The Black Lives Matter ("BLM") movement's core message is that blacks across the gender spectrum are inherent to America's fabric and deserve better than disparate and inexplicably deadly treatment by a justice system constitutionally mandated to treat all Americans equally. The BLM movement has been so effectively organized, issue-oriented and influential that it even commands the attention of presidential hopefuls. Yet black lives, a durable fiber of our nation's history, are also fraying due to stresses beyond the criminal justice system, with many of the root causes directly related to health.
Cultural and ethnic disparities in the U.S. health care system -- from differences in referral for cardiac catheterization to breast cancer survival -- are well documented. But some of the disparity-causing conditions in life expectancy between whites and blacks develop long before visits to the hospital. At the top of this list is the prevalence of obesity within the black community.
The Centers for Disease Control ("CDC") reports that nearly half of non-Hispanic blacks are obese (47.8 percent), compared to non-Hispanic Whites (32.6 percent). Of U.S. Hispanics, approximately 43 percent meet the body mass index ("BMI") definition of obesity. Being obese significantly increases one's risk of developing Type 2 diabetes, heart attacks and strokes, which make up the 1st, 3rd, and 4th leading causes of death among African Americans (homicide is 8th).
While some of this disparity in obesity prevalence can be explained away by the fact that many blacks and Hispanics live in low income food deserts, surprisingly, higher-income black and Mexican-American men are more likely to be obese as their incomes increase. And although often discounted as a cosmetic issue, obesity or even being moderately overweight should be treated as more of an economic one. Like the effect that incarceration or not having a college degree has on one's job prospects, the direct annual medical costs for obese patients may be as much as $1,429 higher than their non-obese counterparts.
This is where movements like BLM could take a strong and visible lead. Given BlackLivesMatter's success in placing a spotlight on aggressive and disparate policing in the African American community, this same disinfecting light could also be shone on: (i) the vast food deserts surrounding many black communities and how to best provide healthy food oases; (ii) increasing Federally Qualified Health Center (FQHC) funding and state spending to improve low-income access to trained nutritionists and dietitians, whose intensive team-based therapy interventions are often more effective than physicians' counseling; and (iii) pushing for a serious, and politically brave Congressional review of how to adjust our current structure of agricultural subsidies so as to not add cheap, concentrated calories to foods ranging from some whole grain breads to low fat yogurt. Such moves would not only help blacks, but all patients, as well as federal and state governments and insurance companies, which would benefit from reduced healthcare spending on chronic diseases.
And just as BLM has elevated disparities issues nationally, locally, our community institutions can do more to make black lives as healthy as possible. Imagine people marching in the streets or community organizers huddling to strategize on how to end obesity in the black community. Some healthier routines could even be woven into our already common social routines: churches and mosques could invite nutritionists to advise on low sugar, low fat recipes and competitions could be held for healthy baked goods. Sunday sermons could occasionally be delivered during neighborhood walks and congregations could sometimes replace their Sunday best with jogging suits.
Many practical, low-cost interventions need to be contemplated and operationalized -- some by governments and others by us individually -- to decrease disparities in multiple facets of American life. Specific to the African-American community, we need to concentrate our efforts on high impact areas like the criminal justice system and preventive health, which is ending many of our lives just as fast and at higher volume. By working together, these movements can be translated into sustained, positive change.
Now, I'm off for a swim and a search for a food oasis.