For the past 15 years my family tradition is to travel from Washington, D.C., along with both grandparents, to sunny Florida to celebrate Thanksgiving with cousins. This year we decided to skip the travel and will have fall and winter celebrations at home.
We are not canceling the holidays, but to keep ourselves and others safe, we are keeping plans small and flexible and remembering that the health of those we love is most important as we enter the season of gratitude.
Before you gather
First, it is important that everyone who will be attending any holiday celebration is on the same page about how to take precautions before getting together. The idea is to lower infection risk in the weeks leading up to the holidays and then test to confirm.
In conjunction with quarantining, testing is the second strategy.
Research has consistently shown that people are most contagious a day or two before they show symptoms, so everyone plans to get tested with an RT-PCR test within 72 hours of Thanksgiving, while still being able to get results in hand before we gather.
No matter how careful you and your family are, there is some risk that someone will be infected. With that in mind, the goal is to reduce the conditions that lead to viral spread. The biggest risks are indoor spaces with poor ventilation, large groups and close contact. So we are planning the opposite: a short outdoor Thanksgiving with a small group and plenty of space between everyone.
To reduce the risk of infection from flying and to keep the gathering small, the only people coming to Thanksgiving at my family’s home in D.C. are my mother, my aunt and my uncle – all of whom live within driving distance. This is in addition to myself, my husband and our kids. When deciding how many people will come to the holidays, keep it small and consider the amount of space you have to maintain social distancing.
If the weather cooperates, we plan to be outside for trivia games and the turkey meal. Rather than eat around one table, we will have individual tables and place settings spaced far apart and space heaters around. I’ve got a mini care package planned for each guest so that everyone will have their own blanket, hand sanitizer, utensils and a festive mask. My mother won’t be helping out in the kitchen this year and, unfortunately, that goes for cleanup too. We won’t take a group picture but I will be sure to capture some of the special moments.
If the weather doesn’t cooperate, Plan B is to be inside in the large family room with as many windows open as possible and with everyone spaced as far apart as possible. Being outside is safer, but if you must be indoors, improve ventilation by opening doors and windows. Consider turning on exhaust fans and using an air purifier.
Everyone who lives in the household will be in one section while my mom will have her own individual area, as will my aunt and uncle. Even though we won’t hold hands before sharing the meal, we will still recite that we are “thankful for family, friends and food.”
Whether outside or inside, everyone will wear masks when they aren’t eating, maintain 6 feet of distance and use the hand sanitizer that I will place throughout the house.
It is also important to be mindful of alcohol consumption, as a pandemic is not the time for lowered inhibitions and bad judgment.
After the event
I hope everyone enjoys the meal and quality time spent with one another in this melancholy year, but the work is not done once the dishes are clean and everyone is home safely.
Everyone is planning to get another COVID–19 test one week after the meal. Additionally, Thanksgiving is our family’s trial run for Christmas, so a few days after, I plan to call everyone and discuss what worked well and what didn’t. If all goes well, I hope to repeat this quarantine, test and gather process for Christmas.
The ending of 2020 deserves to be celebrated, given this difficult year. This Thanksgiving will be different from those of other years, and my kids understand they need to manage their expectations. But we still plan to uphold our tradition of writing all that we are thankful for and reading our messages aloud to one another. We will still share love, some laughs and a good meal while everyone does their part to protect one another.
Dr. Ala Stanford and her staff on duty a coronavirus testing site in Pennsylvania. Stanford created the Black Doctors COVID-19 Consortium and sends mobile test units into neighborhoods. (Nina Feldman/WHYY)
When the coronavirus arrived in Philadelphia in March, Dr. Ala Stanford hunkered down at home with her husband and kids. A pediatric surgeon with a private practice, she has staff privileges at a few suburban Philadelphia hospitals. For weeks, most of her usual procedures and patient visits were canceled. So she found herself, like a lot of people, spending the days in her pajamas, glued to the TV.
And then, at the beginning of April, she started seeing media reports indicating that Black people were contracting the coronavirus and dying from COVID-19 at greater rates than other demographic groups.
“It just hit me like, what is going on?” said Stanford.
At the same time, she started hearing from Black friends who couldn’t get tested because they didn’t have a doctor’s referral or didn’t meet the testing criteria. In April, there were shortages of coronavirus tests in numerous locations across the country, but Stanford decided to call around to the hospitals where she works to learn more about why people were being turned away.
One explanation she heard was that a doctor had to sign on to be the “physician of record” for anyone seeking a test. In a siloed health system, it could be complicated to sort out the logistics of who would communicate test results to patients. And, in an effort to protect health care workers from being exposed to the virus, some test sites wouldn’t let people without cars simply walk up to the test site.
“All these reasons in my mind were barriers and excuses,” she said. “And, in essence, I decided in that moment we were going to test the city of Philadelphia.”
Stanford visits a Black Doctors Consortium testing site in Darby, Pennsylvania, on Sept. 9. Stanford has largely self-funded the testing initiative.(NINA FELDMAN/WHYY)
Black Philadelphians contract the coronavirus at a rate nearly twice that of their white counterparts. They also are more likely to have severe cases of the virus: African Americans make up 44% of Philadelphians but 55% of those hospitalized for COVID-19.
Black Philadelphians are more likely to work jobs that can’t be performed at home, putting them at a greater risk of exposure. In the city’s jails, sanitation and transportation departments, workers are predominantly Black, and as the pandemic progressed they contracted COVID-19 at high rates.
The increased severity of illness among African Americans may also be due in part to underlying health conditions more prevalent among Black people, but Stanford maintains that unequal access to health care is the greatest driver of the disparity.
“When an elderly funeral home director in West Philly tries to get tested and you turn him away because he doesn’t have a prescription, that has nothing to do with his hypertension, that has everything to do with your implicit bias,” she said, referring to an incident she encountered.
Before April was over, Stanford sprang into action. Her mom rented a minivan to serve as a mobile clinic, while Stanford started recruiting volunteers among the doctors, nurses and medical students in her network. She got testing kits from the diagnostic and testing company LabCorp, where she had an account through her private practice. Fueled by Stanford’s personal savings and donations collected through a GoFundMe campaign, the minivan posted up in church parking lots and open tents on busy street corners in Philadelphia.
It wasn’t long before she was facing her own logistical barriers. LabCorp asked her how she wanted to handle uninsured patients whose tests it processed.
“I said, for every person that does not have insurance, you’re gonna bill me, and I’m gonna figure out how to pay for it later,” said Stanford. “But I can’t have someone die for a test that costs $200.”
Philadelphians live-streamed themselves on social media while they got tested, and word spread. By May, it wasn’t unusual for the Black Doctors COVID-19 Consortium to test more than 350 people a day. Stanford brought the group under the umbrella of a nonprofit she already operated that offers tutoring and mentorship to youth in under-resourced schools.
Tavier Thomas found out about the group on Facebook in April. He works at a T-Mobile store, and his co-worker had tested positive. Not long after, he started feeling a bit short of breath.
“I probably touch 100 phones a day,” said Thomas, 23. “So I wanted to get tested, and I wanted to make sure the people testing me were Black.”
Many Black Americans seek out Black providers because they’ve experienced cultural indifference or mistreatment in the health system. Thomas’ preference is rooted in history, he said, pointing to times when white doctors and medical researchers have exploited Black patients. In the 19th century American South, for example, white surgeon J. Marion Sims performed experimental gynecological treatments without anesthesia on enslaved Black women. Perhaps the most notorious example began in the 1930s, when the United States government enrolled Black men with syphilis in a study at Tuskegee Institute, to see what would happen when the disease went untreated for years. The patients did not consent to the terms of the study and were not offered treatment, even when an effective one became widely available.
“They just watched them die of the disease,” said Thomas, of the Tuskegee experiments.
“So, to be truthful, when, like, new diseases drop? I’m a little weird about the mainstream testing me, or sticking anything in me.”
Brothers Tavier Thomas (left) and McKenzie Johnson were tested for the coronavirus at a Black Doctors COVID-19 Consortium testing site. Tavier, who studies history, says he feels more comfortable getting treatment from Black medical providers because of past abuses of Black people by white doctors and medical researchers in the U.S.(NINA FELDMAN/WHYY)
In April, Thomas tested positive for the coronavirus but recovered quickly. He returned recently to be tested again by Stanford’s group, even though the testing site that day was in a church parking lot in Darby, Pennsylvania, a solid 30-minute drive from where he lives.
Thomas said the second test was just for safety, because he lives with his grandfather and doesn’t want to risk infecting him. He also brought along his brother, McKenzie Johnson. Johnson lives in neighboring Delaware but said it was hard to get tested there without an appointment, and without health insurance. It was his first time being swabbed.
“It’s not as bad as I thought it was gonna be,” he joked afterward. “You cry a little bit — they search in your soul a little bit — but, naw, it’s fine.”
Each time it offers tests, the consortium sets up what amounts to an outdoor mini-hospital, complete with office supplies, printers and shredders. When they do antibody tests, they need to power their centrifuges. Those costs, plus the lab processing fee of $225 per test and compensation for 15-30 staff members, amounts to roughly $25,000 per day, by Stanford’s estimate.
“Sometimes you get reimbursed and sometimes you don’t,” she said. “It’s not an inexpensive operation at all.”
After its first few months, the consortium came to the attention of Philadelphia city leaders, who gave the group about $1 million in funding. The group also attracted funding from foundations and individuals. The regional transportation authority hired the group to test its front-line transit workers weekly.
To date, the Black Doctors COVID-19 Consortium has tested more than 10,000 people — and Stanford is the “doctor on record” for each of them. She appreciates the financial support from the local government agencies but still worries that the city, and Philadelphia’s well-resourced hospital systems, aren’t being proactive enough on their own. In July, wait times for results from national commercial labs like LabCorp sometimes stretched past two weeks. The delays rendered the work of the consortium’s testing sites essentially worthless, unless a person agreed to isolate completely while awaiting the results. Meanwhile, at the major Philadelphia-area hospitals, doctors could get results within hours, using their in-house processing labs. Stanford called on the local health systems to share their testing technology with the surrounding community, but she said she was told it was logistically impossible.
“Unfortunately, the value put on some of our poorest areas is not demonstrated,” Stanford said. “It’s not shown that those folks matter enough. That’s my opinion. They matter to me. That’s what keeps me going.”
Now, Stanford is working with Philadelphia’s health commissioner, trying to create a rotating schedule wherein each of the city’s health systems would offer free testing one day per week, from 9 a.m. to 9 p.m.
The medical infrastructure she has set up, Stanford said, and its popularity in the Black community, makes her group a likely candidate to help distribute a coronavirus vaccine when one becomes available. Representatives from the U.S. Department of Health and Human Services visited one of her consortium’s testing sites, to evaluate the potential for the group to pivot to vaccinations.
Overall, Stanford said she is happy to help out during the planning phases to make sure the most vulnerable Philadelphians can access the vaccine. However, she is distrustful of the federal oversight involved in vetting an eventual coronavirus vaccine. She said there are still too many unanswered questions about the process, and too many other instances of the Trump administration putting political pressure on the Centers for Disease Control and Prevention and the Food and Drug Administration, for her to commit now to doing actual vaccinations in Philadelphia’s neighborhoods.
“When the time comes, we’ll be ready,” she said. “But it’s not today.”
This story originally appeared on KHN,org and is part of a partnership that includes WHYY, NPR and KHN.
Since 1985, the month of October has become known throughout the United States as Breast Cancer Awareness Month. During this annual health campaign, charities, hospitals, retailers and others commit to raising funds earmarked for programs that aim at discovering a cause and a cure for breast cancer. Many of these programs also focus on helping women learn what they can do to minimize their risk of ever developing breast cancer in the first place.
Which would you rather do—reduce your risk for breast cancer or race around hoping for a cure? Most women, quite sensibly, would rather reduce their risk for breast cancer as much as possible. So what can you do to reduce your risk? Well, there are at least six strategies that are known and proven to reduce the risk for breast cancer: exercise regularly, maintain ideal body weight, avoid smoking, avoid alcohol, avoid oral contraceptives, and avoid hormone replacement therapy. Let’s take them one at a time. But before we dive into them, let’s first take a look at some important breast cancer facts as they relate to African American women.
According to the American Cancer Society (ACS), breast cancer is the most commonly diagnosed cancer among African American women and is the second most common cause of cancer death among African American women right behind lung cancer.
In addition, Breastcancer.org reveals on its website that while white women are slightly more likely to develop breast cancer than African American women, breast cancer is more common in African American women than white women in those under the age of 45. Research also indicates that Asian, Hispanic, and Native-American women have a lower risk of developing and dying from breast cancer than African American women. So, why is breast cancer so much more common — and deadly — among African American females?
Scientists are not certain why this is the case. Early studies suggested that African American women have, on average, fewer healthcare resources at their disposal. But further analysis shows that there is a distinctly more lethal form of breast cancer stalking black women. Until doctors can figure out precisely what is causing this different pattern of breast cancer in African American women, it just makes for them to use every means available to reduce their risk for breast cancer. So, while early diagnosis and treatment are important for improving survival from breast cancer, it is a wiser strategy to try to prevent the disease in the first place. And this leads us to the above-mentioned strategies.
Exercise, Exercise, Exercise
Moderate exercise, defined as 30 minutes of brisk walking four times per week, reduces the risk for breast cancer by 30 to 50 percent. A pair of tennis shoes is all you need. No pills; just walk! And if you are a breast cancer survivor, the same amount of exercise can reduce your risk of death by 50 percent. As far as I’m concerned, every woman newly diagnosed with breast cancer ought to be given a brand new pair of tennis shoes and told to use them regularly!
Find Your Fighting Weight
Maintaining ideal body weight is also important. Simply put, it is a matter of keeping extra body fat to a minimum. The reason this is beneficial is that estrogen — which is known to increase the risk for breast cancer — is manufactured in fat cells. So the more fat you carry around, the more estrogen you make. By maintaining ideal body weight, you reduce the amount of circulating estrogen and that will reduce your risk for breast cancer. Here’s a link you can use to calculate your ideal body weight.
Where There’s Smoke …
Steer clear of cigarettes because smoking definitely increases the risk for breast cancer; don’t let anyone tell you otherwise. And it most definitely increases the risk of death from breast cancer in those women who do smoke. Although doctors haven’t quite figured out why smoking increases the risk of death in women with breast cancer, there is no doubt that it does.
Rethink That Drink
For reasons that are not entirely clear, but may be related to elevated estrogen levels associated with alcohol intake, drinking increases a woman’s risk for breast cancer. Even half a glass of wine per day increases one’s risk. I know, cardiologists are proclaiming the heart-healthy benefits of drinking red wine, but alcohol increases your risk for breast cancer. So I recommend women steer clear of it.
Other Risk Factors
Oral contraceptives and hormone replacement therapy are also known to increase the risk for breast cancer. As a matter of fact, the World Health Organization (WHO) declared them to be Group I carcinogens, which are substances or agents that are known to cause cancer in humans in 2007, as compared to other WHO categories in which the cancer link is either questionable to yet to be confirmed. Although the FDA has not yet included the WHO analysis in the package inserts for these medications, it would be wise to avoid the use of oral contraceptives and hormone replacement therapy if you want to reduce your risk for breast cancer.
The Good News
Now, here’s some very good news: the world’s first preventive breast cancer vaccine was developed at the Cleveland Clinic in 2010 and is awaiting funding to begin clinical trials to see if it is safe for use in women. It is a very promising discovery, for the vaccine was 100 percent effective in preventing breast cancer in three different animal studies. The results were vetted by a panel of experts and published in the prestigious journal Nature Medicine in May 2010. The scientist who created the vaccine, Professor Vincent Tuohy, received the Cleveland Clinic’s Sonnes Innovation in Medicine Award that same year, and this year the vaccine has become the centerpiece of the Cleveland Clinic’s fund-raising efforts, a mark of the Clinic’s endorsement of Tuohy’s work.
In addition to this amazing development, Drs. Beatriz Pogo and James Holland, scientists working at the Mount Sinai School of Medicine in New York City, have found a virus that appears to be involved in 40-75 percent of breast cancer. They presented their results to the annual meeting of the San Antonio Breast Cancer Symposium in 2006–a very tough and demanding crowd of breast cancer experts. In fact, Pogo and Holland are just one step away from proving this virus causes breast cancer in women. Both of these areas of research, the virus and the vaccine, are now our best hope for ending breast cancer worldwide … just like we ended small pox and are ending polio.
But in the meantime, exercise regularly and maintain ideal body weight. And don’t drink alcohol, smoke, use oral contraceptives or hormone replacement therapy. Though nothing can guarantee you won’t get breast cancer, you’ll reduce your risk and be healthier for it.
Resources for the Fight
Visit the following websites for additional information and resources:
1. National Breast and Cervical Cancer Early Detection Program http://www.cdc.gov/cancer/nbccedp/screenings.htm
This is a government program created to help low-income, uninsured, and underinsured women gain access to breast cancer screenings and diagnostic services.
2. Sisters Network Inc. (SNI) http://www.sistersnetworkinc.org/index.html
SNI is a national organization that strives to educate African American women around the country about breast cancer, as well as provide support to survivors. Visit the website to locate a chapter near you.
3. Are You Dense Inc. http://www.areyoudense.org
Formed to educate the public about dense breast tissue, this organization espouses the value of adding screening ultrasounds to mammograms to increase detection of breast cancer. It also has a government relations affiliate, Are You Dense Advocacy, which aims at helping more women have access to an early breast cancer diagnosis and helps them find out what their state is doing to facilitate this. — By Shelley Bacote
The connection between the pandemic and our dietary habits is undeniable. The stress of isolation coupled with a struggling economy has caused many of us to seek comfort with our old friends: Big Mac, Tom Collins, Ben and Jerry. But overindulging in this kind of food and drink might not just be affecting your waistline, but could potentially put you at greater risk of illness by hindering your immune system.
Hear the word “nutrition,” and often what comes to mind are fad diets, juice “cleanses” and supplements. Americans certainly seem concerned with their weight; 45 million of us spend US$33 billion annually on weight loss products. But one in five Americans consumes nearly no vegetables – less than one serving per day.
When the emphasis is on weight loss products, and not healthy day-to-day eating, the essential role that nutrition plays in keeping us well never gets communicated. Among the many things I teach students in my nutritional biochemistry course is the clear relationship between a balanced diet and a strong, well-regulated immune system.
Along with social distancing measures and effective vaccines, a healthy immune system is our best defense against coronavirus infection. To keep it that way, proper nutrition is an absolute must. Although not a replacement for medicine, good nutrition can work synergistically with medicine to improve vaccine effectiveness, reduce the prevalence of chronic disease and lower the burden on the health care system.
Patients with cardiovascular or metabolic disease have a delayed immune response, giving viral invaders a head start. When that happens, the body reacts with a more intense inflammatory response, and healthy tissues are damaged along with the virus. It’s not yet clear how much this damage factors into the increased mortality rate, but it is a factor.
What does this have to do with nutrition? The Western diet typically has a high proportion of red meat, saturated fat and what’s known as “bliss point foods” rich in sugar and salt. Adequate fruit and vegetable consumption is missing. Despite the abundance of calories that often accompanies the Western diet, many Americans don’t consume nearly enough of the essential nutrients our bodies need to function properly, including vitamins A, C and D, and the minerals iron and potassium. And that, at least in part, causes a dysfunctional immune system: too few vitamins and minerals, and too many empty calories.
A healthy immune system responds quickly to limit or prevent infection, but it also promptly “turns down the dial” to avoid damaging the cells of the body. Sugar disrupts this balance. A high proportion of refined sugar in the diet can cause chronic, low-grade inflammation in addition to diabetes and obesity. Essentially, that “dial” is never turned all the way off.
While inflammation is a natural part of the immune response, it can be harmful when it’s constantly active. Indeed, obesity is itself characterized by chronic, low-grade inflammation and a dysregulated immune response.
Nutrients, essential substances that help us grow properly and remain healthy, help maintain the immune system. In contrast to the delayed responses associated with malnutrition, vitamin A fights against multiple infectious diseases, including measles. Along with vitamin D, it regulates the immune system and helps to prevent its overactivation. Vitamin C, an antioxidant, protects us from the injury caused by free radicals.
Polyphenols, a wide-ranging group of molecules found in all plants, also have anti-inflammatory properties. There’s plenty of evidence to show a diet rich in plant polyphenols can lower the risk of chronic conditions, like hypertension, insulin insensitivity and cardiovascular disease.
Why don’t we Americans eat more of these plant-based foods and fewer of the bliss-based foods? It’s complicated. People are swayed by advertising and influenced by hectic schedules. One starting place would be to teach people how to eat better from an early age. Nutrition education should be emphasized, from kindergarten through high school to medical schools.
Millions of Americans live in food deserts, having limited access to healthy foods. In these circumstances, education must be paired with increased access. These long-term goals could bring profound returns with a relatively small investment.
Meantime, all of us can take small steps to incrementally improve our own dietary habits. I’m not suggesting we stop eating cake, french fries and soda completely. But we as a society have yet to realize the food that actually makes us feel good and healthy is not comfort food.
The COVID-19 pandemic won’t be the last we face, so it’s vital that we use every preventive tool we as a society have. Think of good nutrition as a seat belt for your health; it doesn’t guarantee you won’t get sick, but it helps to ensure the best outcomes.
Cell phones and other digital devices can be a great way to keep up with the news and stay connected with friends and family, but using one excessively can increase your stress levels, negatively impact sleep and limit the amount of quality time you spend with your significant other.
Research shows the average American spends more than four hours a day using a smartphone. If that’s you, it might worth considering a digital detox, something many health experts recommend and a practice that’s becoming more popular in the digital age.
A digital detox is a period of time when a person refrains from using digital devices such as smartphones, TVs, computers, tablets and social media sites. Experts say digital detoxes can translate into more enriching interactions with others and a healthy reset of your inner psyche.
“Spending too much time on mobile devices can be a form of procrastination and a distraction from the things that matter most to us,” says Heather Partridge, a behavioral health counselor at Tidelands Health Family Medicine at Holmestown Road in Myrtle Beach. “It’s important to ask yourself, ‘What are you missing out on during those four hours that you’re on the phone every day?’”
Tech devices have been linked to an increase in stress and anxiety, and research shows using such devices at bedtime can result in shorter sleep cycles and increased bouts of insomnia.
A digital detox can improve mental well-being, relieve stress and help strengthen bonds with others, Partridge says.
Is it time?
Consider a digital detox if:
You’re “phubbing” (snubbing by using your phone) family members with phone in hand when you could be spending quality time together.
Your phone is the first and last thing you see on a daily basis.
You freak out when you’ve forgotten your phone during a trip away from the house.
You turn to your phone when you’re bored and spend time mindlessly scrolling through social media.
You’re staying up late surfing the Internet on your smartphone and compromising quality sleep time.
You’re obsessive about checking your phone for texts and the number of likes a social media post has received.
Completely detaching for a period of time may not be realistic for people whose phones are important to their livelihood, but some separation could be beneficial. It’s about setting healthy boundaries and using the device in ways that enhance both emotional and physical well-being, Partridge says.
“Moderation is key,” she adds. “Set limits and boundaries. There is a great benefit to regularly doing a digital detox.”
Here are some ideas for a healthy digital detox:
Focus on self-care, such as treating yourself to a long bath or meditation instead of spending time scrolling, swiping and browsing.
Practice mindfulness; be fully present in every moment and recognize and appreciate everything around you.
Replace the time you waste on your phone with learning a new hobby such as playing the guitar or painting.
Create boundaries such as limiting the amount of time you spend answering work emails once you’re home.
Commit to no electronics at the dinner table.
Keep the phone out of your bedroom and instead try reading a book or magazine in the minutes before you drift off to sleep.
Use an alarm clock to wake you in the morning rather than depending on your phone.
Join your kids outside to shoot hoops, play catch or ride bicycles.
Detaching digitally might make you feel uneasy initially, but it can be a refreshing and rewarding experience when it’s all said and done. It can help you improve your mental health, become more personable, deepen relationships and sleep better.
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.