Rudd Center for Food Policy and Obesity


1. How can I buy healthful foods for myself and my family if I am on a tight budget?

It is true that healthy food is on average more expensive than cheap calories from high-fat, high-sugar food. Cooking your meals is one way to save financial resources required to prepare a nutritious healthy meal. It does however require time, with shortage of which is an often-cited constraint for why people increasingly eat away from home. Not only is it generally cheaper to cook your meal, you also have control over ingredients that you use and can choose according to your preferences and values (e.g., organic food, local produce, low salt, etc.). There are simple recipes of delicious meals that can be prepared quickly and don’t require long lists of ingredients (especially those rarely used or expensive). Still, buying healthy ready-to-eat meals is more convenient if you are opposed to cooking or have absolutely no time. If this is your choice, try to find vendors that have the best price per quality ratio for healthier food. One seasonal option to provide your family with fresh fruit and vegetables at a bargain is to do Pick-Your-Own (PYO) at local farms. In summer, a number of families enjoy picking their own blueberries, strawberries, apples and peaches at the cost of approximately 50% lower than retail prices, which growers can afford to offer by not paying for fruit/vegetable picking, transportation, and marketing. This is also a fun activity that brings you back to the land.

2. Why are fruits and vegetables more expensive than other foods, such as candy bars?

Technological innovation has lowered real prices of all foods. The most marked decline in costs, however, has been for high-fat, high-sugar, energy-dense foods. Some foods have become even less expensive than others due to federal agricultural subsidies (e.g., corn, soy). As a result, foods like refined grains, added sugars and fats became relatively cheaper compared to the cost of recommended diets based on lean meats, fish, fresh vegetables and fruit. So, palatable foods with added sugar and fats give both convenience and the cheapest sources of dietary energy. The relative cost of healthy foods is particularly large in remote areas and low-SES population groups that often have no access to grocery stores.

3. What percentage of health costs is due to obesity, or obesity-related illnesses?

Obesity increases risk of adverse health conditions and work disability and thereby puts an additional financial burden on public transfer programs and private health plans. The costs are considerable. At the individual level, obesity is associated with health care expenditures that are on average about one-third above medical costs of otherwise similar normal weight people.

4. What cost does obesity have on society (tax dollars, insurance companies, healthcare, production loss)?

Obesity-related direct and indirect economic costs exceed $100 billion per year, and the number is expected to grow. The full effects of obesity growth since the 1980s are not yet apparent due to a time lag between weight gain and emergence of health problems.

Economists generally focus on external costs, which are the consequences of individual decisions imposed on others. For example, secondary smoking presents health risks not only to smokers but also individuals around them. External costs of second-hand smoke, drunk driving, sedentary life, and other poor habits are a substantial burden on society. The social burden of external costs is often an appropriate justification for government action, such as tobacco and alcohol taxes. Economic theory suggests that policy interventions can improve public welfare if external costs are high. This seems to be the case for obesity. The key mechanism through which obesity is responsible for notable external costs is pooled health insurance, estimated to induce about $150 per capita loss in public welfare attributable to obesity.

5. What is the relationship between household income and health status?

The link between income and most health indicators is negative, implying that people with low income have on average worse health status. For obesity too, we observe higher rates of obesity in low-income communities, especially among women and children (the income-obesity relationship for men is less clear). The literature on health disparities gives rich evidence and explanation for the observed variation in health outcomes by income.

6. How is income influenced by weight or BMI?

The evidence on how obesity affects wages varies. Researchers have found that both obese men and obese women earn lower wages than their normal-weight counterparts, and in some studies, women were shown to experience almost two times the wage penalty compared to men. More research must be conducted to explore the direction of causality. It is possible that, instead of obesity leading to lower wages, low wages may cause obesity, or perhaps other variables increase weight and simultaneously lower wages. Explanations of the wage penalty vary from weight-based discrimination to lower productivity of obese people.

7. Is it worth it for insurance companies to cover the cost or part of the cost of obesity prevention programs?

This is likely to be worthwhile given the considerable economic costs due to health conditions that develop because of obesity and substantial difficulties with obesity treatment and efforts to lose weight. Some health insurance plans have already started implementation of wellness policies and other ways to encourage members to prevent weight gain and maintain healthy lifestyles. The economic challenge for health plans is that members tend to frequently move across plans, so that investment in preventing obesity and related health problems may not necessarily generate sufficient savings to the plan that initiated it. For bigger state-wide plans, members’ mobility may, on average, balance out. Nationwide efforts to prevent obesity in all plans would also solve the problem.

8. Do farmers’ markets and small markets/grocers accept Supplemental Nutrition Assistance Program (SNAP)?

There are farmers’ markets and small grocers that accept SNAP. For example, farmers’ markets in New Haven, CT welcome both SNAP and WIC. You should inquire in your city or town. We are not aware of data on how many of all farmers’ markets and small markets/grocers accept SNAP.