The November Experiment: Health and Poverty

If "Health is Wealth" what does that mean for the poor?

November 2013 I embarked on an experiment looking at healthy eating on a tight budget. I promised to spend $20 per week on food and still eat healthily. The first 2 weeks went smoothly and then I reached a budgeting roadblock in the third week. I wanted to celebrate a special birthday with a friend so I used my $20 allotment for that and skipped the grocery that week. I was fine for week 3 and 4 with what I had already in my pantry and making use of leftovers – another important skill on a budget. I used the remainder saved from the previous weeks to splurge for Thanksgiving ($25) and by the end of November I averaged $19.80 for each weekend that I would have gone to the grocery.

Now in doing this experiment I was not going far off the road I am used to. I have been putting myself through school and money has always been tight. Oftentimes I’ve had less to work with and sometimes more. The purpose here was to get concrete information about shopping with a set limit for healthy eating. As an educator I hope to use this information to prepare health and wellness workshops for people in financial hardship. During this time though, there were other things I learned  too.

For one I learned there are some psychological roadblocks that can be associated with or exacerbated by poverty which a recipe list and mere shopping advice cannot solve. Anxiety and depression can be triggered or exacerbated by the very real struggles of poverty. This was well expressed here in a blog post by a woman living in poverty entitled “Why I Make TerribleDecisions, or, poverty thoughts.” 

So in addition to caring for the physical health of those with low socioeconomic status, we need resources caring for their mental health. Taking care of oneself and one’s family is a commitment that can truly be derailed when issues of depression and anxiety overwhelm. Everything starts with the mind, health included. 

The tangible limitations of the cost of food can be worked around with the right MIND set and SKILL set. Knowledge and application of what your body needs, what foods are healthy, how to cook, how to shop for  or grow them; these are all important in overcoming the challenges of being healthy when funds are scarce.

So it comes down to education: not necessarily the institutional classroom and grades type, but the education generations before us were receiving in the home, in the kitchen, the market and the yard. In many U.S. families, for about 3 generations (both boys and girls) have not been leaning how to cook for themselves and their families (here is Jamie Oliver’s TED talk about this). That leads to a deficit contributing to poor health among lower socioeconomic classes. If you are poor and do not know how to cook for yourself, you do not have the money to pay someone else to prepare wholesome meals for you and your family. You end up paying cheap fast food restaurants to cook for you instead. You are stuck with low quality nutrition form the cheapest prepared food sources: fast food and cheap processed bulk foods.

In order for us to truly address the health of the socioeconomically disadvantaged we need to make available resources for their mental health as well as help them develop the necessary skill sets through education.

Truth is socioeconomic imbalance should not even exist and is a symptom of the many things wrong with this world and how it is governed and controlled. The argument that a poor person is responsible for his or her circumstances because of laziness or poor character is the highest level of bullshit. The deck is stacked. Those of us who have knowledge and resources to do something need to look out for those who do not – that is how we build and grow together. The November Experiment helped me gain new insight into what I need to include in developing my strategy to help. I hope it also helps you get a wider perspective of the issues of health and poverty.

The November Experiment a.k.a. Project “Don’t Starve. Thrive.”

Week 1 Groceries. Photo by Kelene Blake

This month I am starting an experiment. Each week I will go to the grocery store with only a $20 bill and attempt to buy healthy food to last a week. People say that eating healthy is expensive and to some extent that is certainly true. Buying organic tends to cost more. Healthier frozen meals cost more. Yet I don’t believe that all healthy eating has to be expensive, so I have given myself the challenge for November to eat healthily 5-6 times a day (3 meals, 2-3 snacks) on $20 per week. I’m doing this for 4 reasons:

1. Because I told an acquaintance of mine that I would prepare a health workshop for low-income housing communities on eating healthy even with a low budget;
2. Because this study (link) by Dr. Katz et al concluded that healthy food does not necessarily cost more and I want to see if it holds true for people with the tightest budget;
3. Because many people’s food stamp benefits are being cut due to the U.S. government budget deadlock and people still need to eat, and eat healthily, but now have less money to work with;
4. Because it’s just that kind of month (the kind where the less money I spend, the better). The struggle is real. But hopefully I can learn from it and benefit others too.

This isn’t a highly controlled research experiment. I am starting off with some food already in my pantry – mostly rice and peas/beans, seasonings, baking ingredients. This experiment is only for food and any non-food items are not included in that $20 grocery list. What I am doing is a real-world experiment. In the real world we don’t go to the grocery each week with a blank slate. However the reality is some people do go to the grocery store with very limited funds and they do their best with those funds to not go hungry. They are forced by their financial restrictions to buy cheap bulk foods just so they and their families have something to eat and avoid hunger pains, even if that something has little nutritional value. Instead of foods rich in vitamins, minerals, phytochemicals, fiber and other good things that help our bodies function well, the cheapest foods in most grocery stores have mostly empty calories, are nutrient poor and not particularly wholesome – made with white flour, sugar, chemicals, preservatives and unhealthy fats. It is a backward system where it is cheaper and easier to be unhealthy than healthy.

My hypothesis is that with $20 each week I can use the skill set I have to prepare for myself healthy, tasty meals that are nutrient-dense, full of vitamins, minerals, fiber, phytochemicals. It will be a mostly plant-based diet but will still provide enough protein and healthy fats. It will require more food preparation time than typical convenience foods, but with careful planning and efficient use of time I will be able to fit it into my schedule. I am hoping it will reveal what skills are most useful under these circumstances so I, as a health professional, can better educate the wider community. I also want to help those who have not experienced it understand some of the basic health challenges of poverty.

I already have my first week of groceries as shown in the photo. It came up to $18.91. I’ve already learned a bit in the process. I experienced quite a bit of anxiety on the way to the grocery store; worrying about whether I can actually do this, worrying what people would think of me, worrying about the embarrassment of going over budget and having to ask to remove some items at the cash register. That first worry I defied by actually doing it. The last one I combated by plugging each item price into my calculator to check the total to make sure I didn’t go over, and took note of which items were on sale to make sure they weren’t rung up at full price. And the one worrying about what people think… I came to the following conclusion: 

When you tie your self-worth to how others think of you or treat you, then you tie yourself to a burden that will inevitably drag you down. Your worth as a human being, a creative, intelligent, magnificent creature of this earth is intrinsic and unchangeable. No one can give you your worth. No one can take it away. All that remains is for you to see and accept your own immeasurable worth, wear it fearlessly and live your greatness.

The most difficult thing I learned so far is that in addition to the tangible hardships of life, these anxieties are a constant part of daily existence for many people in poverty. $20 U.S. a week, roughly $2.86 a day, on food alone for a single person is still more than millions of families around the world have to supply all their needs.  It is not fair. If this project can help people caught in this unfair system to lead healthier lives even with financial restrictions, then that is far more important than a little anxiety. I will keep you updated on this blog on how this experiment is progressing. In the meantime I have some food prep to do. Bless.

The Insanity of Health Disparities

I knew from childhood I am susceptible to diabetes and have valued and studied health to give myself the best chance of avoiding that life sentence. I took for granted what turned out to be an important part of health – the certainty I had some control over my own wellbeing. I understood my choices and actions could affect how I feel and my health outcomes as I aged. Years of studying the human body, how it functions and how it functions best, led me to the conclusion that health is more than a personal issue, it is a social justice one. I took a closer look at health from this perspective. Here is what I found.

In the U.S., a person’s health is too often contingent on factors such as socioeconomic status, race, gender and education. The more money one has, and the more education, then the more likely you are to be healthy and the longer you live. Generally women live longer than men but when it comes to healthcare, women face unequal access and institutionalized sexism in the healthcare industry. The most dramatic health disparities are the racial disparities. In the U.S., African Americans, Hispanics, Native Americans and Asian Americans all have disproportionally higher rates of chronic diseases, higher mortality and poorer health outcomes than European Americans. Furthermore these minority groups have less access to healthcare and receive inferior care than European Americans.

The image shows graphs and information about life expectancy from the CDC’s “Health, United States, 2011” report. It suggests that the life expectancy for a black male in the U.S. is 8 years less than that of a white male and 6 years less than a Hispanic male. Life expectancy for a black female is six years less than for a white female and four years less than a Hispanic female. This is by no means a full picture because Asian Americans, Native Americans, Pacific Islanders and people of mixed race are left out; but it does show the seriousness of health disparities in the U.S.

What does all that mean? Well it means that if you are a rich white woman with at least bachelor’s degree in the U.S. of A. you’ve won the health and lifespan lottery. If you are a poor black man who didn’t make it through high school you’re at the bottom of the health and lifespan barrel as a result of institutionalized classism and racism. Even then; despite the lifespan advantage a female naturally has due to gender, her access to healthcare is even lower than that of any male due to institutionalized sexism.

Health in the U.S. paints a messy picture and right now I am a can of paint about to be splashed all over the canvas. I am embarking on a career as a Health Coach and Educator and determined to make it more than “just a job.” I don’t know if I can impact enough lives to make a tangible difference in this situation, but I’m going to try. Five of the ten leading causes of death in the United States are preventable “lifestyle” diseases (heart disease, stroke, respiratory disease, diabetes, kidney disease) and a further four can be influenced by healthy lifestyles (cancer, Alzheimer’s, influenza/pneumonia, septicemia) this means 9 out of the 10 leading causes of death can be reduced dramatically if people learn to lead healthier lives. I can help with that! (The remaining one is unintentional accidents.)

Institutionalized problems like racism, classism and sexism are big issues and the journey toward change will continue to be long and arduous. While that journey is taking place we can work from the ground up in changing our own mindset and culture when it comes to health; that way we’re not dying off from preventable diseases while we wait for the insanity of these inequalities to be fixed. I will not place the onus of oppression on the oppressed. Institutionalized racism, classism, and sexism all must be fought and done away with. Yet, I will use the one advantage I do have, my education, to wage battle on this problem from where I stand. That’s something we can all do isn’t it? We can use the gifts we have to make a difference where we are – improve our own lives, the lives of our loved ones and extend to our community. Hopefully if enough of us care enough to make a difference, the whole world can be different (better).

Sources:

CDC’s “Health, United States, 2011” report

Chapter 24. Health and Medicine. Introduction to Sociology. Cragun R., Cragun D., Konieczny P. (Open source)

Chapter 19. Health and Medicine. Introduction to Sociology. Openstax College. Rice University (Open source)