Valda Boyd Ford, CEO – Center for Human Diversity
I had the opportunity to speak to a room full of people dedicated to nutrition and health last September. I walked into the Student Union on the East Campus of the University of Nebraska in Lincoln and was very pleasantly surprised to see hundreds of clinical practitioners, students and other interested parties spending the day learning about the latest and greatest in nutrition and health. Now, what I was most unhappy about was, in a room full of nutritionists, I was on the stage, up high, in plain sight, telling these clinicians how to customize their care to a variety of people. You know, I was trying to impart a little wisdom about the ways to talk to the full spectrum of diverse people living in Nebraska – quite a lot of diversity by the way – about eating well and living right.

I was successful in relaying the message of being realistic when helping me to plan a meal (I mean – what are legumes, anyway) and in understanding that a diet of salmon, wild rice, and fresh veggies and fruit, might be a little pricey to the average person. I know I got the point across that if you are trying to help me you will first get to know me. However, I was feeling extremely under qualified for a number of other reasons. Number 1: I’m a little heavy. Number 2: I’m somewhat overweight; and Number 3: I am way too fat to call it anything else!!!!!

Now – I’ve said it and, like any addict, I have had to admit – to my shame and horror – I am so far from that knock-kneed, skinny as a bean pole, nothing but eyes and teeth girl that I used to be that I can no longer make any excuses. Yes, I have been really, really, really busy for the past ten years, barely taking a vacation and tending to the whole of the world, but – come on! Why am I the biggest woman in the room (more often than not)? I mean, I do know better don’t I? I mean, I have been to a whole lot of schools and a lot more continuing education sessions in my more than 25 years practicing as a Registered nurse so – what gives?

I don’t know! Or, maybe I have a little tiny bit of a suggestion of the problem. Or, maybe I have some kind of glandular problem that the doctors have not yet diagnosed. Or, maybe I am just big-boned. OR, maybe I am just FAT. Yes – that’s FAT not PHAT. And yes, I am tall and yes, I don’t look like I weigh that much BUT – enough! I’m FAT.

I know that there is an organization for overeaters but I need something even more drastic than that. I need a mirror on all sides in a room with good lighting with a requirement to be NAKED and some good glasses that keep me from blurring, therefore denying, what I see. I need an INTERVENTION, or a Harpo hook-up from Oprah or a Dr. Phil/Madea come to Jesus talk! I need to stop making excuses.
What about you? What’s your excuse? What kind of excuse do we Black, African-American, Chocolate sisters have for this obesity epidemic? For sure the food industry wants us to keep up the good work! For certain dress designers are trying to add more fabric into what used to be a size 14 so we can feel better about buying clothes that we know would never be classified a “regular” size ten years ago.

I mean, really – how can we justify the fact that the average Black woman is a size 18 (you wish). In 1998 the average Black woman was a size 18 but now that “average” size is a 20! That means that the vast majority of Black women are going into the Big Girl Shops on every trip to the mall – not just right after the holidays when a few more pounds have been packed on!

An article in the March 2000 issue of Ebony magazine quotes Chicago obesity specialist Soundrea Hickman, M.D., founder of the Association for Improving and Maintaining Black Health. According to Dr. Hickman “I think the mistake that is happening is this `full-figured woman’ title–she’s [we are] no longer considered obese, she’s just full-figured–it’s a death sentence for the Black woman. I’d like to choke the person who came up with that title because it’s killing us, and I’m sick and tired of going to funerals of Black women in their 50s.”

Well, AMEN to that sister. I am sick and tired of it too. I am even more sick and tired of being fat! It kills me every time I walk into my closet and see clothing that I KNOW I look great in. It kills me because all of those clothes are on the “hope chest” side of the closet – meaning I hope I can get that blouse to button over my chest! I mean, I used to be called flat-chested but I never was flat (just not un-flat either). Now I am starting with a “D” cup when I go into the store and, let me tell you, that is like changing from driving a Porsche to a Mack truck!!! That is too much of a burden to bear – literally.

So, while I am whining about my weight (and your weight and your Mama’s weight) I am doing something about it. That day as I stood on that stage in front of hundreds of nutrition specialists I asked them to stop being enablers. I asked them to tell me (and you) that we are fat! Yes – I asked them to stop being afraid of what we might say in response to them telling us the TRUTH – as, I believe, is their responsibility and duty. I asked them to accept that even though I might not like what they have to say, I have just paid with my pocketbook and my time to find out what I need to know to live longer and stronger. Too many studies show that too many health care practitioners are either afraid to tell us the real deal when it comes to weight or are so sure that we have no plans to change that they do not bother.

I have a big Tupperware container (about the right size for a family-sized portion of potato salad) full of pills and potions prescribed for what ails me. Well, let me tell you that when I moved to Nebraska a decade ago I was a size 10 and I was not on any kind of medication except an anti-inflammatory drug for the bad back I have from dealing with too many too-heavy, coming-down-off-drugs-lying-about-it, going into the DTs people who have confused me in a nursing uniform with the enemy in their last battle of their personal war. I have had only ONE person (health care practitioner) suggest to me that I need to get off of my expanding behind and get off of my comfortable overstuffed couch and get my one-size-larger feet up and do some walking, swimming, dancing – something! Some people suggest that, as I am a nurse, they (health care practitioners) do not tell me I am FAT because I already know. Well, using that reasoning, there is no reason for me to go to see anyone and that also means that there should not be any doctors, nurses, therapists, or nutritionists that are overweight. Well, we know that’s not the case so I propose another strategy. TELL me what I need to know. And, tell me as many times as I need to hear it and even when I tell you I know, continue to tell me until I show signs of incorporating that knowledge into action.

Okay, I have vented enough now. Maybe I burned off 10 -15 calories hammering away on this keyboard. Okay, okay. I know that’s not enough. I am putting on my walkers and heading out of the door. What are you going to do?

Let me know if you were MOVED to do something. You can reach me at valdaford@aol.com or reddress@theheartandsoul.com. In the meantime, you can read more about heart health (being fat significantly increases your risk for heart disease and death) at The Heart Truth campaign website or check out Slim Down Sister: The African-American Woman’s Guide to Healthy, Permanent Weight Loss by Roniece Weaver, Fabiola Gaines, and Angela Ebron. An excerpt can be found here

Today we will discuss the HIV/AIDS catastrophe. We know that there are thousands of Web sites that discuss HIV/AIDS. Our goal is to reflect on this information and try to bring you a fresh perspective. Information cannot evolve into increased education and communication without adequate context and perspective. Enjoy. Push back. We love dialog.

HIV/AIDS in 2007

The HIV virus was identified in 1982 as an immuno-suppression disorder initially identified and found predominately among Caucasian homosexual males and subsequently for the next decade or more, AIDS was clinically and politically pursued as a gay plague.

So, how did a white “gay plague” evolve into a killer of predominately African-Americans? This is a haunting question throughout America today, especially now that the disease not only wears a “black” face, but increasingly, a heterosexual black female face – and mostly women who were infected by male partners.

Also, for all the money being spent on seeking “cures” or at least a vaccine, nothing seems remotely on the horizon. Even the venerable Gates Foundation, which has already donated close to $3 billion for AIDS vaccination research projects, is now telling the world’s best scientists that if they do not come up with something pretty soon there will some major funding redirections in store.

Every HIV/AIDS counselor/educator has a single mantra: “Becoming infected with HIV is completely preventable.” In the 1980s and early 1990s, gay communities proved as much when they drastically reduced their own infection rates (and subsequent deaths) through massive social education and redirection of certain sexual practices that held maximum risk for catching HIV.

What Happened in the Black Community?

The real tragedy in the African American community is that the disease could have received the same heroic response by black people from the beginning, too, but didn’t. There were a combination of failures – both on the part of blacks and the American social order.

From the very beginning back in the early 1980s, AIDS was actually killing even more black people than Caucasian gays, when total deaths of African American IV drug users and gay men were tallied. But black people were not placed on the radar screen for massive infusion of funding and scientific study. Why didn’t African American patterns of HIV acquisition tweak the interest of the Centers for Disease Control researchers and trackers the way the same developments did when reports came from medical providers of white gay men?

White gay men had better health coverage and more consistent interaction with providers. They were more apt to have the same physician visit after visit, while many blacks, often in the lower economic ranks and dependent upon public health clinics, often saw a different physician every visit. So it was harder for minority-based clinic personnel to pick up on the trends of this new immuno-suppression disorder’s increasingly fatal affects the way the doctors of white gay men did.

Yet, there still were intrepid black physicians who did notice and track an upsurge of strange cancers and other horrible disorders in their black gay and drug using patients and who did bring these trends to the attention of higher level medical and public health authorities. But in those rare cases, the black physicians’ concerns were often dismissed with responses that were inappropriate and insensitive – the kind that still blame the patient for the disease rather than address the best methods of prevention and, if already infected, the best methods for sustaining quality of life.

Another development that favored the white gay community was its long-standing relationship to the bio-medical research establishment’s concern for sexually transmitted diseases. STDs have long been the bane of the gay community, particularly in light of the gay sexual culture’s high frequency of anal sex and frequently accepted practice of unprotected sex with multiple partners. So, the first generation of AIDS researchers found a well-tread study participation path already in place in the nation’s largest gay population centers.

Black people, on the other hand, were still in a state of denial about the very presence of significant numbers of gays in the community. And IV drug users were long considered a social plague and the last people that blacks (or others) would consider spending precious health care dollars to study.

Disease is a medical problem, but epidemics are social problems

So, while AIDS came of age as a white man’s disease, it raged and morphed and spread its tentacles throughout the black community for the first 15-20 years almost unchecked by major community resistance.

Then we add into the mix some key transmission avenues that include:

• Black men who are on the “down low”, that is, who maintain same-sex relations while continuing a public image of heterosexuality
• The relentless media blitzkrieg of images that encourage black youth to abandon themselves to sexual hedonism and material pursuits that are all framed in sexual conquests and connotations
• The astonishing incarceration rates for black men, most of them in the their peak sexual years, who now, thanks to voluntary and involuntary sexual relations while behind bars, are progressively bringing the HIV virus back to the black community’s women straight from prison.

Every black community that is touched by AIDS is crying for more funding for prevention. Yet, prevention funding is being cut year after year. The national focus now is increasingly on managing those who are already HIV positive in hopes that they will not infect more people. But focusing on the infected population to the detriment of expanding prevention programming will harm black people (and all people) in the end. Why? Because the African American community is so many years behind on the open acceptance of both gay people and people living with AIDS.

Where do we go from here?

The Ryan White Act, created to provide funding for people living with AIDS to assist in medication expenses, housing costs, food service, transportation needs and other supportive services, has always been inequitably distributed. The greatest numbers of new cases are in the Black South, and not San Francisco or New York or Chicago. Thousands of people right here in America now are dying for lack of even minimal drug therapy, while others infected in the original target cities still have all types of auxiliary services at their disposal.

And then there is that vaccine thing. No, we’re not biomedical researchers, either, but science has proven this disease can mutate a dozen times in a single person, and 1,000 AIDS patients can each have their very own strain. That’s why even two people who both have AIDS are never encouraged to have unprotected sex together because their separate strains can cancel the effectiveness of either one’s life-sustaining drug therapy and/or create a totally new strain in both carriers that might kill them both if effective new drug regimens can’t be found.

So, up to a million Americans may be infected with HIV and every one of them may have a different strain? Doesn’t this sort of make moot the possibility of any kind of vaccine – which by definition is a counter-active medication that can prevent virtually everybody from catching a particular disease?

Will race and social class rear their ugly heads in the war against AIDS?

Finally, we believe that as AIDS has become more indentified with black people, and brown people and Native American people, there may be less concern, even “fatigue” with the issue among the primary Caucasian financial supporters and possibly even the government itself. Think not? Well, two of the most sacrosanct legal protections for people living with AIDS are now in the process of being erased. Twenty years ago the gay community would have been up in arms at even the suggestions, but today is a different story.

Until 2006, all AIDS clinics and health providers registered new HIV cases by code names or code numbers because there was maximum emphasis on protecting the identity of every carrier, lest they suffer grievous discrimination and ostracism if outed. Now the U. S. Department of Health and Human Services has mandated that real names be put in all these files because it was found that tens of thousands of cases had no “key” to help determine the real names of the patients. Literally, now there are thousands of verified AIDS cases but nobody knows who they are because there are no records listing their real identities.

Secondly, the other sacrosanct aspect of AIDS response was that there would never be mandatory public testing. This year, the Centers for Disease Control – for the first time ever – has publicly called for testing of everybody’s blood, even during routine health examinations, unless the patient puts in writing that he or she doesn’t want their blood tested for HIV.

Now, let’s get this straight. The government wants to test everybody, since its research indicates that at least one out of four people with HIV don’t know they are infected. Thus, in the not too distant future, there may well be the identification of hundreds of thousands of new cases, most of whom presumably will be black and Latino, while the federal funding in response to AIDS is stagnant and may well be on the decrease. Who is going to take care of all of these newly discovered cases and where is that money going to come from?