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Minority health issues often tied to diet, culture

July 29, 2007 by  
Filed under Health, News, Weekly Columns

(Akiit.com) Keecha Harris is a registered dietitian, holds a doctorate in public health and is president of Keecha Harris and Associates Inc., a food systems and public health consulting firm. She is also a spokeswoman for the American Dietetics Association, a former columnist for MSN.com and an authority on African-American nutrition.

Here is her expert opinion on minority health and diet issues:

What are the different health problems African-Americans face?

African-Americans as a group experience more chronic health conditions, like diabetes, high blood pressure, kidney disease and some forms of cancer.

When talking about breast cancer and prostate cancer, African-American men and women tend to be diagnosed later in the disease process and often don’t receive the same quality of care as their white counterparts. Why the difference in care?

There are a lot of different theories out there. Sometimes, people don’t know how to navigate health care and how to work with health care providers. On the providers’ side, often times there is a communication disconnect. The provider may not necessarily understand the patient’s culture. Regardless of race, many times, health care providers tend to speak in medical terms. This makes it hard for any patient not to be intimidated. African-Americans tend to be underinsured, so insurance is a major factor as well.

Is obesity a major problem among blacks?

It is. African-Americans have a higher proportion of the population that is overweight and obese. Nearly 80 percent of all African-American women are in that category. Getting enough exercise, getting enough rest, correct nutrition – those are three things that are really important. African-Americans tend to be heavier than their white counterparts.

But also, when weight tables were developed, they were based on a predominately white population. So the standard for normal body weight is not representative of many groups – Asians tend to be on the lower end of normal. Hispanics and blacks tend to be on the heavier end. The body mass index and the weight-to-hip ratio is more predictive of health problems than just weight alone.

Why is race a factor in health?

There are some basic cultural differences in how people communicate and address health issues and outcomes. For instance, there are some cultures where it’s very inappropriate for a woman to be in room with a man by herself. How can that woman negotiate her needs in the health care system when she does not have a female doctor? This is one type of cultural issue that can impact someone’s health related to culture.

Also, our current health education system can do a lot more to assure that dietitians, doctors, nurses and others professionals are more culturally competent.

We want to place the blame for everything we do on race, but class is definitely a factor when we talk about health care and outcomes. Eating disorders are more common in middle class and upper class girls and women. We’re seeing more eating disorders in blacks as well, because of the pressures that come along with class.

You can’t limit health disparities to black or white or yellow or brown; you also have to see the color of green. There are a lot of factors that come into play.

Education is another factor that we don’t pay enough attention to.

What are the problems you face in getting African-Americans to pay attention to diet?

One of the problems I related to service providers is that we don’t make enough time to think about what makes it hard for individuals to gain access to healthy food. We need to become more aware and sensitive to individual needs and circumstances.

We often go in with the idea that people should come in with all doors open and make changes instantaneously. They don’t do that. Do you think African-American nutrition is an area that will receive much more study?

I think it should. I think it really depends on the availability of funds. I think we’re doing a lot more than we were doing 30 years ago. Researchers and their study subjects then were white males.

About 15 years ago, the National Black Women’s Health Study began, and they recruited black women from all over the country. I am one of the women in the study. Every couple of years, we complete surveys about our health including nutrition and physical activity.

I joined the study when I was a dietetics major as an undergrad, and it furthered my interests in population health. I have always been far more interested in being able to reach large numbers of people. That’s something I do as an ADA spokesperson or with articles on MSN that are still out there. It’s really gratifying to be able to reach a large number of people at one time.

By AMY GORDON


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