The 1991 and 1992 Behavioral Risk Factor Surveillance System (BRFSS) documented an increased prevalence of risk factors for chronic disease--including obesity--among non-whites and among those with lower levels of education. Level of education is an imperfect proxy for socioeconomic status, but it is often the only marker available in large-scale surveillance studies.

However, further smaller-scale studies--published in journals such as Pediatrics and Public Health--have documented a relationship between obesity and poverty among specific and varied segments of the homeless population. These studies have found a prevalence of imbalanced, fast food-dependent diets among homeless children and higher fat intake and prevalence of obesity--along with significant nutritional deficiency in iron, magnesium, zinc, folic acid, and calcium--among a sample of single homeless mothers. In general, homeless study participants had high-fat diets and high serum cholesterol levels, making them more likely to be obese.

The existence of a relationship between poverty and obesity does not imply causality, but surely one could speculate on the nature of the determinants. I would like to make the case that with a little bit of helpful prodding, Hicks might be inclined to venture beyond obtuseness and think a little more deeply about this "perched," "mooching," and "portly" woman's life.

Where do homeless people eat? Although the foods at municipal and charity-run shelters may be of decent quality, foods obtained from fast-food restaurants, delicatessens and garbage bins are not as healthy. What sorts of lives do homeless people live? Wealth and stability--which the homeless lack--invite knowledge of and time for pursuing a healthier lifestyle. This means access to healthy food, appropriate health care and safe locations to exercise or relax. Hicks focuses his dull and uninformed contempt on a woman who can be assumed to lack these resources.

Alexander C. Tsai '98

Oct. 4, 1999