Rebecca (second from left) shares community
with Shani Toor, Jimmy Hannigan, and Kelly Litt.
Almost
every time I make a home visit to one of my patients, something that I discuss
with them, or educate them on, is a healthy diet. The vast majority of my
patients are on a special diet, such as a “low sodium diet” or a “Diabetic diet.”
Sometimes the specific prescribed diet is a result of a health condition that
already exists, and sometimes it is to prevent the individual from developing a
health condition once warning signs are present. Even if a patient is on a
regular diet, discussing a healthy and balanced diet is part of my plan of care
for each individual.
Recently,
I was discussing diet with a particular patient of mine in the Bronx whom I
will call Beth. Beth is diagnosed with many diseases such as morbid obesity,
Type 2 Diabetes Mellitus, and hypercholesterolemia, or high cholesterol. Ideally, Beth should be very conscious of the
amount of sugar, fat, cholesterol, and salt that she eats.
Knowing
that Beth’s diet largely consists of snacks or junk food, I asked Beth what her
favorite snacks are.
“I like
cookies. I eat them a lot. Also…I eat a lot of potato chips and popcorn,” she
said.
“What
kind of popcorn do you eat, Beth?” I asked.
Beth
replied, “I like the Movie Theater Butter popcorn that I make in the
microwave.”
I said,
“Okay. Remember, we’re going to start by making small changes in the food you
eat, Beth. Would you be willing to eat the ‘Light’ or ‘97% Fat Free’ popcorn?”
“Yes,
but they don’t sell that in the store here,” Beth said with a disappointed look
on her face.
“How
about rice cakes, Beth, can you buy some of those next time you go grocery
shopping? Those are a tasty snack and they’re a lot healthier than potato chips.”
“Nope,”
Beth said, “They don’t have those either.”
This
conversation is just a glimpse into a situation that I frequently encounter in
my ministry.
Rebecca prepares to care for clients in their homes.
Think
about food. Food is universal. Food is a reflection of our cultural and familial
traditions. Recipes are passed down from generation to generation and bring
comfort to us. Food is used in celebrations and is offered as a gift to those
we love and care about. Eating certain foods can change our mood and can
resurface memories that were formed long ago.
Food is
powerful. Think about how the economy, politics, and many wars have revolved
around food or crops. Food not only drives the world in many ways, but it
drives our bodies. Food nourishes us and provides the fuel we need to live our
day to day lives. Many say that food also nourishes our minds and spirits. I am
constantly amazed by the effect that food has on one’s health. A few examples
of some of the diseases that are directly related to a poor diet include
obesity, hypertension, and Type 2 Diabetes Mellitus.
My
heart hurt when Beth told me that she was unable to buy certain foods that are
usually common, at least in other parts of the country. Generally speaking, it
is very difficult to get my patients to be willing to change their diet at all.
Beth was now at a point in her life in which she was starting to understand the
impact that her poor diet was having on her health and told me that she wanted
to start making some small changes in her diet. My heart hurt not only because
Beth is unable to purchase these healthier snacks, but because I know that if
she lived elsewhere she would easily be able to.
Granted,
Beth does have access to some sort of grocery store and a variety of foods,
which makes her more fortunate than many individuals in the world. The Bronx
has an abundance of convenience stores that mostly sell unhealthy snacks and
sugary drinks. There are very small grocery stores around the Bronx that have
small sections of out of season and often overly ripened produce. In the
warmest months, one can also often find produce carts and stands on some street
corners.
But
compare this to another New York City borough, Manhattan. There are four Trader
Joe’s grocery stores and at least five Whole Foods stores in Manhattan. There are
zero in the Bronx.
Let me
offer a personal example. The closest grocery store from the Bronx Community of
Dominican Volunteers in which I live is half a mile away. My community members
and I are able to walk to the store with a cart or carry bags home as we need
to. Imagine an individual with impaired mobility or severe respiratory issues
attempting to make a one mile round trip, which is filled with steep hills, to
a grocery store. For many individuals who live in the Bronx, such a journey is
an unrealistic concept. However, they are
able to walk down to the corner convenience store to pick up some packaged
snacks that satisfy their hunger.
Rebecca collects items for her visits with clients.
The United States Department of Agriculture states,
“Food deserts are defined as parts of the country vapid of fresh fruit,
vegetables, and other healthful whole foods, usually found in impoverished
areas. This is largely due to a lack of grocery stores, farmers’ markets, and
healthy food providers. This has become a big problem because while food
deserts are often short on whole food providers, especially fresh fruits and
vegetables, instead, they are heavy on local quickie marts that provide a
wealth of processed, sugar, and fat laden foods that are known contributors to
our nation’s obesity epidemic.” As you can imagine, living in a food desert
presents a variety of complex challenges and effects on one’s health.
After personally facing the challenge of
living in a food desert of some sort for the past nine months, as well as the
challenges my clients face in healthy eating, I found myself asking the
question, “Why is the Bronx a food desert?” Some theories suggest that land-use
policies and lack of demand lead to the existence of food desserts. For
example, individuals on a low-income budget would be unable to complete their
weekly grocery shopping trip at a store such as Whole Foods. So, those stores
do not exist in poor areas. Then I wondered, “Why can’t existing grocery stores
have a larger selection of fresh produce?” There are many possible answers to
this question. Again, it seems demand drives supply. If people are not
purchasing produce but are purchasing packaged junk food, grocery stores will
stock those items and reduce the amount of produce available. If we do not
provide education regarding nutrition and healthy, balanced diets, many
individuals will not be aware of the importance of what they eat.
So what can we do about the availability of
healthy and nutritious food options, or lack thereof? First, I believe that
it’s extremely important to educate yourself on this issue. It’s also important
to support the education of others, such as providing nutritional education in
high school health classes. We can encourage programs such as WIC (Women,
Infants, Children) and SNAP (The Supplemental Nutrition Assistance Program) to provide
education on nutrition and increase the amount of vouchers provided for produce
and other healthy foods. We can ask farmers markets to accept food stamps as a
form of payment and we can volunteer in community gardens. I encourage you to
write letters, attend town hall meetings, and vote on legislation regarding the
availability of healthy foods.
Food is
a complex issue, and surely the answer to this issue will be as well. I am
encouraged every time I see a father helping his daughter to eat a banana on
the way to school in the morning and every time I see a mother include her son
in grocery shopping for healthy foods. I gain hope from the people who are
devoting their time and energy to this issue, ranging from the elderly man
volunteering in his community garden to First Lady Michelle Obama’s dedication
to health and fitness programs. I challenge each of you to take some time to
learn about the food you eat and the availability of healthy food in your
community. I encourage you to plant an extra row of vegetables in your garden
this Spring that you can donate to your local food bank. I invite you to become
an active participant in this journey. I think you’ll find it rewarding, and
you’ll certainly discover the opportunity to be of service to others.
Here
are some links for more information:
