The middle class or higher group people in my life often take care of their health, work out, eat right, etc. They ride bikes, stay active, walk a lot, etc.
The idea that its purely healthcare dollars at work here is unrealistic to me. I think there's more at play here and the knee-jerk answers that are political correct is often wrong. Especially post Obamacare, where so many are now insured and go the same doctors and hospitals everyone else goes to.
Economic changes over the last couple decades mean college students today are poorer than ever on the balance sheet with $100K of college loans etc, but have wealthy people level cash flows. So when your tuition alone is $30K, you can squeeze the bank for an extra $6 for a big mac at any time. Or all college students today have new iphones, new macbooks, etc. But this is a very new phenomena and has lead to weird cultural beliefs among the very young (say gen Y and younger), like "all poor people pig out on junk food" because modern college students think they experienced real poverty in school when they used the same macbook for two years instead of upgrading every six months like the rich kids (LOL).
There are weird statistic warping exceptions, like homeless people have no where to cook or eat, so they disproportionately eat at McDonalds. Also, for very poor people, an occasional trip to the McDonalds for a value meal is like my occasional trips to the $200/plate steakhouse, so their intake skews junkfood, but its very low. And there are the struggling addict types where the money is getting spent in the next 5 minutes and if its not food in the belly it'll be injected death so they skew toward junk food as a preventative.
There is some truth to poor people are often poor because they find ways to waste money, and junk food being a very expensive way to eat, it is in itself a minor status symbol in that culture. My class level would show off the expensive watch my aunt bought me when I graduated, even though my people never wear watches anymore, but they'd show off they bought an entire 2L bottle of corn syrup soda, because, thats what they can afford and their peers can't afford.
http://www.washingtonpost.com/wp-dyn/content/article/2008/02...
http://ajcn.nutrition.org/content/79/1/6.short
http://archpedi.jamanetwork.com/data/Journals/INTEMED/12037/...
http://www.sciencedirect.com/science/article/pii/S0002822307...
Have you ever had to deal with the healthcare system from the bottom? Even with "Obamacare" it's a nightmare. Unless you have fairly high quality health insurance, you tend to be limited in which doctors you can go to. So, no, the poor aren't suddenly going to the same doctors as the upper middle class. And the doctors that work with those cheaper insurance plans seem to, in my experience, have more patients and less time to spend with each. Quality of care is less, because it's an operation designed around high turnover rather than developing a relationship with each client, as is more common from a 'good' doctor, which tend to only accept better insurance plans.
So, certainly being poor vs being rich makes a difference beyond individual habits.
http://www.forbes.com/sites/judystone/2014/12/22/cuba-cost-e...