Houston is known and talked as America’s fattest city that has a problem with obesity for many years now. The dietary choice of the people living there is only one problem of the many that lead to diabetes.
This city has an addiction to cars and sugar. Can anything be done in order to reverse this disease?
In fact, the diabetes is so common in this city that it got to the point that it has its own slang. Patricia Graham says that when she meets people she hasn’t seen in years they say “I’ve got sugar.”
Patricia does not have sugar, but she underwent a foot surgery in 2014 that made her reduce her level of activity. Also, this made her have a raised sugar level.
In her family, there is a history of diabetes. Actually, 3 of her 4 brothers, and also her mother have lost a leg due to diabetes.
In Houston’ third ward which is a historically African American district, there is a Diabetes Awareness and Wellness Network (Dawn). Here Patricia comes 3 times on a weekly basis.
This center is actually a free city gym and support group for pre-diabetics and diabetics. Patricia Graham goes there also for walking sessions. What they do is that they walk on the spot with pulsating music.
Houston, in general, is not made for walking. There is constant traffic and uneven sidewalks. This city has a status as the North America’s capital of oil and gas industry. And basically, there is only a car culture in Houston.
In many surveys, Houston is at the top, but unfortunately as the fattest city in America. It is expected that by 2040, 1 in 5 residents from Houston will have diabetes.
The pharmaceutical company Novo Nordisk reports that when it comes to the prevalence of type 2 diabetes in Houston that is 9.1 percent with an estimation that 1 in 4 is undiagnosed.
According to some surveys done in 2010 and 2011, third of the adults in Houston describe themselves as obese.
By 2040, the number of people with diabetes is projected to be around 1.1. million people. In addition, the costs related to diabetes from $4.1bn in 2015 and by 2040 to be $11.4bn.
Graham says that many of the people she grew up with ended up having diabetes and losing limbs. And now even the young people are starting to have problems, but according to her, they are not afraid.
Verne Jenkins, the member of Dawn, 63 years old, got diagnosed 3 years ago and all that because she didn’t have control over her eating. How she had to cut on red meat, carbs, sugar, and salts and to abstain from German chocolate cake which was her guilty pleasure.
The primary cause of amputations, blindness, kidney disease and death in the U.S. is diabetes. According to the announcement from last year made by a federal researcher the rate of new cases of diabetes has a drop from that in 2009 to 1.7 million and in 2014 to 1.4 million.
While at that same time in Texas the number of diagnosed adults rose from 9.8 percent in 2009 to 11 percent in 2014.
The Cities Changing Diabetes Program is a project in order to publicize, combat and understand the threat of diabetes with the use of cultural analysis.
Houston which is the 4th largest city in America is participating in this program along with Shanghai, Mexico City, Tianjin, and Copenhagen. Also, Johannesburg and Vancouver soon are to be part of the project.
One of the lead partners in this program with the University College London and Steno Diabetes Center, executive vice president at Novo Nordisk, Jakob Riis, says that the majority of people that have diabetes live in cities.
According to him unless there is rethinking when it comes to living in cities and making the cities healthier place to live in, we are not facing the root of this major problem.
It is not that simple to assess the risk of developing diabetes as dividing the population according to race and income.
The strong jobs market and low cost of living aid Houston become among the fastest growing urban areas in America. In return, the city loosened the beltway.
Under construction is the 3 major ring road that has a northwestern segment that is 35 miles from downtown. Once this is completed and opened the Grand Parkway will boast a circumference around 180 miles.
This is a surplus of M25 and its 117 miles, and around 14 million people live inside the orbital motorway of London. That is actually more than twice as many as residing in the area in Houston.
In the sections that are recently opened large homes grow promising middle-class living with a massive cost. Commute to the central Houston can take up to one hour and a half each way in a rush hour. In addition, there are minimal options when it comes to public transport.
According to the assistant director of the Department of Health and Human Services of Houston, Foreman, a lot of time is spent in a car. Time poverty is a risk factor for the development of type 2 diabetes in Houston.
Young people can be a vulnerable segment, although they not always fit the usual profile of individuals that are over 45 that might develop type 2 diabetes.
These people usually have high BMI and elevated levels of blood pressure. Along with disadvantages like lack of health insurance and poverty.
Foreman says that the general view of low-income communities in poverty as the key to health disparities should be expended. That should be done according to the new data in Houston about what is vulnerable and what at risk might mean.
Just because people are part of an urban environment that makes them vulnerable.
To be more accurate and clear, the choices that people make may not be the only cause that leads to diabetes, but also the way Houston is done as a city.
The lead academic for the Cities Changing Diabetes, David Napier of UCL, says that the key challenge is the urban isolation. According to him, there are many obstacles to overcome.
The fact is that the city is expanding and growing quickly. And people find it difficult to walk to work. And also many of them commute long distances and spend a lot of time eating out.
Houston is making an effort to take more care when it comes to the built environment. It’s making a change with better parks, more public transport, more walkable neighborhoods and expanded bike trails.
Foreman says that it is a significant change in the city in the last 3 years. The prevention is as important as the treatment.
Stephen Linder and his team of the local academic lead for Cities Changing Diabetes Research of Houston, the school of public health at the University of Texas collected data on around 5,000 households in the Harris County.
According to him the approach of this project was not to only focus on diabetes. But also to see the social factors that cause the clinical signs to appoint people as prediabetic.
These people did not have biological risk factor nor disadvantages. They are called “time pressured young.” They generally would escape any type of assessment.
They do the long commutes and have a perception that they do not have enough time to get things done. When it comes to this group the obesity is so prevalent that it comes to the point that it actually distorts what a healthy weight is and should look like, reports Linder.
What affected their perception to a healthy weight is the fact that all their peers were overweight. They made judgment according to the peers and not to standard according to experts.
In fact, 3 neighborhoods have the highest concentration of people that might develop diabetes. Also, 2M, which is a research company did detailed interviews with 125 residents.
What came as a surprise was Atascocita. Atascocita is a middle-class area that if located about 30 miles north of the downtown and is near golf courses and a large lake.
According to a study made from the Rice University in 2012, Houston became the largest metropolitan area in the U.S. that is ethnically diverse.
Also, the study came to a discovery that Houston and its cosmopolitan air might be contributing to the crisis of diabetes. Linder says that some people in Atascocita found the change overwhelming and it was stressful for them.
This happened due to the fact that it was an older group of people and even though they are economically secure they face other chronic diseases and satisfied the biorisk characteristics.
Linder calls them concerned seniors. The changes were just too much for them.
When it comes to portions of food there is a link to the cliche the bigger, the better. And because Houston is located near the deep south and Mexico it embraces the love of barbecued red meat of the Lone Star state.
Also, there is a huge variety of restaurants that serve international cuisine that has an unhealthy effect. The food with a traditional aspect is not the healthiest choice of food.
Foods like African American soul food, southern food that has lots of starch and butter and is fried and the Hispanic food like tamales and alike. The UCL people say that makes people gravitate to nourishing traditions.
People not only use food as a way to reinforce ritual and tradition but also as a way to make a social connection. For example, if someone moved from somewhere else they found food as a way to reinforce their identity.
However, that is not the best thing to do when it comes to biological sense. For Linder, the general advice about healthy eating for an extended period has been part of the efforts for awareness of diabetes.
That might not have an effect on a local level considering the variety and complexity of the neighborhoods in Houston. Also the factors, especially the social ones that contribute the population to be vulnerable to diabetes.
According to Linder simple messages like eating more vegetables and fruits, changing the diet. And also adding more color on the plate won’t just work. Why?
Because they are facing with a more complex task when it comes to modifying the diet in Houston. Foreman says that it is crucial to make a targeted approach. That means to go with one neighborhood at a time.
However, at the same time, there are necessary changes when it comes to policies and working collaboratively. Furthermore, no one promises that what might work in one neighborhood that it will work in all of them.
On the other hand, Patricia Graham has high hope. She hopes that the program that she is part of, Dawn program will expand. And with that fight the unhealthy tradition food with the modern new convenience culture.
She says that everything revolves around food. And also that there are people that cannot cook without butter or grease. Simply because that is the way they are raised and that is the only way they know how to cook.