Unnatural Causes, an acclaimed video series, identifies practices and mindsets that perpetuate racism and inequities in health. The episodes portray the widened gap between affluent and impoverished populations in the U.S., specifically exposing the trends in society that allow the health of undervalued communities to decline like the strategic placement of fast food joints and liquor stores in inner-city areas. In a video clip entitled “Impact of Poverty and Stress on Diabetes among Native Americans”, Dr. Donald Warne explains that impoverished conditions and high levels of stress contribute to an unhealthy lifestyle that almost guarantees chronic health conditions like diabetes and hypertension (Impact).
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| Courtesy of Unnatural Causes |
A tally of the suffering Native Americans endured could stretch miles long. The forced removal off their land and the resulting loss of culture and identity that it spurred still damages the physical and emotional health of their communities nationwide. As industrialization and urban migration become increasingly common, which lifestyle features indicate unhealthiness? Why does the highest rate of chronic conditions like diabetes and heart disease continue to occur in the most marginalized of communities in the U.S.?
Dennis Wiedman in “Globalizing the Chronicities of Modernity” delves into the questions I posed above by studying the adapted cultures and lifestyles of communities, particularly indigenous, that have experienced declined health due to the rise of industrialization and globalization. He names the recent emergence of MetS, metabolic syndrome, as directly related to lifestyle change. Most individuals are not predisposed to these disorders, he argues. “No particular foods, genes, socioeconomic class, ethnicity, or other inequality can consistently explain the initiation of metabolic disorders in modernizing populations worldwide”, Wiedman opines of the enigmatic nature of MetS (Wiedman 38). This quote contradicts the remaining content of his article where he develops the theory that Native Americans suffer from a disproportionally high amount of stress due to the forced adaptation of a modern lifestyle.
Several studies exist today that prove the correlation between stress and health conditions. Wiedman cites studies specific to Native American health and their findings that “multiple generations of stressful events are associated with continued loss of identity, demoralization, and ongoing emotional suffering, key elements that maintain the chronic stresses resulting in metabolic disorders” (Wiedman 50). Clearly, he supports the conclusion that the historic oppression of these indigenous communities factor into their accumulation of stress, a scientifically proven causal agent of MetS. While I do agree that the genetic basis for these disorders remains less notable, I feel that undervalued groups in society are victims to social constructs and structural violence that predispose them to poor health and Wiedman’s so-called “chronicities of modern disease”. What are the main mediums that modern diseases use to reach populations? One way is through food.
Consumerism and capitalism are intertwined with the American food industry. In “On the Ideology of Nutritionism” by Gyorgy Scrinis, she cites Marion Nestle’s findings that that the constantly changing food politics obscure the message of recommended nutrition and healthy diet. Methods of coercion include lobbyists ascertaining the agendas of the food industry get passed by the U.S. government so that they can “shape the official dietary guidelines in ways that undermine criticism of processed foods and of high meat and dairy consumption” (Scrinis 39). The reductionism of nutrition Scrinis discusses involves the categorization and manipulation of various foods without context so that they serve to support theories about bodily health or “nutri-biochemical level” (Scrinis 41).
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| Courtesy of "The Tyanny of Choice" from The Economist |
The abundant choices and ambiguity that shape modern-day food marketing further add to the confusion that consumers experience when trying to make health-conscious decisions about diet. The image above depicts the large quantity of items we must sift through, each with respective labels announcing the unique mix of nutrients they offer. For individuals that already feel overwhelmed by society and their designated status in it, like Native Americans, the unreasonably difficult path they must navigate down to eat healthily proves daunting.
A well-known study by Dr. Dean Ornish entitled “Intensive Lifestyle Changes for Reversal of Coronary Heart Disease” investigates the effects of a complete lifestyle change on patients’ health who suffer from coronary atherosclerosis. The treatment involved a “10% fat whole foods vegetarian diet, aerobic exercise, stress management training, smoking cessation, group psychosocial support” with the research team tracking their progress after the first 5 years then after the next 4 years (Ornish). The results shocked the medical and scientific communities. The treatment proved far more effective than medication as the patients’ atherosclerosis actually reversed its course. The findings proved so significant because they linked MetS (the conditions Wiedman discussed in his article) with lifestyle factors like stress and diet.
Devalued communities like Native Americans in the U.S. who have historically endured stress due to forced migration and a shift in culture like subsisting on processed foods instead of traditional meals causes their rates in chronic diseases to spike above most groups. Wiedman specifically addresses this point when he introduces the Cultural Consonance model that links “social status inconsistencies with chronic diseases such as hypertension and circulating levels of stress hormones, the catecholamines” (Wiedman 50).
How can society progress forward in a way that identifies marginalized communities and addresses the societal forces that perpetuate health inequity? “Chronic Conditions, Health, and Well-Being in Global Contexts” by Frank, Baum, and Law suggests that the merging of medical anthropology and occupational therapy could help initiate the process of addressing and improving the quality of life for communities effected by health disparities. The authors consider, “in calling for deeper conversations and more active institutional linkages we perhaps tread a pioneer path for other health professions that are inherently more interested in health and well-being than in elimination of disease”, which seems to me a perfect place to start (Frank 246).
Bibliography:
Frank, Gelya and Carolyn Baum and Mary Law. "Chronic Conditions, Health, and Well-Being in Global Contexts: Occupational Therapy in Conversation with Critical Medical Anthropology." Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness. Lenore Manderson and Carolyn Smith-Morris, eds. New Brunswick, NJ: Rutgers University Press. 2010. 230-246. Print.
"Impact of Poverty and Stress on Diabetes Among Native Americans." Unnatural Causes. California Newsreel, 2007. Web. 15 Feb. 2011.
Ornish, Dean. "Intensive Lifestyle Changes for Reversal of Coronary Heart Disease, December 16, 1998, Ornish Et Al. 280 (23): 2001 — JAMA." JAMA, the Journal of the American Medical Association, a Weekly Peer-reviewed Medical Journal Published by AMA — JAMA. American Medical Association, 21 Apr. 1999. Web. 15 Feb. 2011. <http://jama.ama-assn.org/content/280/23/2001>.
Wiedman, Dennis. "Globalizing the Chronicities of Modernity." Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness. Lenore Manderson and Carolyn Smith-Morris, eds. New Brunswick, NJ: Rutgers University Press. 2010. 38-53. Print.
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