for fat people) Not hate crimes. Not our ongoing history of marginalizing and criminalizing non-white people, disabled people, women, and LGBTQ people. NOT GUN VIOLENCE. The US has the second highest rate of gun deaths per capita IN THE WORLD. Not in the developed world, not in the Western world (whatever the hell those really mean), in the whole world.

But it’s the fat people! The fat people are making the US sick. Not a gutted EPA. Not climate change, mass shootings, pandemics, natural disasters, broken infrastructure, and yes, again, an inaccessible, discriminatory, elitist, insanely expensive health system. Nope. It’s just fat people not trying hard enough not to be fat.

Let me also point out that the expert in this report is a correspondent, not a scientist. He’s not looking at what makes us different from other countries. He’s not looking at the underlying causes of chronic illness; he’s just blaming fat people. He’s also speaking as if he’s one of the authors of the studies he’s citing (“we found”), which he is not. It’s weird.

The interviewer pushes back on Chad’s generalizations, but Chad continues acting like he’s the expert and dissembles. He literally says that kids eating processed food causes them to die younger. You know what kills the most kids, Chad? Guns. It’s the fucking guns. More than even cars, the second highest cause of child mortality.

We have limited agency over our bodies. The more marginalized (and poorer) we are, the less control we have over stress, movement, food, and how others treat us. Our genetics determine a good bit of how our bodies age and respond to stressors, and our environment contributes a whole lot more.

Why is health a moral issue in this country? Why does not looking a certain way subject us to derision and blame? Could this hyper-individualistic self-empowering nonsense be masking a plethora of social and environmental ills that we refuse to deal with, which affect us far more than our individual behaviors and appearance?

Yes, Chad. Yes, they do. Stop shilling for late-stage capitalism, pretending that gun violence and suicide are just inevitable things we can’t control. Other countries have mental illness without multiple mass shootings a week. Other countries have accessible, free healthcare for everyone. And other countries have fat people too. The disparities in longevity in the US are likely caused by the vast, noticeable differences in how our society and government operate, not how many chips you eat.

As a scientist, this makes me crazy. This is not how you science. If you are looking at large, nationwide samples you can’t then extrapolate that individual behaviors (which would be tracked through much smaller studies and samples) are the leading cause of disparities. The Black Death killed 1/3 of the population of Europe because it was a deadly pandemic that overwhelmed our species, not because people didn’t eat enough kale.

It’s like he surveyed a small sample of people in Europe before the Black Death and found they didn’t eat kale, and then they all died of the Black Death, and he claimed the Black Death was caused by low kale consumption.

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The US has deep, systemic inequalities that significantly affect most of its population. Maybe take a look at those things and how other countries have successfully navigated them before resorting to the same fatphobic tropes masquerading as boostrappy individualism. Because that is not serving us well.