Paying The Inequality

Cheap Food, Bad Food

Farooque Chowdhury

Inequality in the area of food and health under capitalism is egregious. With bad food, bad health and difficult-to- or no-access to health services, the poor, the low-income people pay the inequality. It's a payment made with life, and by the subaltern classes.

"There have been huge gains in life expectancy worldwide," the OECD finds, "but large disparities remain among socio-economic groups.... [Everywhere, the richest and the most educated are in better health: at age 30, people with the highest level of education could expect to live six years longer than people with the lowest level of education (53 years versus 47 years). Differences in life expectancy by education level are particularly large in Central European countries, especially among men." (All on Board, Making Inclusive Growth Happen, 2014, © OECD)

The health-inequality comes from many factors that include differences in living and working conditions, and access to and quality of health care. Access to quality health care is influenced by financial and non-financial reasons. And, both—financial and non-financial reasons—are connected to politics of dominating classes, which are not identified by mainstream academia.

"In many OECD countries," the report said, "large inequalities remain in self-rated health status across different socio-economic groups. These inequalities reflect differences in living and working conditions, as well as in behavioural factors... Poorly educated women are two to three times more likely to be overweight and obese than those with high levels of education. People in low-income households may also have more limited access to certain health services or use these services less for financial or non-financial reasons, notably certain preventive services." The power that defines living and working conditions is not identified although the differences are mentioned. The two conditions—living and working—are constructed by none else, but profit. The poor, the multitude is pressed into the conditions, part of competition, by capital.

The OECD report added: "Access to health care varies considerably among social groups, especially in developing and emerging market economies, but also in some OECD countries."

It's the poor that have no access. "In general," the report said, "access to health services continues to be out of reach to much of the low-income population in developing countries, either for financial reasons: or because it is simply unavailable. Women still often give birth without the aid of a trained midwife, nurse, doctor or other skilled birth attendant, and coverage rates of births attended by skilled health personnel are substantially higher among women and children in better-off families than in poor families." It's the seemingly "universal" law of property: the well-off always have all the better facilities, and the poor always have all the worse. And, a human begins experiencing class difference from the moment she steps into the crude capitalist world.

"In many cases," the report said, "the poor pay out of pocket for health services due to a lack of insurance coverage, which puts them at a further disadvantage. By contrast, in most OECD countries the health needs of a majority of the population are met, but low-income individuals may face difficulties accessing some health services. A survey, conducted in 2013 in 11 European and non-European countries, shows that low income individuals are more likely to report unmet health care needs than people on high incomes. In the United States, nearly half of adults with below average income reported having some type of unmet health care need due to cost in 2013." The much propagated old "golden" globalization sold anew failed to ensure access to health services to all, and not even "help" the US with a system of health care for all.

An advanced capitalist economy is an appropriate case to check with inequality in health and food related areas that exists in the capitalist system. Following are only a few and brief findings from England:
Citing Fair Society, Healthy Lives: Strategic Review of the Health Inequalities in Englandpost-2010 (The Marmot Review Team, The Marmot Review, London, 2010) the briefing paper ''Social and economic inequalities in diet and physical activity" said in its introduction: "Health is not distributed equally across society. There is clear evidence of social and economic inequalities in many aspects of health. The lower a group's socioeconomic position, the worse their health tends to be." (Roberts K, Cavill N, Hancock C, Rutter H, Oxford: Public Health England Obesity Knowledge and Intelligence, 2013)

Again referring the Fair Society the briefing paper said: "[T]he higher a person's socioeconomic position, the better his or her health", and "In England people living in the poorest neighbourhoods will on average die seven years earlier than people living in the wealthiest neighbourhoods." Life and death are class-biased!

The briefing paper's conclusions included:
"[T]here are... socioeconomic gradients in dietary intake and physical activity behaviour. People of lower socioeconomic position tend to eat less healthy diets and be less physically active than people of higher socioeconomic position."

The conclusion identified the following interrelated social, economic, environmental, psychological and cultural factors that may be important in explaining these associations:
"[L]ow income households may be less likely to have disposable income for non-essential costs such as leisure-time physical activity and are also likely to be disproportionately affected by any increases in food prices compared with higher income groups.

"[A]reas of greater deprivation have reduced access to environments that support physical activity such as parks, gardens or safe areas for play, and are more likely to have transport environments less amenable to active travel.

"[E]ducation is associated with diet and physical activity behaviour, with lower educational attainment associated with poorer diet and lower physical activity levels."

Gardens, parks, leisure-time activity are off-limits to the poor. "Are" not all these—gardens, parks, all the earthly good—for the rich'? It's not strange in capitalism. Has not "fate" dictated the poor to build up parks and gardens for the rich, to serve the rich, and should not have any leisure-time activity? Is the reality different in Dhaka, Kolkata, Cairo, Chennai and Nairobi?

Citing surveys and studies that included Health Survey for England 2011, Low Income Diet and Nutrition Survey 2003-2005, Living Costs and Food Survey, The Active People Survey, Survey of Public Attitudes and Behaviours towards the Environment 2009, the briefing paper said:
"Dietary intake and eating behaviours in England are related to socioeconomic position. People from lower socioeconomic groups... tend to have diets that are less healthy than people from higher socioeconomic groups....

"[F]ruit and vegetable consumption varies significantly.... [T]he proportion of men and women eating five or more portions of fruit and vegetables per day [is]: 34.6% in the highest quintile... compared with 19.7% in the lowest quintile....

"[T]he mean number of portions of fruit and vegetables consumed by adults aged 16 and over per day also increased from the lowest to highest income quintiles, with a mean of 3 in the lowest quintile and 4.3 in the highest....

"[T]he proportion of food spent on fruit and vegetables increases as equivalised income increases....

"[T]he most affluent 10% of households... spend less on processed meat, and more on unprocessed fish and meat than the least affluent 10%....

"Participation in sport and active leisure pursuits is also socially patterned.... 43% of adults in... managerial/professional [groups] take part in sport for at least 30 minutes once a week or more, compared to 27% of adults in lower supervisory/technical/routine occupations and unemployed/students [groups]....

"People from lower socioeconomic groups tend to have poorer access to environments that support physical activity such as parks, gardens or safe areas for play; are less likely to visit green space, and are more likely to live close to busy roads. The local environment appears to be a more important influence on transport-related physical activity (walking and cycling) than recreational physical activity, which may exacerbate social inequalities. People from lower socioeconomic groups are more likely to live in areas that do not support walking and cycling, but in turn are more likely to need to walk and cycle for transport and to access employment....

"[F]ear of traffic can be a strong disincentive to allowing children to play outside and to walking and cycling. Children in the 10% most deprived wards in the UK are more than three times as likely to be pedestrian casualties as; children in the 10% least deprived wards....
"[W]hen food prices rose in real terms by 12% in 2007, low income households were disproportionately affected with a rise of 1.6% of their household spending going on food and drink, compared with a 0.3% rise in all households.... [L]ower income households responded to rises in costs by choosing to buy cheaper alternatives....

"[I]ncome and cost of food has an influence on food choice and dietary intake.... 36% of respondents [in a survey reported] they couldn't afford to eat balanced meals." As barriers to making positive changes to their diets as were relevant to them, 30% of the respondents identified "price of healthy foods" was the most frequently selected factor.

"[T]he cost of food (including the perceived cost of buying more healthy food) may be a more important issue.... [I]n the face of budgetary pressures, individuals may be reluctant to risk experimentation with home cooking or different types of food. For low income families outlay on food may be considered flexible relative to other household expenditure such as fuel, rent and water, with items such as fresh fruit and vegetables being replaced with cheaper alternatives....

"[A]ffordability may be a barrier to taking part in many sports and activities, with costs for gym membership being out of the range of many people on low incomes.... Although it may appear to cost little to take part in activities such as walking, socioeconomic factors such as competing pressures on time for work or child care may make this impractical for some people.... 45% of men and 34% of women thought 'work commitments' were a barrier to being active. This can mean that people from lower socioeconomic groups may have a lack of discretionary time to take part in physically active leisure pursuits—even if they are free. Conversely some people on low incomes may walk out of necessity, due to lack of access to a car or inability to pay for public transport."

It added:
"People from the highest social group were much more likely than those from the lowest social group to visit green spaces frequently.... [T]his relationship is likely to be due to a complex interaction of factors including differences in access to green space, leisure time, transport options, education, or culture."

"[W]omen of lower educational attainment had less perceived control over their families' food choices; less support for attempts to eat more healthy food; fewer opportunities to observe and learn good food-related practices; more environmental barriers; and more ambiguous beliefs about longer term health outcomes associated with diet."

Studies conducted in Australia, New Zealand and the US found that in many poorer neighborhoods healthy food is neither available nor accessible nor affordable.

Doesn't it echo Engels? "The workers get what is too bad for the property-holding class. In the great towns of England everything may be had of the best, but it costs money; and the workmen... cannot afford much expense.... The potatoes which the workers buy are usually poor, the vegetables wilted, the cheese old and of poor quality, the bacon rancid, the meat lean, tough, taken from old, often diseased cattle, or such as have died a natural death, and not fresh even then, often half decayed." (The Condition of the Working-class in England)

The reality the facts form is not only from a single society. In Dhaka neighborhoods dwelt mostly by the working poor, the same potatoes, the same bananas, the same meat, from cattle and chicken, the same fruits and rice, the same color and quality—bad, tasteless, unhealthy, unhygienic—are present only to be purchased by the poor. The market places that house the shops for the poor are also unhygienic as are the shops. And, the poor don't have the time to care for. The poor taste polaao and beereeaanee, the rich-food the rich consume, after these are discarded and thrown away in near-to-rotten condition by the rich. The poor either collect it after those are thrown away after a feast, or they buy it from petty traders, who collect it from cooks of the rich. The children from the poor families, termed street urchins, taste drops of soft drinks from thrown away soft drink cans. The bread the poor buy, the fish they buy, the cooked food they consume from roadside stalls are of bad quality. The rich shall never touch those even. And, in the city, press reports over the years said, price of food sold in restaurants for the well-off vary: from Taka, the Bangladesh currency, 600 to more than 10,000 (around Tk77=$l). The food prepared along the city streets for the working people is priced a few Taka while the rich pay Taka 60-100 for a piece of candle for their birthday party. A Dhaka press report said: "Although Bangladesh registered an overall economic growth in excess of 6 percent per year and carried one million tonnes of public stocks of cereals every year during 2007-2011, over 20 percent of its population did not have access to minimum dietary requirement during this time", said senior economist Quazi Shahabuddin. "Many people suffer from chronic hunger in Bangladesh, making the country home to one of the largest undernourished population in the world", said Shahabuddin, also a former director general of Bangladesh Institute of Development Studies. (New Age, Dhaka, October 16, 2014, "Hunger stalks millions despite growth in food production, World Food Day today") The inconsistent "picture" is not only from Bangladesh and from England. It's in India, and it's in Nepal and South Africa also. It's the overall reality in the world system.

Don't the facts reaffirm the reality of inequality, and the demands the working people struggle for: affordable better food, affordable better health care, affordable better environment, safer life, affordable leisure-time? The inequality turns cruel if one compares this with profit-stories of health care and food industries.

The cited facts are fresh but the reality of inequality is old. It's an old narration of the triumphal march of capital with its devastating power.

Vol. 47, No. 23, Dec 14 - 20, 2014