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PaperclipPerfector  1mo ago (text post)   25859 thread views

Culture War Roundup for the week of March 25, 2024

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Health, Fitness, Obesity, and Politics

Something that’s been bouncing around in my head for quite some time is how people relate their politics to their personal health. This story from The Daily Beast on Wisconsin Senate candidate Eric Hovde has resurfaced this for me by providing a clear illustration of what I perceive as a current difference between the American left and right on this issue:

“Look, we have an explosion of Type 2 diabetes right now. Explosion. Obesity is off the charts. You know, we’re removing people from being responsible for their own health,” Hovde said.

“If they all of a sudden started to realize that they’re going to pay more for their health care by consuming, you know, by consuming massive amounts of soda every day or fatty foods and not exercising, maybe they would change their behavioral patterns.”

Hovde then claimed obesity was a “personal choice.”

“It’s a personal choice,” he said, “but there should be consequences to those personal choices. Fine, you want to do that, you become obese, your health care is going to cost more. Or, the quality—or not the quality, but the amount of health care may go down, because you may not have the money to afford it.

“You have to force personal responsibility back to people, and also make them smart consumers.”

The Daily Beast helpfully loops in a putative expert on the matter, a professor at NYU:

Jay said that Hovde’s comments singling out obesity as something that should raise people’s insurance rates reveals that “either you’re not understanding or you’re really discriminating against people who have a chronic disease.”

“It’s assuming that obesity is some sort of moral failing that people need to be punished for,” she said. “That’s not true.

She added: “It’s a pretty awful and dangerous thing to say.”

This is the latest spat about these sorts of things and probably lays the dichotomous beliefs out about as clearly as possible. There is a policy angle (some people think insurance should be risk-based, some don’t), but that is comparatively dry relative to the beliefs in personal responsibility and how those views extend into political beliefs. There was an old throwaway post from the dissident right blog Dividuals that stuck with me a decade later because of how clearly it captured something that I felt when I read the left-leaning positions:

One realistic way to parodize liberals / lefties / Progressives / feminists / SJWs etc. would be to present them as narcissistic, solipsistic, self-absorbed people with huge and fragile egos who demand that everything should revolve around themselves.

…

The simple fact that feminists tend to be fat would only make, in itself, a weak joke. But when you find they run around parading their fatness, and make it a political goal to make men somehow adore it – imagine it, human beings making it a political goal that other should have a positive opinion of their own personal fsckups! “I have crap for character, now praise me for it, oppressor!” Imagine programmers making it a political goal to convince people that bugs are actually good!

At the time, I wasn’t particularly right-aligned, so this wasn’t really an ingroup-outgroup thing, but an articulation of a growing frustration I had with people on the left, this absolute refusal to ever tell people to own up to their situations, take responsibility for where they are in life, and fix it. Everything, always, forever is just contingent on circumstances, completely outside of their control. While I could understand the arguments about this sort of thing when it comes to wealth accumulation or crime, to be so extreme as to not grant that people have agency over what they eat was the kind of thing that was just steadily pushing me away from having any inclination to share goals with the economic left.

Since then, there has been a steady (if not particularly large) genre of articles characterizing fitness as a right-wing phenomenon. Some of these are really silly things about how gyms are gateways to far-right extremism, but let’s look at one example that’s a little more self-serious and not obviously ridiculous:

The study found a significant correlation between those men who were heavier and stronger and the belief that some social groups should dominate others. These men were also less likely to support the redistribution of wealth, a typically left wing principle.

Specifically, the researchers found a specific correlation between the number of hours spent in the gym and having less egalitarian socioeconomic beliefs.

Dr Michael Price, a senior lecturer in psychology at the university and the lead author of the study, suggested the findings could come down to three things: The result of the men “calibrating their egalitarianism to their own formidability”, that less egalitarian men strive to become more muscular or there could be a third variable at play.

“Our results suggest that wealthier men who are more formidable physically are more likely to oppose redistribution of wealth,” he said. “Essentially, they seem more motivated to defend their resources. But less wealthy men who are still physically formidable don’t seem more inclined to support redistribution either. They’re not demanding a share of the wealth.

Vice covers the same thing, but with an oddly smug glee:

To all you gym-bro haters amongst us, come, be seated. This one's for you. Science—objective, empirically tested science, the science that tells us that the ice caps are melting—has confirmed what many of us have long suspected: Gym bros are right-wing jerks.

…

Price's findings? That rich muscle dudes are the worst! Under those rock-hard abs lie the rock-hard souls of men who doesn't believe in spreading their riches around. "It's basically your tolerance to the idea that wealth shouldn't be redistributed," Dr. Price explains. "Some people thought it was horrible; some people thought it was fine."

If there was ever a line that called for a YesChad.jpg response, it’s that one. While I am not a particularly big guy, I will self-report that I do believe my work as an endurance athlete has substantially shifted my views against egalitarian perspectives and more towards personal responsibility. Rather than modeling that as being about domination and aggression, I would propose that the mechanism is the personal sense of accomplishment and mastery coupled with knowing how much of it is a direct product of your internal locus of control. I’m not decently fast because of some random freak accident of nature - I wasn’t fast when I started running, I’m much faster now, and I keep getting faster in almost perfect concert with how much work I put into the sport. Others will fare better with less work, such is life, but we all have a great deal of control over our outcomes. So, yeah, I am inclined to believe that pursuing fitness as a hobby will tend to lead one to the right of their current positions.

The belief that fitness is a right-wing thing doesn’t stop with this sort of relatively modest claim about egalitarian tendencies though. The Society for Cultural Anthropology has a weird writeup on Gym Fascism. To go nutpicking a bit, the Manitoba University newspaper has Fitness culture and fatphobia are fascistic - Our obsession with looking the same is culling joy and body diversity:

Prof. Brian Pronger points out that almost everything that we stress about physical education centres around maximizing the body’s performance. It’s the way that we are all expected to structure our lives around our fitness regimens, and those five days a week when we’re supposed to work out must be in service to making ourselves as strong as possible.

Fitness fanaticism constipates our personal growth. Think about what it means to “work on yourself.” It often means to work out, as if your character is tied to your physical strength and muscle tone.

OK, too much nutpicking. Back to a serious journalistic outlet, Time magazine. Just before the New Year, Time published a story that might dissuade people from making an ill-advised resolutions for 2023 titled The White Supremacist Origins of Exercise, and 6 Other Surprising Facts About the History of U.S. Physical Fitness:

It was super interesting reading the reflections of fitness enthusiasts in the early 20th century. They said we should get rid of corsets, corsets are an assault on women’s form, and that women should be lifting weights and gaining strength. At first, you feel like this is so progressive.

Then you keep reading, and they’re saying white women should start building up their strength because we need more white babies. They’re writing during an incredible amount of immigration, soon after enslaved people have been emancipated. This is totally part of a white supremacy project. So that was a real “holy crap” moment as a historian, where deep archival research really reveals the contradictions of this moment.

Oh dear.

Anyway, to return to that Hovde story that kicked things off, I find it pretty interesting to think about how these things play with different crowds. Something that’s kind of obvious is that Red Tribe America is not actually very fit at all, while Blue Tribe power centers consistently have quite a few fitness-minded individuals. Nonetheless, when Hovde says that fat people are responsible for their own bodies, it seems to me that most Red Tribers basically agree and accept that they’re fat because they like burgers and beer a little too much, while the Blue Tribers recoil at the suggestion that people are responsible for eating themselves into Type 2 diabetes. This reminds me of how discussions of marriage and morality play out as well - educated elites, regardless of political persuasion, stay married at very high rates and seem to be well aware that this is the correct way to live, but are hesitant to say this about the underclass. They hold standards for themselves that they believe don’t apply to others. As far as electoral politics goes, I doubt this little newscycle item means much of anything, but it does provide a fun case study and litmus test for perspectives on the topic.

While one can no doubt find a sizeable contingent to defend any belief, the more common and reasonable argument people such as myself would furnish against focusing on personal agency is not that it is 'wrong' but that it is useless. If we are approaching this from a policy perspective how much control any particular person had over their health is only important insofar as it impacts what we need to do to remedy poor health now, on a society-wide scale. Politicians and academics are generally in the business of policy, not personal advice.

What is really useless is creating policies that distort incentives and make problems worse. You can’t just ignore personal agency interacting with incentives just because the scale went up.

You have to consider effects on incentives for future behavior and “willingness to pay”, when it becomes a black hole of government spending for everything because it’s labeled a “chronic disease.”

In this case, individuals being shielded from bearing the cost of their poor lifestyle decisions will almost certainly make things worse.

A long life into old age costs the taxpayer a lot more. Smoking and obesity are cost saving for society. Nothing is more expensive than 10 years in assisted living.

Neither of those facts remotely modifies the argument I presented about incentives.

Assisted living and end-of-life care should also not be subsidized by taxpayers. Entitlements need reform across the board.

Perhaps they do. But in the current climate, smoking and heart disease save money for everyone.

It may be true for the retirees who reverse-mortgage their house and go on cruises around the world, but if the elderly do what they've done historically, they can be a welcome support in inter-generational homes, helping their children raise more grandchildren.

You'd have to factor the cost of that lost fertility before saying that the elderly are a net cost per year. There are some other benefits that the elderly provide, as outlined in this article.

Elderly people being a net cost on society would just be an additional sign of a sick society. I'd be surprised if a successful grandma who supports children and grand-children 'cost' more to society than a childless woman in her 40s.

I am speaking in healthcare costs. Also, Multigenerational households consistently make up about 3.8% of all households in the US. https://imgur.com/Cgv9Lrm So it really shouldn't factor into accurate cost saving simulation of costs. If that is a sign of a sick society, then we are terminal and in hospice already. It is just a true fact that the elderly take more than they give and it is much cheaper to have people die at 65 from smoking or heart disease.

I don't think that is GOOD thing! Far from it, but raising rates on fat people and smokers to save money is actually going to cost a lot more money. So if you want to save people from themselves, great, but it isn't for the ratepayers or the taxpayers.

Well healthcare costs are over-inflated anyway. Hospital systems, doctors and Big Pharma writing themselves blank checks off the government or third-party insurance.

Multigenerational households consistently make up about 3.8% of all households in the US.

From my personal experience, parents of families with grand-parent help look at least 30% less stressed-out than the ones without. Not necessarily in a same household.

I'd expect multigenerational households to have lower healthcare spending for the elderly: younger relatives can look after them, notice any serious health issues, and social interaction is important for health outcomes.

Instead of promoting obesity to decrease healthcare spending, I think it'd be preferable to promote family unity, as this would also help with the drop in birthrates.

It seems that the West will be a theocracy again or it will stop existing.

I agree that "it takes a village" and parents and kids have suffered from not having it in the nuclear family system we have fallen into in the states. I'm not promoting that as an end goal, just as I am not promoting the idea that we should have people smoke and overeat to die sooner and reduce the surplus population.

I am pointing out that it is silly to think it would save the taxpayer any healthcare money to incentivise healthier living in the current environment due to the cost of elder care being crazy high. If your Dad smokes you might get an inheritance, if he doesn't you and the taxpayer are on the hook for 10 years of declining mobility in a retirement home at 8k a month and 5 years of dementia in a 20k a month memory care unit.

if he doesn't you and the taxpayer are on the hook for 10 years of declining mobility in a retirement home at 8k a month and 5 years of dementia in a 20k a month memory care unit.

Or just bring him home. People pay for these things because they have too much money to know what to do with it.

And you know, maybe the next time a 'deadly' pandemic that's mostly fatal to the very elderly comes around, maybe just don't freak out as much?

More comments

The degree of personal responsibility does have an important policy implication - who pays? If someone is completely blameless for the state of their health, it's reasonable to say that it's deeply unfair that they be charged more for medical insurance, or even that they should pay more for medical care than someone that isn't utilizing those services. If, on the other hand, people carry the weight of their own choices, Hovde's suggestion seems correct.

One could do away with this concern by declaring that no one should pay for medical care and it should always be government spending or that government should pay for zero healthcare and to each their own, but neither of these is going to win in the United States anytime soon.

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