Food deserts

I recently did a group presentation on Food Deserts for my Environmental Health class. According to the CDC, food deserts are "areas that lack access to affordable fruits, vegetables, whole grains, low-fat milk, and other foods that make up the full range of a healthy diet." One thing we learned while researching food deserts is that there's even one in Iowa City. There's a great online tool available that was developed by the USDA that allows you to search by address and see if there's a food desert in your area. The food desert in Iowa City included the very place where we were giving our presentation (which was in the University of Iowa medical school building, part of the health sciences campus).

Even though I had known some about food deserts before this presentation, this USDA report to Congress about food deserts was very interesting and had a lot I didn't know before. One of their major findings was that access to food actually isn't an issue for the majority of people - the bigger issues may be easy access to unhealthy foods and the cost of food. They also outline a lot of neat potential solutions to food access issues, including community food projects, and some of the major gaps in the research.

Anyway, next week is the last week of classes and I have two big papers due on the same day and then two big tests on the same day (it seems like it always works out like that, doesn't it?), so I should probably get back to work!

Here are some articles I thought were interesting:

Emergency Room Closures Hit Minorities, Poor Hardest - Kristopher Husted, NPR
Depressing.

Xeni Jardin Live-Tweets Her First Mammogram, Is Diagnosed With Breast Cancer - Dodai Stewart, Jezebel
I've been reading BoingBoing for years - a blog that Xeni Jardin helped found - so when I read this, it almost felt like it had happened to someone I know. I thought this article had some good points about the fact that she live-tweeted her experience getting her first mammogram and her results is a "sign of How We Live Now." Stewart also notes that "Jardin's decision to update her followers as she went for her breast exam highlights a positive aspect of public sharing: The ability to reach out of a community, and have that community embrace you, in turn."

Scooby-Doo and Secular Humanism - Chris Sims, Comics Alliance
This has nothing to do with public health, I just thought it was a really good read. My partner Tim, who is a major Scooby-Doo fan, showed it to me, because I am not a big fan of the show (I've just always found out pretty boring and formulaic.) This article does make a compelling case for why Scooby-Doo is awesome. As a person who values rationalism, I was somewhat moved (although I still don't have an urge to watch Scooby-Doo).

Pizza is a Vegetable: Another Example of Corporate Influence on US Politics

You've probably already heard that Congress reclassified the tomato sauce on pizza as a vegetable for school lunches. The phrase "pizza is a vegetable" has even already become an internet meme.

In case you don't know what I'm talking about: basically, Congress blocked proposed changes by the USDA to make school lunches healthier.

As the New York Times reported, "Food companies including ConAgra, Coca-Cola, Del Monte Foods and makers of frozen pizza like Schwan argued that the proposed rules would raise the cost of meals and require food that many children would throw away... The companies called the Congressional response reasonable, adding that the Agriculture Department went too far in trying to improve nutrition in school lunches."

This is a perfect example of the control large companies have over our political system. These big food companies basically bought out Congress to not allow healthier changes to be made - "practical, science-based standards" supported by nutrition experts.

I read the politics section of reddit occasionally, and Tarkaan, a reddit user, wrote something I really agree with: "See, the reason this is offensive and that you should be outraged by it is because nutritionists and scientists guided public policy to improve health and nutrition in children. ConAgra came in and spent a bunch of money, and erased the work that science has done." Tarkaan relates this decision back to Occupy Wall Street and one of the major things the movement is about: protesting the corporate influence on our democratic process.

The Occupy movement has been getting a lot more attention lately, especially after the videos of the police officers pepper spraying UC Davis protesters went viral. Although the videos showing police brutality are disturbing and important, the Occupy movement is about much more than reforming our enforcement practices. Corporate influence and lobbying affect so much, including public health.

Weight and health

I’m very interested in the relationship between weight and health, although I hold some unconventional views. I think that weight alone should not be used as an indicator of health and that focusing on weight loss as a goal in health interventions can have some unintended negative outcomes.

First, I will preface this by saying that I am not denying that the US population, on average, eats worse and is less active than it was in previous generations, and that this has led to poorer health outcomes. As a person interested in public health, I think there should be efforts (on multiple levels, not just individual) to improve our nation’s health. I also realize that we have, on average, gained weight.

While I recognize this relationship between our increasingly unhealthy environments/lifestyles and our increasing size, I don’t think that it’s as clear-cut as many in our society make it out to be. I believe that someone can have a technically unhealthy BMI (over 25) but still be healthy while someone who has a normal BMI can be unhealthy. Now, clearly there are countless credible studies that have found that people with higher BMIs tend to be at risk for an assortment of health problems that are less common among people with lower BMIs, but there are also a number of studies that complicate this apparently obvious relationship (for example: here, here, and here). And while perhaps on average someone with a BMI of 30 is more likely to have certain health issues than someone with a BMI of 20, this does not mean that all people with a BMI of 30 are unhealthy and that all people with a BMI of 20 are healthy.

I believe that our focus on weight as the primary sign of health and our obsession with weight loss as the way to gain health has lead to some unintended negative consequences: 

1. There are many very unhealthy ways to lose weight. If weight loss is the focus instead of adopting healthy behaviors regardless of weight loss, people may try to lose weight at any cost, even if it means actually being less healthy. 

2. People who have a normal BMI may think they’re healthy even if they aren’t eating well or getting enough physical activity, while people with higher BMIs who adopt healthy behaviors may become discouraged and think they aren’t healthier if they don’t lose weight. 

3. By conflating weight with health, people who do not have a normal BMI are automatically judged as being unhealthy, even if they actually are healthy/do have a healthy diet and exercise regularly.

As a society, we are very focused on losing weight as the key to being healthy, but I think there may be a different way to approach it. What about being healthy simply for the sake of health, not weight loss? This is what I like about Health at Every Size (HAES). I find this approach to health very interesting and others have argued that we should have a paradigm shift away from focusing on weight loss to HAES. Here, here and here are some published articles on the benefits of HAES.

Of course, it should go without saying that even someone who does have a high BMI and actually is very unhealthy (for whatever reasons) should still be treated as a human being and not discriminated against. Here’s an example of weight discrimination: this study found that the higher your BMI, the less your doctor respects you.

It should also be noted that the degree of agency people have in controlling their weight (and health in general) is greatly debated. Our society tends to put the blame largely on individual-level factors (usually focused on behaviors, but sometimes genetics are mentioned too). Public health professionals and some other experts have done an excellent job of pointing out other factors, including environmental and social.

I am not the first person to say these things, and many other people have written much more eloquently than me on these issues. I know many people feel passionately about this topic and may disagree with me. I love to discuss this issue, so feel free to voice your opinion!

Kale and Rabies

This year is certainly starting off busy! There's always something happening on campus or in town. This weekend, I went to the New Pioneer co-op's Kale Fest, had a blast at the Old Capital City Roller Girls' Roll Out Party (a fun event hosted by the local roller derby team), and played the board game Arkham Horror for the first time with some friends (the verdict: fun but very time-consuming!).

The only time I really eat kale is when it's in kale chip form (a delicious and easy snack recipe my coworker introduced me to), but kale fest was quite interesting and featured some unexpected recipes (like "kale kupkakes," below). Dr. Terry Wahls came and spoke about how she reversed many of the effects of her multiple sclerosis by changing her diet to include more mitochondria-supportive foods. I'm usually fairly skeptical of first-hand accounts like this, but her story was fascinating and had an important take-home message: healthy food can have a powerfully positive affect on your life. Many people in public health are trying to come up with ways to not only increase knowledge about the benefits of healthy foods and how to prepare them, but also increase access and affordability. There are a number of barriers to getting healthy foods, including cost or living in a food desert.

Other eventful things this week include that the first MPH Professional Development seminar happened. Maj. Loren Adams spoke about his practicum in Afghanistan, which involved setting up a rabies prevention program. He worked with local veterinarians to vaccinate 1,500 dogs against rabies and educated children about how to prevent been bitten by dogs. His presentation was incredibly interesting and he talked about how he hoped it would keep going now that he's gone and that ideally a neutering component would be added (although it sounds like much of Afghanistan lacks a lot of the infrastructure to put that aspect into place right now). His talk was definitely great way to kick off the MPH seminars.

Anyway, here are some articles I read in the past week that you might find interesting:

Uninsured Largely Unaware of Benefits Coming from Overhaul - Julie Rovner
I would love to see what kind of campaign some health communication experts would come up with to help remedy this.

Vaccine Cleared Again as Autism Culprit - Gardiner Harris
Not surprising, but still good to be reminded that vaccines have no link to autism.
On a related note, This American Life had a great (and by great, I mean mostly horribly depressing) story on the harms of not vaccinating about three years ago called Ruining It for the Rest of Us. (Full disclaimer: I'm absolutely obsessed with This American Life.)

Size Advocacy: An Inclusive Vision of Justice - Leah Krandel
Leah went to Grinnell with me. I'm very interested in fat discrimination and I thought her article was thought-provoking.

If you're in school, I hope you also had a good first week of classes!