{"id":6519,"date":"2023-02-08T21:08:00","date_gmt":"2023-02-08T21:08:00","guid":{"rendered":"https:\/\/lifestylemedicine.org\/?p=6519"},"modified":"2025-09-23T21:07:14","modified_gmt":"2025-09-23T21:07:14","slug":"lifestyle-medicine-root-cause-focus","status":"publish","type":"post","link":"https:\/\/lifestylemedicine.org\/lifestyle-medicine-root-cause-focus\/","title":{"rendered":"What every lifestyle medicine provider must add to their root-cause focus"},"content":{"rendered":"\n

What every lifestyle medicine provider must add to their root-cause focus<\/strong><\/h1>\n\n\n\n
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More than a century after W.E.B. DuBois first documented racial health disparities, we now understand that addressing social determinants of health is essential to closing the gap and advancing equity.<\/p>\n<\/blockquote>\n\n\n\n

By Columbus Batiste, MD, FACC, FSCAI<\/strong><\/p>\n\n\n\n

February 8, 2023<\/p>\n\n\n\n

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\u201cBut knowing is not enough, we must apply what we learn into the development of lifestyle behavior change treatment plans.<\/em>\u201d<\/em><\/p>\n\n\n\n

\u2013 Columbus Batiste, MD, FACC, FSCAI<\/p>\n<\/blockquote>\n\n\n\n

In 1899, just 34 years after slavery ended, W.E.B. DuBois wrote \u201c\u2026one thing, we must of course expect to find, and that is a much higher death rate at present among Negroes than whites.\u201d\u2013 \u201cPhiladelphia Negro\u201d chapter X page 148. <\/p>\n\n\n\n

The unfortunate truth is that 126 years later, African Americans still suffer from a significantly higher death rate compared to non-Hispanic whites. A 2024 study published in JACC<\/i> revealed that due to their higher cardiovascular mortality rates, Black Americans have endured nearly 800,000 excess deaths, translating to approximately 24 million additional years of life lost between 2000 and 2022. Beyond these staggering losses, African Americans are diagnosed with cardiovascular disease six years earlier and are twice as likely to develop high blood pressure as non-Hispanic whites. As a result, they experience an earlier onset of heart failure and face a significantly higher risk of death. <\/p>\n\n\n\n

Despite medical advancements, African Americans continue to experience significantly higher rates of heart disease-related deaths. In 2018, they were 30% more likely to die from heart disease than non-Hispanic whites. By 2019, Black men and women still faced higher cardiovascular mortality rates than their White counterparts, with Black women having a 32% greater risk and younger Black women under 65 more than twice as likely to die from cardiovascular disease. Black men also faced a 33% higher risk. More than a century after The Philadelphia Negro<\/i> was published, African Americans are still living sicker and dying sooner than other racial groups. <\/p>\n\n\n\n

Since 80% of health outcomes are influenced by factors beyond clinical care, health challenges are deeply connected to social factors\u2014often referred to as social determinants or drivers of health\u2013 every healthcare professional must put into play a new patient intake and history lens if we are to help remedy these differences. Clinicians can no longer limit care to prescriptions and procedures without considering the circumstances in which our patients live, work, play, and pray. We can no longer preach healthful eating and increased activity without considering the financial and neighborhood environments where our patients live. <\/p>\n\n\n\n

The health of our communities depends on each of us being more like a social activist \u2013 looking beyond lifestyle as the root cause of disease and looking at the environment which enflamed the unhealthy lifestyle habits in the first place and making sure your patient can be successful in their environment. <\/p>\n\n\n\n

ZIP Code Matters <\/h2>\n\n\n\n

Why do African Americans live sicker and die sooner? In the same chapter of \u201cPhiladelphia Negro,\u201d W.E.B. DuBois gave the answer \u201c\u2026to assume that in discussing the inhabitants of Philadelphia, one is discussing people living under the same conditions of life is to assume what is not true.\u201d Nearly a century and one quarter later, public health experts have described the fact that where African Americans live, work, play, pray, and eat are vastly different conditions compared to other racial groups. <\/p>\n\n\n\n

A study from the think tank Brookings<\/a>\u202ffound that generational poverty is over 16 times higher among African American adults than white adults. Poverty occurs when an individual or family lacks the resources to provide life necessities, such as clean water, shelter, and clothing. It also includes a lack of access to such resources as health care, education, and transportation. Another consequence of poverty is access to affordable or good-quality fresh food, also known as food deserts. Food deserts disproportionately exist in communities of color. According to\u202fa survey done in 2016 by McKinsey & Company<\/a>, \u201cone out of every five African American households is situated in a food desert, with few grocery stores, restaurants, or farmers markets.\u201d <\/p>\n\n\n\n

Food Matters<\/h2>\n\n\n\n

Low\u2010income areas and communities with a high proportion of racial minorities also have a greater density of fast-food outlets and convenience stores with meager healthy food options.\u202fResearchers have revealed<\/a>\u202fthat for every 1% increase in the percentage of the white population, there was a 17% decrease in the density of fast-food outlets in low\u2010income neighborhoods. Foods sold in convenience stores and fast-food establishments have been linked to disease and offer insight into a possible cause of disparities. <\/p>\n\n\n\n

One study reported<\/a>\u202fthat \u201cDietary risks accounted for 529,299 deaths in 2016, with 83.9% of these deaths due to cardiovascular diseases.\u201d\u202fA 16-year health study<\/a>\u202ffound the risk of dying from heart disease was 20% higher for participants who ate fast food once a week than participants who did not eat fast food. That number rose to 80% for participants who ate fast food four or more times a week. The study also found that for every additional fast-food outlet, there were four additional heart attacks per 100,000 people each year. <\/p>\n\n\n\n

Amidst the appalling statistics, there is a \u201crose in the concrete.\u201d The relationship between poverty and health has been long recognized by many civil rights activists like Shirley Chisolm, who played an instrumental role in establishing a federal nutrition program providing pregnant women, new mothers, and their infants access to healthy, nutritious foods. Fannie Lou Hamer stated, \u201cIf you give a hungry man food, he will eat it; if you give him land, he will grow his own food.\u201d Her personal experiences facing food insecurity and her strong desire to create economic opportunities for Black communities eventually led her to establishing the Freedom Farm Cooperative in 1969. The program was dedicated to grassroots participation and providing Black households economic opportunity and sustainable access to healthy, locally grown foods. <\/p>\n\n\n\n

Research from the\u202fREGARDS study<\/a>\u202fhas demonstrated the power of plant-based foods. Eating more plant rich foods compared to a southern dietary pattern, characterized by added fats, fried food, eggs, organ and processed meats, and sugar-sweetened beverages, is associated with lower rates of acute heart disease, stroke, and heart failure. In the\u202fprospective Million Veterans Program study<\/a>, researchers identified that adherence to a healthy plant-based diet was associated with a lower burden of cancer, diabetes, heart disease and that these beneficial effects extended to both African Americans and non-Hispanic whites, eliminating disparities. In a five-week, non-dairy\u202fvegetarian nutrition intervention study<\/a>\u202fin an at-risk African American population, authors concluded, \u201cIf widely adopted, this could dramatically reduce and possibly eradicate the racial disparity in ASCVD events and mortality, if 19% of the 21% increase is eliminated by this lifestyle change.\u201d <\/p>\n\n\n\n

Knowledge and application matter <\/h2>\n\n\n\n

\u201c\u2026When you know better you do better.\u201d We all must seek knowledge to understand why disparities exist rather than accepting that they are just a way of life. The first step is to ask and listen to your patients about their individual situations that drive their health. There are several tools available to assist\u202fassessment of SDoH<\/a>\u202fas well as to\u202flocate local resources<\/a>. <\/p>\n\n\n\n

But knowing is not enough, we must apply what we learn into the development of lifestyle behavior change treatment plans. For example, start by joining ACLM\u2019s Health Equity Achieved through Lifestyle Medicine\u202f(HEAL Initiative)\u202fto learn more and use its resources to make a change. Consider attending the 2nd Annual HELP Conference May 16-18, 2025 in Jupiter, FL.\u00a0<\/p>\n\n\n\n

Together we can make a real difference for our patients. As we observe February\u2019s dual Heart Health and Black History months, let\u2019s take action to change the reality DuBois chronicled. <\/p>\n","protected":false},"excerpt":{"rendered":"

As we observe February\u2019s dual Heart Health and Black History months, Dr. Columbus Batiste, issues an important call for the implementation and development of lifestyle behavior change treatment plans to address the alarming trends in health disparities.<\/p>\n","protected":false},"author":3,"featured_media":6624,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[9],"tags":[],"class_list":["post-6519","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-equity"],"acf":[],"yoast_head":"\nWhat every lifestyle medicine provider must add to their root-cause focus - American College of Lifestyle Medicine<\/title>\n<meta name=\"description\" content=\"We all must seek to understand why disparities exist rather than accepting that they're part of life. 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