Food Choice and Obesity in Black America: Creating a New Cultural Diet - PowerPoint PPT Presentation

Food Choice and Obesity in Black America: Creating a New Cultural Diet

Eric J. Bailey, Ph.D., M.P.H.

Medical Anthropologist

East Carolina University

Department of Anthropology

Department of Family Medicine

(Masters of Public Health Program)

• Investigate disease, illness, medical problems, theories of illness, and health care systems in different cultural and ethnic groups from a biopsychosociocultural perspective. In other words, we view health care issues from a “holistic” perspective.

Specific Goals:

1. To develop and to validate a health belief assessment tool that is responsive to the cultural perspective of African Americans.

Specific Goals:

2. To administer the health belief assessment tool to two NIDDM patient samples and determine the relationship between the patients’ beliefs and actual usage of health care services.

Research Design:

• Conduct a quantitative and qualitative study at a university –based diabetes clinic
• Sample consists primarily of African Americans and European Americans

Sample Sociodemographics:

Ethnic Background

• African Americans – 40%,

European Americans – 56%

Other – 4%

Sample Sociodemographics:

Gender

• Males – 68%

Females – 32%

Sample Sociodemographics:

• Educational Background

Less than High School Degree – 30%

High School or Equivalent - 48%

College Education - 22%

Total sample: 25 patients

Research Findings:

• African Americans (50%) were less likely than European Americans (14%) to recognize diabetes-related symptoms (p = .05)
• African Americans (50%) were more likely than European Americans (7%) to join a support group for their diabetes (p = .03)

Research Finding:

• European Americans (100%) were more likely than African Americans (80%) to believe that excess weight is related to diabetes (p = .05).

Research Finding: Qualitative Data

• Patient Informant #8:(African American Female)

“I’m not sure what caused my diabetes. I know that there is a family connection to diabetes and my weight has something to do with it, but I don’t take all of it too seriously.”

Research Finding: Qualitative Data

• Patient Informant #8(African American Female)

“My sons and husband want their meals the way they normally have it. They don’t want no unseasoned meals, so what am I supposed to do.”

“Keep Moving Toward the Lite.”

USA Weekend (November 15-17, 2002)

• Relocating from Little Rock, AR to

Bethesda, MD

• Cultural Health Issues associated with Weight Gain – Not Recognized or Not Discussed Enough

• Sixty-one percent of U.S. adults are either overweight or obese.
• Obesity increased in men and women and across all sociodemographic groups.
• There are more overweight and obese people in the U.S. than people of normal weight.

(Centers for Disease Control and Prevention 1999)

• African American adults (30.4%) were considerably more likely than European American adults (20.8%) to be obese.
• African American women (34.9%) were more likely than African American men (24.9%) to be obese.

(Centers for Disease Control and Prevention 2004)

• African Americans obesity rates increased from 19% in 1991 to 27% in 1998.
• Hispanics/Latinos obesity rates increased from 12% in 1991 to 21% in 1998.

(Mokdad et al. 1999)

• Body Image Preferences
• Food Preferences
• Exercise and Physical Fitness Preferences
• Adding African American Culture to Health, Fitness, Diet and Food Programs

• Body Image – is the internal, subjective representation of physical appearance and bodily experience.
• Body Type – is the ideal which one measures or compares one’s own body’s size and shape

(Thompson and Smolak 2001)

Critical Thinking Questions:

• Do African Americans prefer a particular body type?
• What are the preferences of body images among African Americans?
• How do African Americans perceive a healthy body type?
• How do African Americans perceive an overweight and/or obese body type?

• Qualitative Comments from a study on adolescents in middle and high school:

“I think pretty matters more to guys than to me. I don’t care. They want them to be fine, you know what guys like, shapely. Black guys like black girls who are thick – full figured.”

(Parker et al. 1995)

• Qualitative Comments from a study on adolescents in middle and high school:

“I don’t hear that a lot. I hang out with black people and they don’t care – we don’t worry if we’re fat because we’d all be drawn away from that.”

(Parker et al. 1995)

• Food – any substance that provides the nutrients necessary to maintain life and growth when ingested.
• Food Habits – ways in which humans use food, how food is obtained and stored, how it is prepared, how it is served and to whom, and how it is consumed.

(Kittler and Suchler 2000)

Critical Thinking Questions:

• Is there a distinguishable set of foods that African Americans prefer?
• How did this set of food preferences become established in the African American community?
• How is “soul food” viewed in the African American community?
• Why do a large percentage of African Americans adhere to the traditional soul food pattern?

Qualitative Comments from a focus group of African Americans:

“Soul food consists of the way you cook it. You take like your green vegetables – we as blacks cook our green vegetables different than whites.”

“We ate basic things, chicken, fatback, beans, chitlins, a lot of poor homemade stuff like bread, ham, grits, fruit, vegetables and stuff like that.”

(Airhihenbuwa et al. 1996)

Qualitative comment from Patty LaBelle’s cookbook:

“I realized why cooking has always been such a labor of love for me. Because it’s as much about friendship and fellowship as it is about food. Because, behind the whole process – the shopping, the planning, the preparing, the serving – cooking – is really about love. Cooking is a way to show it, share it, serve it. Cooking is as much about nourishment for the soul as it is the stomach.”

(LaBelle 1999 – LaBelle Cuisine: Recipes to Sing About)

• Exercise – a physical activity that is planned or structured.
• Physical Fitness – a set of attributes a person has in regard to ability to perform physical activities that require aerobic fitness, endurance, strength, or flexibility and is determined by a combination of regular activity and genetically inherited ability.

(Centers for Disease Control & Prevention 2005)

Critical Thinking Questions:

• Do African Americans have a different view of exercise and physical fitness than other Americans?
• Why are there so few books targeted for African Americans in the area of exercise and physical fitness?
• Do African Americans consider exercise and physical fitness important factors in losing weight?
• Why is it difficult to get African Americans to adhere to an exercise and physical fitness regimen?

Qualitative Comments from a focus group of African American women:

“I don’t exercise that often, but when I do have time I walk around the building with my children and go to the park and play with them. I want something that I can do every day, but not too long.”

“I want to do the type of exercise that helps me get toned and make me lose some inches.”

(Nies, Vollman, and Cook 1999)

Qualitative Comments from a focus group of African American women:

“I think that would help a lot of women if they knew the importance of exercise. Some people know and still have a problem, but maybe if someone told them how important exercise was to them (they would take it more seriously).

(Nies, Vollman and Cook 1999)

Qualitative Comments from a focus group of African American women:

“But if exercise is by yourself, I’m not motivated. Without the structure I won’t do it. Exercise is like way down on the bottom of my list; oh, I’ll do it tomorrow. I had my first heart attack and I’m supposed to ride a bike, but to be truthful I do it very seldom.”

(Nies, Vollman and Cook 1999)

• Several Successful Research Studies
• Several Federal Public Health Programs
• Certain successful books

The New Black Cultural Diet ®

• Mission:
• To establish a new way for us to view our body images and body types,
• A new way in selecting healthier foods,
• A new way in preparing our foods,
• A new way of exercising and achieving physical fitness all within our cultural health belief value system.

The New Black Cultural Diet ®

• Body Image
• Food Selection
• Food Preparation
• Exercise and Physical Fitness

The New Black Cultural Diet ® Website

www.newblackculturaldiet.com

Main Features: Access to Podcast Shows, online journals, and interactive forums designed to share information and to educate African Americans and all those who share similar lifestyles on cultural strategies to lose and maintain weight and exercise.

(Description from Kaisernetwork.org)

• Culture – a system of shared beliefs, values, customs, traditions, and behaviors that are transmitted from generation to generation through learning.

• Cultural Competence – comprises of behaviors, attitudes, and policies that can come together on a continuum: that will ensure that an individual, agency, system, or program can function effectively and appropriately in diverse cultural interactions and settings.

• Cultural Competence - ensures an understanding, appreciation, and respect of cultural differences and similarities within, among and between groups. Cultural competency is a goal that an individual, agency, system, or program continually aspires to achieve!

Eric J. Bailey, Ph.D., M.P.H.

Medical Anthropologist

East Carolina University

Department of Anthropology

Department of Family Medicine

(Masters of Public Health Program)