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… 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?

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