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Many people living in the 'Diabetes Belt' are plagued with medical debt

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Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#101
post #92
post #11

Earlier quoted context omitted.

A lot of these states have big problems with gerry-mandering and there tends to be huge wealth disparity between the few small wealth centers in the state and the rest of the state is extremely poor. The money just isn't being distributed with any sense of equity.

Income inequality is at least as big of a problem, if not bigger, in blue states than red states: https://en.wikipedia.org/wiki/List_of_U.S._states_and_territ... . New York is the most unequal state in the country. I don’t know about gerrymandering. In the most recent Texas house election (Texas being one of the major ACA holdouts) republicans won a 12-point seat margin with a 7-point popular vote margin. The governo…

Income inequality isn't an issue, wealth inequality is.

I find it perfectly fine to earn 8 time as much as my artist best friend does as long as we are in a market-based system. What bothers me is that I do not pay enough taxes, and could pay even less by declaring my donations.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#102
post #78

Earlier quoted context omitted.

I seriously doubt that in Alabama there are many people who don’t have a grocery store within an hour drive. Almost certainly less than 10% of population. Even if you said 20 minutes instead of an hour, it wouldn’t be a lot of people either. The thing with areas this remote is that few people live there.

I did exaggerate a little, I apologize. It's not just rural areas though, there are plenty of small towns without any grocery stores, and urban areas where the nearest grocery store is very far away, especially if you don't have regular access to a car. Here's one source that says 1.8 million Alabama residents don't have a grocery store within 45 minutes: http://humsci.auburn.edu/news/hunger_solutions_institute_awa..…

Are these people more or less obese than the ones who have easy access to grocery store? You are suggesting that this is a major driver of obesity, so you must be basing this on some data, no?

Also, that link doesn’t say whether this is 45 minutes drive, and since it does not reference any source, it’s hard to look that up.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#103
post #101
post #92

Earlier quoted context omitted.

Income inequality is at least as big of a problem, if not bigger, in blue states than red states: https://en.wikipedia.org/wiki/List_of_U.S._states_and_territ... . New York is the most unequal state in the country. I don’t know about gerrymandering. In the most recent Texas house election (Texas being one of the major ACA holdouts) republicans won a 12-point seat margin with a 7-point popular vote margin. The governo…

Income inequality isn't an issue, wealth inequality is. I find it perfectly fine to earn 8 time as much as my artist best friend does as long as we are in a market-based system. What bothers me is that I do not pay enough taxes, and could pay even less by declaring my donations.

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Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#104

Earlier quoted context omitted.

If you're that fat you're statistically unlikely to lose weight without medical intervention of some sort, even something as basic as talking to a fucking nutritionist about portion sizes.

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They use the internet and find people who tell them that it's not their fault. It's the fault of vegetables for being so expensive, even though vegetables are cheaper than junkfood. It's the fault of food deserts, even though they live in walking/driving range of half a dozen full-sized super markets. It's the fault of their genes, even all 8 of their great grandparents were fit. It's anybody/anything's fault, except their own. And so they stay fat, and join the ranks of those who perpetuate these fat-excusing myths (on full display throughout this discussion section.)

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#105
post #102

Earlier quoted context omitted.

I did exaggerate a little, I apologize. It's not just rural areas though, there are plenty of small towns without any grocery stores, and urban areas where the nearest grocery store is very far away, especially if you don't have regular access to a car. Here's one source that says 1.8 million Alabama residents don't have a grocery store within 45 minutes: http://humsci.auburn.edu/news/hunger_solutions_institute_awa..…

Are these people more or less obese than the ones who have easy access to grocery store? You are suggesting that this is a major driver of obesity, so you must be basing this on some data, no? Also, that link doesn’t say whether this is 45 minutes drive , and since it does not reference any source, it’s hard to look that up.

Well the driving part doesn't matter, the thing we care about is how hard it is for someone to get to a place with affordable healthy food, however they get there. If it's an urban area where a significant portion of people don't have easy access to a car, then you wouldn't look at driving times.

These are called food deserts, and there is a ton of research on them. From what I've read there is not a direct line between food deserts and higher obesity rates, but it is a relevant factor, especially when abundant dollar stores and fast food places are offering cheaper and more accessible food than the nearest grocery stores (if there are any). I've also seen this described as a "food swamp".

I've never seen any research or data showing disparities in American obesity rates are influenced by cultural attitudes toward food.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#106
post #58

Earlier quoted context omitted.

Whoa whoa whoa, I'm the first one to call out perverse incentives in government programs, but even I would assume that dentists had meaningful ethics codes and enforcement that would largely mitigate this kind of abuse. OTOH, if the "unnecessary" there just means "not satisfying the platonically correct cost/benefit analysis", and there's still some net benefit to the patient, and the government program didn't ask th…

When the government provides a vending machine that dispenses gold coins at the push of a button, how many of us could resist pushing that button as much as possible? A society cannot be run on expecting people to resist the powerful incentives set up for them. You can see this effect in every aspect of government operations.

If too many of us would literally cut off the limbs of others unnecessarily to acquire said gold coins than we're done here. Let's just burn it all down and start over.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#107
post #91

"Seventy-nine out of the 100 counties with the highest levels of medical debt are in states that have not expanded Medicaid under the ACA" Who benefits in these 10 states that have still failed to expand Medicaid? What is the upside, to either the populations of these states or the politicians who run these states and make those decisions? Because the downsides are obvious and seem to directly harm a lot of people.

Given how often I see the argument that “blue states subsidize red states” I can see why folks who want to maintain their dignity wouldn’t want to expand their reliance on blue state largesse. That money comes with no strings attached. Also, even if it’s true that blue states may bear the brunt of taxes, inflation hits everyone equally.

Inflation literally doesn't hit everyone equally, prices are set in local markets, not fixed at a national scale.

Things like federal mortgage subsidies probably cause more inflation in less affluent regions where housing is less competitive than they do in affluent regions (where the competitors for housing aren't particularly pricing their offers to the largest payment they can afford).

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#108
post #78

Earlier quoted context omitted.

I seriously doubt that in Alabama there are many people who don’t have a grocery store within an hour drive. Almost certainly less than 10% of population. Even if you said 20 minutes instead of an hour, it wouldn’t be a lot of people either. The thing with areas this remote is that few people live there.

I did exaggerate a little, I apologize. It's not just rural areas though, there are plenty of small towns without any grocery stores, and urban areas where the nearest grocery store is very far away, especially if you don't have regular access to a car. Here's one source that says 1.8 million Alabama residents don't have a grocery store within 45 minutes: http://humsci.auburn.edu/news/hunger_solutions_institute_awa..…

What makes things so bleak? My small county is somewhat below the national median income (so doing fine but not wildly wealthy) and like half of the people that live here live within 10 miles of 3 large grocers and multiple other grocers. The most concentrated population is within a couple miles, and the people that live further away are doing so because they want to live outside of town, they mostly aren't stuck there or whatever.

Small stores out in the county mostly don't have much fresh stuff, but probably a few things.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#109
post #102

Earlier quoted context omitted.

Are these people more or less obese than the ones who have easy access to grocery store? You are suggesting that this is a major driver of obesity, so you must be basing this on some data, no? Also, that link doesn’t say whether this is 45 minutes drive , and since it does not reference any source, it’s hard to look that up.

Well the driving part doesn't matter, the thing we care about is how hard it is for someone to get to a place with affordable healthy food, however they get there. If it's an urban area where a significant portion of people don't have easy access to a car, then you wouldn't look at driving times. These are called food deserts, and there is a ton of research on them. From what I've read there is not a direct line betw…

> Well the driving part doesn't matter, the thing we care about is how hard it is for someone to get to a place with affordable healthy food, however they get there.

Can’t be much harder than it was 100 years ago, when everyone was extremely poor by today standards, and visiting a grocery store was often a whole day trip, no? Obesity didn’t seem to have been a problem at that time. Seems like it really is not about lack of access to affordable healthy food, which today, by any historical standard, is very easy even in most deprived places in US.

> If it's an urban area where a significant portion of people don't have easy access to a car, then you wouldn't look at driving times.

Most poor people in urban areas do have easy access to a car. Cars are extremely cheap in US, poor Americans enjoy high consumption levels by global standards, which typically entails access to cars.

In any case, for this to support your argument, which that lack of access to affordable healthy food drives obesity, we’d need to have that in urban areas, carless people are significantly more obese than people with cars. To reiterate, your argument is that drivers are less obese than people who are too poor to drive. Is it actually the case? I seriously doubt it, but you’re welcome to show data supporting your theory.

> These are called food deserts, and there is a ton of research on them. From what I've read there is not a direct line between food deserts and higher obesity rates, but it is a relevant factor, especially when abundant dollar stores and fast food places are offering cheaper and more accessible food than the nearest grocery stores (if there are any).

Yes, I’ve heard about this stuff, and most of this stuff is highly motivated logic with extremely meager support in facts. Even you admit that the whole food desert thing has little actual observed causal impact on obesity rates. Instead, the poor just go to convenience stores and buy crap, and they do this even if they have healthy options easily available (this is true, because otherwise you’d see clear correlation that people close to grocery stores with cheap and healthy food are not obese, which you don’t).

Here, let me propose an alternative theory, which matches facts on the ground much better: many poor people in US are low in conscientiousness and long term thinking, and so instead of engaging in relatively complex activity of buying bulk staples and cooking simple and healthy meals, prefer to spend extra for convenience of unhealthy foods from dollar stores and fast food. This is possible, because their “poverty” is not an absolute level, but rather relative measure. By this I mean the fact that by global standard, American poor enjoy quite high consumption levels, so they can easily afford these unhealthy habits. Making healthy food easier to obtain for them will, as you admit, not change much, because people will just not take advantage of it, instead preferring easy and unhealthy food instead. Instead, what you’d need to do is to immiserate them even more by either taking away convenient and unhealthy options nearby, or reduce their purchasing power to make them unaffordable. This is, of course, seen as immoral, so it will not happen.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#110
post #109

Earlier quoted context omitted.

Well the driving part doesn't matter, the thing we care about is how hard it is for someone to get to a place with affordable healthy food, however they get there. If it's an urban area where a significant portion of people don't have easy access to a car, then you wouldn't look at driving times. These are called food deserts, and there is a ton of research on them. From what I've read there is not a direct line betw…

> Well the driving part doesn't matter, the thing we care about is how hard it is for someone to get to a place with affordable healthy food, however they get there. Can’t be much harder than it was 100 years ago, when everyone was extremely poor by today standards, and visiting a grocery store was often a whole day trip, no? Obesity didn’t seem to have been a problem at that time. Seems like it really is not about l…

> visiting a grocery store was often a whole day trip, no?

I mean, no. 100 years ago was the 1920s. Not really sure what you're referring to and this is not a useful comparison anyway, obviously many many aspects of the US food system and economy have changed in 100 years. I don't really know how to respond to this.

> To reiterate, your argument is that drivers are less obese than people who are too poor to drive. Is it actually the case?

Yes, because obesity is very strongly linked to poverty. Rich people tend to have more cars and eat healthier food because it's more accessible. Here's a study: https://www.sciencedirect.com/science/article/pii/S222658561...

Obviously I disagree with your opinions in the last two paragraphs, but if you have some evidence for them I'd be happy to look at it.

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