Читать книгу A Companion to Medical Anthropology онлайн

97 страница из 242

Estimates for “overnutrition” parallel undernutrition on a global scale (Gardner and Halweil 2000), and links between poverty, hunger, and nutrition are also strongly implicated in the global obesity pandemic (Himmelgreen et al. 2011, and this volume). Early in the emergence of overnutrition as an emerging public health crisis, Crooks (1998) investigated the relationships between poverty, diet, and obesity among poor families in Appalachia provide an example of the dynamics of these biocultural webs. Part of how poverty, diet, and nutrition in Appalachia are linked is the consumption at home and in schools of calorie-rich but nutrient-poor foods. Home environments are linked to structures of parental work, perceptions about providing for the wants of their children, and child-activity patterns. School environments offer the ready availability of calorie-rich and nutrient-poor snack foods because snack food concessions were one of the only sources of income for school-based extracurricular activities in these impoverished counties. Thus, structures of poverty severely limit options for meeting personal, social, parental, and dietary goals and needs, and the result is the global association between poverty and obesity. Moreover, as Brewis and Wutich (2014, 2019) have shown, stigmas associated with weight, as with poverty in the work of Crooks, serve to undermine anti-obesity programs and further contribute to a syndemic of poverty, obesity, diabetes, and multiple associated health outcomes (see also Ginzburg 2020).