Community Stories

Well Fed•Community Stories

Category: Community Stories

Telling you what’s really happening in your community related to the food access system.

What is… Biological Determinants of Health

What determines our health?

Dr. Bortz likes to explain it using the life of a car. “The life of a car depends on 4 elements: design, accidents, maintenance, and aging. If the car is a “lemon,” is involved in many accidents, or is poorly maintained, it will not have the chance to grow old. (1)” Our bodies work similarly. This is called the biological determinants of health.

What are biological determinants of health? For the purposes of simplification, biology is the study of the vital processes of life. For humans, that encompasses things we do that keep our body functioning correctly, or in contrast, what can deteriorate it faster. Internal factors such as how much or what we put in our body and how much exercise we do and don’t get, even factors outside our control like what genes we’ve inherited and external factors including bacteria and viruses, can significantly impact our health and quality of life. These are the biological factors that determine our health.

Some of these we can control. We can determine, to a certain point, our diet, whether we smoke or drink alcohol, and how much exercise we get. Other parts of our biology, paired with careful actions, can result in positive health outcomes. For example, someone with type 2 diabetes in their family history can reduce their risk of becoming diabetic through healthy regulation of their diet and exercise (2). There are biological determinants that are out of our control such as the deterioration of our body’s vital processes with age, but even as we age, how we treat our body can influence how fast our body ages and how resistant our body is to disease and harm.

This is where Well Fed is set up to make the most impact. We are focused on biology and behavior. We work in underserved communities where diet-related illness affects many people’s daily lives. The choices they make often determine their health outcomes. Some struggle to change bad habits and choose a healthy diet and as a result their diabetes or hypertension gets worse. Others will develop illnesses because they do not change their current lifestyle. However, we recognize the barriers they face which make choosing to cook and eat healthy difficult and sometimes out of reach.

Phinehas Adams / UNSPLASH

This brings us to the social determinants that drive health outcomes. These are the conditions in which a person is born, grows, lives, works, and ages that contribute to their health (3). The governmental policies, cultural values placed on health, your socioeconomic status— who you are in society as far as your income, occupation, education, ethnicity, and gender impact your health. Even psychological factors like if you have a healthy relational support network or have stressful living circumstances can all govern your ability to live and eat healthy.

There are organizations that hold an important role in working hard to influence policy and the conditions in which people live. Well Fed is in some of those conversations, but our expertise and where we can help the most is with the biological determinants that are causing poor health, hospitalizations, and death among under-represented communities in Arkansas.

We empower families to make healthy choices by providing them with consistent cooking and nutrition education. We’re giving them the tools so that they can construct a healthy lifestyle for themselves.

Each conversation about how to cook a particular vegetable and its related nutritional benefits is a step forward in real behavioral changes.

They see the importance and simplicity of cooking healthy. 1) We give them fresh fruits and vegetables so they can access it, because many of our participants have physical restrictions to healthy food access. They may live in a food desert (link), they could be disabled, or their transportation could be inconsistent. 2) Our participants can use the food we give to make the recipes they get from our education segment. 3) The healthy food we give them adds vital nutrients to what they already make!

The statistics in Arkansas are not good. In previous blogs we wrote about the devastating effects in the Natural State in regards to the obesity rates, rate of food insecurity among adults and children, and the risk of diabetes, hypertension, and heart disease. The social determinants need addressing, however, as Dr. Bortz explains (4),

it is evident that the biological factors are more proximate determinants than the socioeconomic contributors, which are upstream and ultimate in their role.

What goes into our bodies has the closest impact on our health outcomes! Although it may be a daunting task to impact behavior and biology in a way that heals people living in underserved communities in Arkansas, through the cooperation of our partners and our community, we can begin to change the future health of communities one person at a time.

What is… Causing The Obesity Epidemic in Low-Income America

Fast, cheap, supersized food has been running through America’s veins since sliced bread was invented. Also driving the heartbeat of America is innovation and making everything bigger and cheaper. The popular Netflix series History 101 explains that culture shifted after World War II from mom cooking 1,095 meals a year to eating out due to higher disposable income, entertainment value, and convenience. Supply chains shifted and convenient food became cheaper with increased production. The US government began subsidizing farmers to grow high energy-dense commodities like corn, soybeans, and wheat to fuel rising demand (1).

One study discovered the American diet now derives close to 40% of daily energy (calories is the way we measure the energy in food) from added sugars and fats.

With such a high ratio it’s no wonder why the U.S has the lowest-cost food supply chain in the world (2). That begs the question, who is impacted by this low-cost, high-energy dense food system the most? Low-income households.

Refer back to the beginning of the first paragraph; it was higher disposable income that allowed for convenient consumption of fast food. Fast-forward to today. Processed, high energy-dense foods are still convenient, but add to convenience, affordability and accessibility. And it’s not just fast food, but grocery store shelves are loaded with calorie heavy products.

Photo by Nathalia Rosa/Unsplash

Now the tables have turned. People with lower disposable income are consuming this low-nutrient food. But do they have a choice or has the low-cost U.S. food supply chain inevitably determined what the low-income households can purchase?

Harvard researchers discovered that the healthiest diets were $1.50 more expensive than the least healthiest diets (3), so the actual cost of a healthy diet, independent of location, is higher. However, there is a general food price gap by location, too. We see that inner-city grocery stores, where many low-income communities are, have 4% higher prices overall than suburban areas due to less competition, less mobility for clients to respond to higher prices, and smaller stores with higher margins and therefore higher costs (4).

Another factor to consider is the role government-subsidized farming plays on the price of food. A subsidy is money that the US government gives to farmers in order that they are protected against changing prices of what their crops sell for and the amount of crops they are able to grow in a season. There are a few crops that are highly subsidized because US farmers are very efficient at producing them: wheat, soybeans, and corn (5).

Photo by Scott Goodwill/Unsplash

Large farms will grow these highly subsidized crops and grow less crops like fruit, vegetables, and other grains. This drives the cost of processed, pre-packaged foods down while increasing the cost of much-needed nutrient rich produce.

So, families with low-incomes, attempting to keep a food budget with a low salary or government assistance, will be primed to purchase energy-dense foods, at higher proportions, containing grains, added sugars, and added fats (6). And when they live in a food desert, the chances that they will find healthy fruits and vegetables decreases substantially because typically only convenience stores occupy retail space in food deserts. Furthermore, price is not the only point to consider; taste, nutritional knowledge, and confidence in cooking healthy meals are motivating when choosing food, too.

Changes in the food system from the top down through Government policy is a complex and arduous process. In the meantime grass-roots and state level action is vital for impacting the statistics now.

Well Fed is strategically set up as a mobile healthy food and nutrition education non-profit for this exact reason. We work with local and state partners to bring fruits, vegetables, grains, dairy, and meat, all products that tend to be expensive or inaccessible, directly to low-income communities. We partner with nutritionists to educate them about how to shop smart, cook healthy, and know the nutritional value of their food. Whether or not healthy food prices decrease, the US government starts to subsidize

healthy food, or more inner-city grocery stores open up and the general price of food decreases, Well Fed will be innovating programs and serving underserved, low-income communities in Arkansas.

What is… Covid-19’s Impact On Low-Income Communities

If asked what the trending health issue has been the last two years there’s no doubt the answer would be Covid-19. The economic impact proceeding the lockdowns and the aggregated number of hospitalizations and deaths has affected many Americans on a personal level, not to mention the global impact it has had on the supply chain, health, and travel. There is a portion of the population, however, whose high health risk has put them in greater jeopardy during the Covid-19 pandemic: Low-income communities.

The prevalence of diet-related illnesses in low-income communities has been a leading comorbidity issue, the simultaneous presence of two or more diseases in a patient, among Covid-19 patients. In this article I will give some background concerning diet-related illness in these communities, what are the main factors that lead to diet-related illnesses, how the emergence of Covid-19 has been worse for communities prone to these illnesses, and what solutions can be offered.

The Covid-19 pandemic has only perpetuated health risks associated with diet-related diseases that have been present among low-income households with food insecurity for decades. A study done in the early 2000’s among low-income households in counties across Arkansas, Louisiana, and Mississippi found that food insecure individuals have 2.4 times higher risk of diabetes and hypertension. And since the 70’s, mortality rates connected with cardiovascular disease (CVD) have declined, however, about 659,000 people in the United States still die from heart disease each year—that’s 1 in every 4 deaths [1]. Communities on the south side of Chicago (where the majority of the population represented is low-income African-Americans) made up “more than 50% of Covid-19 cases and nearly 70% of Covid-19 deaths [in Chicago city limits]…” Why were infection and mortality rates in low-income communities so high?

First, the concept known as “social determinants of health” needs to be defined and addressed for us to arrive at an informed conclusion. Boiled down it is the “view that health and illness are not randomly distributed throughout human society neither are the resources to prevent illness and its effects [2].” Where you are born, live, work, your age, and the systems around you that are in place to deal with illness determine health outcomes.

Before the pandemic began, socioeconomic circumstances made it less likely for them to have access to healthy food whether it’s because they live in a food desert (we have written about this before), have a disability, or less income due to unemployment.

 Furthermore, they may have learned poor health behaviors or have a poor social support system which contributes to stress and poor health.

These factors naturally cause or perpetuate food-related illnesses. Now add in the effects of a pandemic like unemployment, increase in cost of healthy food, decreased public transportation, and fear of going to hospitals or clinics (one study found a decline in “food related disease diagnosis during the pandemic without the indication of a fall in prevalence of these conditions [3]”).

The risk is substantial. Early on, researchers began developing studies that showed a substantial increase in risk of 2-to-3 fold for infection and hospitalization among patients with diabetes and CVD.

What can be done? We agree with Michael Thomsen, a professor of agricultural economics and agribusiness at the University of Arkansas, when he said, “COVID relief should place more focus on food assistance [4].”

We believe food-related disease comorbidity among Covid-19 patients is addressable with proper food access and education, especially among low-income and underserved communities.

Access to proper nutrition is the powerhouse that fuels a healthy immune system, fights diabetes, hypertension, and CVD, and is the best long-term solution to keep people from hospitalization. And nutrition and cooking education empowers and equips families to cook and eat healthy.

Since Well Fed’s mission focuses on food access and nutrition education, our goal is that, through providing healthy food and nutrition education, underserved individuals and families will have the good health, energy, and motivation to focus on other important areas of their lives such as acquiring a job or maintaining their mental health. They cannot focus on these fundamental steps in life while they remain at high risk for Covid-19 comorbidity. There is hope for these communities battling Covid-19 and it starts with healthy food, it starts with organizations like ours. Will you join us?

What’s Really Happening in… Rural Arkansas

We met with the mayor of a town not so far from Little Rock and our visit blew my mind and reset my perspective on small town living. Here’s some facts about this tiny dot on the map:

# of Families: 200
Stoplights: None
# of stores with processed foods in town limits: 2
# of stores with fresh, unprocessed food: Zero
# of community buildings owned by the town: Zero
# schools: Zero

The mayor, with a weariness caused by many years of little progress, described to us the dire situation as she gave us a tour. She has many projects that are doomed to never start due to lack of funding.

The water pipes underground are completely rusted and have been unsafe for years. The water tower is an ugly shade of rusted orange.

We were searching for a suitable building fit to hold our food programs. We walked around the plot that had once been the only school 10 years ago. To this day it remains unused and overgrown. Though the mayor would like to purchase the land to put it to use, that project has been pushed way into the future.

We drove to the the small fire station on main street. It was large enough to host a program but its crew consists of three volunteers living outside of town. There were a few churches but all their pastors live outside town, the mayor explained, so they don’t have office hours during the week for us to host a program.

Josh asked her if the town had any community centers as we walked around a small park on the edge of town. The mayor confirmed that there are none and said the kids have nothing to go to after school.

We finally landed on the town’s library (owned by the county, not the town) which has just enough room to do a mobile food market and education.

For many of the residents that participate in our monthly program, the fruits and vegetables we provide are the only produce to which they have access. The nearest fully-stocked grocery store is 15 miles away, a fair distance for residents with unreliable transportation. And for a family with low income, fresh produce is expensive and not even on their shopping list.

The nearest fully-stocked grocery store is 15 miles away

Even a food pantry is just as far away and, if you have read our article about food pantries, you will know that they are a short-term solution for people with chronic health issues.

The moment I love the most, and the type of help I believe makes the biggest waves, was when Josh suggested the mayor should partner with the Boys and Girls Club to construct a community center in the town.

The mayor seemed to be stuck without a solution.  All she needed was someone’s fresh perspective and see a solution.

You can’t get anything better than a win-win! A local business helping a local community so that they both benefit, that’s neat.

There’s hope for this small town. With some years of external and internal community investment, its residents can have a much better situation.