Obesity in the African American Community

Running head: OBESITY IN THE AFRICAN AMERICAN COMMUNITY

Incidence rates of obesity in the African American Community

Stephanie L. Butler Health Promotion and Education Research Paper University of Cincinnati February 28, 2013

Obesity in the African American Community Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health (World Health Organization, [WHO], 2013). In 1835, a Belgian statistician by the name Adolphe Quetelet was determined to explain the body measurements of the average person, so the body mass index (BMI) was created. BMI is a persons weight (in kilograms) divided by the persons height (in meters), squared. The formula for body mass index is used to estimate the proportion of fat a person has based on height and weight. Adults with a BMI between 18.5 and 24.9 are considered to be at a healthy weight. Adults with a BMI between 25 and 29.9 are considered to be overweight and the adults with a BMI of 30 or greater are considered obese. According to the National Center for Health Statistics, 2009, obesity rates have more than doubled in adults and children since the 1970s (Food Research and Action Center, [FRAC], 2010). Although recent estimates proposed that the overall rates of obesity have plateaued, obesity continues to be a leading public health problem in the U.S. On top of that, significant disparities exist based on demographics such as race, ethnicity and gender, geographic region, and socioeconomic status. FRAC (2010), states that 68.8% of adults are overweight or obese; 35.7% are obese and 31.8% of children and adolescents are overweight or obese; 16.9% are obese, with African American men, women and children leading the prevalence rates in obesity and extreme obesity. Recent national data shows that 82.1% of African American women are overweight or obese compared to 59.5% of White women. Another alarming problem is extreme obesity. It continues to be higher among women (8.1%) than men (4.4%), especially among Africa American women who have extreme obesity rates of 17.8%. Childhood obesity is also a major problem in the African American community. Ogden et al., (2012) stated that 25.6 percent of

Obesity in the African American Community White girls are overweight or obese compared to 41.3 percent of Black and 38.6 percent of Hispanic girls. However rates are very alarming for 12-19 year old African American girls with 45.1% being overweight or obese. There are serious health risks to being overweight or obese. Carrying excess fat can lead to severe health concerns such as cardiovascular disease, like heart disease and stroke, type 2 diabetes, musculoskeletal disorders like osteoarthritis, and some cancers (endometrial, breast and colon). These conditions can cause an untimely death and significant disability. What many people dont know is that the risk of health problems starts when a person is only somewhat overweight, and the chance of problems increase as a person becomes more and more overweight. It is estimated that more than 80% of people with type 2 diabetes are overweight. According to the Office of Minority Health (2012) people who are overweight are more likely to suffer from high blood pressure, high levels of blood fats, and LDL cholesterol -- all risk factors for heart disease and stroke. In 2010, African Americans were about 70% less likely to engage in physical activity. It is no surprise these conditions can cause long-term distress for an individual and their families, not to mention, the costs of health care can be tremendously high. However, there is good news. Being overweight and obese is mainly preventable. Achieving balance between calories consumed and calories used will help to maintain a healthy body weight. It is very difficult to make healthy choices when all the indications and supports in a persons environment tell you to do the complete opposite. As an African American I have lived and witnessed the excuses, we as culture refuse to change our mentalities and this is a major problem within our community. Socioeconomic status, unhealthy eating habits and lack of ambition to engage in physical activity are all reasons African Americans struggle with weight

Obesity in the African American Community problems. There is one other theory to why African Americans, especially Black women, that we are taught from childhood to embrace ourselves. In the Black culture, we are taught to love ourselves, our body and mind. While this is a positive trait to pass down to a daughter, it is seen throughout generations that a heavier woman is to love their curves, even if they are insecure, they'd never admit it, and so their child wouldnt see it. Furthermore, all these also lead to childhood obesity. Several health disparities in the United States are directly related to inequalities in education and income. It is already evident, the highest rates of obesity occur among population groups with the highest poverty rates and the smallest amount of education. According to Drewnowski and Specter (2004), poverty and food insecurity are associated with lower food expenditures, low fruit and vegetable consumption, and lower-quality diets. Prices and incomes affect food choices, dietary habits, and diet quality. While I dont necessarily believe all people with a low-socioeconomic status and who are on public assistance purposely abuse their privileges, many of them also dont use that aid for healthy eating choices like fresh lean meats, fruits and vegetables. Although they have the assistance, people still have a habit of buying the cheaper foods so they can get more for their money. The issue is, the cheaper foods that people are consuming are full of artificial flavors, hidden sugars and fat, MSG and sodium. There have been many studies that have observed the influence to the obesity epidemic of dietary sugars and fats, larger portion sizes and the lower nutrient density of foods eaten away from home. Data from the Bureau of Labor Statistics indicate that income disparities do affect diet quality (Drewnowski and Specter, 2004). Food purchases made by high-income households differed noticeably from those made by low-income households. Wealthier families have the

Obesity in the African American Community means to buy higher-quality meats, more fish and seafood, more fruits and vegetables, and more convenience foods. So, it is safe to say to achieve a healthy diet it may be necessary to spend more money. One other issue many people who have a low socioeconomic status have to face is food deserts. Food deserts are geographic areas where a neighborhoods access to affordable, healthy food options (especially fresh fruits and vegetables) is limited or even nonexistent due to the lack of grocery stores within a suitable travelling distance. In an article written by Morland and Wing et al., studies have found that wealthy districts have three times as many supermarkets as poor ones do, that white neighborhoods contain an average of four times as many supermarkets as predominantly black ones do, and that grocery stores in African-American communities are usually smaller with less selection. Due to several people not owning their own vehicle and the lack of public transportation, many times, this leaves African Americans living in these communities the only option of processed foods, such as snack cakes, chips and soda, typically sold by corner delis, convenience stores and liquor stores are usually just as unhealthy. This leads to the next major issue: African Americans and unhealthy eating habits. In the Butler household, our Thanksgiving, Christmas dinners, family gatherings and evening weekly Sunday dinners may consist of fried chicken, turkey and fish, ribs (in the summertime), ham, macaroni and cheese, mashed potatoes, greens and green beans, cornbread and rolls, sweet potatoes with butter, brown sugar and marshmallows and sugary fruit drinks. Then on top of that there are a number of desserts: cheesecake, chocolate, red velvet and pound cake, apple pie and a sweet potato pie.

Obesity in the African American Community African-Americans have dietary preferences born from cultural influences and necessity. The preference for a particular type of cuisine and what I described above is called soul food, which has caused several health problems for African-Americans. Soul food typically involves fried foods and lots of fatty meats prepared with rich gravies. As I explained above with my own family, when most African American families get together, their social interactions are centered around food. Soul food is the food of choice especially African Americans who live in the South. Unfortunately, soul food is not a healthy type of food, and African Americans have some of the highest rates of obesity and heart disease because of eating this type of food. As a culture, African Americans associate these foods with social interactions and also with our history of slavery. Therefore any efforts to get them to eat other types of healthier foods are met with resistance and are seen as trying to eradicate Black culture (Belle, 2009). It is important for African Americans to understand it is still possible for us to eat the soul foods we love but in a healthier way so that we can overcome these high rates of obesity and cardiovascular disease. It has been challenging to encourage African Americans to eat healthier due to their strong cultural beliefs concerning food. To us, food is about protecting cultural traditions and developing strong family bonds. A good method to encouraging healthier eating habits would include teaching one another to cook soul food in healthier ways such as baking, roasting, or broiling meats instead of frying them. Education is also important to helping African Americans eat a more healthy diet. Simple changes in diet might include substituting herbs for high sodium seasonings, increasing the amount of vegetables and decreasing the amount of meat, removing the fat and

Obesity in the African American Community skin from meat, and eating more fresh vegetables and fruits. Incorporating daily physical activity is also important to improving our health as a community. It is also a serious problem that African Americans, mainly women, are predominantly sedentary. Young and Voorhees (2003) reported that [for African American women] the ability to be physically active was inuenced by personal factors (time and lack of motivation); social factors (family responsibilities, lack of role models, and support from family and friends), environmental factors (safety from crime and need to travel to exercise facilities), and policies (few workplace policies that encouraged physical activity). The purpose of their study was to determine links between personal and social and physical environmental factors with physical activity in urban African American women. In an earlier study (Young & Voorhees, 2003) a sample of 234 African American women in Baltimore Maryland, 21% (48) of women met recommendations for physical activity, 61% (143) were insufciently active, and 18% (43) were inactive. The results were used to create awareness. Many African Americans obtain their nutritional information from health fairs, churches, television and radio. They also are likely to receive nutritional information from their doctors, when they go. Belle (2009) stated that it has also been reported that many Black Americans have problems understanding nutrition guidelines. If churches and other organizations held seminars to encourage healthier eating habits, it would help the African American community to make healthier food choices. It would also help to teach more adults about their African ancestors and how they ate, especially, since they ate much more differently than African-Americans do today. It is important as a community that we continue to embrace our heritage and culture but it is also important that we make changes to the traditional foods we love, to decrease the rates of

Obesity in the African American Community obesity in our community, especially in our children. One in four African American girls and almost one in five African American boys are overweight. Childhood obesity has more than doubled in children and tripled in adolescents in the past 30 years. It is very alarming to know that the percentage of obese children in the U.S. between the ages of 6 and 11 increased from 7% in 1980 to 18% in 2010. The same problem occurred in adolescents aged 12 to 19 with obesity increasing from 5% to 18% over the same time. The latest study suggests that children and adolescents who are obese are likely to be obese as adults and are therefore more at risk for adult health problems such as heart disease, type 2 diabetes, stroke, several types of cancer, and osteoarthritis (Centers for Disease Control and Prevention [CDC], 2013). I found one study that indicated that children, who developed obesity as young 2, were more likely to be obese as adults. Unlike adults, children are only partly responsible for their eating and exercise choices. Parents and other care givers exert an influence over the diet and exercise patterns, especially when children are still young. Young-Hyman et al., (2000) argues efforts to prevent obesity will have to change care givers attitudes and behaviors in order to impact the eating and activity patterns of their children. Childhood obesity is a big problem in America and it needs to be addressed. While there are many different reasons of obesity like genetics, and social and emotional influences, poor eating habits and living an inactive lifestyle are the main causes of obesity. The latest studies show the U.S. Department of Health and Human Services recommends that young people aged 617 years participate in at least 60 minutes of physical activity daily (CDC, 2013). Physical activity and inactivity are very important factors. Many studies have shown that kids who spend

Obesity in the African American Community more time watching television and playing video games are at higher risk of becoming overweight and obese. There are treatments for obesity. Surgery and medications are used for extreme cases of obese children, but in many cases is common with adults. However, the best solutions are to embrace dietary changes, exercise and physical activity and behavior changes. This combination of things will help children, adolescents, teens and adults get to a healthier and happier weight. So often does obesity become a lifetime problem. Many obese people fall back into their old habits of poor eating and being inactive, so they gain back the weight they lost after accomplishing their goals. One of the main objectives for obese people is to find out what healthy food they like best and enjoy eating those foods in moderation. They also need to stay active on a regular basis to keep up their preferred weight. It is also best that parents play a role in the development of an obese childs self-esteem; they should encourage their strengths and enthusiastic behaviors instead of reminding them of the weight issues. It is time for the African American community to take charge of our actions. While it is still important to pass on cultural traditions from generation to generation, African American families need to begin passing down the traditions of family fitness and health, rather than obesity and other preventable diseases.

Obesity in the African American Community References Belle, G. (2009). Can the African-American Diet be Made Healthier without Giving up Culture. The York Scholar, 5(2). Retrieved from http://www.york.cuny.edu/academics/writing program/the-york-scholar-1/volume-5.2-spring-2009/introduction-to-volume-5-issue-2 Centers for Disease Control and Prevention (CDC). (2013). Adolescent and School Health: Childhood Obesity Facts. Retrieved from http://www.cdc.gov/healthyyouth/obesity/facts.htm Drewnowski, A. & Specter, S.E. (2004). Poverty and obesity: the role of energy density and energy costs. The American Journal of Clinical Nutrition, 79, 6-16. Food Research and Action Center (FRAC). (2010). Overweight and Obesity in the U.S. Retrieved from http://frac.org/initiatives/hunger-and-obesity/obesity-in-the-us/ Morland, K., Wing, S., Diez Roux, A. & Poole, C. (2002). Neighborhood characteristics associated with the location of food stores and food services places. American Journal of Preventive Medicine, 22(1), 23-29. Ogden, C. L., Carroll, M. D., Kit, B.K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among U.S. children and adolescents, 1999-2010. Journal of the American Medical Association, 307(5), 483-490. The Office of Minority Health (OMH). (2012). Obesity and African Americans. Retrieved from http://minorityhealth.hhs.gov/templates/content.aspx?ID=6456 World Health Organization (WHO). (2013). Health Topics: Obesity. Retrieved from http://www.who.int/topics/obesity/en/

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Obesity in the African American Community Young, D.R., & Voorhees, C.C. (2003). Personal, Social, and Environmental Correlates of Physical Activity in Urban African-American Women. American Journal of Preventive Medicine, 25(3Si), 38-44. Young-Hyman, D., Herman, L.J., Scott, D.L. & Schlundt D.G. (2000). Care Giver Perception of Childrens Obesity-Related Health Risk: A Study of African American Families. Obesity Research, 8(3) 241248.

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