A dozen doughnut holes. Growing up, that was a typical breakfast for Tassiana Willis, a 24-year-old African-American poet. In her family, moments of joy centered around sweets. Her grandfather, a man of few words, showed affection through weekend trips to McDonald’s.
learned to find i love you in white paper bags
instead of his lips
see, I loved food out of ritual
Willis, who grew up in San Francisco, has harnessed the power of poetry to raise awareness about Type 2 diabetes, a preventable disease caused largely by poor dietary habits and lack of exercise. It once affected mostly adults but now is spreading at alarming rates among young people, especially minorities and youth from low-income households.
“Raise your voice and change the conversation,” urges the tagline on four new videos produced for an arts and public health campaign called The Bigger Picture. The videos, including one by Willis called “The Longest Mile,” show young poets telling deeply personal stories about the life circumstances that promote diabetes.
The videos challenge viewers to look at “the bigger picture” behind the startling rise of diabetes. Instead of highlighting poor individual choices, they expose the social and economic factors — everything from food pricing and marketing to unequal access to parks and playgrounds — that conspire to push young people of color into an unhealthy lifestyle.
“The way these stories are told … really calls for social change,” said Natasha Huey, who managed the campaign for Youth Speaks, one of four youth development organizations across California that partnered with the University of California-San Francisco’s Center for Vulnerable Populations to produce the poetry videos.
The Bigger Picture, which launched in 2011, has produced more than two dozen videos about diabetes, which together have been viewed more than 1.5 million times on YouTube. They have also been presented at school assemblies for thousands of Bay Area students.
Willis said she is obese now because of the way her financially strapped family ate when she was young. “There are powerful emotions behind why we eat what we eat,” she said in an interview.
In “The Longest Mile,” Willis recalls the humiliation of being unable to run a mile during PE class in middle school. “I wasn’t slow / I was just fat.” Obesity is fueling the spread of Type 2 diabetes, and Willis knows she’s at high risk for the disease.
by luck I escaped type 1
i feel like I’m always
1 soda away from type 2
that’s like dodging a bullet
and committing suicide with a gun
in my kitchen
Unlike Type 2 diabetes, which is related to lifestyle choices and obesity, Type 1 diabetes typically develops in early childhood and is believed to be the result of genetic factors and environmental triggers, including viruses.
“We’re at the tipping point in this disease,” said Dr. Dean Schillinger, a professor of medicine at UCSF and director of health communications at Zuckerberg San Francisco General Hospital and Trauma Center, who co-created the Bigger Picture campaign. “The trajectory is very scary and the rate of increase, particularly in youth of color, is exponential.”
In a recent JAMA paper featuring the new videos, he stressed the importance of shifting the way diabetes is characterized in public health education.
“The overarching objective is to change the conversation about diabetes away from it being an individual ‘shame and blame’ message to approaching it as a societal problem,” Schillinger said.
In another video, “Empty Plate,” Anthony “Joker” Orosco, a 20-year old Chicano poet, depicts his farmworker relatives who can’t afford to buy the produce they pick.
Backs breaking bones aching Harvesting healthy fruits and veggies Acre by acre, The bounty of California’s breadbasket That almost never blessed the tables of farmero families,
Orosco, who grew up in Stockton, a city in California’s agricultural San Joaquin Valley, said he was inspired to honor the hard work of immigrants who sacrificed for his generation.
Low-income people often struggle to buy fresh vegetables, whole grains and other nutritious foods, because those choices are more expensive than the sugary, fat-laden processed foods widely available in many poor neighborhoods. In a 2013 study, researchers at Harvard and Brown universities found that a healthful diet costs about $550 a year more per person than an unhealthy one.
Schillinger said that, based on his earlier experience with the AIDS epidemic and anti-tobacco campaigns, he believes there needs to be a “groundswell of grass-roots activism” if the course of Type 2 diabetes is to be reversed.
“A young person getting diabetes is an injustice, and so the campaign features young people who are targets of diabetes risk but are now becoming agents of change,” he said.
In “Monster,” Rose Bergmann, 17, and Liliana Perez, 16, talk about fathers who relied on sugar-packed energy drinks to work double shifts to support their families.
52 grams [of sugar] from the can keep his eyes open
Sugar creating their own hands around his throat
The industry that makes sweetened drinks has taken notice. “We do agree that people need to manage their sugar intake,” said Lauren Kane, senior director of communications for the American Beverage Association in Washington, D.C. She said beverage makers are “aggressively working to innovate to offer more products with less sugar … and to create interest in access to those beverages.”
McDonald’s has also recently announced new nutritional standards to reduce the number of calories in its Happy Meals, which are marketed to children.
Los Angeles poet Edgar Tumbokon, 19, said nutritious food did not play a big role in his childhood. “I grew up in a food desert surrounded by a culture and kids who loved to eat junk food,” he said. “Eating healthy was considered ‘a white thing.’”
Tumbokon, who weighed 13 pounds at birth, said his poem, “Big Boy,” was inspired by his immigrant Filipino mother, who developed gestational diabetes, which now afflicts 1 in 11 pregnant women. He grew up watching her test her blood sugar and inject herself with insulin.
Yet, older Black Americans have received little attention as protesters proclaim that Black Lives Matter and experts churn out studies about the coronavirus.
“People are talking about the race disparity in COVID deaths, they’re talking about the age disparity, but they’re not talking about how race and age disparities interact: They’re not talking about older Black adults,” said Robert Joseph Taylor, director of the Program for Research on Black Americans at the University of Michigan’s Institute for Social Research.
A KHN analysis of data from the Centers for Disease Control and Prevention underscores the extent of their vulnerability. It found that African Americans ages 65 to 74 died of COVID-19 five times as often as whites. In the 75-to-84 group, the death rate for Blacks was 3½ times greater. Among those 85 and older, Blacks died twice as often. In all three age groups, death rates for Hispanics were higher than for whites but lower than for Blacks.
(The gap between Blacks and whites narrows over time because advanced age, itself, becomes an increasingly important, shared risk. Altogether, 80% of COVID-19 deaths are among people 65 and older.)
The data comes from the week that ended Feb. 1 through Aug. 8. Although breakdowns by race and age were not consistently reported, it is the best information available.
Mistrustful of Outsiders
Social and economic disadvantage, reinforced by racism, plays a significant part in unequal outcomes. Throughout their lives, Blacks have poorer access to health care and receive services of lower quality than does the general population. Starting in middle age, the toll becomes evident: more chronic medical conditions, which worsen over time, and earlier deaths.
Several conditions — diabetes, chronic kidney disease, obesity, heart failure and pulmonary hypertension, among others — put older Blacks at heightened risk of becoming seriously ill and dying from COVID-19.
Yet many vulnerable Black seniors are deeply distrustful of government and health care institutions, complicating efforts to mitigate the pandemic’s impact.
The infamous Tuskegee syphilis study — in which African American participants in Alabama were not treated for their disease — remains a shocking, indelible example of racist medical experimentation. Just as important, the lifelong experience of racism in health care settings — symptoms discounted, needed treatments not given — leaves psychic scars.
“A lot of Black elders in this area migrated from the South a long time ago and were victims of a lot of racist practices growing up,” said Margaret Boddie, 77, who directs the program. “With the pandemic, they’re fearful of outsiders coming in and trying to tell them how to think and how to be. They think they’re being targeted. There’s a lot of paranoia.”
“They won’t open the door to people they don’t know, even to talk,” complicating efforts to send in social workers or nurses to provide assistance, Boddie said.
In Los Angeles, Karen Lincoln directs Advocates for African American Elders and is an associate professor of social work at the University of Southern California.
“Health literacy is a big issue in the older African American population because of how people were educated when they were young,” she said. “My maternal grandmother, she had a third-grade education. My grandfather, he made it to the fifth grade. For many people, understanding the information that’s put out, especially when it changes so often and people don’t really understand why, is a challenge.”
What this population needs, Lincoln suggested, is “help from people who they can relate to” — ideally, a cadre of African American community health workers.
With suspicion running high, older Blacks are keeping to themselves and avoiding health care providers.
“Testing? I know only of maybe two people who’ve been tested,” said Mardell Reed, 80, who lives in Pasadena, California, and volunteers with Lincoln’s program. “Taking a vaccine [for the coronavirus]? That is just not going to happen with most of the people I know. They don’t trust it and I don’t trust it.”
Reed has high blood pressure, anemia, arthritis and thyroid and kidney disease, all fairly well controlled. She rarely goes outside because of COVID-19. “I’m just afraid of being around people,” she admitted.
Other factors contribute to the heightened risk for older Blacks during the pandemic. They have fewer financial resources to draw upon and fewer community assets (such as grocery stores, pharmacies, transportation, community organizations that provide aging services) to rely on in times of adversity. And housing circumstances can contribute to the risk of infection.
In Chicago, Gilbert James, 78, lives in a 27-floor senior housing building, with 10 apartments on each floor. But only two of the building’s three elevators are operational at any time. Despite a “two-person-per-elevator policy,” people crowd onto the elevators, making it difficult to maintain social distance.
“The building doesn’t keep us updated on how they’re keeping things clean or whether people have gotten sick or died” of COVID-19, James said. Nationally, there are no efforts to track COVID-19 in low-income senior housing and little guidance about necessary infection control.
Large numbers of older Blacks also live in intergenerational households, where other adults, many of them essential workers, come and go for work, risking exposure to the coronavirus. As children return to school, they, too, are potential vectors of infection.
‘Striving Yet Never Arriving’
In recent years, the American Psychological Association has called attention to the impact of racism-related stress in older African Americans — yet another source of vulnerability.
This toxic stress, revived each time racism becomes manifest, has deleterious consequences to physical and mental health. Even racist acts committed against others can be a significant stressor.
“This older generation went through the civil rights movement. Desegregation. Their kids went through busing. They grew up with a knee on their neck, as it were,” said Keith Whitfield, provost at Wayne State University and an expert on aging in African Americans. “For them, it was an ongoing battle, striving yet never arriving. But there’s also a lot of resilience that we shouldn’t underestimate.”
This year, for some elders, violence against Blacks and COVID-19’s heavy toll on African American communities have been painful triggers. “The level of stress has definitely increased,” Lincoln said.
During ordinary times, families and churches are essential supports, providing practical assistance and emotional nurturing. But during the pandemic, many older Blacks have been isolated.
In her capacity as a volunteer, Reed has been phoning Los Angeles seniors. “For some of them, I’m the first person they’ve talked to in two to three days. They talk about how they don’t have anyone. I never knew there were so many African American elders who never married and don’t have children,” she said.
Meanwhile, social networks that keep elders feeling connected to other people are weakening.
“What is especially difficult for elders is the disruption of extended support networks, such as neighbors or the people they see at church,” said Taylor, of the University of Michigan. “Those are the ‘Hey, how are you doing? How are your kids? Anything you need?’ interactions. That type of caring is very comforting and it’s now missing.”
In Brooklyn, New York, Barbara Apparicio, 77, has been having Bible discussions with a group of church friends on the phone each weekend. Apparicio is a breast cancer survivor who had a stroke in 2012 and walks with a cane. Her son and his family live in an upstairs apartment, but she does not see him much.
“The hardest part for me [during this pandemic] has been not being able to go out to do the things I like to do and see people I normally see,” she said.
In Atlanta, Celestine Bray Bottoms, 83, who lives on her own in an affordable senior housing community, is relying on her faith to pull her through what has been a very difficult time. Bottoms was hospitalized with chest pains this month — a problem that persists. She receives dialysis three times a week and has survived leukemia.
“I don’t like the way the world is going. Right now, it’s awful,” she said. “But every morning when I wake up, the first thing I do is thank the Lord for another day. I have a strong faith and I feel blessed because I’m still alive. And I’m doing everything I can not to get this virus because I want to be here a while longer.”
KHN data editor Elizabeth Lucas contributed to this story.
Photo by National Cancer Institute/Unsplash/Creative Commons
The presidents of two historically Black universities — one Catholic, the other Protestant — have announced that they are participating in a COVID-19 vaccine study.
President C. Reynold Verret of Xavier University of Louisiana and President Walter M. Kimbrough of Dillard University said Wednesday (Sept. 2) they are taking part in the Phase 3 trial of the Ochsner Health System. They said they have received injections and are reporting and monitoring any side effects or symptoms.
Ochsner Health said in July that it is one of 120 sites across the world that plan to enroll as many as 30,000 trial participants, with half receiving the vaccine and half receiving a placebo. Neither the investigators nor the patients will know which they have received.
“Overcoming the virus will require the availability of vaccines effective for all peoples in our communities, especially our black and brown neighbors,” the two men wrote in a letter to the faculty, staff and students at their institutions. “It is of the utmost importance that a significant number of black and brown subjects participate so that the effectiveness of these vaccines be understood across the many diverse populations that comprise these United States.”
President C. Reynold Verret of Xavier University of Louisiana, left, and President Walter M. Kimbrough of Dillard University. Courtesy photo
Xavier is a Roman Catholic school and Dillard is affiliated with the United Methodist Church and the United Church of Christ.
The two presidents, whose schools are located in New Orleans, encouraged members of their academic communities and other institutions to take part in a COVID-19 vaccine trial.
“Upon our enrollment, we were fully informed, and any possible risks that would exclude us from the study were disclosed,” they said in the letter. “We are both well.”
“As presidents of HBCUs, we do recall unethical examples of medical research,” they said. “We remember the Tuskegee Syphilis Study, which misused and caused harm to African Americans and other people of color, undermining trust in health providers and caretakers.”
A Washington, D.C., religious leader has also announced his participation in a trial related to finding a vaccine to fight the coronavirus pandemic.
Rabbi Shmuel Herzfeld, the leader of Ohev Shalom, an Orthodox synagogue, has tweeted about his role in the trial and been featured in a Washington Post video explaining what happens during the study. Writing in Hebrew, he tweeted his thanks to God for his participation in the trial.
“Boruch Hashem I received my second dose of the vaccine for the covid-19 clinical trial,” he said in an Aug. 27 tweet. “Thank you to Hashem and to all those who are working day and night to bring relief from this pandemic.”
This story has been updated to correct the spelling of the first name of Rabbi Shmuel Herzfeld.
First, the incidence of colorectal cancer has risen dramatically among adults under age 50 in the U.S. and in many countries around the world. Second, African Americans have a much greater likelihood of being diagnosed and dying from the disease at any age. Both issues are important to the public health community and efforts are ongoing to address them.
Colorectal cancer remains a major source of cancer incidence and death in the U.S. The American Cancer Society estimates that in 2020, about 147,950 people will be diagnosed with colorectal cancer and 53,200 will die from the disease, making it the fourth most prevalent form of cancer and the second leading cause of cancer mortality.
In 2017, Dr. Rebecca Siegel and colleagues published detailed and compelling statistical data clearly bringing the issue into sharp focus, stimulating greater coverage in the media.
Analysis of trends in colorectal cancer incidence and mortality have clearly shown a decline in the general U.S. population overall during the past few decades. Unfortunately, this has not been the case for young adults.
For example, incidence has decreased by an average of 4% per year between 2007 and 2016 in those over 65 years of age, in contrast to an increase of 1.4% per year during the same period in those under 50. The observed decrease in older adults is likely due to preventive screening, which is recommended and advocated for people over 50 and has been undertaken by a larger fraction of the population.
Similarly, colorectal cancer mortality has declined by 3% per year between 2008 and 2017 in those over 65, while it has increased by 1.3% per year in those under 50.
I have met a number of young people, including several in their 20s and 30s, who had been diagnosed with colorectal cancer and were in the midst of fighting it. I have also met parents who lost young adult children to the disease, and were still trying to understand how this could have happened.
I have been struck by the intensity and complexity of emotions displayed by these people, including anger, resentment, embarrassment, hopelessness, fear and resolve. While a cancer diagnosis at any age is scary and disorienting, it extracts a particularly powerful psychological and social toll on young adults.
What is causing the increase in young adults? We do not know for certain. Several studies have indicated that the disease in young people is different with regard to the specific location of the tumor within the colon or rectum.
Also, the pathology, genetics and response to treatment differ. Lifestyle trends, such as overweight and obesity, lack of physical activity and changing diets, have been suggested to play roles. Studies have indicated that obesity is associated with increased risk of early-onset colorectal cancer in women.
While these trends may contribute, they are not fully explanatory. Physicians have told me anecdotally that many of their younger patients are thin, fit, physically active and in general good health, suggesting that something else must be going on.
What could that something else be? One intriguing possibility may lie in the billions of microbes, collectively termed the microbiota, that live on and within our bodies. Preliminary findings reported at the 2020 Gastrointestinal Symposium recently indicated that there may be differences between the microbiota within tumors from younger versus older colorectal cancer patients.
African Americans and colorectal cancer
The death of Boseman has also underscored the long-standing racial disparity for colorectal cancer. African Americans suffer from high incidences and mortalities, regardless of age. Incidence in African Americans was 18% higher than in whites during 2012-2016, while mortality was 38% higher during the same period. For reasons we do not yet know, incidence in younger African Americans has been relatively stable in contrast to that in younger whites.
Increased incidence and death from colorectal cancer in African Americans is likely a consequence of lower rates of screening, as well as environmental, socioeconomic and lifestyle factors. Reduction of the disparities may depend upon addressing these factors.
Screening can prevent colorectal cancer
Screening for colorectal cancer not only detects the disease but is also highly effective in preventing it. Screening can readily identify precancerous growths called polyps, as well as early-stage cancers. These often can be removed before they progress to life-threatening stages.
In addition, research is underway to find new methods for colorectal cancer screening based upon analysis of easily obtained body fluids such as blood and urine.
Based upon the knowledge that about 90% of colorectal cancer cases occurs in those 50 and over, the U.S. Preventive Services Task Force currently recommends that screening should begin at age 50 for those who have no predisposing symptoms. This population is experiencing the decrease in colorectal cancer incidence and death that is currently being observed overall.
But screening is not typically recommended for those under 50, and most health insurers do not pay for screening in this group.
This lack of screening, combined with a general lack of awareness about colorectal cancer and its symptoms among young people can result in late diagnoses. Later diagnoses can often result in more advanced stages of the disease, when it is harder to treat and significantly more lethal.
There is also a need to increase screening in the African American community. At present, recommendations vary. In contrast to the U.S. Preventive Services Task Force and the CDC, the U.S. Multi-Society Task Force recommends that screening in African Americans should begin at age 45 rather than 50. I hope these influential organizations will reach a consensus on this issue.
Sorting out the causes of age and race disparities in colorectal cancer incidences and mortalities, and understanding the nature of the disease more thoroughly, will take time.
As Boseman’s untimely death reminds us, colorectal cancer is a difficult and emotional disease for all people at any age. Awareness of signs and symptoms, along with engagement in screening as appropriate, will lead to the eventual eradication of the disease as a major form of cancer.
Two emergency room doctors, Dr. Tsion Firew in New York and Dr. Cedric Dark in Houston, discuss their cities’ coronavirus outbreaks — and responses. (Columbia University Irving Medical Center; Baylor College of Medicine)
Health workers across the country looked on in horror when New York became the global epicenter of the coronavirus. Now, as physicians in cities such as Houston, Phoenix and Miami face their own COVID-19 crises, they are looking to New York, where the caseload has since abated, for guidance.
The Guardian sat in on a conversation with two emergency room physicians — one in New York and the other in Houston — about what happened when COVID-19 arrived at their hospitals.
Dr. Cedric Dark, Houston: When did you start worrying about how COVID-19 would impact New York?
Dr. Tsion Firew, New York: Back in February, I traveled to Sweden and Ethiopia for work. There was some sort of screening for COVID-19 in both places. On Feb. 22, I came to New York City, and nothing — no screening. At that point, I thought, “I don’t think this country’s going to handle this well.”
Dark: On Feb. 26, at a department meeting, one of my colleagues put coronavirus on the agenda. I thought to myself, “Why do we even need to bother with this here in Houston? This is in China; maybe it’s in Europe?”
Firew: On March 1, we had our first case in New York City, which was at my hospital. Fast-forward 15 days and I get a call saying, “Hey, you were exposed to COVID-positive patients.” I was told to stay home.
Dark: My anxiety grew as I saw what was happening in Italy, a country I’ve visited several times. I remember seeing images of people dying in their homes and mass graves. I started to wonder, “Is this what we’ll see over here? Are my colleagues going to be dying? Is this something that’s going to get me or my wife, who’s also an ER doctor? Are we going to bring it home to our son?”
In March, we repurposed our urgent care pod, which has eight beds, into our coronavirus unit. And for a while, that was enough.
Firew: In late March, health workers without symptoms were told to come back to work. It felt like a tsunami hit. I’ve practiced in very low-resource settings and even in a war zone, and I couldn’t believe what I was witnessing in New York.
The emergency department was silent — there were no visitors, and patients were very sick. Many were on ventilators or getting oxygen. The usual human interactions were gone. Everybody was wearing a mask and gowns and there were so many people who came to help from different places that you didn’t know who was who. I spent a lot more time on the phone talking to family members about end-of-life care decisions, conversations you’d normally have face-to-face.
In New York, the severity of the crisis really depended on what hospital you were at. Columbia has two hospitals — one at 168th and one at 224th — and the difference was night and day. The one on 224th is smaller and just across the bridge from the Bronx, which was hit hard by the virus.
There, people were dying in ambulances while waiting for care. The emergency department was overwhelmed with patients who needed oxygen. Its hallways were crowded with patients on portable oxygen tanks. We ran out of monitors and oxygen for the portable tanks. Staff members succumbed to COVID-19, exacerbating shortages of nurses and doctors.
My friends who work in Lower Manhattan couldn’t believe some of the things we saw.
Dark: I went to medical school at NYU and have a lot of friends in New York I was checking in with at the time. I thought that in Houston, a city that’s almost as big, we had the conditions for a similar crisis: It’s a large city with an international airport, it attracts a lot of business travelers, and thousands of people come here each March for the rodeo.
In late March, a guy about my age came into the hospital. It was the first day we got coronavirus tests. A few days later, a nurse texted me that the patient had tested positive. He hadn’t traveled anywhere — it was proof to me that we had community transmission in Houston before any officials admitted it.
You became infected, right?
Firew: In early April, I became sick, along with my husband. I never imagined that in 2020 I would be writing out a living will detailing my life insurance policy to my family. Walking from my bed to the kitchen would make my heart race; I often wondered: Is this when I drop dead like my patient the other day?
A few days before I got sick, the president had said that anybody who wanted a test could get one. But then I was on the phone with my workplace and with the department of health begging for a test.
It was also around that time that a brown-skinned physician who was about my age died from COVID-19. So I knew being in my mid-30s wouldn’t protect me. I was even more worried when my husband became ill because, as a Black man, his chances of dying from this disease were much higher than mine. We both recovered, but I still have some fatigue and shortness of breath.
When did cases pick up in Houston?
Dark: We saw a gradual increase in cases throughout April, but it stayed relatively calm because the city was shut down. The hospital was kind of a ghost town because no one was having elective procedures. Things were quiet until Texas reopened in May.
I remember when I lost my first COVID patient. He started to crash right in front of me. We started CPR and I ran the algorithms through my mind trying to think how we could bring him back, but kept ending up at the same conclusion: This is COVID and there’s nothing I can do.
It’s like serving on the front lines of a war. We initially struggled to find our own personal protective equipment while the hospitals worked to secure the supply chain. Although that situation has stabilized, a lot of patients who come in for non-COVID reasons wind up testing positive. COVID is everywhere.
Our patient population is heavily Latino and Black and, for a time, our hospital had some of the highest numbers of COVID cases among the nearly two dozen hospitals in the Texas Medical Center network. It’s revealed the fault lines of a preexisting issue in terms of inequities in health care.
As area hospitals fill up, they reallocate additional floors to COVID patients. Who knows, if we don’t get this under control, maybe one day the whole hospital will be COVID.
Firew: Now I’m just chronically angry. The negligence came from the top all the way down. Our leaders do not lead with evidence — we knew what was going to happen when states reopened so quickly.
Dark: Yeah, this was completely avoidable, had the governor [Texas Gov. Greg Abbott] decided not to open up the economy too fast.
How are things in New York now?
Firew: There have been several days where I’ve seen zero COVID cases. If I do see a case, it’s usually someone who has traveled from abroad or other states.
People are coming in for non-COVID reasons. Recently, a woman in her early 40s came in with a massive lesion on her breast. She’d started experiencing some pain three months ago, during the peak of the pandemic, and was too frightened to come to the hospital. To make matters worse, she didn’t have insurance and couldn’t afford the telehealth that many had access to.
By the time she made it to our hospital, the mass had metastasized to her spine and lungs. Even with aggressive treatment, she likely only has a few months to live. This is one of the many cases we’re seeing now that we are back to “normal” — complications of chronic illnesses and delayed diagnoses of cancer. The burden of the pandemic layered with a broken health care system.
Dr. Tsion Firew is an assistant professor of emergency medicine at Columbia University and special adviser to the minister of health of Ethiopia.
Dr. Cedric Dark is an assistant professor of emergency medicine at Baylor College of Medicine and a board member for Doctors for America.
This conversation was condensed and edited by Danielle Renwick.
DENVER — Beverly Grant spent years juggling many roles before yoga helped her restore her balance.
When not doting over her three children, she hosted her public affairs talk radio show, attended community meetings or handed out cups of juice at her roving Mo’ Betta Green MarketPlace farmers market, which has brought local, fresh foods and produce to this city’s food deserts for more than a decade.
Her busy schedule came to an abrupt halt on July 1, 2018, when her youngest son, Reese, 17, was fatally stabbed outside a Denver restaurant. He’d just graduated from high school and was weeks from starting at the University of Northern Colorado.
“It’s literally a shock to your system,” Grant, 58, said of the grief that flooded her. “You feel physical pain and it affects your conscious and unconscious functioning. Your ability to breathe is impaired. Focus and concentration are sporadic at best. You are not the same person that you were before.”
In the midst of debilitating loss, Grant said it was practicing yoga and meditation daily that helped provide some semblance of peace and balance. She had previously done yoga videos at home but didn’t get certified as an instructor until just before her son’s death.
Yoga then continued to be a grounding force when the coronavirus pandemic hit in March. The lockdown orders in Colorado sent her back to long days of isolation at home, where she was the sole caregiver for her special-needs daughter and father. Then, in April, her 84-year-old mother died unexpectedly of natural causes. “I’ve been doing the best that I can with facing my new reality,” said Grant.
As a Black woman, she believes yoga can help other people of color, who she said disproportionately share the experience of debilitating trauma and grief — exacerbated today by such disparities as who’s most at risk of COVID-19 and the racialized distress from ongoing police brutality such as the killing of George Floyd in Minneapolis.
While the country still needs much work to heal itself, she wants more people of color to try yoga to help their health. She said the ancient practice, which began in India more than 5,000 years ago and has historical ties to ancient Africa, is the perfect platform to help cope with the unique stressors caused by daily microaggressions and discrimination.
“It helps you feel more empowered to deal with many situations that are beyond your control,” said Grant.
She teaches yoga with Satya Yoga Cooperative, a Denver-based group operated by people of color that was launched in June 2019, inspired partly by the Black Lives Matter and #MeToo movements. The co-op’s mission: Offer yoga to members of diverse communities to help them deal with trauma and grief before it shows up in their bodies as mental health conditions, pain and chronic disease.
“When I think about racism, I think about stress and how much stress causes illness in the body,” said Satya founder Lakshmi Nair, who grew up in a Hindu family in Aurora, Colorado. “We believe that yoga is medicine that has the power to heal.”
Satya’s efforts are part of a growing movement to diversify yoga nationwide. From the Black Yoga Teachers Alliance to new Trap Yoga classes that incorporate the popular Southern hip-hop music style to the Yoga Green Book online directory that helps Black yoga-seekers find classes, change appears to be happening. According to National Health Interview Survey data, the percentage of non-Hispanic Black adults who reported practicing yoga jumped from 2.5% in 2002 to 9.3% in 2017.
Nair seeks to plant the seeds for more: The co-op is trying to make classes more accessible and affordable for people of color. It offers many classes on a “pay what you can” model, with $10 suggested donations per session. Satya also hosts two intensive yoga instructor training sessions for people of color per year, with hopes to offer more, in an effort to diversify the pool of yoga providers.
A Unique, Healing Experience
Blacks and Latinos consistently top national health disparities lists, with elevated risks for obesity and chronic conditions such as heart disease, diabetes and some forms of cancer, which has made them more susceptible to contracting and dying of COVID-19. They also face an elevated risk for depression and other mental health conditions.
Yoga is obviously not a panacea for racism, but it has shown positive results in helping people manage stress, and as a complement to therapeutic work on trauma.
Satya co-op member Taliah Abdullah, 48, said stress brought on by a toxic work environment and family problems inspired her to finally attend classes. The effect was so life-changing that she enrolled in Satya’s teacher training.
“I didn’t know I needed this, but it’s really changed my life for the better,” she said. “I feel like now I have the tools and the toolbox that I need to better navigate the world as a woman of color.”
At a Saturday morning class Grant led before the pandemic hit, five Latina and Black women and a lone Black man sat atop colorful yoga mats in a half-circle around Grant with smoke billowing around them from a copal-scented incense stick.
Grant spoke in hushed tones during the hourlong session, leading them through cat-cow, downward dog and boat poses. The theme was more spiritual than physical, more relaxing than vigorous, as illustrated by the mantra she used to begin the class: “We are resilient, we are grounded, we are complete. And the spirit of love is in me.”
First-time attendee Ramon Gabrielof-Parish, 42, a Black professor at Naropa University in Boulder, became so relaxed that at one point he began snoring. He said that after an exhausting week he appreciated the serene vibe.
Sarah Naomi Jones, 37, who graduated from Satya’s training, said the co-op provides a safe space to bond, vent and heal — a very different vibe from predominately white yoga spaces where many people of color often feel unwelcome. She said she felt that icy reception when, as a Black yoga newbie, she attended an intensive yoga class mostly filled with white attendees.
“When I walked in, it was kind of like, ‘What are you doing here?’” recalled Jones. “The spiritual component was totally missing. It wasn’t about healing. It felt like everyone was there just to show off how much more stretchier they were than another person.”
Moving Forward in New World
Denver-based Black yogi Tyrone Beverly, 39, said the growth of yoga among people of color is a sign of yearning for more inclusivity in the practice. His nonprofit, Im’Unique, regularly hosts “Breakin’ Bread, Breakin’ Barriers” yoga sessions with a diverse mix of attendees followed by a meal and discussion on topics such as police brutality, racism and mass incarceration.
“We believe that yoga is a great unifier that brings people together,” he said.
Because of the pandemic, Beverly has moved all his events and classes online for the foreseeable future as a safety precaution. Satya took a brief hiatus of in-person classes, Grant said, but now offers some classes outdoors in parks in addition to daily online classes. Grant said that during the pandemic, even online classes could make a difference for individuals.
“That’s the beauty of yoga,” Grant said. “It can be done in a group. It can be done individually. It can be done virtually and, most importantly, it can be done at your own pace.”