Episode 195: Obesity Uncovered: The Hidden Struggles in Minority Communities

[00:00:00] Welcome back to the Back on Track Achieving Healthy Weight Loss, where I help you get on track and stay on track with your weight loss journey. I'm your host, Dr. Alicia Shelly. So let's get started.

[00:00:28] Welcome back to the Back on Track Achieving Healthy Weight Loss podcast. I'm your host, Dr. Alicia Shelly. Now, April is National Minorities Health Month. And today we're diving into a critical topic, obesity in the minority communities. Why are obesity rates higher in a certain racial or ethnic group? And what role does culture, environment and health care access play?

[00:00:55] And most importantly, how can we break this cycle and create a lasting health change for all people? So if you have someone or if you or someone you love has struggled with your weight, this episode is for you. Let's talk about real solutions that work in our communities. Now, obesity is a growing health concern in the United States and minority communities are proportionately affected.

[00:01:24] According to the CDC, Black and Hispanic adults have the highest rates of obesity, with over 40% of adults in these communities being classified as obese. The Native American and Pacific Islander populations also have experienced high obesity rates. But why is this the case? Is it not just about individual choices?

[00:01:49] Or is there something deeper, systemic and cultural factors that are at play? Let's explore some of the key reasons behind these statistics. Now, the first reason why obesity rates are higher in the minority communities is the fact that number one, that there are food deserts and limited access to healthy foods. And many of the Black and Hispanic communities, fresh fruit, vegetables and healthy foods aren't as accessible.

[00:02:18] Or aka food deserts. So food deserts are areas with limited access to grocery stores that force families to rely on fast food or processed foods like foods that are in a can that are high in sugar and salt and unhealthy fats. Now, I live in the suburbs of Atlanta. But over the last few years, the grocery stores downtown Atlanta shut down due to arson.

[00:02:45] And unfortunately, after they repaired the arson, these grocery stores did not open back up. And therefore, the people that were counting on going to the grocery store, getting fresh produce, they were stuck in a lurch and severely affected.

[00:03:02] Now, in 2023, Emory University did a study and found that only 44% of small food stores, which is your mom and pop stores or convenience stores, offer fresh produce. And a big factor is your zip code with only 36% of stores in majority Black neighborhoods carry fresh produce compared to 61% in the non-majority back Black neighborhoods.

[00:03:30] Meaning in the non-Black neighborhoods, they had more fresh produce in the small stores than in the Black neighborhoods. And what that means is, is that there are many people who don't have access to fresh produce, especially if they live in a Black neighborhood. And nearly a million of people living in Georgia have limited access to a full service supermarket, especially in areas that are rural.

[00:03:57] Sometimes you see a dollar, a dollar supermarket or a dollar store, but you're not seeing your grocery stores. Or you're having to travel even further to find a grocery store. And if you don't have a car, you need to take public transportation to get to the store. And that can be a hardship on people, especially if you're working two jobs and don't have time to get to the closest supermarket to get fresh produce.

[00:04:23] Now, I do want to say that the city of Atlanta has recognized that this is a problem. And they have been working to get new grocery stores in the areas. They're working with community partners who have been approved to bring fresh food markets to these areas that are affected.

[00:04:41] And when we look at in 2015, where 52% of Atlanta residents lived within a half mile of the grocer, and 2020, 75% of Atlanta residents lived within a half mile of a grocery store. And so I know they're trying to improve that and approve more grocery stores in these areas. Now, the second reason why obesity rates are higher in minority communities is economics and time constraints.

[00:05:09] When you have families that are working multiple jobs, they're going from one job to the next, maybe sleeping a little bit and then going to the next job and dealing with financial struggles. Convenience often outweighs nutrition. Fast food can be cheap and accessible. You go through the line, 10 minutes, you're on your way. While fresh food, organic foods can be very expensive and you have to cook them and you have to plan for them. And so sometimes that time constraint can be difficult.

[00:05:39] The third reason why obesity rates are higher in the minority community is the cultural eating patterns. Food is a huge part of our culture. It's how we celebrate. It's how we connect and comfort ourselves. However, sometimes these traditional dishes can sometimes be high in calories, high in fats, high in salt and high in sugar.

[00:06:00] And instead of eliminating them, we do need to find ways to modify the recipes while still keeping the same flavors and traditions alive so that it can be healthy for us down the line. The fourth reason why obesity rates are higher is due to the mistrust in health care and limited resources. Many minority communities have a historical mistrust in health care, which leads to fewer doctor visits and missed opportunities for early interventions.

[00:06:29] Sometimes I have patients who, you know, they just come when something's wrong. They don't come from their checkup. They don't come from the preventative exam. And so sometimes we may see them every few years. And in that one visit, they have 20,000 problems. We can't get to the preventative stuff that may help them stay on this earth longer. And so we have to deal with what we can. And in some other communities, there's a language barrier where maybe the provider does not speak the same language as the patient.

[00:06:58] And so there is a lack of communication and a lack of cultural competency with the health care providers. A good example my friend told me was that when she was a medical student, there was this lady who was Hispanic and spoke Spanish primarily. And so when she would come in, they kept telling her that her kidneys are failing her, that she needs to do this better. She needs to change how she's eating. And then she was right back in the hospital. It was like a revolving door.

[00:07:27] And they couldn't understand why they were speaking to her in English and they slowed it down. But she primarily spoke Spanish. So when my friend was just happened to be on the team that was caring for this lady, did an interpretation, she actually explained to lady in her language what was going on. And the patient was like, well, why did anybody tell me I had kidney failure and that I should do this and do that? And it's because of the language barrier.

[00:07:52] Even though some people, they speak a predominantly different language, sometimes they don't want you to think that they don't understand or that they're not smart. So they may just be like, yes, I understand. And even some people who speak the same English as we do, the change in economic education level, they may not quite understand. So it's important for us health care providers that we number one are, if we have somebody who does not speak the same language as we do, make sure we have an interpreter.

[00:08:20] Because even if they bring their own family members, there's no telling what the family member is saying to them is the correct thing. And so because sometimes language doesn't actually correlate, you know, the different words don't correlate the same. So it's important that you have somebody who is a certified interpreter to interpret. But then also to make sure that you do a playback where the patient explains to you what they understood that you said, even if they are speaking English.

[00:08:47] Because like I said, due to different education levels, it may be that they don't understand and they don't feel comfortable asking you to repeat yourself or in a way that makes sense to them. The fifth reason why obesity rates are higher is there's less access to safe spaces sometimes. I've had patients to tell me that it just was not safe in their neighborhood to go walking because guess what? There's people who are getting mugged all the time and not every community has access to safe parks, safe gyms or recreation centers.

[00:09:17] And so if your environment does not support physical activity, sometimes staying active can be a real challenge. And so next, let's talk about how we can break this cycle, have sustainable health changes, even though we may live in an area that doesn't have, you know, fresh foods or in an area that may not be safe for us to exercise. And the good news is, is that we can take control of our health, starting with small, manageable steps.

[00:09:45] And so the first thing that we can do is make healthier food choices within our budget, because I get it. Sometimes fast food can be cheap, but it will be helpful for us in the future. It may be cheap now, but we may be having more issues down the line where we have heart disease, stroke, diabetes, because we've been eating this cheap food. So let's finding healthier choices.

[00:10:11] A good example of this is if we're eating white rice, maybe we can get brown rice or quinoa that we can substitute. If we're using herbs and spices or we're eating like lots of salt or sugar, we can switch that to more herbs and spices to still give us flavor in our foods, but less of the salt that can increase our blood pressure.

[00:10:31] Also, if fresh produce is too expensive, maybe trying frozen or low sodium canned options, which can be a great alternative because they can the food when they are at the highest ripeness. But get the low sodium so they're not putting too much salt in that can. The second thing we can do is modify traditional dishes for better health. Now, for example, I love collard greens, but growing up, they had all types of pork in there.

[00:10:59] So we can switch it to maybe adding some turkey nut or putting in some vegetable broth or things like that to give it still flavor and using vegetables to flavor the collard greens instead of using the pork. Also, if you love fried foods, maybe try using an air fryer or baking the foods instead. Reduce the sugar in your drinks like sweet tea or horchata and gradually start to cut back instead of quitting cold turkey. I do sometimes find if you stop something cold turkey, it makes it a little bit harder.

[00:11:29] But if you reduce how frequently you drink it, it makes it a lot easier. Try adding veggies to your meals like through your soups, your stews or stir fries. That way you can kind of sneak them in a little bit, especially if you have children who don't like vegetables. You can kind of sneak it in. Also, prioritize physical activity in your everyday life. If you can't get to the gym, try walking, dancing or even home exercises.

[00:11:55] I love to go to YouTube and like do some yoga, do some line dancing. It's on YouTube and I'm still at home. Also, you can try to take the stairs instead of the elevator. That's one way how to get more exercise or park a little bit further away in the parking lot and walk to the store or to your job. Also, try to incorporate exercise as a family or a community event. Invite your friends, invite your family to go. This can be one way you guys can join.

[00:12:22] You can have like a walking group where you all can talk about the day and still be able to exercise. Also, you can join a walking, a walking club or a dance class where you can still have that support of other people, but you're still getting exercise in. The fourth thing you can do to break the cycle is find a support group. Surround yourself with people who like to do what you do. If it's dance class, you guys go to the same dance class. You may be able to have that support.

[00:12:50] You get on their WhatsApp or their group me where you guys can chat about what's the upcoming class. Also, maybe get a health equity partner like either a friend, a spouse or co-worker who encourage you to stay on track, especially when it gets difficult. Also, seek out an online community or a local health program tailored to minority health or a Facebook group where you can find that support system to help you. And the fifth thing we can break the cycle is to advocate for health equity.

[00:13:20] Push for more healthier food options in schools, in your local stores, asking them to have fresh produce. Join the support community gardens or local farmers markets where you can get fresh produce from farmers locally. And then encourage better health access with your family and friends. Encourage them to go to the doctor for their checkup and be a representation in your community. I realize this is a lot, but decide to take one thing.

[00:13:47] Because obesity in the minority communities is definitely a complex issue. But we are not powerless. And it starts with small, everyday decisions. Choosing water over soda. Swapping fried foods from baked foods. Moving a little bit more each day. But choosing one thing to start with today. Change won't happen overnight, but every step forward is a step toward a healthier, stronger community.

[00:14:14] And if this episode resonated with you, I encourage you to share it with a friend and a family member. And I'd love to hear from you about what changes you are making in your life. Tag me on social media at DrShelliamd or leave a review sharing your biggest takeaways from today's episode. Thank you for tuning in to the Back on Track Achieving Healthy Weight Loss. Stay strong, stay committed, and stay consistent. And I'll see you all next time. Bye.