A Tale of Two Cities: New York's Diabetic Dilemma
Continuing from yesterday's story, New York Times reporter N.R. Kleinfeld probes deeper into New York City's diabetic epicenter. In East Harlem diabetes is extremely common. The next neighborhood to the South, on the other hand, has one of the lowest rates in the city. As the article explains, culture and income drive important dietary differences:
A few things to notice. On Third Avenue, around the corner from the art shop, a banner outside McDonald's proclaimed, "$1 Menu." Down the way, plastered on Burger King, "New Enormous Omelet Sandwich. It's Huge." At KFC, a sign boasted, "Feed Your Family for Under $4 Each."
The art-shop gatherers sometimes talked about 96th Street, the tangible southern divide of a neighborhood and of a disease. Go north of 96th Street and you enter a constricted world laden with poverty. Go south and you find promise and riches, thin not fat, the difference between East Harlem and the Upper East Side, the difference between illness and health.
Go north and the chances of bumping into a diabetic are maybe 20 times greater than if you go south. For the Upper East Side, according to the health department, has the lowest prevalence in the city, about 1 percent.
In East Harlem, people sometimes have to choose between getting their diabetes medication and eating. They sometimes share their pills, cut them in half and take half-dosages. They improvise. Everywhere blare the signals that the best meal is the biggest meal.
Nutritious food exists, but it isn't easy to find. Dr. Carol R. Horowitz, an assistant professor at Mount Sinai School of Medicine, heads an East Harlem coalition trying to improve diabetes care. She oversaw a study several years ago that tracked the availability of diet soda, low-fat or fat-free milk, high-fiber bread, fresh fruit and fresh vegetables in food stores in East Harlem and the Upper East Side.
Stores on the Upper East Side were more than three times more likely than those in East Harlem to stock all five items. It did not seem to matter that East Harlem has more than twice as many food stores per capita as its wealthier neighbor to the south.
The plot thickens. Kleinfeld points out that a person's image also has a lot to do with their food selection. A resident of East Harlem comments:
"We've got cultural differences. Here, for a guy to eat a salad, he's a wimp. He'll eat a big portion of rice and beans and chicken. The women can't be chumps, either. A woman can eat a salad but has to eat it on the low. She has to do it quiet. They make fun of you: What are you, a rabbit?"
Diabetes Mine also has news that New York City recently announced plans to track people with diabetes.
For more of Dr. Fuhrman's thoughts about the diabetes epidemic, refer to New York City's Diabetes Epidemic from yesterday.
