On the last day of our trip to Italy, my wife and I were sitting at a coffee shop enjoying a very strong and very expensive coffee. As we looked out the front door, we saw a woman with three young boys sitting on a small bridge. (Venice has a lot of bridges.) All three boys were eating sandwiches wrapped in napkins and drinking bottled water. My wife snapped a perfect picture of them:
Look beyond the hipster attire for a second and look at what they were eating. These were more than likely homemade sandwiches accompanied by water, not sugary drinks. I bet you dollars to donuts (or euros to, uh…) that very little of what they were eating was processed. I feel safe in my bet because very little of what we ate when we were there, even the stuff bought at the small shops in the touristy areas, was processed. Also, all drinks, even the sugary ones, had regular sugar in them, not any kind of syrup.
Now that we’re back in the States, it’s been hard to replicate the European experience with regards to food. So much — too much — of what we buy at the grocery store is processed. Worse yet, if you want to get something a little fresher, it’s a lot more expensive. And that’s us with the advantage of having a couple of grocery stores within a few minutes from our home. It’s much, much worse in cities like Baltimore where food deserts and food swamps abound.
The lack of readily available fresh food is one of those structural problems that is causing a lot of public health problems right now, and things are not going to get any easier. Too many of us are relying on these processed foods every day, and too many of us are overweight or obese, increasing our risk dramatically of developing diabetes. (That reminds me that I need to go for a long jog tomorrow.) So what do we do? What can we do?
Looking at Baltimore, for example, food stores that offer nutritious food will not open in the food deserts and swamps if there is high crime. There is going to be high crime as long as poverty is abundant. And there will be poverty as long as companies won’t hire minorities at the same rate that they hire members of racial and/or social majorities. And companies won’t hire equally until there is a cultural change whereby minorities are not regarded as unreliable and prone to crime. In essence, we have to attack the causes of the causes (of the causes) of lack of good food if we’re going to make a dent in the coming epidemic of chronic disease.
Good luck with that, right?
And Europe? Europe is on its way to where we are here in America because the homogeneity of that continent is changing with immigration from Northern Africa and the Middle East. Countries that are seeing these immigrants arrive are reacting rather badly, shunning away the immigrants to the poorest corners of their cities instead of welcoming them and integrating them into their respective societies. What Europe is going to end up having, if they don’t do already, is an expansion of food deserts and swamps like we do, and all the other public health problems that come with racial/ethnic/national bias will come along for the ride.
All they had to do in Europe — like we have to do here — is realize that everyone truly does deserve a fair shot at a good job, a safe place to live, good schools for their children, and good food to buy and take home to cook. It’s not rocket science, and it’s not asking for miracles. But we would much rather have discussions about what group of people to dehumanize and blame next. That’s how we roll, I guess.
René F. Najera, DrPH
I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
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