Could it also be that the reason for the disproportionate burden, hospitalization and death from COVID-19 on African American and Hispanic populations is that these communities often live in food deserts and food swamps, survive on Supplement Nutrition Assistance Plan (SNAP or food stamps), which provides much assistance but little nutrition. Seventy five percent of the SNAP benefits are used for ultra-processed food and ten percent for soda (or about $7 billion a year).
In Chicago and Louisiana, 70 percent of COVID-19 deaths are in African Americans who make up only about 30 percent of the population in those communities. Deaths in predominately black counties are sixfold higher than white counties.
A legacy of poverty, lack of access to healthy food, health care, living wage employment, inadequate housing, and race based advertising and targeting of minorities by food companies, or what are referred to as social determinants, explain these health disparities, not race. On a good day life expectancy in African American communities burdened with poverty is up to 15 less than average. And today is not a good day.
The highest rates of obesity, diabetes, and chronic disease are found in the African American, Hispanic, Native American, and poor communities. In the last decade, type 2 diabetes rates have tripled in Native American children, doubled in African American children, and increased 50 percent in Hispanic youth. Native Americans, Native Hawaiians, Pacific Islanders, and Asians are also twice as likely as Caucasians to get diabetes. And African Americans are more than four times as likely to have kidney failure and three and a half times as likely to suffer amputations as whites.
Why are minorities suffering so much? An insidious but subtle form of racism is harming their health and their communities, but few, if any, are asking the tough questions. It’s a topic I address in depth in Food Fix.
Food & racism
When we talk of racism we think of white supremacists, police brutality, job discrimination, limited opportunities, and hate speech, but rarely do we think of food. Hundreds of thousands of African Americans, Hispanics, and the poor are killed every year by an invisible form of racism, a silent and insidious injustice. Here’s how:
You may have heard of food deserts—where the closest grocery store is more than a mile away and it’s hard to find fresh fruits and vegetables or other healthy food. About 23 million Americans live in these food deserts. But the problem isn’t only food deserts. It is also food swamps, communities filled with fast-food chains and bodegas plying highly processed addictive foods. Food deserts imply a natural phenomenon, like an unfortunate desert somehow just occurred. Nothing is less true. It’s hard to find fresh produce but easy to find gallon cups of soda and other sugar-loaded beverages, and fast-food chains peddling burgers, fries, and fried chicken are on almost every street corner. These toxic food swamps are more predictive of obesity and illness than food deserts.
Black communities have almost twice as many fast-food restaurants as white neighborhoods. Only 5 percent of African Americans have a healthy diet. That is a big change from the 1960s, when African American diets were twice as healthy as average diets, with more fruits, vegetables, fiber, and good fats.
Perhaps a better term is food apartheid, an embedded social and political form of discrimination. The history of sugar is closely linked to slavery. The slave trade served the growth of sugar production. Legal American slavery is over (although slavery still occurs on some farms with migrant workers). But today sugar, especially in its new form, high-fructose corn syrup, is connected to a new kind of oppression—food oppression, which makes people of color sick, fat, and disabled. It is a form of apartheid in which the poor and minorities live in areas that lack healthy food and have an overabundance of foods that can kill them.
Why this matters
How did this happen? It’s a combination of factors: poverty, social disenfranchisement, racial targeting by the food industry, and government subsidies and programs that support the most profitable foods for the food industry—the very foods that also happen to be the most harmful to our health. This form of internalized racism is not as obvious as limiting voters’ rights and employment opportunities, the bombing of churches, or hate speech and hate crimes. But it is far more pernicious and destructive, in part because most of the victims don’t know it’s a problem.
Of all deaths, 1.1 percent are caused by gun violence. Seventy thousand people die every year from the opioid epidemic. Those problems are real and tragic and need to end. But 70 percent of deaths, or more than 1.7 million deaths, a year are caused by chronic disease such as heart disease, diabetes, cancer, high blood pressure, and stroke—mostly the result of our toxic food system. More African Americans, Hispanics, and poor people are killed by bad food than anything else.
Even when food is available to disadvantaged communities, fresh whole foods can be expensive, which leads to the purchase of cheap, unhealthy junk food. Those who are on limited incomes struggle to get enough food, so when the decision is between facing hunger and eating cheap processed food, the choice is inevitable. Yet we remain silent about the role of the food system killing millions of Americans.
Food companies use cultural icons to influence minorities. Do you think LeBron James actually drinks Sprite? McDonald’s uses Serena and Venus Williams and Enrique Iglesias in their TV ads to attract black and Hispanic consumers. Is a Big Mac, fries, and a Coke really Serena’s pregame meal? No matter, their dollars are well spent. Race-based advertising works.
Big Food’s marketing ploys are amplified even more for minority children. In 2019, the Rudd Center for Food Policy and Obesity published a damning report entitled, “Increasing Disparities in Advertising Unhealthy Food to Hispanic and Black Youth.” The big food companies target black and Hispanic youth with their least nutritious products, including fast foods, candy, sugary drinks, and snacks. From 2013 to 2017, food advertising on black-targeted TV increased by 50 percent. Black teens viewed 119 percent more junk-food-related ads—mostly for soda and candy—than white teens. The top ads came from Nestlé, Yum! Brands (like KFC and Taco Bell), Mars, McDonald’s, and General Mills. The average teen saw more than 6,000 junk-food ads a year just on television.
On top of that, our government is complicit in the perpetuation of these behaviors and the support of the production and sale of the very foods it tells Americans not to eat in its Dietary Guidelines. What may shock some is that government-guaranteed loan programs support fast-food outlets, which are far more prevalent in poor communities of color. Why do government loans pay for the expansion of food that kills Americans?
This oppression must end
The work of transforming this system of oppression must come from multiple sectors—changes in government policies, regulation, nonprofits creating local programs to educate and empower people, and grassroots efforts of citizens working to change their communities.
Imagine if black church leaders (or any affected minority group) collectively joined in a campaign to link the struggles of minority communities to food, to food apartheid, to racial targeting by the food industry, to the invisible form of oppression that keeps communities down, and created a call to action to change all that. They might follow the example of Ebenezer Baptist Church, Martin Luther King Jr.’s church in Atlanta, that started a 2-acre urban garden where parishioners participate in growing food for the local community. Or Ron Finley, the Gangsta Gardener from South Central Los Angeles, started curbside gardens, turned lawns into food forests, and created raised-bed gardens in dilapidated vacant lots, helping gang members, ex-convicts, and drug dealers find a way out of their struggles.
In West Oakland, California, a very poor neighborhood of 30,000 with no grocery store but fifty-four liquor and convenience stores, community members started the People’s Grocery, a mobile grocery store (much like an ice cream truck), that brought produce to the local community for 15 years.
In the Bronx, Karen Washington founded Black Urban Growers to support black urban and rural farmers and helped turn abandoned lots in the Bronx into thriving community gardens. These are a few of the stories of hope and empowerment that I write about in Food Fix, as well as Food Tank, Soul Fire Farm, Black Church Food Security Network, and The Bigger Picture Project. These pockets of redemption and innovation are happening all across the country; they are models for breaking the cycle of food injustice. But we need so many more, and we must expose this problem for what it really is.
Sources:
Mayer-Davis EJ, Lawrence JM, Dabelea D, et al. “Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002–2012.” N Engl J Med. 2017 Apr 13;376(15):1419–29.
Wheeler SM, Bryant AS. “Racial and Ethnic Disparities in Health and Health Care.” Obstet Gynecol Clin North Am. 2017 Mar;44(1):1–11.
CDC, “America’s Drug Overdose Epidemic: Data to Action.” https://www.cdc.gov/injury/features/prescription-drug-overdose/index.html
Cooksey-Stowers K, Schwartz M, Brownell K. “Food Swamps Predict Obesity Rates Better Than Food Deserts in the United States.” Int J Environ Res Public Health. 2017 Nov 14;14(11):1366.
Block JP, Scribner RA, DeSalvo KB. “Fast Food, Race/Ethnicity, and Income: A Geographic Analysis.” Am JPrev Med. 2004 Oct 1;27(3):211–17.
Luna GT. “The New Deal and Food Insecurity in the Midst of Plenty.” Drake J Agric L. 2004;9:213.
Nutrition and Well-Being A to Z. (2019). “Diet and African Americans.” http://www.faqs.org/nutrition/A-Ap/African-Americans-Diet-of.html.
Freeman A. “Fast Food: Oppression through Poor Nutrition.” Calif L Rev. 2007;95:2221.
Centers for Disease Control and Prevention. (2019). “National Vital Statistics System.” https://www.cdc.gov/nchs/nvss/deaths.htm.
Centers for Disease Control and Prevention. (2019). “Deaths and Mortality.” https://www.cdc.gov/nchs/fastats/deaths.htm
Harris JL, Frazier W, Kumanyika S, Ramirez AG. “Increasing Disparities in Unhealthy Food Advertising Targeted to Hispanic and Black Youth.” UConn Rudd Center for Food Policy and Obesity. 2019. http://uconnruddcenter.org/files/Pdfs/TargetedMarketingReport2019.pdf=.
Appiah O. “It Must Be the Cues: Racial Differences in Adolescents’ Responses to Culturally Embedded Ads.” In Advertising and Consumer Psychology. Diversity in Advertising: Broadening the Scope of Research Directions, ed. Williams JD, Lee WN, Haugtvedt CP, 319–39. Mahwah, NJ: Lawrence Erlbaum Associates Publishers; 2004; Pereira MA, Kartashov AI, Ebbeling CB, et al. “Fast-Food Habits, Weight Gain, and Insulin Resistance (the CARDIA Study): 15-Year Prospective Analysis.” Lancet. 2005 Jan 1;365(9453):36–42.
Edwards C. “Empowering Citizens to Monitor Federal Spending.” Cato Institute. 2006. https://object.cato.org/sites/cato.org/files/pubs/pdf/tbb_0718-38.pdf.