Three Essays on Obesity: Food Environment, Attitudes toward Food, and Cash Transfers

This dissertation analyzes determinants of obesity and a cash transfer policy to alleviate poverty and its effects on obesity. I used data from the United States and Mexico to highlight evidence from two countries that are neighbors but very different in their socio-economic makeup. In the first chapter, I examined the relationship between the number and type of food outlets in a neighborhood and dietary intake and body mass index (BMI) among adults in Los Angeles County. I also assessed whether this relationship depends on the geographic size of the food environment. I found little evidence for associations between proximity of respondents’ homes to food outlets and dietary intake or BMI among adults in Los Angeles County. A possible explanation for the null finding is that shopping patterns are weakly related to neighborhoods in Los Angeles County because of motorized transportation. In the second chapter, I investigated pathways linking consumer attitudes toward food (nutrition, taste, freshness, and preparation time) and BMI through physical activity and diet quality among adults in the United States. I found that the importance of nutrition relative to price is the only consumer attitude significantly associated with BMI and diet quality. No consumer attitudes were significantly associated with the level of physical activity. Socioeconomic status influenced BMI, diet quality, and physical activity both directly and indirectly. These results suggest that the problems of excess weight and obesity could be reduced by implementing policies that change the perception of the nutrition of healthy and unhealthy food. In the third chapter, I analyzed the effects of a cash transfer program on the obesity and diet of a highly-vulnerable group in a middle income country: persons aged 70 and older in Mexico. Two cities in the state of Yucatan, Valladolid (treatment) and Motul (control), were selected for the cash transfer experiment. Elderly residents of Valladolid were provided the equivalent of an additional $87 per month, a 44% increase in average household income. Relative to the control site, there was a significant decrease in the prevalence of anemia in the treatment site, but no effect on obesity in the short run. I also found that the program reduced the demand of tortillas --a food with high caloric content--, and decreased food insecurity. These findings