"Foodie" Thoughts

Not long after I moved to Dallas, my husband accompanied me to Austin, where I had a meeting. It didn’t take long for me to fall in love with Austin and the culture, so I was anxious to share the city with my husband. Honestly, it was probably too much of a stretch to assume that my husband, whose hatred for anything Texas Longhorns had been cultivated years earlier when he was an undergraduate student at the University of Arkansas, but I had hope.

We had driven to Austin from Dallas. The plan was for him to drop me off at the meeting location, then he would spend the day in Austin. Typically, when I stay in Austin, I stay at hotels within walking distance of a local, craft coffee shop, or at the very least, near a Starbucks. But that wasn’t the case on that particular trip, so as left the hotel, I immediately started “Googling” the closest Starbucks to my meeting location. I found one and directed my husband there. As I drank my chai tea latte while we sat at a table in that Starbucks, I noticed my husband looking out the window. I followed his gaze to the Denny’s restaurant across the street and asked, “What are you thinking?”

“I’m wondering why we are at this designer coffee shop, when we could be having a full breakfast at Denny’s for half the price,” he replied.

And that, in a nutshell, explains the difference between us!

I haven’t always been a “foodie;” that happened when I moved to Dallas. In fact, I had always been a picky (and bland) eater – a very well-done hamburger, any kind of potatoes, and chips and dips were my “go to” staples. If you looked in our cabinets when my daughter was young, you would have found rows of Hamburger Helper boxes (I didn’t really like Hamburger Helper, but it was easy).

In 1998, my father was diagnosed with pancreatic cancer, and I became a vegetarian. Because my culinary skills were limited, as were vegetarian options in Oklahoma in 1998, I relied even more heavily on potatoes and chips and store-bought hummus. After several months, I finally found a small grocery store that stocked organic vegetarian meals and products.

Possibly because I’m now surrounded by “foodie” friends, it’s 20+ years later and trendy, and I live in a thriving urban area, but my tastes have changed. And, it’s way more convenient for me to not only find healthy eating options, but numerous exercise options also abound. Within 2-3 blocks of where I live, there are numerous restaurants that have healthy fare on their menus. There are even three healthy “fast food” establishments where I can grab a variety of veggie and quinoa bowls in less than 10 minutes. Just steps from my door is the Katy Trail, an urban walking and biking trail that was converted from train tracks. The Katy Trail stretches 3.5 miles in length and leads to many other restaurants and retail shops. I can walk to Trader Joe’s – 1.7 miles, Whole Foods – .7 miles, or Tom Thumb – .3 miles.

This scenario isn’t unusual, even when I’m traveling on business. On a recent trip to Austin, I stayed in the Domain area, where I walked to a different restaurant for dinner every night. Not one of those restaurants was part of a restaurant chain. Many of the establishments had an ethnic flair, and every one of them had excellent healthy options. This is usually the case when I’m traveling, whether it is Austin, Washington, DC, Atlanta, or any other city. It is so convenient for me to be healthy that I often take it for granted and forget that this isn’t the case everywhere, particularly in rural areas.

A few weekends ago, I went to a high school basketball game in Weatherford, Oklahoma with my husband. Weatherford is approximately 70 miles from Oklahoma City. Once past Oklahoma City, I noticed that the only eating options were either various chain restaurants, fast food chains (not the healthy ones), diners where the menu specials featured some type of meat with gravy, or truck stops that reeked of fried grease. While I didn’t visit any grocery stores along the route, I think it is a safe bet that their shelves were not stocked with many, if any, healthy options.

For the past several months, Parkland Health & Hospital System and Dallas County Health and Human Services have partnered to complete the 2019 Dallas County Community Health Needs Assessment (CHNA) to identify the geographic areas and populations that experience the most significant health disparities in the county. The CHNA is a requirement of the Affordable Care Act (ACA), and outlines health disparities and incidence of diseases across racial and ethnic minorities, socio-economic factors, underserved populations, and access to care. Also required is an implementation plan to address those disparities.

I’ve been fortunate to assist with those efforts. Many of the conversations that my colleagues and I have are centered around the differences in life expectancy in zip codes in Dallas County. Life expectancy is defined as the expected average number of years of life remaining at a given age. It can vary by race/ethnicity, gender, socioeconomic status, and education. According to a UT Southwestern interactive map, the life expectancy near where I live is more than 86 years, compared to 74.2 in 75217, 70.8 in 75216, and 67.6 in 75215, which are three of the zip codes in the southern sector of Dallas County targeted by the CHNA. The overall life expectancy for Texas is 78.5, which is close to the US life expectancy at 78.6.

As I pondered the limited food options on that drive to Weatherford, I was reminded about a newspaper article that was published on September 23, 2018 in The Oklahoman, entitled “Life is short in some Oklahoma communities.” The article published statistics from the National Center of Health Statistics that showed that of the seven American towns or neighborhoods with a life expectancy below 60 years, three were in Oklahoma. – one of those three was my husband’s hometown, and the community where most of his family still resides. Even a few miles can make a difference in life expectancy. In the center of my hometown of Ada, the life expectancy is 66 years; just south of town, it is 84.

While access to affordable, high-quality health care is important, it is not the primary determinant of health and life expectancy. According to the Bipartisan Policy Center, medical care accounts for only 10% of what makes us safe and healthy, while our environment and our behavior determine 70% of that equation (the remaining 20% is due to genetics). As my colleagues at the Prevention Institute have noted, medical care is important but it does not address the underlying cause of disease or injuries and violence. Safe environments, access to affordable, healthy food, good schools, and jobs that provide adequate financial resources are some of the factors that contribute to life longevity. Those are the conditions that can help keep us from getting sick in the first place.

That brings me back to my earlier comments about access to affordable, healthy food options. My colleagues and I often talk about the “food deserts” in the southern sector zip codes of Dallas County because of the lack of quality grocery stores and the high density of fast food establishments. After my trip to Oklahoma, I began thinking about the potential “food deserts” in many rural areas.

Please understand that I’m not advocating that all of the “mom and pop diners” or fast food restaurants be replaced, or that everyone become a vegetarian. I also don’t believe decisions impacting those in rural areas or “flyover America” should be made without including those impacted in the decision-making process. If my 30+ year career has taught me anything, it is that there is power in collective wisdom and that solutions won’t be acceptable to those impacted unless we bring everyone into the conversation.

I certainly don’t pretend to have all the answers, but I do believe that if healthy options are available and convenient, more people will begin to consume a healthier diet. Just as important, though, is that the healthier options be affordable. While I love the fact that I can walk two blocks to Freshii and purchase my favorite Oaxaca bowl, I also understand that a family of four can eat at Denny’s for the cost of my meal at Freshii.

Whether I’m in Dallas or Oklahoma, I hope we can find solutions to improve the health of everyone – not just the ones who can afford it.