Do economic circumstances affect our concept of a healthy diet? Do personal economics make it difficult to stay on a healthy diet? In How the Other Half Eats Priya Fielding-Singh suggests most of us have a clear concept of a healthy diet. Poverty affects the ability to maintain that diet. Note the subtitle, The Untold Story of Food and Inequality in America. It helps us understand her answers to questions raised in the book. Fielding-Smith pursues the economics of healthy diets in a sociological context. She presents a different perspective, but the message overlaps with the book Pressure Cooker. The introduction states that the analysis is “short on judgement and long on empathy.” The book poses other critical questions:

• • What is a healthy diet?
  • How successful are the mothers in achieving a healthy diet?
  • What does equity have to do with healthiness? and
  • Why focus on the mothers?

The study. Her goal was to study family eating habits as affected by economics. Were there factors other than “price and proximity” that affected these diets? Her research contradicts previous conclusions about poor families and the foods they eat. She conducted interviews with 160 individuals in the San Francisco Bay area. Her work focuses in-depth on the food habits of four families. One family was Black living in poverty. A white family was poor but a little above the official poverty line. The third family was middle-class Latino; the fourth, affluent and Jewish. Economics was not the only distinguishing factor between families and food practices.

Feeding kids. The mothers considered fruits, vegetables, whole grains, fish and lean meat healthy foods. Fresh, homemade, organic and whole foods were also good for their families. Making the unhealthy list were candy, chips, and soda. Foods high in fat, salt, and sugar were unhealthy including those that were fast or fried.

One issue that elicited a surprising result involved food access. Her research suggests that food deserts are not the problem. I am not sure I buy her conclusion about food access. Her sampling might not have picked it up, but we may be overemphasizing the problem of access. Price was a much more important factor than access.

Even family finances are not a full explanation. The author points out limited ways to give kids a treat for poor families. Fashionable clothes and concert tickets cost more than an ice cream cone or a Twinkie. Food marketing targets kids, and it is often easier to give in than fight. Mothers attempt to buffer their children from hardship. This effort is easier to do with food than other treats. The greater the income of a family the easier it is to say no to junk food. The two poorer families were single-parent homes. These families required intensive mothering. Much of the book describes gender inequity. American society assumes that the mother handles most food preparation. It is the woman who gets blamed for the health of the child, with particular attention to their child’s weight.

Food scarcity, hunger, and food pantries were other topics of discussion. How the Other Half Eats found food insecurity to be a major problem. The food-insecure family falls into a feast-or-famine cycle. Eat as much food as you can when you have it because you never know when it will run out. There needs to be a stockpile of non-perishable food to last out the month. Spoilage-resistant food is not considered healthy. Organic food, perceived to be healthier, is more expensive. Mothers must balance kid’s preferences with food waste or invite a fight. Then there is the burden of raising an “organic child” who eats only organic products. It is challenging for the mother who has other children not interested in an organic diet. Expense is also an issue.

School lunch programs did not get good marks. Too much processed food and not enough fruits and vegetables. As a lunch buddy each Wednesday in the local school cafeteria, I noted some strange behavior. I did not expect as much packaged food as appeared on student trays. The lunchroom had an exchange program, where a student could place an item they did not want and pick up one they did. Apples and bananas were the most exchanged items. Some children refused to eat the fruit while others indulged. The most surprising observation was from the lunches brought from home. They contained more packaged products, particularly of the high-sugar type.

Food pantries were not visited by the four families or most in the wider-interview group. That was a place one only went to when there were no other options. They received the types of food that were available, not what they wanted. One criticism was that only sugarless, tasteless breakfast cereals were options. Children wanted the sugar-coated, flavorful ones.

Assumptions about nutrition as related to food abound and many are not valid. Food becomes a status symbol. Fielding-Singh asks

• • Are more expensive foods healthier than less expensive ones?
  • Are upscale burgers more wholesome than those from McDonald’s?
  • Should we buy Trader Joe’s cookies rather than Oreos?
  • Is local Mexican food superior to Taco Bell?
  • Is premium pizza better than $5 pizza?

Answers to these questions obscure deeper issues about food and health.

The author regrets the pickle that moms find themselves in. Outsiders judge moms on the healthiness of their children. Moms don’t want to come off as elitist. The wealthier mothers can afford to fall for the latest trends. The poorer mothers cannot. Wealthier moms find themselves in competition with their rich friends. Not all these trends improve the healthiness of the foods their children eat.

So, what are some of the problems in distinguishing healthy from unhealthy foods? First in the blame game is Big Food and their marketing efforts. We can also blame the media who incite new trends. Many stories promote stories of health and well being that contradict each other. Are we surprised when consumers become confused? There is a racist tinge to some of the dietary recommendations. Does soul food deserve its bad reputation? Why are whites portrayed as thin and Blacks as fat? Are these stereotypes fair or do they perpetuate myths we need to abandon?

Compromise becomes a way of life. When is compromise OK, and when does it become a slippery slope that affects diet and health? It all comes back to moms as dads are a net negative. When confronted with preparing a meal in mom’s absence, dad opts for drive-thru more often than not. In single-parent households the oldest child or a close relative or friend is in charge when mom is away. The designated-person-in-charge is not as invested as mom. Is time or money more important when the two conflict? How do working moms balance responsibilities at work and home? Wealthy moms can outsource cooking to paid helpers. Poorer moms don’t have this option.

Processed foods become an option in time of stress, but all moms in the study preferred home cooking. Processed food feels too artificial. A rotation of a few home-cooked offerings becomes boring after a while. The pressure of extracurricular activities makes preparation of a family meal difficult. Then there is the need to balance healthy items with kid preferences. Around the corner are the challenges of fluctuating finances. Certain items are available in good times disappear in bad times leading to dissatisfaction. Even the middle-class family felt the financial squeeze at times. The temptation arose to prepare fast-food versions at home. Does that make them healthier?

A final challenge comes to immigrant mothers whose children desire to become American. One son enjoyed both traditional Mexican dishes and American processed foods. What happens when he opens his lunchbox in the school cafeteria? Mom’s intentions clash with peer pressure. The author loses her pledge to be nonjudgmental when it comes to immigrant mothers. She can’t understand why they don’t push back against American foods. There is a nice passage in Pressure Cooker that explains why these moms don’t push back.

Emotion rules our understanding of food. How the Other Half Eats introduces terms to describe emotional responses to food. Downscaling describes lowering expectations to cope with inadequate incomes and opportunities. Diets suffer because basic needs are not met. Upscaling refers to the dilemma faced by wealthy moms. There is not only pressure to go beyond a healthy diet to getting the ‘best’ diet. Peer pressure forces these moms to outcompete their peers. Thus, they pursue questionable practices touted as healthy when they are not.

Priority setting depends on the home environment as tied to income level. Low-income moms worry about the safety of their children on the streets. Wealthier moms worry about college prep. Diet is important, but it doesn’t always rank at the top of the list! Control of the children’s diets is a lower priority for poorer moms. Dietary control is more important for high-income moms. Poor families downscale while the rich ones upscale. Stacking up is how families relate to other families in similar circumstances. How do moms perceive their situation relative to that of their friends and neighbors? Can they keep up or are they falling behind? What can they do to compete with other families around them?

Conclusion. Scarcity, uncertainty, and anxiety cut across all income levels. They fall much harder on low-income families. Too little money and too little time are the major problems in feeding children. Access to healthy foods in food swamps or deserts is not the problem, at least from the author’s perspective. She concludes that “processed treats can have their place. But they don’t belong at the center of our diets.” It appears that she equates processed and junk. With neither time nor money to prepare a meal at home how do working moms proceed? Processed staples are apparently not satisfactory.

Unlike many of books in this genre, How the Other Half Eats presents a detailed plan to change the way America eats. First, the plan would reform SNAP (food stamps) and food banks. The amount of money available in SNAP would increase. It would also be available to undocumented families. Incentives to buy more fruits and vegetables instead of junk food would be part of the reform. Food banks should change their goal from alleviating hunger to promoting better nutrition. As a society we should aim for healthier foods in school lunch and breakfast programs. She calls for banning of all junk-food advertising. Income inequality is at the heart of the problem. The plan calls for a living wage and affordable housing. It presents a noble goal, but is it attainable?

My political viewpoint favors any effort we can make to lower income inequality. The plan in the book has merit, but is it viable in today’s environment? It reads like a version of Build Back Better only more expansive. I recall the $3.7 trillion price tag slashed to $1.7 trillion down to table scraps pasted into other bills. The author makes the case for narrowing income inequality. She doesn’t tell us how to pay for it in this political environment.

Priya Fielding-Singh describes how four moms feed healthy meals to their families. She backs up her data through interviews with others in similar circumstances. Sociological studies put human faces on current issues. They provide insights we can’t find in survey data or meta-analyses. I commend the author for her view on how wealth and poverty affect the healthiness of the American diet. I only wish that she didn’t imply that all homemade foods are healthy, and all processed products are not.

Next week: Are food deserts real?