There’s been this one thing that has been nagging at me ever since I first saw it, about a year ago:
But a study published Tuesday in The Journal of the American Medical Association suggests that Southern cuisine isn’t serving African-Americans, whose ancestors imagined and perfected it, very well. The Southern diet may be at the center of a tangled web of reasons why black people in America are more prone to hypertension than white people.
Researchers from the University of Alabama at Birmingham crunched data collected from nearly 7,000 men and women older than 45 living across the U.S. — not just in the South — over the course of a decade. Their goal: to figure out why black Americans are at greater risk for high blood pressure.
Over the course of the study, 46 percent of black participants and 33 percent of white participants developed hypertension — and diet seemed to explain much of the disparity.
Black participants were much more likely than white participants to eat a Southern-style diet, which the researchers defined as one that heavily features fried foods, organ meats and processed meats, dairy, sugar-sweetened beverages and bread. And this diet was more strongly correlated with hypertension than any other factor the researchers measured, including participants’ levels of stress and depression, exercise habits, income or education level.
46% of the study’s black participants and 33% of the study’s white participants developed high blood pressure over the course of the study. That’s a 13% difference. Thirteen percent.
“If you think about [the] disparity — African-Americans’ life expectancy is about 3.5 or 4 years less,” said a professor at the university in question. Apparently, the diet is to blame.
What I don’t understand, is how you draw that conclusion about one segment of the population when the rate of heart disease across the country has been on the rise for at least a decade, completely irrespective of race, gender, or geographic region[1].
What’s more, I’m not sure how you write off the socioeconomic aspects of health disparities, when Black people in America are far less likely to have the kind of health insurance that would help provide care for those who do present early symptoms of chronic illness[2].
Having the kind of job that affords you access to health insurance is already a privilege. States with the highest number of uninsured residents also happen to be, like Alabama, states that ban unionized labor, one of the few ways in which residents can ensure they have quality health care.
There is a crisis happening in this country—we collectively rely on the products of a food industry that sells us items engineered to be consumed and digested rapidly, craved to an unhealthy degree, contributing to the increasing rates of chronic illness for everyone. Only the ones with the ability to access and afford the freshest of produce as well as having the time and skill set to cook it are able to escape it.
If that’s the case, what’s with the need to single out Black people? I have a guess.
The Southern Diet, the one that black people are “more likely to eat,”[3] is not even remotely different from any other culture-centered diet in terms of macronutrient profiles. Lots of produce, lots of bread to accompany that produce, and lots of non-premium cuts of meat. What is different, and what has changed over the course of cooking those meals in America is the quality of the ingredients. There’s an abundance of fillers, preservatives, different kinds of salt, and added sugar to “make it taste better.”
And every cultural staple in America has had this infusion of additives: pasta, tortillas, pitas, and more. The additives make it easier for the food to be enjoyable even though it has had the most filling elements—read: most important—removed: protein, fat, and fiber. Pasta, often made with semolina flour and egg, has been reduced to flour and additives and water; corn tortillas, reduced to the starchy parts of corn and some additives, and don’t even get me started on flour tortillas. They’re just made differently now.
Actually, every food is made differently now. It’s what’s contributing to the problem of chronic illness.
However, it is a special kind of pattern when we isolate a particular negative trait and claim that the reason a certain population experiences it is because they indulge in their own non-white culture.
The collective understanding of white supremacy—and all those who seek to benefit from it—has one mandate: every time you see a non white, non-anglo saxon, non-straight, non-protestant person or collective suffer, explain away their pain by proclaiming it’s because of their refusal to give up their non-white, non-anglo-saxon, non-straight, non-protestant ways: ways of dressing, ways of worshipping, ways of communicating, ways of eating. And this is how, even as everyone is experiencing higher rates of chronic illness, Black people’s specific suffering is due to their own cultural foodways, even when that chronic illness hasn’t existed over the entire course of Black people eating that food and those rates of chronic illness only appeared around the same time as the explosion of processing in food.
When you make a problem “a Black problem,” it stops being a “national” problem to be solved by everyone, because it is a “community problem” that is caused by their community. I don’t have to care, they think. That’s their problem, they think. They need to just…, they think.
This ultimately means that white supremacy treats basic human instincts like “empathy” like a scarce resource—we’re saying we don’t have to care about your community and what happens to you.
When medical research employs this approach, isolating the health conditions of a particular population and blaming it on their culture instead of the far more realistic reason of disparities in access to health care, it operates in service to white supremacy and further foments the distrust that marginalized populations have in health care and science altogether. It absolves medical science and the health care industry of its responsibility to strategize to reach, touch, and save those beyond the few who can afford it. It’s not a we problem. It’s their culture.
It is dangerous, scary, and irresponsible to use the reputation of a major institution to perpetuate the myths that white supremacy creates about culture and community—to pretend that culture causes harm that increased access to care could not cure. We have to not only call that out at every turn, but we have to counter it every chance we get. The integrity of medical science and health care are at stake if we don’t.
Photo credit: Flickr / Jennifer Woodard Mazerado
Footnotes:
[1]—“The death rate from the chronic, debilitating condition rose 20.7% between 2011 and 2017 and is likely to keep climbing sharply, according to a study published Wednesday in the journal JAMA Cardiology.
The rapid aging of the population, together with high rates of obesity and diabetes in all ages, are pushing both the rate and number of deaths from heart failure higher, the study said. Most deaths from heart failure occur in older Americans, but they are rising in adults under 65, too, the study showed.” — Wall Street Journal, October 30, 2019 (Click here to return to paragraph.)
[2]—Prior to the [Affordable Care Act (ACA)], about 19 percent of the non-elderly US population was uninsured (Clemens-Cope et al. 2012) but the prevalence of uninsurance differed substantially by race or ethnic group. About twenty-percent of African Americans were uninsured. In comparison non-Hispanic whites had an uninsurance rate of about thirteen percent (KFF 2013). About 18 percent of Asians were not insured. Hispanics had the highest prevalence of uninsurance; about a third of Hispanics living in the United States were without health insurance. Researchers cite low income and propensity to work in jobs with no health benefits as the primary causes for high uninsurance rates among African Americans (Institute of Medicine 2003). Studies say that these low-income jobs pay too much to qualify for public assistance but pay too little to be able to afford private insurance policies leaving individuals and families to live without coverage (Edin and Kefalas 2011). [Sohn H. Racial and ethnic disparities in health insurance coverage: Dynamics of gaining and losing coverage over the life-course. Population Research and Policy Review. 2017;36(2):181–201.] (Click here to return to paragraph.)
[3]—Can we cut the bullshit right quick and acknowledge that ain’t nobody on Aunt Pookie’s Earth eating nothing but soul food three times a day, seven days a week? She might cook Sunday, and that food might last until Tuesday for lunch. Why? Because soul food is so labor intensive, there’s no possible way anyone is cooking it often enough that all they’re eating is soul food. It is literally impossible. (Click here to return to paragraph.)
