Health and Social Justice

Recently I heard a radio story about health in the Mississippi Delta region of the United States.  You may know that in a national health index, Mississippi comes in dead last among 50 states: America's Health Rankings.  "Dead last" is an expression I use advisedly since the practical expression of that low health ranking is that the average age of death in Mississippi is several years lower than in the rest of the country. 

Several years.  Think about it: would you want to give up several years of health and well-being, several years in which you could experience life and watch children and grand-children grow?  Do you want to be in a situation where government policies and food business practices limit your choices and make that more likely?

A New York Times article titled What Can Mississippi Learn from Iran? reports: "A Mississippi black man’s life expectancy is lower than the average American’s life expectancy was in 1960. Sixty-nine percent of adult Mississippians are obese or overweight, and a quarter of the state’s households don’t have access to decent, healthful food. Adequate grocery stores can be 30 miles away. In one of the country’s most fertile regions, people sometimes have to shop for their groceries at the gas station. Consequently, Mississippians are dying from diabetes, hypertension, congestive heart failure and asthma. Shirley points out that in the 1960s people starved, and today they die from food."

These appalling and sad facts about Mississippi are reported at a time when "In the last decade, the Annual Improvement in America's Health has declined (a whopping) 69% compared to the 1990s." (America's Health Rankings). 

Scary? Yes! Instructive? Absolutely! Prophetic? I believe it is.  Motivational? It can be. 

Scary: "In the 1960s, people starved...today they die from food."  I do believe this, and it is scary.  An article in The American Journal of Clinical Nutrition presents these facts: "In the United States, chronic illnesses and health problems either wholly or partially attributable to diet represent by far the most serious threat to public health. Sixty-five percent of adults aged ≥20 y in the United States are either overweight or obese (13), and the estimated number of deaths ascribable to obesity is 280184 per year (14). More than 64 million Americans have one or more types of cardiovascular disease (CVD), which represents the leading cause of mortality (38.5% of all deaths) in the United States (15). Fifty million Americans are hypertensive; 11 million have type 2 diabetes, and 37 million adults maintain high-risk total cholesterol concentrations (>240 mg/dL) (15). In postmenopausal women aged ≥50 y, 7.2% have osteoporosis and 39.6% have osteopenia (16). Osteoporotic hip fractures are associated with a 20% excess mortality in the year after fracture (17). Cancer is the second leading cause of death (25% of all deaths) in the United States, and an estimated one-third of all cancer deaths are due to nutritional factors, including obesity (18)."

In an early post, I mentioned that my grandmother died at a relatively young age from colon cancer.  That event probably drove much of my lifelong interest in health.  Today I believe her cancer was in large part a "foodborne illness."  I believe that the American diet is at the root of much of the disease I see around me, among people whom I love, and it is a problem that is growing exponentially.  These levels of disease and death, the wasted potential and the cost, are sad and unnecessary and...yes, scary.

Instructive: As we connect the dots between changes that began to occur in the American diet in the early years of the 19th century with results that began to manifest dramatically by the 70s, we learn more and more about the specifics of the relationship between food, lifestyle and health.  The idea that processed foods, "bad" fats, low fiber and over-consumption of salt and sugar damages our health and causes many chronic diseases is no longer an intuition based on anecdote.  It is documented fact.

Prophetic: Classical biblical prophecy not only reminds its constituency of moral imperatives but suggests what the future may hold depending on current behaviors.  From What Can Mississippi Learn from Iran?: "Sixty years ago, Mississippi, the country’s poorest and most racially divided state, was “the standard by which this nation’s commitment to social justice would be measured,” the historian John Dittmer wrote."  Briefly, the case presented in the article is food which is cheap (as a result of government policies and food business practices) is what is primarily available to the poor.  The result of those policies and practices is higher levels of obesity, more chronic disease and a shorter lifespan.  People with money (and who, statistically speaking, are better educated) have the possibility of making other choices -- although other statistics show clearly that they aren't always making the better choices.  The health statistics from the Delta remind us of the imperative to be concerned for the poor, who today "die from food" -- and suggest a grim future for us all if we continue to support, actively or passively, the same policies and practices.

Motivational: I hear or read these things, and I think, "What can I do?" 

When I first heard the radio report, I thought of food and lifestyle.  As Michael Pollan highlighted for me in The Omnivore's Dilemma, political decisions directly impact our health and culture, often in unforeseen ways.  I'm thinking specifically of the way in which corn was so heavily subsidized beginning in 1973 under the Nixon Administration and Agriculture Secretary, Earl Butz. The cost of food had gone up, and corn subsidies were a politically expedient solution.  As growers grew more corn -- and food manufacturers used more of the cheap product -- "food" (more and more corn-based) prices went down, and it took pressure off the current government.  Michael Pollan and others show how this decision drove the increase in diabetes and obesity and what we now know are related diseases.  And yet...corn continues to be heavily subsidized, while tomatoes and yams and spinach, for example, are not.   We all know how political positions are a reflection of our values -- but what about our responses, or lack of response, to unintended consequences of political decisions? Isn't this also a statement of our values?

Increasingly I feel a growing consensus that there is a problem -- and that our diet is one very significant part of the problem.  My grandmother had so much to offer...and like many others lost years of precious time to offer what she could have.  As I make the connection between a diet that leads to disease...and government policies and business practices...and make the further connection between those policies and practices and important values I was taught we hold as a nation, I am motivated to do something. 

My first thought was rather grandiose, a personal project somewhat along the lines of those who flocked to Mississippi to help out after Katrina.  I could go to Mississippi and find a way to provide information and assistance to those who need it.  As the New York Times article suggests, though, non-local people are regarded with some suspicion, not to mention, I have responsibilities here.  Not a realistic option and probably not a terribly helpful option. 

And it's not just Mississippi.  This particular health crisis increasingly affects the whole country:  "In the last decade, the Annual Improvement in America's Health has declined 69% compared to the 1990s." And as other countries and cultures are infiltrated by modern processed foods and move away from traditional diets, their statistics for chronic disease and average age of death are also changing.

Genesis tells us that Adam was placed in the Garden to till it and enjoy its fruits. It seems that in our arrogance and greed, we have in fact poisoned it, and the effects of that poisoning as always are most devastating to those less able to help themselves.

So what to do?  I'm just one person.  As one person, though, I have one vote. I can educate myself, and then I can vote for those candidates who demonstrate awareness of the now known devastating effects of certain government policies and food business practices.  I have purchasing power.  I can refuse to purchase those products which are implicated in the deterioration of the food chain.  I can, within the limits of my budget, make it a point to purchase only wholesome, or at least more wholesome, products.  I can find ways to share what I know with others.  When enough of us are exercising our "power of one," we will have an impact beyond ourselves and our own lives. 

What I most love about my cafe is that it gives me an opportunity -- as one person -- to cook in a way that I know is healthful and offer it to people.  On the grand scale, it is a miniscule contribution to making the world better, but it is what I can do.

The article, What Can Mississippi Learn from Iran? , is excellent, btw, and I highly recommend it.  It describes an important project initiated by the "power of one". I'd like to hear your ideas about what we can each do.