Systemic Racism and Obesity

Hey everyone! It's Dr. Angela here. I wanted to talk to you today about how systemic racism affects obesity. 

I had a three part series on the food industry that I had planned to talk about in succession. Last week, I talked about how they create cravings. Today, I was going to talk about how they market convenience, and then next week I was going to talk about how they market to children. Instead with everything that's been going on, I wanted to shift gears a little bit and talk about how it is that systemic racism affects obesity. It's a really poignant topic right now. We have a lot going on! And I’m wondering what kinds of challenges people of color may experience when it comes to their efforts to lose weight. So I would invite you to comment about it if you’re a person of color, let me and others know what it’s like for you and if you’ve experienced any discrimination by health care professionals.

I realize that there's a lot that I personally, as a white woman, don't understand about racism. Many years ago I worked as an epidemiologist at the Washington State Health Department. One of my tasks was to write about the Social Determinants of Health for a broader report on the Health of Washington State. My research led me to a disheartening conclusion: That basically, it’s very difficult for minorities to be healthy. It’s not impossible, but it’s definitely difficult, because there are so many factors stacked up against them.  

1. Overall obesity prevalence rates are higher in minority communities. While 38% of white women have obesity, 55% of black women and 51% of Hispanic women have obesity. For men, rates of obesity are similar among black and white men (37-38%), but higher for Hispanic men. 43%. (*Kuminyika Am J Public Health. 2019 October; 109(10): 1350–1357.)

2. Poverty. Non-whites experience poverty at higher rates than whites. And let’s face it, In the US, nutritious food is more expensive than junk food. That’s not true in all countries, but it is true here. One of my patients used to live in Chile I believe, and he told me that it was way cheaper to go to the farmer’s market and buy fresh produce, and that a box of cake mix was expensive, it cost the equivalent of about $6. That’s not true here in the US. Just go to Mc Donald’s where you can get a meal off the dollar menu. Easy and cheap! 

3. Food Deserts: Here’s something else: Research shows that minority communities are disproportionately located in food deserts. So what’s a food desert? The government defines a food desert as an area where 33 percent of a city’s residents live more than one mile from a supermarket and 20 percent earn salaries below the poverty line. Many residents of food deserts — which are disproportionately located in communities of color — do not have cars and lack access to public transportation, making it difficult to get to a grocery store. So these areas have fewer supermarkets and more small grocery stores with very little whole food options. Fast food and unhealthy food options that are marketed as cheaper and more easily accessible in small stores become more desirable. As a result, the obesity rates in these areas are generally higher, meaning life-threatening illnesses like diabetes and heart disease are on the rise.

4. Increased food advertising to minorities: I’ve been thinking a lot about the food industry lately, and their marketing tactics. A study came out last year ….. From 2013 to 2017, spending on TV advertising for restaurants, food and beverages directed at black teens increased by 50 percent — from $217 million to $333 million — underlining the disparity in exposure to advertising between white and black teens.

Another study that looked at TV advertising in 2017 found that 80% of the $11 billion dollars in food ads were for fast food, candy, sugary drinks and unhealthy snacks. The top companies that were targeting the black market were Taco Bell, Dominos, Burger King, Wendys and Arbys. 

“The marketing is so pervasive that it’s almost invisible,” Kumanyika told NBC News. “I’m not sure it’s really widely known in black communities that this amount of money is being used to promote unhealthy products. Some companies spend quite a bit of money to endear themselves to these communities that they don’t even give public health organizations a chance.”

I’m not sure what the answer is here, short of a complete reformation of the food industry and their marketing…a shift in how we subsidize and price food… there is no reason why healthy food should be more expensive than junk food except for how easy it is to produce it, and that has to do with the how we subsidize food production. There is also a lot of work to be done to make health care more affordable. 

So I believe that a lot of the reason for the higher prevalence of obesity among people of color has to do with systemic racism. I’ve pointed out a few obvious factors here, but I’m sure that this list is simplistic and is only hitting the tip of the iceberg. I feel pretty sure that people who are living in situations where they fear for their life are not going to be able to consider their food choices with any sense of preventing future disease. That’s just a fact.  

So, these problems are big. And I for one am glad to see that we are gathering the political will to change things, to end the systemic prejudice and discrimination that has been going on for generations. I think one thing we can do is to demand that the food industry stop marketing junk food to minorities and children. I would boycott these companies that target blacks in their advertising. Taco Bell, Dominos, Burger King, Wendys and Arbys. If you care about your health, you shouldn’t be going to these places anyway, but it makes sense to spread the word that these companies are specifically targeting blacks and other minority communities.  I see a lot of reason for hope. 

There is one other thing I want to ask you, and this is specifically to people of color This is a painful question to ask but I need to know the answer or I can’t change. Have I personally or has member of my staff ever done anything discriminatory? In other words, have you ever felt any discrimination coming from my office or from this platform? If so I want to know about it. What I’m discovering is that because this problem is so systemic, those of us who are white may be doing things without even realizing it that are very hurtful. So let me know if that’s the case. I’m in a mentorship program that will be providing some diversity and inclusion training for us by Trudy LeBron, who is highly regarded. So I’m looking forward to learning a lot from her. But in the meantime, I want you to let me know how we might improve. 

Please follow this link to find "5 Dirty Little Secrets The Food Industry Doesn't Want You To Know" to learn more about what the food industry is doing to keep you and your children addicted to unhealthy products!

To your health!

Dr Angela