EDITOR’S NOTE: Sharon Easterling, the newest member of the ICD10monitor editorial board, will be reporting on health equity while also sharing thoughts about her personal experiences as a Black woman working in the healthcare industry.
We all go to the grocery store or send someone for us, right? This seems like a relatively simple task. Either make a grocery list or grab what you need when you get in.
Well, what if I told you that for many, it is not in any way simple? It is in fact a complicated and sometimes stressful endeavor. It is turned into a journey of tough decision-making, strategy, analysis, and psychological discomfort.
It has been stated that obesity is one of the top health concerns in minority America. I believe this is a multifold issue. Let me share some insight.
Sally has finally headed into the grocery store after going through all her purses to collect what change she may have laying around. She knew she needed to get enough food to last at least two days, and hopefully there won’t be another problem with payroll releasing her check. Her paycheck is only $310, but it is vital to making it through the week. Sally has $27 to her name at the moment and needs at least three meats, a vegetable, and some more cereal and milk for breakfast. She would love to get the kids some fresh fruits and vegetables, but that would easily take up $8-10 of her funds, and she still needs meat. So she decides on canned fruit and vegetables. Sally always gets rice as a filler just to stretch the meal, but can’t seem to adjust to brown rice. She will have just enough to get her a double cheeseburger and a small fries on the $.99 menu on her way home, because she hasn’t eaten, needs a quick meal, and can’t cook now, as she only has enough for dinner. As Sally is shopping, she realizes that she needs other items to fully complete her meals, but will have to do without today – she hopes she has some things at home to suffice. Sally walks out of the store feeling like she got some stuff, but frustrated – and most importantly, STRESSED.
Stress is the physiological demand placed on the body when one must adapt, cope, or adjust, according to a paper by Nevid & Rathus in 2003). It has been confirmed that stress is one of the leading causes of obesity, and it impacts multiple health conditions. Sally has made some poor food choices primarily because she is shopping to survive, not for health. Sally’s choices and stress not only impact her health, but also the health of those in her household, leading to obesity at times extending throughout the family. As noted by the American Psychological Association, “when an individual experiences stress, certain hormones are released, such as catecholamines and cortisol, the primary stress hormone.” Long-term activation of the stress-response system can disrupt almost all the body’s processes and increase the risk for numerous health problems, the Mayo Clinic Organization noted a decade ago. Allostatic load is the cumulative biological burden exacted on the body through daily adaptation to physical and emotional stress. It is a risk factor for several diseases, including coronary vascular disease, obesity, diabetes, depression, cognitive impairment, and both inflammatory and autoimmune disorders. Stress may also prematurely age the immune system and could enhance the risk of illness, as well as age-related diseases.
The root cause of health problems is wide and deep. Not only do economic challenges contribute to inadequate food choices and stress, but we also must consider the impact of genetics and what we are taught. As we take on the enormous task of achieving equitable population health, it will take experts to address socioeconomic, mental, and lifestyle challenges for us to fully be able to meet our goals.