Dr. Jill Foster was a practicing family physician in Cincinnati when she became increasingly dismayed treating preventable illnesses. “A young female patient of mine who weighed 200 pounds asked me, ‘Doctor, am I obese?’ Foster recalls. “When I told her she was, the poor child was devastated.” As both a vegetarian and doctor, Foster knew that unhealthy diets were the root cause of many of her patients’ problems. So rather than slog upstream through the quickening torrent of diet-related disease, she took leave from her practice to study nutritional science in Birmingham, Alabama.
Had she been looking for the fastest route to the belly of the beast, Foster couldn’t have chosen a better place. According to the Trust for America’s Health, Alabama has the second-highest level of adult obesity (28.9 percent) in the nation. For African-Americans the numbers are worse: 38 percent are obese. And 286,000 Alabamians, or about 6 percent of the state’s population, have been diagnosed with diabetes, a number that has climbed by more than 50 percent since 1994.
As a new resident of Birmingham, Dr. Foster, a petite black woman, soon noticed that most of the people around her were at least fifty pounds heavier than she was. “Poverty has a lot to do with obesity,” she noted, “and so does race. When you’re poor, you eat what’s cheap and what’s available.” She also found that the only vegetables available in the city’s poorer neighborhoods were fried okra and fried green tomatoes.
Foster’s experience comes as no surprise to researchers and community food advocates, who commonly use the term “food desert” to describe the lack of affordable, healthy food outlets across the country. In general, the data show that people living in lower-income, nonwhite communities must travel greater distances to reach well-stocked and reasonably priced food stores than people living in higher-income areas. Healthy food is also more expensive on a calorie-for-calorie basis than junk food. According to the Institute for Agriculture and Trade Policy, the real cost of fresh fruits and vegetables has risen nearly 40 percent in the past twenty years, while the real cost of soda, sweets, fats and oils has gone down.
While Alabama’s obesity rate tops the national charts, the state is beginning to distinguish itself for its efforts to improve its food environment. Tapping into Alabama’s agrarian roots, community leaders, clergy and government officials are hoping that the agricultural sector can play a vigorous role in promoting healthy eating. But is this just wishful thinking in a state where cotton, peanuts and poultry are the dominant farm industries?
Skepticism is warranted. The homepage of Alabama’s Department of Agriculture and Industry’s website reads: “Our department has the responsibility to help the few family farmers that remain in business in any way that we can.” This doesn’t sound like a bureaucracy that can save itself, let alone the hundreds of thousands who are suffering from obesity.