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February 10, 2010 / Katie

Low IQ a predictor of heart disease? On fatphobia and classism.

A recent study has been done looking at a number of risk factors for heart disease to compare them with one another and find out which are the greatest predictors.

The relative strengths of the association were measured by an “index of inequality,” which summarised the relative risk of a health outcome (cardiovascular death) in the most disadvantaged (high risk) people relative to the most advantaged (low risk). This relative index of inequality for the top five risk factors was found to be 5.58 for cigarette smoking, 3.76 for IQ, 3.20 for low income, 2.61 for high systolic blood pressure, and 2.06 for low physical activity.

Get that? Smoking is the highest predictor, followed by low IQ. Then you have low income, high blood pressure, and low physical activity. They looked at obesity (see first paragraph in link) but it didn’t make the top five. Are we surprised?

At first glance, this seems to support a HAES approach. After all, not smoking, moving more, and being seen regularly by a doctor to keep blood pressure controlled probably helps lower your risk for heart disease, right?

But then I start to worry about the class associations here. There are a lot of folks for whom going out to the gym or going hiking just aren’t options as they work two jobs to make ends meet, or have physically demanding jobs that leave them exhausted and aching at the end of the day. Smoking, low income, and low IQ are all related to class issues as well. I guess what I’m seeing here is a picture of how a lot of the risk factors are related not just to cardiovascular disease, but also to a socially oppressed status. This just really poignantly shows how oppression winds up affecting every aspect of our life, including our physical health.

So this study is a win for us FA folks because we can point to it and say, “see? You can stop moralizing to me now about how being fat is going to give me a heart attack!” but it also points to a fail in the discrepancies between the haves and the have-nots regarding access to health care, nutritious food, and adequate recreation time. My initial feeling of delight upon reading the article has been replaced by a deep sadness.

Those of us who are fat do have somewhat of a victory here, but I’m beginning to realize just how much this focusing on “obesity” as the problem is such a nice and easy cop out for those who don’t want to address the injustice of a classist world.

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12 Comments

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  1. Nicole / Feb 10 2010 1:54 pm

    I’m consistently amazed at how much oppression really does impact all areas of life.

    The first time I remember it really hitting me was when I learned that black children had a 3 times greater chance of drowning than white children. Factors such as access to water/pools is a social/class issue that is killing children.

  2. Thalia / Feb 10 2010 4:14 pm

    There are a lot of folks for whom going out to the gym or going hiking just aren’t options as they work two jobs to make ends meet, or have physically demanding jobs that leave them exhausted and aching at the end of the day.

    Funny how some things count as exercise and some don’t. Because I’d say if you have a physically demanding job that leaves you exhausted, your physical activity is not low.

    Which isn’t to say I disagree with anything you said, just that it struck me as odd. Is it a classist assumption also that only extra, recreational exercise counts? I have a feeling studies tend to discount it, and just assume that poor people are lazy.

    • Katie / Feb 10 2010 6:14 pm

      Thalia, that’s a good point that I thought about after posting but I don’t like to go back through and edit because then it shows up twice on the feeds (I believe?)

      Anyway, what I meant to say was a job like standing at a fast food restaurant’s cash register all day, or taking stock at a grocery store, or working in a factory performing a very specific and repetitive task with only one part of the body all day every day. In my very limited experience, these types of jobs often leave a person aching and exhausted, but this is probably not the type of activity that is helpful for protecting against heart disease (perhaps it is, I could be wrong, but I believe the type of activity they are referring to in the study is the type that raises one’s heart rate).

      So there are other active jobs I can think of, such as working on a construction site, which in many cases would absolutely qualify as a higher activity level. With that clarification, are we on the same page?

    • living400lbs / Feb 11 2010 3:49 pm

      There may be some classist assumptions there. It may also be that some of the benefits ascribed to exercise have to do with relaxation and not with the actual activity per se. Some things I found earlier:
      One study found “a high level of occupational activity is associated with a decreased likelihood of being obese.”
      Another found that one factor in heart disease – plasma viscosity – improves with leisure-time activity but not work activity.  
      This study describes how work-related activity and leisure-time activity often don’t go together.

  3. Thalia / Feb 10 2010 6:59 pm

    Oh we were on the same page anyway; I wasn’t even saying that you were necessarily discounting it, though I get it about having, say, a job where you stand up all day and come home achy and tired, but maybe haven’t gotten a lot of (aerobic I guess) exercise. I was just remarking that it tends to get overlooked. I’ve seen a lot of instances where stuff like housework, keeping up with a two-year old, &c aren’t counted as ‘exercise’ since it’s already built into the day or something. It’s something to do with the diet mentality I think, which I suppose does come back to class issues.

    I’m not being very coherent here, :) I don’t think, and I’m not even sure what I’m trying to say about it, just pointing out that I’ve run across assumptions like that before; and so I was wondering how the study defined exercise.

    • Katie / Feb 10 2010 7:03 pm

      ahh, I’m with you totally, and yeah, I think you’re right—we don’t give enough credit to just moving, in any way (and especially in a way that brings us joy!). If it’s not a “step class” or “50 minutes on the elliptical” then it’s not “real” exercise.

      Case in point, I had a doctor who was asking me about my exercise routine, and I listed off, “well, I walk a lot of places because I live in a dense area, and I go to the gym at least three times a week where I go on the elliptical and swim.”

      “Swimming’s not cardio!” she snapped, and I didn’t disagree because I honestly didn’t know, until I researched later and found out that the laps I do actually DO qualify as “cardio”… but even if it didn’t, then so? Was she saying there’s no point to me doing something I like to do just because it doesn’t fit whatever definition she has of what exercise is “supposed” to look like? Yeah.

  4. Meowser / Feb 10 2010 10:49 pm

    No, the post won’t show up twice on the feed if you edit it. What will happen is, when the feed refreshes, the new version will show up in the same place the old version was in before. I edit posts all the time after putting them up because I always spot some editing glitch, and I’m pretty sure only changing the title will repeat it on the feed.

    And so, so true about nobody being willing to have a real, substantive, policy-altering conversation about inequities in socioeconomic status and what that does to people’s health. I too find it hard to fathom that someone who works 8 hours a day hanging drywall and then goes home and watches TV is “sedentary,” while the corporate manager who goes running for 30 minutes before work and then spends most of the day sitting around is “active.”

  5. bri / Feb 11 2010 3:50 am

    Awesome post. Totally with you on all of it.

  6. wriggles / Feb 11 2010 4:09 am

    Funny how some things count as exercise and some don’t.

    Well observed. The reason is to support the unproven assertion that physical activity is good for you and that there’s a certain amount and type of physical activity you can do which will mean you cannot be fat.

    So if you are active and fat, you’re activity doesn’t count. Ditto physical activity that isn’t perceived to increase health.

    • Katie / Feb 11 2010 10:56 am

      The reason is to support the unproven assertion that physical activity is good for you

      Is it unproven though? I have seen several studies, including the one I have linked to here, that do say that physical activity is important (and lack of it can be problematic).

      What I think is majorly problematic is the healthism in assuming that everyone can be active—that everyone has equal access to fun ways of being active, time and money to engage in them, and the physical capability to move in ways that are socially deemed “acceptable exercise.” It seems to me like there is a huge problem with how this is moralized and social issues are ignored. But, I am seeing studies that support the idea that moving around is good for us.

      • wriggles / Feb 12 2010 9:37 am

        What I’m getting at is that by stating physical activity must be good for you, physical activity that clearly isn’t-for instance that of a repetitive and stressful kind-is excluded, certainly from the category of exercise, which no longer means physical activity.

  7. rahmad fl / Feb 18 2010 9:03 am

    good info .. I am very interested with your article …

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