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Varun Sreedhara

FeaturedLife

Combating Food Deserts

by Varun Sreedhara
3 mins read

A food desert is usually a low-income area in which people have little to no access to fresh, healthy food at affordable prices, and face several hardships in procuring nutritious foods such as fruits and vegetables. Not only are grocery stores harder to find in food deserts, but the fresh, nutritious products they sell are more expensive than processed foods. With processed foods often being an alternative, they can lead to an increase in health problems such as obesity, type 2 diabetes, cardiovascular disease, high blood pressure, and various types of cancer linked to obesity. The Food Desert Locator developed by the USDA’s ERS(Economic Research Service) found that about 10 percent of the approximately 65,000 census tracts in the United States as food deserts. About 13.5 million people in these census tracts have low access to a supermarket or large grocery store, with 82 percent living in urban areas. Wherever there are food deserts, they tend to affect Black and Brown communities disproportionately. According to a multi-site study done by Moreland et al in 2002, it was evident from their findings that predominantly white neighborhoods had 4-times as many supermarkets than black neighborhoods. Likewise, according to “Food Deserts: What They Are and WHAT CAUSES THEM”, “Indigenous peoples of America live farther away from grocery stores than any other demographic. 12% of American Indians and Alaska Natives live 20 miles or more from their nearest grocery store.” 

What causes food deserts? As wealthier people have access to privatized mobility, they are able to move out from densely populated cities, and with them went many grocery stores that were in the area– this leads to the emergence of food deserts within city centers. With lower rates of employment and higher rates of poverty, low-income areas aren’t as appealing for

grocery store owners to open up shop as they prefer more affluent areas which are more profitable. According to “Urban and rural grocery stores struggling in Illinois” by Andrew Hensel of The Center Square, “Some grocers have cited poor store performance or lack of sales as reasons for their exits.” According to Owen Walsh of the Humane League, in Chicago alone over 500,000 live in food deserts. In a recent study on areas with predominantly Black residents, the closest grocery store is twice as far as the nearest fast food restaurant. High crime rates in inner city neighborhoods has also been cited as one of the reasons for supermarket owners to avoid these areas. According to Charles D. Ellison of The Philadelphia Citizen, “Rates of food insecurity, ranging from 20 percent to over 30 percent in Philadelphia, are also most prevalent where there is rising violence.” 

There are several strategies that can be utilized for dealing with urban food deserts. These communities don’t just need another grocery store, they need a holistic approach that prioritizes residents and their health. Cities need to improve infrastructure like transportation so that residents have easier access to grocery stores. City planners could also encourage small retailers such as farmer’s markets or other small street vendors near residences. Community gardens are a great alternative since fresh, healthy produce could be grown by residents and distributed to others. This could encourage a healthy and economic lifestyle as well as a sense of community between people. People in Winchester, Illinois have also tried to combat food deserts through co-op markets, where residents open up collectively owned and operated markets. As a result, the residents become both the suppliers and customers of these businesses. Another approach is to have small grocer and corner stores stock their shelves with affordable healthy foods instead of unhealthy processed foods. Currently in New York City, there is a city-wide initiative to restock the shelves of bodegas and small stores with fresh, healthy, affordable foods. Last but not least, mobile markets are another great solution to tackle food deserts, it’s just like bringing a grocery store right to your house. Transportation is often a struggle, so having a mobile market to bring fresh produce to their doorstep instead of having to commute long distances to a grocery store is a great solution. 

References: 

Michele Ver Ploeg, David Nulph, and Ryan Williams “Mapping Food Deserts in the United States” Economic Research Service U.S. DEPARTMENT OF AGRICULTURE 16 October 2022 online. 

Nathaniel M. Mead “Urban Issues: The Sprawl of Food Deserts” Nation Institute of Health 16 October 2022 online. 

Charles D. Ellison “Violent Areas Are Hungry Areas” The Philadelphia Citizen 16 October 2022 online.

Andrew Hensel “Urban and rural grocery stores struggling in Illinois” The Center Square 16 October 2022 online. 

Owen Walsh “FOOD DESERTS: WHAT THEY ARE AND WHAT CAUSES THEM” The Humane League 16 October 2022 online.







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Featured

Maternal Mortality in the U.S.

by Varun Sreedhara
3 mins read

The World Health Organization defines a maternal death as the death of a woman during pregnancy or within the first 6 weeks of the end of pregnancy “from any cause related to or aggravated by the pregnancy or its management,” including a condition that developed before or during pregnancy and was worsened by the physiologic effects of pregnancy. According to Joan Stephenson, PhD, maternal deaths have been increasing in the US since 2000, according to a 2020 report from The Commonwealth Fund. That report also noted that the US maternal mortality rate is double or more the rates of 10 other high-income countries.


According to Michael C. Lu, MD, MS, MPH, “Every year in the United States, more than 700 women die of complications related to pregnancy and childbirth and more than 50 000 women experience a life-threatening complication (severe maternal morbidity).” In the same article Dr. Lu states, “Large racial/ethnic, socioeconomic, and geographic disparities persist. For example, African American women are nearly 3 times as likely to die of complications related to pregnancy and childbirth compared with white women (56.3 vs 20.3 maternal deaths per 100 000 live births in 2013-2014), a gap that has not narrowed in decades”. These sobering findings emphasize the urgency to address health inequity with regard to racial and ethnic disparities in maternal mortality. According to the CDC, “Multiple factors contribute to these disparities, such as variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias”. The CDC also states that two in three cases of maternal deaths are preventable which makes it all the more tragic. According to Samantha Artiga of the Kaiser Family Foundation, the leading cause of pregnancy-related deaths overall is caused by cardiovascular conditions, although there are other causes linked to specific races and ethnicities. According to Geraldine I Oribhabor, an OBGYN, at the California Institute of Behavioral Neurosciences & Psychology, African Americans are at a poverty rate of 20.8%, which is more than double that of Non-Hispanic whites at 8.1%. This economic disparity, combined with other racial constraints and hardships, limits the quality of prenatal care received by Black mothers which puts them at significant health risks. Dr. Oribhabor also states that women belonging to racial and ethnic minorities deliver in inferior quality hospitals than white women, and if the same care was given to black women, maternal mortality for women of color would decrease from 4.2% to 2.9%.


Several measures need to be taken to fix health inequity relating to maternal mortality, including improvement of quality of care during maternity, pre and post maternity, sufficient funding to educate healthcare providers and physicians on eliminating implicit biases, improved healthcare facilities in minority communities, and educating healthcare providers on certain conditions specific to ethnic groups, making care more patient-centered. These measures can be ensured through collaboration between patients, families, communities, healthcare providers, and hospitals and healthcare systems.


References:

Joan Stephenson “US Maternal Mortality Rate Rose Sharply During COVID-19 Pandemic’s First Year” JAMA Health Forum 16 June 2022 online.

Michael C. Lu “Reducing Maternal Mortality in the United States” JAMA Health Forum 16 June 2022 online.

CDC “Working Together to Reduce Black Maternal Mortality” JAMA Health Forum 16 June 2022 online. 

Samantha Artiga “Racial Disparities in Maternal and Infant Health: An Overview” KFF 16 June 2022 online. 

Geraldine I Oribhabor, Maxine L Nelson, Keri-Ann R Buchanan-Peart, and Ivan Cancarevic “A Mother’s Cry: A Race to Eliminate the Influence of Racial Disparities on Maternal Morbidity and Mortality Rates Among Black Women in America” NIH 16 June 2022 online.
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HealthLife

Exploring Health Disparities in Diabetes

by Varun Sreedhara
3 mins read

According to Monica E. Peek of the NIH, as the average lifespan of US citizens is increasing, serious disparities exist in today’s society with regard to diabetes for racial and ethnic minority groups. This spells important health implications in terms of their health outcomes and quality of care. Diabetes is a chronic condition in which blood glucose levels in the body become too high and can cause heart disease, blindness, chronic kidney disease, and nerve damage which may even result in lower-extremity amputations. In 2019, The Centers for Disease Control and Prevention (CDC) listed diabetes as the seventh leading cause of death in the United States.

 

According to Dr. Yogish Kudva MBBS, it is unclear why some people have diabetes and others don’t; however, certain risk factors have been identified such as obesity, a sedentary lifestyle, family history, race or ethnicity, and age. In a survey done by the CDC and the U.S. Census Bureau: 14.7% of American Indians/Alaska natives, 12.5% of Hispanics, and 11.7% of non-Hispanic blacks, 9.2% of Asian Americans have diabetes, while only 7.5% of non-Hispanic whites have diabetes. In 2013, the Center for Medicare Advocacy(CMA) found that 25% of Hispanics, 11% of persons of Asian descent, and 27% of African Americans lived in poverty while only 12% of Caucasians lived in poverty. Today in the US, healthcare is very expensive, and the more impoverished a person is, the less likely they will be able to afford healthcare. The FDA stated that, “Coupled with a lack of access to healthcare, diabetes can progress in minority populations faster due to an unhealthy life of poor diet, obesity, and sedentariness”.

 

Sandra Voda, a nurse at the Masonic Home of New Jersey in Burlington, stated that diabetes education courses are poorly attended by people of minority groups. Per Dr. Peek, “Patients have the ability to affect their health care and health outcomes through self-education, treatment adherence, and health-promoting behaviors. This is particularly important in chronic diseases such as diabetes, where self-management is a central tenet of care and has been linked to positive health outcomes”. 

 

References:

 

Centers For Medicare & Medicaid Services “Diabetes Disparities in Medicare Fee-For-Service Beneficiaries” 17 June 2022 online. 

 

Mayo Clinic “What is type 1 diabetes? A Mayo Clinic expert explains” 17 June 2022 online.

 

Monica E. Peek, Algernon Cargill, and Elbert S. Huang “Diabetes Health Disparities” National Institute of Health 17 June 2022 online.

 

Center for Medicare Advocacy “Racial and Ethnic Health Care Disparities” 17 June 22 online. 

 

U.S Food and Drug Administration “Fighting Diabetes’ Deadly Impact on Minorities” 17 June 2022 online.

Sandra C. Voda “Improving diabetes education for minority-group members” Nursing 2022 17 June 2022 online.
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HealthLife

How are We Without Baby Formula?

by Varun Sreedhara
3 mins read


Supply chain disruptions stemming from several factors have resulted in a shortage of baby formula across the United States, a big problem for Black parents as they are less likely to breastfeed, and so, feel the weight of this problem more significantly. Abbott Nutrition, the nation’s largest baby formula manufacturer, recalled its baby formula produced at its Michigan plant after four babies fell ill with bacterial infections and two of those four children died. The FDA has checked Abbott’s facilities several times and found no bacteria, yet to-date, Abbott has not been allowed to produce Similac, Similac Alimentum, and EleCare powdered infant formulas. Because Black families are more likely to use formula, experts worry they face disproportionate impacts as a result. 

 

  Dr. Valeria Cohran, a pediatric gastroenterologist at Ann & Robert H. Lurie Children’s Hospital of Chicago, who treats  infants with feeding difficulties and digestion issues asserts: “Feeding your child is one of the fundamental things, as a parent, that people do. To not know where you’re going to get formula from, or if you can get formula, has been very stressful for families.” Per Dr. Cohran, “Some of the formulas are made for kids with a variety of different medical conditions. Some children may have difficulties breaking down the proteins that are in milk or are simply allergic to different products in the milk … [resulting] in some kids even getting admitted to the hospital until their families could get formula for their children … some of these formulas can cost thousands of dollars a month.”

 

  The shortage reflects larger issues that perpetuate disparities persistent across healthcare, as well as targeted marketing among the reasons why Black parents might opt for formula over breastfeeding and limited parental leave from work and paid breaks for feeding or pumping.”  Pediatricians and health experts warn against parents making their own formula, diluting what they have to make it last longer, or introducing cow milk too soon, all which can be dangerous to babies or lack necessary nutrients, as diluting formula causes diluting different electrolytes in the formula and may cause health problems for children. 

 

References:

Joseph Choi, Peter Sullivan, and Nathaniel Weixel “Health Care — House investigating baby formula shortage” The Hill 13 May 2022 online.

Margo Snipe “What the National Shortage of Baby Formula Means for Black Families” Capital B News 13 May 2022 online. 

UC Davis CHILDREN’S HEALTH “The infant formula shortage is making parents desperate. But do not do these 4 things.” 13 May 2022 online.

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