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Published in: International Journal for Equity in Health 1/2005

Open Access 01-12-2005 | Commentary

The appearance of discretionary income: Influence on the prevalence of under- and over-nutrition

Authors: Robert J Karp, Cindy Cheng, Alan F Meyers

Published in: International Journal for Equity in Health | Issue 1/2005

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Abstract

Undernutrition – protein energy malnutrition or specific nutrient deficiencies – has been an inherent characteristic of impoverished populations throughout the world. Over-nutrition, obesity and nutrition imbalance is a current concern among those with rising though still insufficient incomes. We review data to suggest that the prevalence of these forms of malnutrition in populations is highly influenced by the rate of appearance of discretionary income.
In developed countries, discretionary (alternatively "disposable") income refers to funds available after obligate payments (rent, heat, and the cost of getting to work) and payment for necessities (food and clothing). For families living at or below poverty, the last dollar earned is spent on these obligations. Undernutrition is common. By contrast, likelihood for obesity or imbalance increases with rising income when that last dollar is earned without certainty that it is available for discretionary spending. In the United States, neither under- nor over-nutrition is likely when new income is free and clear of debt or obligation. This occurs at approximately three times the poverty level.
While income poverty and food insecurity affect risk for malnutrition rather than outcome, nutrition education programs that address issues of income and food support increase likelihood for adherence to recommendations.
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Literature
1.
go back to reference Karp RJ, Fairorth J, Kanofsky P, et al: Effects of Rise in Food Costs on Hemoglobin Concentrations of Early School_Age Children, 1972–1975. Public Health Reports. 1978, 93: 456-4592.PubMedPubMedCentral Karp RJ, Fairorth J, Kanofsky P, et al: Effects of Rise in Food Costs on Hemoglobin Concentrations of Early School_Age Children, 1972–1975. Public Health Reports. 1978, 93: 456-4592.PubMedPubMedCentral
2.
go back to reference Frank DA, Roos N, Meyers AM, et al: Seasonal variation in weight for age in a pediatric emergency room. Pub Health Rep. 1996, 111: 366-71. Frank DA, Roos N, Meyers AM, et al: Seasonal variation in weight for age in a pediatric emergency room. Pub Health Rep. 1996, 111: 366-71.
3.
go back to reference Bhattacharya J, DeLeire T, Haider S, Currie J: Heat or Eat? Cold-weather shocks and nutrition in poor American families. American Journal of Public Health. 2003, 93: 1149-54.CrossRefPubMedPubMedCentral Bhattacharya J, DeLeire T, Haider S, Currie J: Heat or Eat? Cold-weather shocks and nutrition in poor American families. American Journal of Public Health. 2003, 93: 1149-54.CrossRefPubMedPubMedCentral
4.
go back to reference Karp RJ: Malnutrition among children in the United States. The impact of poverty. Modern nutrition in Health and Disease. Edited by: Shils ME, Olson JA, Shike M, Ross AC. 1999, Williams and Wilkins, Baltimore, MD, 9th and 10th, Karp RJ: Malnutrition among children in the United States. The impact of poverty. Modern nutrition in Health and Disease. Edited by: Shils ME, Olson JA, Shike M, Ross AC. 1999, Williams and Wilkins, Baltimore, MD, 9th and 10th,
5.
go back to reference Immink MDC: Purchasing power and food consumption behavior: how poverty level is defined. Social and cultural perspectives in nutrition. Edited by: Sanjur D. 1982, Engelwood cliffs NJ: Prentice Hall, 91-122. Immink MDC: Purchasing power and food consumption behavior: how poverty level is defined. Social and cultural perspectives in nutrition. Edited by: Sanjur D. 1982, Engelwood cliffs NJ: Prentice Hall, 91-122.
6.
go back to reference Bloom BS: Stability and Social Change in Human Characteristics. 1964, New York, Wiley and Co, Publishers Bloom BS: Stability and Social Change in Human Characteristics. 1964, New York, Wiley and Co, Publishers
7.
go back to reference Katz MB: The Undeserving Poor. 1989, Pantheon Books, New York Katz MB: The Undeserving Poor. 1989, Pantheon Books, New York
8.
go back to reference Weitzman M, Moss ME: Ambulatory Pediatrics. 2001, 162-66. 10.1367/1539-4409(2001)001<0162:ACSOHN>2.0.CO;2. Weitzman M, Moss ME: Ambulatory Pediatrics. 2001, 162-66. 10.1367/1539-4409(2001)001<0162:ACSOHN>2.0.CO;2.
9.
go back to reference Jelliffe DB: The Assessment of Nutritional Status of the Community World Health Organization Monograph Series # 53. 1965, World Health Organization Monograph Series: Geneva Jelliffe DB: The Assessment of Nutritional Status of the Community World Health Organization Monograph Series # 53. 1965, World Health Organization Monograph Series: Geneva
10.
go back to reference Karp R: The problem of changing food habits -1: how habits are formed. Malnourished Children in the United States: Caught in the Cycle of Poverty. Edited by: Karp RJ. 1993, New York: Springer Publishing Co, 194-211. Karp R: The problem of changing food habits -1: how habits are formed. Malnourished Children in the United States: Caught in the Cycle of Poverty. Edited by: Karp RJ. 1993, New York: Springer Publishing Co, 194-211.
11.
go back to reference Belle D: Lives in stress: Women and depression. 1982, Beverly Hills, CA: Sage Publishing Co Belle D: Lives in stress: Women and depression. 1982, Beverly Hills, CA: Sage Publishing Co
12.
go back to reference Hepner R, Maiden NC: Growth rate, nutrient intake, and mothering as determinants of malnutrition in disadvantaged children. Nutrition Reviews. 1971, 29: 219-223.CrossRefPubMed Hepner R, Maiden NC: Growth rate, nutrient intake, and mothering as determinants of malnutrition in disadvantaged children. Nutrition Reviews. 1971, 29: 219-223.CrossRefPubMed
13.
go back to reference Bradley J: Nurturance and nutrition. Malnourished Children in the United States: Caught in the Cycle of Poverty. Edited by: Karp RJ. 1993, New York: Springer Publishing Co Bradley J: Nurturance and nutrition. Malnourished Children in the United States: Caught in the Cycle of Poverty. Edited by: Karp RJ. 1993, New York: Springer Publishing Co
14.
go back to reference Gopalan C: Undernutrition: measurement and implication. Nutrition and poverty. Edited by: Osmani SR. 1992, Oxford/New York: Oxford University Press, 17-48. Gopalan C: Undernutrition: measurement and implication. Nutrition and poverty. Edited by: Osmani SR. 1992, Oxford/New York: Oxford University Press, 17-48.
15.
go back to reference Engle PL, Zeitlin M, Medrano Y, et al: Growth consequences of low income Nicaraguan mothers' theories about feeding 1-year-olds. Parents' cultural belief systems: their origins, expressions and consequences. Edited by: Harkness S, Super C. 1996, Guilford Press, New York, 428-46. Engle PL, Zeitlin M, Medrano Y, et al: Growth consequences of low income Nicaraguan mothers' theories about feeding 1-year-olds. Parents' cultural belief systems: their origins, expressions and consequences. Edited by: Harkness S, Super C. 1996, Guilford Press, New York, 428-46.
16.
go back to reference Mayer J: Obesity. Modern Nutrition in health and Disease. Edited by: Goodhart RS, Shils ME. 1980, Philadelphia: Lea and Febiger, 721-6 Mayer J: Obesity. Modern Nutrition in health and Disease. Edited by: Goodhart RS, Shils ME. 1980, Philadelphia: Lea and Febiger, 721-6
17.
go back to reference Mead M: The problem of changing food habits. Bulletin of the National research Council No. 108. 1943, Food and nutrition Board of the National Academy of Science Washington DC Mead M: The problem of changing food habits. Bulletin of the National research Council No. 108. 1943, Food and nutrition Board of the National Academy of Science Washington DC
18.
go back to reference Kumanyika SK: Special issues regarding obesity in minority populations Ann Internal Medicine. 1993, 119: 650-654. Kumanyika SK: Special issues regarding obesity in minority populations Ann Internal Medicine. 1993, 119: 650-654.
19.
go back to reference Lewin K: Forces behind food habits and methods of change. The problem of changing food habits. Bulletin of the National research Council No. 108. 1943, Food and nutrition Board of the National Academy of Science Washington DC Lewin K: Forces behind food habits and methods of change. The problem of changing food habits. Bulletin of the National research Council No. 108. 1943, Food and nutrition Board of the National Academy of Science Washington DC
20.
go back to reference Ritchie JAS: Learning better food habits. 1968, Food and Agriculture organization. Rome, Italy Ritchie JAS: Learning better food habits. 1968, Food and Agriculture organization. Rome, Italy
21.
go back to reference Drewnowski A, Specter SE: Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr. 2004, 79 (1): 6-16.PubMed Drewnowski A, Specter SE: Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr. 2004, 79 (1): 6-16.PubMed
22.
go back to reference Karp RJ, Greene GW: The effect of Rising Food Cost on the Occurrence of Malnutrition Among the Poor in the United States: The Engels Phenomenon in 1983. 1983, Bull New York Acad Med, 59: 721-727. Karp RJ, Greene GW: The effect of Rising Food Cost on the Occurrence of Malnutrition Among the Poor in the United States: The Engels Phenomenon in 1983. 1983, Bull New York Acad Med, 59: 721-727.
23.
go back to reference Burnett J: English diet in the 18th and 19th centuries. Progress in Food and Nutrition Science. 1976, 2-11. Burnett J: English diet in the 18th and 19th centuries. Progress in Food and Nutrition Science. 1976, 2-11.
25.
go back to reference Meyers A, Frank D, Roos N, et al: Housing subsidies and pediatric undernutrition. ARCH PED ADOLES Med. 1995, 149: 1079-84.CrossRef Meyers A, Frank D, Roos N, et al: Housing subsidies and pediatric undernutrition. ARCH PED ADOLES Med. 1995, 149: 1079-84.CrossRef
26.
go back to reference Citro CF, Michael RT, eds: Measuring Poverty: A New Approach. 1995, Washington DC: National Academy Press Citro CF, Michael RT, eds: Measuring Poverty: A New Approach. 1995, Washington DC: National Academy Press
27.
go back to reference Garn SM: Family-line and socioeconomic factors in fatness and obesity. Nutrition Reviews. 1986, 44: 381-86.CrossRefPubMed Garn SM: Family-line and socioeconomic factors in fatness and obesity. Nutrition Reviews. 1986, 44: 381-86.CrossRefPubMed
28.
go back to reference Drewnowski A: Obesity and the food environment: dietary energy density and diet costs. Am J Prev Med. 3 (Suppl): 154-62. 2004 Oct 27 Drewnowski A: Obesity and the food environment: dietary energy density and diet costs. Am J Prev Med. 3 (Suppl): 154-62. 2004 Oct 27
29.
go back to reference Barker DJ: The developmental origins of chronic adult disease. Acta Paediatr. 2004, 93 (446): 26-33. Barker DJ: The developmental origins of chronic adult disease. Acta Paediatr. 2004, 93 (446): 26-33.
30.
go back to reference Boney CM, Verma A, Tucker A, Vohr BR: Metabolic Syndrome in Childhood: Association With Birth Weight, Maternal Obesity, and Gestational Diabetes Mellitus Pediatrics. 2005, 115: e290-e296.PubMed Boney CM, Verma A, Tucker A, Vohr BR: Metabolic Syndrome in Childhood: Association With Birth Weight, Maternal Obesity, and Gestational Diabetes Mellitus Pediatrics. 2005, 115: e290-e296.PubMed
31.
go back to reference Mendez MA, Monteiro CA, Popkin BM: Overweight exceeds underweight among women in most developing countries. Am J Clin Nutrition. 2005, 81: 714-21. Mendez MA, Monteiro CA, Popkin BM: Overweight exceeds underweight among women in most developing countries. Am J Clin Nutrition. 2005, 81: 714-21.
32.
go back to reference WHO/FAO: Report of the Joint WHO/FAO Expert Consultation on Diet, Nutrition, and the prevention of Chronic Diseases. 2002, Geneva: World Health Organization WHO/FAO: Report of the Joint WHO/FAO Expert Consultation on Diet, Nutrition, and the prevention of Chronic Diseases. 2002, Geneva: World Health Organization
33.
go back to reference Sia CC: The medical home: Pediatric practice and advocacy in the 1990s. Pediatrics. 1992, 90: 419-23.PubMed Sia CC: The medical home: Pediatric practice and advocacy in the 1990s. Pediatrics. 1992, 90: 419-23.PubMed
34.
go back to reference Karp R: Breaking the cycle of poverty. Malnourished Children in the United States: Caught in the Cycle of Poverty. Edited by: Karp RJ. 1993, New York: Springer Publishing Co, 253-257. Karp R: Breaking the cycle of poverty. Malnourished Children in the United States: Caught in the Cycle of Poverty. Edited by: Karp RJ. 1993, New York: Springer Publishing Co, 253-257.
35.
go back to reference Primus W: The Safety Net Delivers: The Effects of Government Benefit Programs in Reducing Poverty. Washington DC: Center on Budget and Policy Notes, 1997 November 15. Primus W: The Safety Net Delivers: The Effects of Government Benefit Programs in Reducing Poverty. Washington DC: Center on Budget and Policy Notes, 1997 November 15.
36.
go back to reference Olson C, Rauschenbach BS, Frongillo EA, Kendall A: Factors contributing to household food insecurity in a rural upstate New York county. Family Economics and Nutrition Review. 1997, 10: 2-17. Olson C, Rauschenbach BS, Frongillo EA, Kendall A: Factors contributing to household food insecurity in a rural upstate New York county. Family Economics and Nutrition Review. 1997, 10: 2-17.
37.
go back to reference Karp RJ, Snyder E, Fairorth JW, et al: Parental behavior and the availability of foods among undernourished inner-city children. J Family Practice. 1984, 18: 731-35. Karp RJ, Snyder E, Fairorth JW, et al: Parental behavior and the availability of foods among undernourished inner-city children. J Family Practice. 1984, 18: 731-35.
38.
go back to reference Sen A: Development as Freedom. 1999, New York: Knopf, 11- Sen A: Development as Freedom. 1999, New York: Knopf, 11-
39.
go back to reference Rosen D: Paralyzes of response to poverty. Malnourished Children in the United States: Caught in the Cycle of Poverty. Edited by: Karp RJ. 1993, Springer Publishing Co., New York, 250-252. Rosen D: Paralyzes of response to poverty. Malnourished Children in the United States: Caught in the Cycle of Poverty. Edited by: Karp RJ. 1993, Springer Publishing Co., New York, 250-252.
Metadata
Title
The appearance of discretionary income: Influence on the prevalence of under- and over-nutrition
Authors
Robert J Karp
Cindy Cheng
Alan F Meyers
Publication date
01-12-2005
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2005
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/1475-9276-4-10

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