Yes, it is institutional racism – but that is not my specialty, so I am not going to comment on its outsized role. Others who are studying the effects of racial disparity are much better at explaining it than me. There will be lots of commentary about all the ways America has failed its African American population. However, I’m a clinical dietitian who has counseled 100’s of middle-aged African American males and can speak about that.
- Males, as a whole don’t go to the doctor unless they have to and African American males even less so. African American men mistrust the white medical community and prefer black male doctors. Who hasn’t heard of the Tuskegee experiment? Unfortunately, there are simply too few African American male doctors. Did you know there are fewer African American males going to medical school than in 1978? Reasons include the high cost of medical school and lack of access to a quality education early in life. All of this means they do not get the medical care when needed and when they do, disease has progressed to a dangerous level. This makes them especially vulnerable to COVID-19.
- African American males work the night shift and may hold a day job at the same time. This leaves little time for physical activity or meal planning/cooking. People that work at night have significantly more health problems long term than those working during the day. It has to do with circadian rhythm, but night shift workers have higher blood pressure, higher blood glucose, and higher cholesterol. These are all the diseases putting African American men at higher risk from dying due to COVID-19.
- Diet is too processed. Researchers from The University of Alabama at Birmingham looked at the diets and hypertension rates of over 7,000 men and women older than 45 living across the U.S. Black participants had higher rates of hypertension and were much more likely than white participants to eat a Southern-style diet. Foods such as fried meat, fish, and chicken, organ meats, processed meats such as bacon and sausage, high-fat dairy such as cheese and ice cream, sugar-sweetened beverages like soda and juice, and white bread in the form of biscuits are main staples of many African American men. These foods are also associated with all of the co-morbidities (cardiovascular disease, diabetes, and kidney disease) making COVID-19 particularly lethal.
- Many African American males live in a LILA (low-income, low access) community without a major grocery store within walking distance. Grocery store chains typically do not open in low-income neighborhoods and convenience, corner, and liquor stores fill the gap. These types of stores typically do not sell fresh produce. Changes to diet require resources to do so. Without easy access, healthy eating practices may be too difficult to overcome.
- African American participation in regular physical activity is lower than other population groups. Lower socio-economic levels (SES) may partly explain why African Americans participate less in leisure-time activities. Among those with lower SES, activity was devoted to walking as a form of transportation and household chores. Black men are often criminalized in public spaces, and this may discourage regular participation in leisure-time physical activity as well. Physical activity lowers the risk for the chronic diseases killing African American men disproportionately.
Diet is very personal. It is the one area of enjoyment that does not require anyone else. It is a form of self-nurturing and creates a feeling of satisfaction. It is relatively cheap too. I had a black male patient tell me after a diet consultation, “if you call, and I don’t pick up, that means I didn’t do what you said.” We had a good laugh. I called, and he did not pick up. He is a man of his word – I will say that. That is too bad because I really did want to help him. I understand how difficult it is to make a change, but it is time for African American males to take their health seriously. I am here when you need me.
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