Laurie and I are trying to keep this blog generally COVID-19 free, but today I am making an exception. A white friend who is a talented and dedicated amateur epidemiologist forwarded me this interview with Dr. Michael Osterholm, conducted by Dan Buettner at Blue Zones.
Let me be clear: this is generally an excellent article. Osterholm is thoughtful, considerate, compassionate, and knowledgeable. And yet, my friend forwarded it to me because it made them feel guilty, triggered, and more in danger because of the emphasis on obesity as the greatest risk factor for people under 55. Because Osterholm is so clear and careful, they felt especially threatened, and they asked me what I could tell them that would help.
Here’s what I responded.
My basic reaction, with all due respect to Osterholm (which seems like it is a lot) is that this is not something he has thought through. We know beyond a doubt that there is a huge racial disparity in both cases and deaths. You and I know that a lot of the reason for that racial disparity is who is on the front lines and must work and be in contact with the public, whether it’s nurses, grocery store workers, delivery drivers, postal carriers, etc., etc. We also know that there are racial disparities in levels of obesity, and we know some of the reasons for them as well.
I would bet my last dollar that if you correlate that obesity statistic with 1) level of involuntary exposure to the public; and 2) poverty leading to reduced dietary options, the obesity itself would shrink or even disappear. Someone is undoubtedly doing that, because enough doctors of color understand that. But if you are not alert and aware of the correlations between race and obesity, and you are not familiar with health at any size (and most doctors are neither), then obesity looks like a controlling factor. So that’s how I see the science.
The rest of my answer was personal to their situation, and not relevant here. I will say that my answer seems to have provided some relief.
When we learn to look beneath the automatic demonization of fatness, we almost always find that the underlying issues are complicated, racialized, and rooted in many forms of injustice.