Noncommunicable Diseases Disproportionately Impact Impoverished Communities: A Vicious Cycle

April 27, 2023 by Xueting Ni

Diet-related chronic diseases, such as Type 2 diabetes and cardiovascular disease, are the United States’ leading causes of death and disability today.[1] Diseases like Type 2 diabetes and cardiovascular disease are also known as Noncommunicable Diseases, or NCDs. These diseases used to be called “diseases of affluence” as researchers believed they were caused by overeating and lack of exercise, or in other words, personal unhealthy lifestyle choices.[2] In recent years, however, NCDs have become a worldwide problem that is no longer limited to the wealthier communities. Despite being a widespread problem, these diseases now disproportionately threaten the poorer communities.[3]

Recent studies have shown that rather than resulting from personal unhealthy lifestyle choices, NCDs are a result of industrial marketing.[4] Despite popular beliefs to contrary, these unhealthy choices are not made consciously by individuals. Individuals do not deliberately choose unhealthy food over healthier alternatives, despite their better judgement. Rather, their choices over diet and general lifestyle are subconsciously affected by advertisement and marketing made by the food industry. Marketing techniques range from traditional television advertisement to modern social media influencers, to even placing these unhealthy food options at the most visible and reachable aisle at your local grocery store.  Marketing also goes deeper than simply advertising the product—industries have enhanced their reach and scope, and thereby profitability, through the utilization of modern science.[5] Food industry around the world uses frontier scientific findings to “design, produce, and sell” their products to the consumers.[6] Researchers have spent lengths of time find the most eye-catching and appetizing color orange for the brand Cheetos. Significant time and resources go into the development of that subconscious mental cue, which nudges individuals towards choosing their products. The result of this expansion in food industry is the increase in rate of NCDs across the world.

While industry marketing efforts reach all communities alike, poorer communities are more negatively affected and left to carry the burden of the negative effects. Take diet related NCDs for example. The cause of diet related NCDs is the increased dependence on hyperpalatable food.[7] These foods are high in fat, sugar, and sodium, along with flavoring and additives.[8] In other words, hyperpalatable food is dense in energy yet low in nutrients.[9] The lack of nutrients is not the only danger of hyperpalatable food. Hyperpalatable food is abnormally enticing to its consumer, producing cravings through the release of dopamine.[10] These cravings will lead to a higher consumption of high fat, high sugar diet.

Advertisements of hyperpalatable food are especially directed towards to the poor. Individuals of the poorer communities are the “primary consumers of high-fat foods” given their low price, large portion size, and readily availability.[11] Impoverished individuals simply have fewer food choices compared to the wealthier part of society. The gap in financial resources limits their ability to seek out healthier diet alternatives, even if these alternatives are readily accessible.[12] In addition, where there are limited financial resources, these unhealthy food options are simply more practical than alternatives.[13]

Due to their lack of resources, poor communities are more likely to face higher rates of NCDs. Unhealthy diets consisting of hyperpalatable food pose a greater threat to individuals of poorer communities because alternative healthy options are not readily available or accessible to them. To worsen the issue, not only do NCDs disproportionally threaten the impoverished, NCDs also have the potential and tendency to push individuals further into poverty.[14] Existing health inequalities in access to health care and to medical resources are double blow to poorer individuals, and the high incurred medical bills due to NCDs will only worsen the situation for those already impoverished.[15] Furthermore, for those who are slightly more well-off, the diagnosis of an NCD risks pushing the individual and their loved ones into poverty.[16] In short, NCDs do not only disproportionally harm the impoverished, but they can also push people into poverty and push those already impoverished further into poverty.

 

[1] FDA Proposes Updated Definition of ‘Healthy’ Claim on Food Packages to Help Improve Diet, Reduce Chronic Disease, U.S. Food & Drug Admin. (Sept. 28, 2022),

https://www.fda.gov/news-events/press-announcements/fda-proposes-updated-definition-healthy-claim-food-packages-help-improve-diet-reduce-chronic-disease.

[2] Christopher Newdick, Health equality, social justice and the poverty of autonomy, 12 Health Econ., Pol’y & L. 411, 411 (Oct. 2017).

[3] Id. at 412.

[4] Nicholas Freudenberg, Lethal but Legal: Corporations, Consumption, and Protecting Public Health 8 (Oxford Univ. Press 2014).

[5]  Id. at 4.

[6] Id.

[7] Id.

[8] Id.

[9] Amandine Garde, Research Handbook on Global Health Law 389-426 (Gian Luca Burci & Brigit Toebes, 2018). (Chapter 13: “Global health law and non-communicable disease prevention: maximizing opportunities by understanding constraints”).

[10] Freudenberg, supra note 4, at 4.

[11] See generally Fernando D. Simões, Paternalism and Health Law: Legal Promotion of a Healthy Lifestyle, Eur. J. of Risk Regul. 360 (2013).

[12] Id.

[13] Id. at 361.

[14] Poverty Increases Risk of Non-Communicable Diseases in Lower Income Countries, Johns Hopkins Bloomberg Sch. of Pub. Health (Apr. 5, 2018), https://publichealth.jhu.edu/2018/poverty-increases-risk-of-non-communicable-diseases-in-lower-income-countries.

[15] Id.

[16] Id.