Healthy food elusive as diabetes sweeps Mott Haven, Bronx
by Elizabeth R. Stark and Beth Kowitt
Doctors expect Bernice King to eat one slice of wheat bread, a banana, broiled meat and veggies every day.
As a 64-year-old diabetic living in poverty, she constantly struggles to stay on her diet and to make ends meet. “Sometimes, when you’re on a limited income, it’s difficult,” she says of the need to buy healthful but more expensive food. Obesity causes Type II diabetes, the most common variety.
King, who was diagnosed three years ago, is one of almost 15,000 people afflicted with diabetes in the Mott Haven and Hunts Point sections of the Bronx.
At a time when the mayor has declared diabetes and obesity among his chief health concerns, the figures for Mott Haven, where King lives, are particularly stark. Seventeen percent of the population is diabetic, almost double New York City’s rate, according to the city Department of Health.
Mott Haven is also one of city's poorest neighborhoods, with 45 percent of residents living below the poverty line.
The relationship between diabetes and poverty is complex; the epidemic has multiple causes, exacerbated by poverty and lack of access to education, to exercise, to fresh fruits and vegetables, and to adequate medical care.
Diet: Forever fighting the starch battle
Certain ethnic groups are predisposed toward diabetes, including Hispanics, who compose 70 percent of Mott Haven residents. If a person has the genetic predisposition toward diabetes, a poor diet can trigger the disease, says Linda Sicard, 57, a diabetes educator at All Med, a Mott Haven health clinic.
Ideally, at-risk populations should eat non-starchy vegetables and meat, because starch triggers diabetes.
However, few stores in the neighborhood sell fresh produce, and where it is sold, “the quality isn’t there,” says Marie Inserra, 60, a nurse practitioner at Segundo Ruiz Belvis health center, with 20 years experience in Mott Haven.
Culture and cost also prevent many residents from eating the way they should. Sicard and Inserra say Hispanics mainly consume starchy vegetables, including yucca, green plantain and potato.
In an area where almost half of residents live below the poverty line, and 36 percent receive food stamps, the cost of fresh produce can be prohibitive.
For a family of four, $135.50 in weekly food stamps has to reach far. "It's just not enough," says Henry Cruz of the American Diabetes Association, "and then you're trying to stretch that money and it removes those healthy foods. Junk food is cheaper.”
As King puts it, impoverished residents “have to choose between the rent and food.”
Exercise: Nowhere to run
Exercise can help prevent diabetes, delay its onset and manage the disease, Sicard says, but Mott Haven has only nine exercise facilities, and most of those cost money. St. Mary’s Park, the main neighborhood recreational center, costs $75 a year for adults and may be too expensive for poor residents.
Inserra says she encourages residents, especially the elderly, to go for walks, but says, “Some of them are afraid, especially the older patients who really don’t like to go outside without somebody with them.”
Gloria Cruz, 47, a neighborhood resident who works at a local church, says safety concerns make exercising difficult for youngsters. “I’d rather leave my son home alone than in the park,” she says. Street violence is a real concern in this neighborhood where in 2005 stray gunfire killed Cruz’s 10-year-old niece during daylight hours.
Furthermore, Cruz says many parents in the area work several jobs and may not have time to ensure their children exercise.
Health care: 'Let the bills pile up'
Most Mott Haven residents qualify for Medicare or Medicaid, according to neighborhood health clinics. Both programs cover most prescriptions and doctors visits. However, co-payments add up. And, Sicard says, patients need to test their blood twice daily with testing strips.
The strips cost $1.50 to $2 per day. It doesn't seem like a lot, but the median household income in Community District 1, which includes Mott Haven, is $16,000, according to the most recent Department of City Planning figures. Thus, testing strips for one person alone would absorb 7 to 9 percent of an entire household's income.
King says sometimes she cannot afford her co-pay, so she must "let the bills pile up – and let the state see that I need attention."
Although poverty, diet and exercise play major roles in the Mott Haven diabetes epidemic, sometimes human nature is a factor. As King puts it, “you might see cake, and you want to eat it.” Fellow diabetic David Chavez, 47, echoes her sentiment. Sometimes, he says, he can't help himself:
"They put a piece of apple pie in front of you, you gonna eat it." |
