When It Comes to Your Health, Your Zip Code Matters More Than Your Genetic Code

Today is the one year anniversary of the passage of the Affordable Care Act and guess what? According to a recent survey, over one half of Americans don't think health reform is actually a law.

It is folks.

I'm marking the one year anniversary by attending the National Association of Black Journalists Media Institute on Health, Health Policy and Health Disparities in Washington, DC.

I heard two very profound statements today that tell the story about rampant health disparities impacting communities of color. Those two statements were not long prognostications about the social determinants of health or the root causes of these racial and ethnic inequities.

The comments indeed were about those things, but they were short enough for Twitter but utterly profound in answering those questions.

Comment #1: "Your zip code may be more important than your genetic code when it comes to health disparities."

Comment # 2: "We have a sick system not a healthcare system."

Comment 1 struck me because it alarms me that where you live is one of the key drivers of your health. According to the World Health Organization, Report on the Social Determinants of Health, avoidable health inequities arise because of the circumstances in which people grow, live, work and age and the systems put in place to deal with illness. In turn, the conditions in which people live and die are, in turn, shaped by political, social and economic forces.

That's why I was really impressed with a new initiative by The Joint Center for Political and Economic Studies, called Place Matters, which seeks to address conditions in the natural environment, built environment and social environment that lead to poor health. The goal is to eliminate health disparities by identifying the complex underlying causes and defining strategies to address them.

I am convinced these issues play a significant role in maternal and child health.

Comment # 2 was just too simplistically truthful to ignore. Healthcare is a misnomer for our system. It takes care of your sickness but does little to protect your health. In fact, today I learned that for every $1 spent on healthcare only 5 cents goes to prevention.

This is pathetic because so many mothers wouldn't needlessly die if there were more prevention programs and community-level interventions.

Battling the Bulge from Birth

This is the time of year when everyone is thinking about eating lots of good food with family. Then in a few weeks, we will all make new and not-to-be kept resolutions about losing the weight gained by eating those same meals and many others throughout the past year.

But to really battle the bulge, not just for ourselves but for our children, we have to start early, avoid empty promises and face the facts.

Now, for the most part we black women love our curves and really have no use for the latest crash diets. The way we walk, talk, and dress says "I am bold and beautiful, love it or leave it!" But at as fabulous as we think we are, obesity is still a prominent issue in the black community.

I have heard every excuse from "My family is big- boned" to "queen- sized" and my favorite "That just means there's more of me to love!" And, while these statements and mantras seem to scream I am confident and love my body, we need to address why statistics show that six out of every ten African American women are overweight and four out of every ten is morbidly obese. There is a huge difference between having a little belly or being a little hippy and packing on 30 to 100 extra pounds or more. 50 percent of African-American women are obese compared to only 40 percent of Mexican-American women and only 30 percent of White women.

While we already know that the high rates of obesity in our community is linked to the prevalence of diseases such as heart disease, diabetes, high blood pressure, stroke, arthritis and cancer. We don't see too many people addressing prevention strategies for all of these diseases that start at birth. If we really want to curb the obesity epidemic in our community we have to start well before childhood. We can start as soon as the baby is born.

Breast-feeding helps us lose the weight we gained during pregnancy and has many other health benefits for us too.

Breastfeeding is proven to reduce your baby's chance of being obese. The breastfeeding-obesity link is now recognized by key government agencies and professional groups, Including the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics. Experts at the CDC in Atlanta estimate that 15 percent to 20 percent of obesity could be prevented through breastfeeding. Here are some of the reasons why:

• Breastfed infants may be better at self-regulating their intake. Mothers cannot see how much milk their child is drinking, so they must rely on their infant's behavior, not an empty bottle, to signal when their infant is full. Thus, breastfed babies might be better able to eat only as much as they need.
  
  
• Breastfed infants are more likely than formula-fed infants to try and accept new foods. Acceptance of new foods is important because a healthy diet should include a wide variety of foods, especially fruits and vegetables. Because breast milk contains flavors from foods eaten by mothers, breastfed infants are exposed to a variety of tastes early in life. In contrast, artificial baby milk (formula) always tastes the same.
  
  
• Breastfeeding has different effects than formula feeding on infant's metabolism and hormones such as insulin, which tells the body to store fat. Formula-fed infants tend to be fatter than breastfed infants at 12 months of age.
  
  
• For us to make a real impact on obesity in our community, we have to start at birth. It's really that simple. Resolving to breastfeed more and support any breastfeeding mother you know, is a real resolution for change.

Memo to Michelle Obama: Big Food Makers Don't Give a Fructose About Our Kids

I love Michelle Obama. Her strength, professionalism, sass and savvy are enviable. And as a mom, I can only applaud her efforts to reduce the embarrassingly high obesity rates in this country. Earlier this month she spoke at the Grocery Manufacturers Association meeting and asked big food companies like General Mills, Kraft Foods and Coca-Cola to produce more healthful food. What chutzpah! Then she went one step further by asking the food companies to then market the healthy food to children, instead of the red-dye, high sodium, high calories crap they usually market to our children.

Now I can certainly understand that the First Lady has to ask everybody to join in the fight against obesity. It is certainly an all-hands-on-deck type of goal. But if she really thinks big food companies will actually do something , then I'm a little concerned. I'm hoping she figured, "well, the event is in D.C. and I won't have to miss school pick up so what the heck."

The truth is, big food makers are not going to kill their cash cow by actually making healthier food, especially when making the unhealthy stuff is so cheap and rakes in serious money. I mean, hey, if it ain't broke, why fix it? That was like asking the healthcare companies to support health care reform with a public option. It was never going to happen. These corporations are big businesses looking for a profitable business model that works. Remember the multi-billion dollar kick in the bottom line it took for the tobacco industry to actually clean up their act? Big business, no matter what public relations spin they try to put on it, only acts in their own self interest. That interest is to keep shareholders happy and CEOs happier with fat paychecks and even fatter bonuses. My child's health is the last thing on the mind.

Thankfully it is the first thing on my mind. That's why it is really my responsibility and that of every other parent to make sure their child has a healthy diet and an active lifestyle. This is particularly true in our community where studies show that almost 36 percent of black children between the ages of six and eleven are overweight, and more than 19 percent are considered obese. Among twelve- to nineteen-year-olds, 40 percent are overweight and nearly 24 percent are obese.

More importantly, we as black mothers have to set a good example by modeling healthy living and healthy eating ourselves. Our own health impacts our children from pregnancy through adulthood.

I appreciate that the First Lady has to make all the appropriate rounds (and like I said, no out of town trip required) but no parent or reasonable adult should ever expect big business (or government, for that matter) to do what we need to do for ourselves and our children. That is, take back our power as parents and as the CNO (chief nutrition officer) in our homes. When your child begs for unhealthy crap, try this novel approach and simply utter, "No!" and actually mean it. Or better say, yes, but only once in a while.

Attention world, here's how to get the food makers on board: Stop buying the unhealthy stuff. When they lose the financial incentive for making unhealthy food options then they will stop. Period. When we educate ourselves as parents so that, as Mrs. Obama noted, we don't fall for gimmicks such as a food maker marketing one healthy aspect (such as adding one gram of fiber) while doubling the calories, then they will be forced to clean up their act. Until then it's just photo opps, PR spin and back to the sodium-laden processed foods with ingredients you can't even pronounce (Someone please ask the good folks at Hooked on Phonics to produce a special edition to help us get through our food labels).

That's fine for them. But we, as moms, have plenty of work to do. Let's get down to our big business.

Michelle Obama's Plan: Mothers Need Apply

Soy milk invaded my childhood at age 6 and not because I particularly preferred it. Rather my mom bought it, packed it in the fridge, and drank it. And because I adored and mimicked my mom, I drank soy milk with enthusiasm.

This past Tuesday, thoughts of soy milk and my mother came to mind as I attended Michelle Obama's White House kick-off of "Let's Move," her multi-year, multi-agency, and era-changing plan to fight childhood obesity in America.

It was my first time inside the White House and as soon as Michelle Obama walked out confident and beautiful, I realized that she could tell America to eat turnips and flax seed every morning and night and a good portion of people would follow suit.

Michelle Obama has that stunning package of qualities that my mother has. Fearless, authoritative, and caring, the mother-of-two and Harvard-trained lawyer can command many children and adults to follow her quest just by suggesting them. And like my mother, Michelle appears to walk on water.

Now, I believe it is that power for women and mothers to be role models that I think will amplify the goals of Obama's movement aimed to reverse the fact that young people, due to obesity-related disorders, might have a shorter life-span than their parents. A focus on women and mothers could turn Obama's national fitness movement into a penetrating cultural, psychological mandate.

Right now, Michelle Obama's plan combines major thrusts: moves to provide front-of-package nutrition labeling on food products and the elimination of food deserts in neighborhoods with no grocery stories; a policy to increase healthy meals in public schools; marketing and tools to spur athleticism in children and wellness decisions in families; and billions towards these goals over the next 10 years. Her vision, fortified by private and public support, is both necessary and impressive.

In addition, child's health foundations will come together to fund the Partnership for a Healthier America, which is a non-partisan convener of sectors and agencies supporting solving childhood obesity in 30 years. And President Barack Obama signed a Presidential Memorandum to launch the first Task Force for Childhood Obesity to review and create countrywide plans to employ federal resources to improve child nutrition and exercise.

Imploring Americans to read about what they eat, talk health with their circles, and see health as a self-esteem issue, Michelle Obama's plan is simply epic, a practical movement that could change everything.

Yet one thing I noticed about Michelle Obama's informative and passionate literature about the plan is that the words families and parents are preferred over women and mothers. It appears state and social forces will usher in this very crucial movement, when in fact, women and children are the exact linchpin. Many people like me, even with two active parents, draw a direct line of my eating and lifestyle experiences to my mother. While my father influenced my eating habits, healthy food practices were often implemented by my mother. Fathers can regulate the diet of children, but can they manage the lifestyle of mothers?

Still now, I don't understand the mechanism of vegetables and I can't explain the chemistry of pure hair oils. But I know that when I cook greens in too much oil, they don't taste as good as my mother's, and when I use olive oil on my hair instead of synthetic creams, my hair becomes shiny, beautiful, and strong as my mother's.

This relationship works in reverse. Four out of five African American women are obese, making us the most obese group of Americans. And the CDC finds that maternal pre-pregnancy obesity is associated with childhood obesity. Some of this explains why African American children between ages 6 and 17 are 1.3 times as likely to be overweight as their white peers and are at greater risk of diabetes, asthma and heart disease. A lot of the problem is, mother see, child do. Michelle Obama's campaign has the chance to embrace and nurture mothers in a huge, phenomenal way.

For years my mom was soy-minded, making as many trips to mainstream grocery stores as small health food shops. Her bookshelves were lined with alternative healthy living literature. When she was going to make a big change in her life, she meditated on it. And when she went vegetarian, she invited her children to join along.

Throughout the years, I adopted these habits, and not because I was a health guru like my mother, but because I absorbed them as a result of admiring my mother, my role model since the womb. Now I have a health propensity without thinking about it. And, some things are just wired. No matter where I am in the world, if I have even a cold, I call my mom first. How maternal health emerges in this vast obesity fight will be amazing to watch, and necessary to see.

Folic Acid and You—What Every Woman of Color Needs to Know

It’s the New Year! And who knows what 2010 will bring. According to recent stats approximately 50 percent of women aged 15-44 have at least one unplanned pregnancy in their lives. That means a good number of us may have an surprise in 2010.

 

That also means every woman of childbearing age, should be thinking about their health all day, every day. That’s why I wanted to tell you that this week, January 4-10^th, is Folic Acid Awareness Week. Sponsored by the National Council on Folic Acid (NCFA) http://www.folicacidinfo.org/pages/folicacid_info.php, the week is intended to educate all women about folic acid. If taken before and during early pregnancy from a multi-vitamin or fortified foods, folic acid can prevent from 50 percent to 70 percent of some forms of serious birth defects of the brain and spine, called neural tube defects (NTD).

 

Getting the right amount of folic acid is particularly important to Black and Latina women. Not only do Latinas have higher rates of NTD-affected pregnancies, they also have the lowest awareness about folic acid than women of other ethnic groups, and lower consumption of folic acid than white non-Hispanic women, according to recent studies.

 

In addition to preventing NTDs, increased folic acid has been linked to preventing preeclampsia, a form of severe high blood pressure that usually occurs after 37 weeks of pregnancy. The potentially fatal condition is more common in black women. Studies indicate that when black women have preeclampsia they tend to have a severe form of the disorder and experience it as early as six months in the pregnancy compared to the typical ninth month. 

 

Doctors have not yet pinpointed exactly why this disparity exists, however, one study found that black women had less folic acid and more of a certain amino acid than white women as a pre-existing condition, which put them at a higher risk during pregnancy. The findings suggest that black women take more folic acid before and during pregnancy and as early as possible. (http://www.msnbc.msn.com/id/4781703 )

 

The easiest way to make sure you’re getting enough folic acid all the time is by taking a multi-vitamin, B vitamin complex pill or folic acid pill and eating fortified foods like grains, pastas or breakfast cereals. Folate is found naturally in foods such as leafy green vegetables, beans, liver and some fruit. But for some reason, scientists have found that folic acid, the synthetic version of folate, is actually easier for your body to absorb than folate.

 

Even if you don’t have a planned or unplanned pregnancy in the cards, folic acid is pretty important to your healthy living. Studies show that folic acid reduces the risk of certain cancers; cardiovascular diseases including coronary heart disease and stroke; and cognitive diseases or mental conditions such as Alzheimer's disease, age-related dementia or cognitive decline and depression. We can all use that.