Racism is a system of structuring opportunity and assigning value based on the social interpretation of how one looks (which is what we call “race”), that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources.”

–APHA Past-President Camara Phyllis Jones, MD, MPH, PhD

The recent uprisings triggered by the murders of Breonna Taylor, Ahmaud Arbery, George Floyd and others have resulted in very visible calls for a national reckoning to confront wrongs built on 400 years of systemic injustice.

The disparities around rates of infection and death from COVID-19 have been clear and dramatic. So far, the data indicates that Latino and Black Americans are three times as likely as whites to become infected with the virus and twice as likely to die. These disparities have been consistent across state lines, and in urban, suburban. and rural areas. They’ve also been consistent across age groups.

In Kent County, Mich., African American and Latino residents are 20% of the population but account for 63% of infections. In Milwaukee, where FEI is located, Black residents have been disproportionally affected, about 1 in 2,000 vs. 1 in 4,700 for whites. Hispanic residents have also been disproportionally affected, and at one point, Wisconsin was the third worst in the country with respect to disparities in the numbers of deaths from COVID-19.

The possible factors for these disparities have been many and varied: Proportionally, more African American people are working frontline jobs and not able to work from home. Financial necessity may force them to work regardless of their health status. More rely on public transportation, which exposes them to more risk. Cramped living spaces or multigenerational homes make social distancing and isolation difficult to impossible. And, their communities often have less access to adequate medical care and testing.

The health disparities between groups of people are well-documented. Regarding diabetes, we know that African Americans have a 77% higher risk than whites, and Hispanics have a 66% higher risk than whites. We also know that those with diabetes, obesity and other chronic conditions not only have a much higher risk for infection, but also a greater risk for complications that could lead to death. It is important to understand that these outcomes go beyond the personal choices of individuals and are the result of the insidious legacy of racism embedded in society’s unjust policies and infrastructure.

All these factors and more make up the social determinants of health—the conditions in which people are born, grow and live. In this country, racism often underlies the complex and interconnected disparities and health outcomes among people, which led the American Public Health Association to declare that “racism is a public health crisis that needs our attention now.” As of July 13, 2020, more than 50 cities have declared the same.

A Hidden Injustice

While abuses within the criminal justice system are undeniable, and the disproportionate rates of infection and death from COVID-19 indisputable, a more subtle, hidden form of racism often flies under the radar. And that is the issue of food injustice, or food apartheid.

Food injustice is the idea that structural issues in the form of unjust policies, the decentralization of food production, mass farming monopolies and targeted marketing have created a system that has had intended and unintended consequences. Furthermore, these consequences affect every aspect of our economy, including healthcare costs that continue to skyrocket. In addition, they affect each of us living in this country whether we realize it or not. And, as always, they impact vulnerable communities and groups disproportionally.

While many pioneers in this movement have been focusing on food injustice for decades, there is a rising recognition among the general population that addressing these issues is essential to claiming and reclaiming health and vitality for all of our citizens and ensuring the well-being of our country in disparate, surprising and seemingly unrelated areas.

The First Step: Naming It

The first step in attaining justice or change in any endeavor is to recognize the problem. As writer and activist James Baldwin famously said, “Not everything that is faced can be changed, but nothing can be changed until it is faced.” Hidden forms of injustice are not immediately obvious and require a deeper look to take informed and effective action, individually or collectively.

To educate yourself in this area, below are a few examples of how food injustice may manifest itself. Dr. Camara Jones suggests asking the critical question, “How is racism operating here?” to sharpen your ability to look beneath the surface and see hidden truths.

  • Food insecurity during COVID-19: The advocacy group Food Research & Action Center reports “appalling levels of food insecurity … and a disproportionate impact.” In households with children, 16% report that their children are not getting enough to eat: This includes 29% of Black households and 24% of Hispanic households. These disparities have persisted for decades, but COVID-19 has caused the gap to widen quickly and recovery is slower.
  • Antiquated and Racist Labor Polices: The Fair Labor Standards Act (FLSA) and the National Labor Relations Act (NLRA) were passed in the 1930s to provide worker protections like minimum wage, overtime pay, child labor protections, and the ability to take collective action. Outrageously, this legislation excluded food and farm workers, mostly because they were Black or Brown. Although there has been progress in some states, this legislation still exists in many areas of the country, and the work conditions of farmworkers are reflected accordingly. How ironic that a group once deemed not worthy of protecting has proven mission-critical during a time of national crisis. To learn more, watch the Food Chains Documentary or the podcast episode: Is Your Food Grown by Oppressed Farmworkers?
  • Limited Access to Health-Promoting Food: Food deserts, where access to affordable, nutritious food is limited, and a grocery store is more than a mile away; and food swamps, which are areas with an overabundance of fast food, junk food outlets, bodegas, corner stores, and liquor stores, are associated with poor physical and mental health in the population. Unexpected sources of food at retail stores like Staples, Dollar General or CVS (what researcher Sean Lucan calls “Other Storefront Businesses” or OSB) can also be a significant source of mostly processed and unhealthy food.

Food deserts and food swamps, typically located in low-income areas where people may not have access to transportation and are forced to consume cheap, poor-quality food, are at a much higher risk for diet-related illnesses such as obesity, diabetes, kidney disease and other chronic conditions. Children and youth are also at higher risk for behavioral and academic issues and learning problems. Overall, these food environments are more predictive of health outcomes than personal choice and responsibility.

  • Targeted Marketing to Children and Vulnerable Groups: Companies spend billions of dollars to target children and youth to create lifetime customers and “heavy users” of their products. Products are formulated to produce a “bliss point” (“the amount of an ingredient such as salt, sugar or fat which optimizes deliciousness.”) These products—full of sugars, salt, and unhealthy fats—have been shown to have an addictive effect on the brain, similar to cocaine. A general rule is that the worse a food product is, the more that is spent on its marketing and advertising. Products are marketed through TV, social media, celebrity promotion and “friend marketing.”

One example of environmental marketing is Dr. Sean Lucan’s research on subway advertising in the Bronx. Dr. Lucan’s team looked at every ad in all 68 Bronx subway stations and categorized and analyzed 1,500 ads looking at the promotion of unhealthy foods and beverages. Although no healthy foods were advertised, there were advertisements for alcohol, sugary cereals, sweetened beverages, and processed and fast food. Analysis of the results showed that the ads were disproportionally located in challenged neighborhoods with higher rates of diabetes, hypertension, more poverty, lower education, more children, more foreign-born and more immigrants. Even when controlled for the station size, the results indicated that advertisers were targeting not the biggest audiences, but select audiences consisting of those groups most at-risk. For more on this topic check out the podcast: How Food Marketing is Making Us Sick and Fat.

The Way Forward

Despite the complexity of these issues, much good work is being done. If you want to be inspired, explore the work of Leah Penniman and the Soul Fire Farm, which is committed to ending racism and injustice in the food system through reconnecting people with the land.

Dr. Mark Hyman’s address Our Food System: An Invisible Form of Oppression at the Riverside Church in Harlem provides a quick and compelling introduction to this topic. Dr. Hyman’s podcast and book take an in-depth look at the problems within our food system and how they can be fixed.

“Beware the somnolence—the sleepiness of racism denial,” exhorts Dr. Camara Jones. It behooves each of to shake ourselves from complacency and consider how our choices around the issues of food and food justice have revolutionary implications. We deny deep-seated issues of food injustice at our collective peril and the peril of the most vulnerable in our midst.

In the words of Martin Luther King, Jr., “Injustice anywhere is a threat to justice everywhere.” When it comes to issues of food injustice, this could not be truer.