By Laura Onyeneho
The 2015 “What’s Trending in Nutrition” survey shows Americans are becoming more aware of obesity problems sweeping the nation. But the obesity epidemic is targeting one population group more than any other: African-American women.
A 2012 study by the Centers for Disease Control and Prevention stated that four out of five African-American women are obese or overweight. Though two-thirds of U.S adults are obese or overweight, national data reveals that 82 percent of black women are obese compared to 77.2 percent of Hispanic women, and 63.2 percent of white women.
The root causes of this epidemic come from a variety of places. Race, socio-economic status, and ethnicity are some key reasons. The life expectancy for African-American women is decreasing at a time when they have an increased chance of having obese-related yet preventable illnesses such as type 2 diabetes and heart disease.
In order to improve the health of black women, it requires an understanding of the causes of these problems, and the preventative measures to follow. For the last 20 years, Boston University Slone Epidemiology Center’s Black Women’s Health Study (BWHS) was designed to take on the task.
Dr. Yvette Cozier, assistant professor of epidemiology at Boston University, is co-investigator of the BWHS. Her research focuses on social and genetic factors on sarcoidosis (an inflammatory disease) and cardiovascular disease. Cozier said many factors have contributed to the obesity crisis, one of them being a lack of access to healthy food and fitness recreation spaces. “Communities of color often have many fast food restaurants than they do high functioning grocery stores,” she said. “Children of color may spend less time in physical activity,” Cozier noted, citing limitations such as “safety of neighborhoods, availability of public spaces, and local programs that encourage youth activity.”
The BWHS also found a relationship between obesity and racism and discrimination. In 2000, Cozier presented data on the experiences and perceptions of racism in the study. She found that 58 percent of participants experienced racism at work, 35 percent in housing and 23 percent with law enforcement. “Stress does effect physiologic pathways, that does effect with certain hormonal receptors are laid down in the body,” said Cozier. “That can result in the retention of fat and the physiological process of enjoying comfort food.” The BWHS newsletter stated that racism might influence health through both the mind and body. The body produces a substance called cortisol, sometimes called the stress hormone, which could lead to metabolism issues.
Though there are many factors that correlate to the obesity problem, Cozier said the problem should first be addressed at home. She said the launch of First Lady Michelle Obama’s “Let’s Move,” campaign was a great way for people to educate themselves in diversifying their food. Cozier noted that in the African-American community culture, people tend to consume fatty foods. In 2006, more than 40 percent of food money in the U.S .was spent on meals consumed away from home, mostly from fast food restaurants.
The BWHS conducted a study based on the eating habits of its participants. The graph below shows the percentage of restaurant food eaten at least once a week. Fried chicken and burgers were among the popular preferences. Almost 20 percent of women had burgers and 14 percent had fried chicken.
Access to healthier food options is often debated in the topic of obesity. Even with access to farmers markets and grocery stores in some neighborhoods, some families with limited financial means may not be able to afford some healthier options. Mattapan is listed as having the highest adult obesity at 37 percent, with North Dorchester at 32 percent, and Hyde Park at 20 percent. Only 7 percent of people in the Kenmore/Fenway area are obese.
Dr. Monica L. Wang, assistant professor in the Department of Community Health Sciences at the Boston University School of Public Health, said culture plays a key role in obesity. But in this case, culture means much more. “Most of the time when people think of culture, they think ethnic culture.” said Wang. “ When I think of culture I think of a set of values, norms and behaviors specific to belong to a specific group.”
Yet some studies have shown black and Latino women have body image ideals that are different from white women. “There is a greater acceptance for women with larger body sizes, and ideals of those can vary,” Wang said. She said for programs that aim to improve health, it should be gender and race and ethnicity specific. “There isn’t quite a universal set of messages and activities that can appeal in the same way in all populations,” she said.
The city has a number of initiatives to address healthy eating and physical activity in low-income communities. One example is called “Train for Change,” and it’s a collaboration with the Tufts University School of Medicine, the Tufts School of Arts and Science, and Community Health Department. The program targets physical fitness and employment among women of Caribbean decent. These women live in Dorchester, Jamaica Plain or Roxbury and they train women to become physical fitness instructors.
“Not only do the participants value health, but they value being able to make a living, said Wang.
In 2012, the city received a $4.6 million grant from the CDC to initiate healthy dietary physical activity programs in low-income communities. One example involves subsidizing annual bike share memberships through the Hubway Bike Share Program. “If you’re of low income you can have an annual membership for $5.”
With many city initiatives focusing on health and fitness, Wang said there has yet to be something that is evidence-based that can be effective and engage all populations. “One of the challenges is that you can have all of these programs, but the people who come and participate are the people who are interested,” Wang said. “We could be missing a whole chunk of the population that really needs it and might not have the time to participate in these programs. Those are maybe the people that we really need to reach the most.”