08/28/2011 12:48 am ET | Updated Oct 28, 2011

The Cultural Reasons America's Underprivileged Struggle With Nutrition

There has been a surge in the recognition of the toll bad eating, obesity and related health problems are causing poor Americans. Michelle Obama, of course, contributed to this recent surge of interest with her garden and lectures on nutrition to inner-city kids.

New York Times food columnist Mark Bittman has been a consistent advocate for enhancing our diets and our health. As he has moved towards nutritional concerns Bittman has become more of a social and a political, rather than a food, commentator, because food and health are social and political issues. Recently, he lauded the creation of FoodCorps, a shoestring effort to place 50 young people in the field in the most socially-nutritionally disadvantaged places in America (largely poor urban and rural minority communities). When I say shoestring, each nutritional advocate is paid $15,000 annually.

But the NBC Nightly News had -- for me, an addiction specialist -- an even more interesting focus on this concern about poor eating habits in poor communities. A Southern minister was featured trying to convince his parishioners to eat healthily. Many extremely obese women were shown struggling to their pews at the church.

Also depicted were church-served meals (several parishioners joked that church was all about eating) where the reverend had substituted veggies and fruits for deep-fried chicken, sweet potatoes and collard greens. A 40-year-old woman -- who had already suffered a stroke and heart attack and bore a visible scar on her chest -- sponsored a sugar-free dessert demonstration, to prove that people couldn't tell the difference, or at least enjoyed the substitute formulations.

But, virtually unanimously, the community rejected the new foods -- politely but firmly. They said that they simply didn't satisfy them.

Thus, at this grass-roots level, we confront the real issues in getting an entire community to change its eating habits. These obstacles are based at the level of human experience -- the source for all addiction.

These difficulties include:

  • Past learning and cultural support for one set of foods versus another are not readily replaced. And the African-American (and, to a lesser extent, Latino) community is not addicted to healthy food.
  • Money-money-money: The fast/junk/corn-syrup-related food industries are mega-economic powers in the United States.
  • When you are poor, your primary sources for pleasing yourself are cheap, indigenous, accustomed rewards -- fatty foods and cigarettes being two primary examples. Telling people to go to the gym instead to feel good means nothing in this context.
  • Values-values-values. Yes, we want to look sleek. Yes, we want to live long. And we may posit that everybody does. But these values are more salient and more readily reinforced in some environments than in others. Individual efforts at communication are not sufficient to dislodge rewards firmly ensconced in people's current lives and worlds.

I applaud all of the aforementioned efforts (Michelle's, Bittman's, the FoodCorps', the minister's), but they are grossly insufficient.

Too bad government is no longer allowed to play a larger role in encouraging and regulating healthy eating.

We -- and the black and Latino communities -- will just have to live with the consequences -- more and more lifestyle-related diseases and preventable death and suffering.

That's just life in these United States.