Health of Worcester 2011

Worcester’s Commissioner of Public Health has been working on a new report – “The Health of Worcester 2011”.  The report presentation that Dr. Magee has giving to various groups in the City uses striking visual representations of local and state data to highlight the public health issues Worcester faces.  What rises to the top? The three primary causes of premature death in Worcester are obesity, smoking, and opiate overdose.

The report showed 27 percent of adults in Worcester are obese, and another 35 percent are overweight. The number of obese children entering the city’s schools has doubled nationally to 10 percent over the past 30 years; in the city that number exceeds 18 percent, the report said. One in five city high school students is obese, the report said, with the percentage even higher among Hispanics and low-income.

Adults in the city are also dealing with diabetes and cholesterol issues. Cardiovascular disease is the city’s number two cause of premature death. Public health officials here want to decrease obesity and people being overweight by 5 percent in five years.

The Commissioner highlights large portion size, high consumption of fast food, and poor cooking and buying habits as the culprit of this extreme increase in overweight and obesity.   While these are of course true, its also important to look at the way our environment, policies and media influence peoples general food habits.  Strategies that address individual behaviors as well as our food environments and policies are most important.  Addressing one without the other will not solve the many diet-related problems our country faces.  Obesity, hunger, and diet-related disease (among many other issues) are all just symptoms of a very broken national and international food system.

The Commissioner has given the presentation to City Council, the Food & Active Living Policy Council, the City Manager, and will continue to present the information to relevant groups and organizations that can help work together to combat the obesity issue here in Worcester.

Read the article that ran in the T&G on August 16th.

The full Health of Worcester report is available at in the Health & Safety section.

Access to grocers doesn’t improve diets

“Access to grocers doesn’t improve diets, study finds” is the title of an article that ran in the LA Times yesterday.  The article discusses a study that tracked thousands of people in several large cities for 15 years and was published in the Archives of Internal Medicine on Monday.   The study concluded that people didn’t eat more fruits and vegetables when they had supermarkets available in their neighborhoods; instead, income and proximity to fast food restaurants were the strongest factors in food choice.  This is not information that should surprise any of us, really, but especially those of us that work in this world of community food security. Yet the article was written such that it implied that these results are a major blow to the movement to increase the number of grocery stores in areas that lack adequate access, such as urban centers and rural areas.  It is important that we don’t view healthy eating as dependent on one factor. It is also important to understand what “access” really means when it comes to food.  And, what we eat is not only dependent on access and our ability to consistently make good choices, but also on our mental and emotional well-being overall.

We cannot view “healthy eating” as something that happens in a bubble.  There is no “quick fix” to our nations issues of diet-related disease, complete disconnection from where our food comes from, cheap fast food, and emotional eating.  There is a complicated web of relationships between each of us and the food we eat, and we must work through that web in order to make lasting change.  Setting up grocery stores in communities that have no grocery store will not simply solve these problems.

Changing the way we all eat (and shop, and cook, and interact with food), and not only people of low-income, or people that are overweight/obese, should really be the focus of our work as community food security advocates and professionals.  Of course, people of limited economic means have added challenges that include the reality that healthy whole foods can cost more, or appear to cost more, or are assumed to cost more.  Healthy foods may also be harder to find in some rural or urban settings.  This historical and structural inequality is a key social justice issue that must be addressed with and by disenfranchised communities, yet rhetoric that frames the issue as “How can we make them eat healthy?” is paternalistic, disempowering, and really misinformed.  We should be working together to change the food system for everyone, rather than only focusing on changing the behaviors of a few people.  If we had a food system that was less industrial, not as consolidated, fair and just, environmentally sustainable, and not as commodified, we would most likely see fewer diet-related diseases and a lower rate of overweight and obesity, and we would not see these ailments disproportionately born by people of color or by low-income communities.

The article also does not tackle the complex issue of “access”.  “Access” is a three-pronged issue.  It could be geographic. Whether or not someone lives close enough to a grocery store, as opposed to having to rely on a corner store or fast food restaurant, is a piece of food access.  “Access” is also financial.  Having enough money to buy the foods that are healthy and that are available is a major component in food choices.  As long as fast food continues to be (or be perceived as) the cheapest and easiest way to feed a family, it will continue to be a primary choice for many folks.  “Access” is also about knowledge, ability, and attitudes.  If preparing meals from whole ingredients is out of the scope of someones knowledge and ability, then fast food or snack foods will again be a primary choice.  If people think that anything healthy will be bland and unenjoyable, then they will choose what tastes good, however unhealthy it may be.  Without cooking skills and knowledge of foods and basic nutrition, many people will be at a disadvantage in making healthier choices, or really being able to stick with a healthier diet.

Yet even if someone has the access, there are other factors that come into play.  A persons mental and emotional health is always a major factor in food choices.  For people that are stressed out, over-committed, depressed, lonely, etc. food can often become something that soothes and comforts.  Many of us turn to comfort foods from time to time, but people that are consistently in an unbalanced mental state turn to food regularly, and of course to fatty, sweet, salty, delicious foods.  And with approximately 12 million women and roughly 6 million men experiencing clinical depression each year, there are increased possibilities for instances of overweight and obesity amongst that population.

Hopefully what this study brings to light is that changing our food system is much more complicated than only grocery store access.  While concrete strategies like increasing healthy food options in communities is a key part of the equation, we must all work together across professions, across race and class lines, and across communities, states and regions to build a healthier food system for everyone.