Here's some quick food for thought. I hear a lot about healthy living everyday in New York City when talking to friends, clients and just chatting after a workout. People like to mention new classes that can help them stay more trim, websites like GOOP, brought to us by Gwyneth, fabulous detox cleanses, gym memberships, raw diets and dietary supplements that can help get them to the next level of peak, "A-list" wellness. And of course, I'm always interested in these perspectives.
But just recently, when an editor asked me to write an opinion piece on how living well is becoming out of reach for a lot of Americans due to a myriad of constraints like time, cost, omnipresent cheap food, etc., it really pushed me to better define how we should be delivering healthy living messages because "wellness" does not necessarily mean the same thing for one person as it does for another.
There are many levels to living well. For a large majority of Americans, popular and highly promoted healthy living products and services have become similar to luxury goods. Being able to visit farmers markets, eat purely organic, and do Pilates once a day is (for the time being) simply unattainable for a whole lot of people.
The foundation of living a healthy life - having access to healthy food, time to exercise, and the means to purchase the basics - are unfortunately out of reach to a large section of our population. It bodes poorly for the future productivity of our nation and its something all of us in the wellness community should keep in mind.
The Quick Dish
There are vast disparities among just who lives well which has lead researchers to focus on many environmental factors in their studies. They find that geography, income level and race have a lot to do with the ability to get and stay well. They look at a wide variety of indicators in making their assessment such as obesity rates, food availability, prices of food, Type 2 diabetes, and lifespan as it relates to chronic disease (because at the end of the day, diet and activity contribute significantly to three major chronic diseases - cancer, heart disease, and stroke - that together account for 50 percent of all deaths each year).
Where you live matters. If you can't get it, you can't eat it! Being able to get your hands on fresh, nutritious food is harder for some urban and rural populations than it is for the rest. In her campaign to make American children live healthier, Michelle Obama discusses access as it relates to "food deserts" where a lot of inner city kids as well as those from rural America don't have supermarkets within reach - only fast food restaurants and bodegas. Manhattan's Borough President, Scott Stringer is also trying to address this problem in a major way through a new initiative based on the report, FoodNYC, that aims to promote urban agriculture and regional food production. Moreover, studies have shown that obesity rates can actually be predicted by zip code.
Price Matters. Even if you can get your hands on it, can you afford it? Research has shown that nutrient-deplete foods average around $1.76 per 1,000 calories versus healthy, nutrient-rich foods which can average nearly 10 times more than that. If you can buy an entire lunch meal at a fast food restaurant for $1 versus a head of organic broccoli for more than $3, eating for your wellness becomes a pretty tough decision. Healthy foods simply cost more. And, unfortunately, vegetables and fruits are becoming luxury goods for many. So its not surprising that scientists find the highest rates of obesity among people in lower income groups.
Ethnicity and Race Matters. In a recent report released by the U.S. Department of Health and Human Services, Surgeon General Regina Benjamin noted in her Vision for a Healthy and Fit Nation, that many racial and ethic groups in our country are disproportionately affected by the epidemic of overweight and obesity. Her report states that among 40 to 59-year-old women, about 52 percent of non-Hispanic blacks and 47 percent of Hispanics are obese versus 36 percent for non-Hispanic whites. And in the super popular, academy award nominated documentary, Food Inc., it's noted that according to the CDC, 50 percent of American minorities born after 2000 will contract early onset diabetes in their lifetimes as opposed to about 33 percent for non-minority groups.
The Quick Summary
So in short, although healthy living is "in" and wellness is totally trendy, it really isn't accessible to everyone in the same way. In fact, it's quite a complicated subject and although geography, economics and ethnicity matter, they're not the only factors involved. Wellness in America is rooted in a deep web of social, political, economic, scientific and financial issues.
It's my hope that a lot of the fantastic teachers, writers and advocates of healthy living out there get this too because even though its so great to hear all the buzz surrounding wellness these days, unless it's made to be within reach for everyone, its bound to be more of an ideal than a reality!
1. Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services. Accessed at http://www.cdc.gov/chronicdisease/overview/index.htm on February 25th.
2. National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. "Deaths, Percent of Total Deaths, and Death Rates for the 15 Leading Causes of Death in 5-Year Age Groups, by Race and Sex: United States, 2000." Hyattsville, MD: CDC, 2002.
3. Flegal K, et. al. "Prevalence and Trends in Obesity among U.S. Adults, 1999-2000." Journal of the American Medical Association 2002, vol. 288, pp. 1723-1727.
4. Drewnowski and SE Spector, "Poverty and obesity: the role of energy density and energy costs", 2004. The American Journal of Clinical Nutrition 2004, vol. 79, No. 1, pp. 6-16.
5. U.S. Department of Health and Human Services. The Surgeon General's Vision for a Healthy and Fit Nation. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010.
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