Barrier Survey: Identifying The Obstacles To Activity And Healthy Eating

It is now estimated that approximately 58 million adults — over a third of the adult U.S. population — are overweight or obese. What is even more troubling is that these rates continue to go up, from 25 percent of American adults in 1980 to 33 percent today.

But these alarming obesity statistics are even worse for low-income populations and especially poorer women. Research on minority women finds that among Mexican American females aged 20-74, the age-adjusted prevalence of overweight is 46 percent for low-income women compared to 40 percent for those living above the poverty level. Similarly, non-Hispanic women below the poverty line have obesity rates of 39 percent compared to rates of 25 percent above the poverty line.

Why do lower income Americans have a greater problem with obesity than their higher income counterparts. To some extent, the weight-related attitudes of lower-income adults, especially African-American and Hispanic women, reveal a more "obesity tolerant" view. But public health officials also surmise that resources play a very important role in the extent to which lower-income Americans adopt health messages about sensible eating and increasing physical activity levels. Specifically these resources include things that higher income Americans may take for granted such as places and time to exercise and the availability of healthy foods at affordable prices.

To determine the extent to which lower-income Americans lack these resources, Shape Up America!, the campaign initiated by former Surgeon General C. Everett Koop, recently commissioned a new opinion poll of 1599 urban residents, half of which (47 percent) have family incomes before taxes of less than $25,000 a year. Conducted by Yankelovich Partners, Inc., the survey compared the attitudes and concerns of these lower-income Americans with the rest of the general public, uncovering a number of barriers that make it more difficult for poorer men and women to be more active and eat a better diet. Using random digit dialing to a nationwide sample of urban areas, the survey equally polled men and women. Further, 31.3 percent of the sample was non-white.

The survey findings are also noteworthy because Yankelovich was able to calculate those in the sample who are overweight, underweight, or of normal weight and then determine if there are differences in attitudes or behaviors that could be associated with a person’s weight. Specifically, Yankelovich asked respondents for their height and weight and then used this information to calculate the Body Mass Index (BMI) for those surveyed. This may be the first time that an opinion survey was analyzed by BMI and the results demonstrate important differences in how overweight individuals compare with people who are underweight or at a normal weight when it comes to attitudes about physical activity and dieting.

What follows is a summary of the survey’s findings:

1. Regardless of income, child care responsibilities are an obstacle to getting more physical activity

— Specifically, one in three respondents said that they did not have anyone in the household to watch the children which prevented them from getting more activity outside the home

2. Neighborhood safety and lack of access to parks, sidewalks and recreational areas are major deterrents for lower-income Americans trying to be more physically active

— Over half of those making less than $15,000 a year (51 percent) say the inability to afford a gym or health club keeps them from becoming more physically active. In contrast, only 23 percent of people making more than $25,000 a year share this concern.

— Low-income Americans worry about the safety of their neighborhoods for undertaking outdoor activity, which is not a major concern of those who live in more affluent areas. While 15 percent of higher income respondents expressed concern over neighborhood safety, twice as many (31 percent) Americans making less than $15,000 said this was a problem.

— However, regardless of income, one in four women (25 percent) say that safety is an impediment compared to only 16 percent of men.

3. Low-income Americans face significant barriers to healthier eating that are thwarting their efforts to respond to current nutrition messages.

— One in four Americans making less than $15,000 a year cited the cost of healthier foods, such as fruits and vegetables, as an obstacle. In contrast, only 8 percent of higher income people hold this view.

— Low income consumers also report that fruits and vegetables are not readily available where they shop for food. Compared to only 4.6 percent of higher income Americans who cite availability as an issue, 11.4 percent of those making less than $15,000 yearly say that this is a major problem.

4. The survey provides new evidence that low-income Americans are more sedentary than their higher-income counterparts. Here, the survey asked respondents how many hours of television they watch a day and analyzed the responses by income and BMI, finding a correlation between income and obesity levels.

— Almost half of those polled (42 percent) say they watch three or more hours of television a day

— Of those watching the most television, 62 percent have incomes below $25,000 a year; only 38 percent have incomes above $25,000 annually

— Over half of the overweight respondents (52 percent) watch three or more hours of television daily compared to 38 percent of normal weight individuals.

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