There’s nothing wrong with fried chicken. I enjoy a good drumstick every now and again just as much as the next man (or woman), but, as we all know, there’s a long-stemming stereotype about Black folks and their alleged love of fried chicken. Despite people from all walks of life enjoying this Southern delicacy, there’s still a negative connotation that comes to mind whenever I think of a person of color and chicken. That’s why I found it disheartening when I caught word last November that former Public Enemy hypeman turned reality TV star Flavor Flav (born William Drayton Jr.) was planning to open a chain of fast food restaurants dubbed Flav’s Fried Chicken.

I initially shook it off as one of those ideas that would never get off the ground, just another one of those “celebrity” rants that would amount to a whole lot of nothing. Well, to my dismay, I found out earlier today that the first FFC franchise was real and officially open for business in Clinton, Iowa. In an almost seven-minute video interview, Flav explained how he and partner Nick Cimino got the business off the ground. I watched in disbelief as Flav broke down his deep-frying technique to a White journalist on site to cover the opening of the restaurant.

I’m all for entrepreneurship and people of color starting their own businesses; but something in this scenario just doesn’t sit well with me. A Black man opening a chicken shack in the heart of Middle America (read primarily White) seems more like a big joke, but I checked the calendar and April’s Fools Day is still two months away. Some could argue that this is better than another Flavor of Love “reality” show; but is it really? Obesity, heart disease and hypertension are serious issues in our community, and here we have one of our own shelling out buckets of grease-soaked chicken. Why couldn’t we get a Flavor Flav Juice Bar or a Flavor Flav Organic Supermarket instead?

To make matters worse, Flav isn’t alone. A couple weeks ago Shawn “Jay-Z” Carter, along with his mother, sister and first cousin, invested in Buffalo Boss, a Brooklyn, NY-based chicken wing restaurant. A part of me expects such moves from Flav, but I would have expected a bit more from someone like Jay-Z. It’s almost as head scratching as the Obama Fried Chicken that opened in Brownsville, Brooklyn in early 2009 as a form of “tribute” to President Obama. I can’t speak for our Commander-In-Chief, but I’m quite sure he’d much rather a school or hospital named after him than a random takeout spot.

Perhaps I’m being too sensitive and reading too much into the politics of poultry but given the racial implications, and, more importantly, the health concerns associated with funneling more fast food into our community, I feel like there’s a problem with fried chicken that needs to be addressed. Actually, it has less to do with what goes into the deep fryer and more to do with the people that would rather serve up stereotypes than actual food for thought. If Flavor Flav, and those in positions of power like him, truly wants to be considered a keen businessman, I’d rather he do something that adds value to the overall health of the community instead of presenting another value(less) meal.

What are your thoughts on the racial connotations associated with people of color and chicken, as well as celebrities who endorse chicken franchises? Share your voice in the comments section.

Thomas battles stress to reduce the burden on her heart. (Source: Darnell Wilburn)

Pamela Thomas had always received a ­perfect bill of health. At six feet, and 140 pounds, she worked out six days a week—a regimen that included weight training, yoga, and Pilates—and ate a vegetarian diet. To physicians and lay people alike, she didn’t fit the stereotype of someone with heart disease.

But at age 38, Thomas’ life changed. She became one of roughly 5.5 million Americans diagnosed with congestive heart failure (CHF), a cardiovascular condition in which the heart can no longer pump enough blood to the body. Thomas was born with an enlarged heart that never gave her trouble but last fall, she remembers severe swelling of her legs, feet, and abdomen that prompted her to see a doctor. During the visit, her primary physician dismissed her symptoms, telling her that she didn’t look like a candidate for heart problems and to come back if symptoms persist. “I cried all the way back to my office. I felt, at that point, nothing was solved.”

At that point, Thomas began tracking her condition by creating a photo diary of her body. “I would walk out of my house at 140 pounds and come in again at 170,” she says of the swelling. “I started feeling heaviness in my heart. It felt like a board was on my heart.”

Nearly a month later, her primary doctor finally suggested she see a cardiologist. Tests revealed that two liters of fluid had built up around her heart, and she was rushed to the hospital for emergency surgery. Within the past year, Thomas has undergone three major operations to repair her damaged heart. The first procedure to remove the fluid around her heart was done by a inserting a needle in the chest. Two weeks later, the fluid came back. The second procedure, called pericardial windows, required a surgeon to open her chest and insert tubes to drain the fluid. The procedure was successful and fluid hasn’t returned. In the third procedure a surgeon used a robot to repair her heart valves and an atrial septal defect, which is a hole in the heart. Thomas also takes medication for a condition called atrial fibrillation, a disorder in which the heart doesn’t pump at a normal rate. For an adult, a normal resting heart rate ranges from 60 to 100 beats per minute (bpm). For a well-trained athlete, a normal resting heart rate may be as low as 40 to 60 bpm. “My exertion level is completely different now. Any type of stress, I feel now,” says Thomas. “Now I feel it on my heart. I physically feel it.”

Thomas’ condition is just one example among many different types of life-threatening cardiovascular diseases (CVD). In fact, an estimated 80 million Americans—one in three adults—are afflicted with one or more types of CVD, considered the No. 1 killer of men and women worldwide. The condition is often used interchangeably with “heart disease,” a range of ailments that affect your heart including blocked blood vessels that can result in a heart attack, stroke, or chest pain (angina). Other maladies that also fall into this category include ailments related to blood vessels such as coronary artery disease, heart rhythm problems (arrhythmias), and congenital heart defects.

In many cases, such afflictions have gone unnoticed among African Americans due to neglect. In fact, experts say that 80% of heart disease and heart attacks are preventable with knowledge of your risk factors, medication, and lifestyle changes.

A Critical Situation
In the United States alone, heart disease is responsible for 40% of all deaths, more than all forms of cancer combined. The American Heart Association reports that heart disease claimed 864,480 lives in 2005, compared to 559,312 cancer-related deaths; 117,809 death caused by accidents; and 12,543 deaths due to complications from the HIV/AIDS virus.

In 2006, death rates from CVD were 306.6 for white males and 422.8 for black males; 215.5 for white females and 298.2 for black females. (Death rates are per 100,000 population).

According to Dr. Christopher Leggett, director of Cardiology for Medical Associates of North Georgia and one of BE’s Top Doctors, African American women and men have the nation’s highest prevalence rate related to heart disease at 45.9%, superseding 37.8% and 33.3% rates for white men and women, respectively. The reason blacks represent the greatest at-risk group: A high prevalence of risk factors such as hypertension, obesity, and diabetes. Says Leggett: “For every 10 diabetics, eight are going to die from heart attacks.”

A Preventable Disease
Author of Heart Smart for Black Women and Latinas (St. Martin’s Griffin; $13.95), Dr. Jennifer Mieres, director of nuclear cardiology at the New York University Medical Center and one of be’s Top Doctors, maintains heart disease is preventable and encourages patients to participate in designing their own wellness program. “Heart disease is one of those things that’s sort of silent,” she says. “Plaque builds up in the arteries and you sometimes don’t know anything until you start having chest pains. For the unlucky people, there are no warning signs and they just die of heart attacks.”

Mieres explains the lining of arteries that supply blood to the heart deteriorates over time due to high blood pressure, elevated cholesterol, obesity, smoking, and diabetes. Once the lining weakens, it acts as a foundation for the build-up of fatty plaque which can cause the formation of blood clots. As a result, these clots prevent blood flow to heart muscles, causing heart attacks and other severe problems.

She believes the best protection is maintenance and prevention through four simple lifestyle changes: Exercise or, as Mieres says, “choosing to move” for 30 minutes at least five to six days a week. Exercise increases HDL (good cholesterol) and decreases LDL (bad cholesterol) which, in turn, helps to prevent heart disease.

Avoid smoking. According to the AHA, cigarette smoking is the leading cause of premature death in the United States. Cigarette smokers have a higher risk of developing chronic disorders such as fatty buildup in arteries and coronary heart disease. Also avoid second-hand smoke.

Change your diet. Eat five daily servings of heart-healthy foods such as fruits and vegetables; broiled or baked dishes—skip the french fries; and put down the salt shaker.

Control stress levels. Evidence suggests, according to AHA reports, a relationship between cardiovascular disease risks and environmental and psychosocial factors. Acute and chronic stress may affect other risk factors such as high blood pressure, cholesterol levels, physical inactivity, and overeating.

How Stress Can Be Deadly
For Bernard Tyson, a healthcare executive for Kaiser Permanente in Pleasanton, California, the inability to control stress put his life in jeopardy. Tyson admits work–life balance has always been a struggle. His usual week consisted of 15-hour workdays and constant travel. In 2006, Tyson felt short of breath and thought he was having mini asthma attacks. Actually, he suffered from cardiomyopathy, a disease of the heart muscle that made it difficult to pump blood to the rest of the body. Usually the condition can be treated if caught early. His case, however, was left untreated and after a weekend with friends in Las Vegas, he was hit by a full-blown attack and went into congestive heart failure. During the attack, Tyson, 50, remembers having difficulty breathing, his heart palpitating quickly, and feeling congested. His valve was not closing properly, so blood backed up into his lungs and other parts of his heart. After his friends rushed him to the hospital, he slipped into a coma for three days and had to be flown to San Francisco for open-heart bypass surgery, a procedure that creates a new route for blood and oxygen to reach the heart. “I knew I was dead. But then they woke me up out of my coma and I realized that I was still alive, he recalls. “So everything in me was geared toward the next step to full recovery.”

Since his surgery, Tyson hasn’t had any complications. He needed to make serious changes to his diet and lifestyle though. The first change: Reducing his salt intake. “Sodium is in almost everything we eat. The biggest eye-opener for me is how much salt we use to preserve products that we buy every single day,” says Tyson.

The second change was getting back in shape. “Every day, no matter how miserable I felt, I had to do some type of exercise, whether that meant walking to the corner, around the house, or lifting minor weights” he says. “It was a very deliberate and aggressive program to get me back up to full speed.”

Cultural or Individual Responsibility?
Leggett believes while some cultural differences predispose African Americans to certain behavior, they must be vigilant and exercise self-discipline. “You can say that African Americans culturally like to eat or don’t exercise or are just overweight in general, and I’ll say to you the things we want to do seem to get done,” says Leggett. “African American men will jump in a car and drive 100 miles to play golf, but won’t drive two miles to see a doctor.”

Today, both Thomas and Tyson know their lives will never be the same again. With the help of family and friends, they are both making the necessary individual changes to live healthy and productive lives. “I’m learning how to love my heart more and more every day. I don’t overdo it,” says Thomas. Currently, Thomas is in a 22-week physical therapy program and is up to 17 minutes walking on the treadmill. She decided to also cut her work hours and works only two full-time days and three part-time days as a district sales manager at General Motors in Atlanta. “I enjoy what I do, but the underlying stress of the load will harm you, especially someone like me,” says Thomas.

Both make sure to stay physically active and take medication to help their hearts be as efficient as possible.  “If I’ve learned anything from this heart situation, it’s that I have a different appreciation for life, “ says Tyson. “I don’t sweat the small stuff nearly as much as I used to beforehand.”

This article originally appeared in the February 2010 issue of Black Enterprise magazine.

The United States currently spends more per capita than any other nation on healthcare, including $1.5 trillion in medical costs associated with chronic diseases, such as diabetes, heart disease, and cancer, according to a report from the United Health Foundation released Tuesday. These diseases are said to have a direct link to smoking and obesity, the nation’s two largest national risk factors.

“We know that the results and the consequences of these [preventable diseases] will show themselves in … ultimately a worsening of health disparities and a shortening of lifespan,” says Dr. Reed Tuckson, executive vice president and chief of medical affairs for UnitedHealth Group.

An analysis of the study shows that America now spends $80 billion in direct healthcare costs associated with obesity. At this rate, obesity will add nearly $344 billion to the nation’s annual healthcare costs by 2018 and account for more than 21% of healthcare spending.

“This is not only incompatible with meaningful survival it is incompatible with affordability for healthcare,” says Dr. Tuckson.

Obesity has increased nearly 130% since the first edition of the report, “America’s Health Rankings,” was issued 20 years ago. While 27% of the population is currently obese, almost 37% of African Americans are obese. In fact, the prevalence of obesity among African Americans increased by 42% in the past 10 years, according to the report.

The report also provides an annual ranking of the healthiness of each state. Ohio ranked No. 1 as the state with the highest prevalence of obesity (43.1%) among African Americans compared with whites in the state (27.7%), and Virginia led the country in the incidences of diabetes among African Americans (14.9%) compared with 7% of whites.

Because obesity plays such a huge part in other chronic illnesses and since the prevalence of obesity among African Americans is so high, then African Americans will carry a higher burden of the economic costs of these illnesses and it will significantly affect the stability of the black family, Dr. Tuckson says.

The prevalence of smoking, the other risk factor that results in preventable chronic diseases, decreased among African Americans by 7% in the past 10 years. Yet, African Americans still smoke at a higher rate than the national average.

The United Health Foundation will publish tips, tools and programs online, including a searchable database that can be used to find out how each state — and the nation — rates now compared to 20 years ago; and an obesity cost calculator that highlights current national and state-specific costs of obesity and projects future costs.

The foundation, which published the findings in partnership with the American Public Health Association, and the Partnership for Prevention, hope individuals, elected officials, healthcare professionals, employers, and communities use the findings to improve the health of American citizens by implementing methods of prevention.

The South Orange, New Jersey, resident began treatment on Metformin, an oral diabetes medicine that helps control blood sugar levels, and uses a medical meter to monitor her daily concentration of sugar (glucose) in the blood. She was diagnosed with the most common form of the disease––type 2 diabetes, in which the body is insulin resistant or fails to use insulin properly. Although diabetes runs in both sides of her family, Chambers knew very little about the disease when she was diagnosed. And worse, her primary doctor was not much help. Her physician scheduled an appointment two days after the call, but had double-booked patients which allotted only 10 minutes to discuss the  diagnosis. During the short meeting, her doctor wrote her a prescription for medication, recommended a nutritionist, and suggested online research. Feeling angry and confused, Chambers stopped seeing her primary care physician for her diabetes and sought the advice of an endocrinologist, a nutritionist, and a friend who is also a chiropractor to learn how to cope with her disease. “I told her it’s not a death sentence, but a wake-up call,” says New Jersey-based chiropractor Paula Parker. “It’s a chance to do something different in your life.”

What Chambers learned is that diabetes is manageable for those who are proactive and disciplined about diet, physical activity, and overall health. “I asked myself, ‘How much do I love my body and how well am I going to treat it?’ ” says Chambers. Vanessa Jones Briscoe, a veteran diabetes educator and research assistant professor of medicine at the division of diabetes, endocrinology, and metabolism at Vanderbilt University Medical Center, concurs. “Whatever [people] do affects their blood sugar,” says Briscoe. “It’s a hard disease to live with, but through education people learn to manage and hopefully learn to avoid complications.”

A Critical Situation
Chambers is one of 3.7 million, or 15% of blacks aged 20 years or older who have been diagnosed with diabetes, according to the American Diabetes Association (www.diabetes.org). Most experts believe the cause of diabetes is both genetic and environmental. Once known as juvenile diabetes or insulin-dependent diabetes, type 1 is usually diagnosed in children and young adults. Type 1 is a chronic condition in which the pancreas, a gland behind the stomach, produces little or no insulin, a hormone that helps convert sugar into energy the body needs. The cause of type 1 is unknown, but experts know that in most cases a person’s immune system—which normally fights bacteria and viruses—destroys the insulin-producing (islet) cells in the pancreas. Normally, once a person eats, the pancreas secretes insulin into the bloodstream which helps to lower the amount of sugar in the blood flow. But with type 1 diabetes, there is no insulin to release sugar into the cells. Instead, sugar builds up in the bloodstream and can cause major complications. Type 1 has no cure, but with proper treatment can be manageable. Experts believe that genetics and exposure to certain viruses may be factors.

Type 2 diabetes, a far more common disease, occurs when the body has trouble metabolizing sugar—either the body does not produce enough insulin or the cells ignore the insulin. With type 2 diabetes, the islet cells function, but the pancreas doesn’t produce enough insulin so sugar builds up in the bloodstream, which can also cause major complications. The cause of type 2 is also unknown, but excess weight and inactivity are believed to play major factors. Similar to type 1, there is no cure for type 2; however, the disease can be managed or prevented with medication and a healthy lifestyle.

In total, there are nearly 24 million Americans, including children and adults, or 8% of the population diagnosed with diabetes. The ADA also estimates that of the 12 million or 11.2% of all men aged 20 years or older who have diabetes, nearly one-third of them don’t know they have the disease. In comparison, 11.5 million or 10.2% of all women aged 20 years or older have diabetes. Approximately one-quarter of them are unaware. Furthermore, the disease is two to four times higher among black, Latina, American Indian, and Asian/Pacific Islander women than white women. Even more staggering is that there are an estimated 57 million Americans who have pre-diabetes, a condition that occurs when a person’s blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. If unchecked or untreated, pre-diabetes can eventually result in a diagnosis of the disease and increase a person’s risk of having heart disease and stroke. In fact, a person with diabetes is twice as likely to develop heart disease or suffer a stroke.

Briscoe often explains to patients that type 1 and type 2 diabetes can have devastating effects on the body. Both types present similar and severe complications that aside from heart disease and stroke include blindness, nerve damage, sexual dysfunction, and kidney disease. “People don’t take diabetes seriously. When you get complications, you can’t reverse them,” she explains. “People must make that connection in order to control the disease.”

Chambers refuses to call herself a diabetic. Instead, she says she is managing diabetes––and with great success. Within three months of her diagnosis, Chambers’ blood sugar dropped to a normal rate. Using the A1C test, which gauges glucose levels over two to three months by measuring what percentage of a person’s hemoglobin––a protein in red blood cells that carries oxygen––is coated with sugar, Chambers was able to see the results of changes in her diet and increased physical activity. Her A1C level went down from 8% to 6.3%. According to the ADA, a person who does not have diabetes has an A1C level of roughly 5%. Someone with a result between 6% and 6.5% is considered pre-diabetic. Anything above 7% is considered high and unhealthy. Levels can go as high as 25% if diabetes goes unmanaged for an extended period.

The Obesity Factor
Eating foods that are high in sugar and carbohydrates along with physical inactivity does not cause diabetes, but will contribute to obesity. Being overweight, particularly central obesity (fat around the abdomen and waist), is believed to be a major contributing factor to the disease. According to the U.S. Department of Health & Human Services, in 2007, African Americans, who are genetically predisposed to diabetes, were 1.4 times as likely to be obese as whites. In addition, African American women have the highest rates of being overweight or obese compared with other groups, with four out of five black females being overweight or obese. Unhealthy weight gain due to poor diet and lack of exercise is responsible for more than 300,000 deaths each year.

Obesity is increasingly becoming a problem, even for children. According to the American Academy of Child and Adolescent Psychiatry, between 16% and 33% of children and adolescents are obese and are more likely to become overweight adults unless they adopt and maintain healthier patterns of eating and exercise. According to the ADA, 186,300 children under the age of 20 have diabetes; 2 million, or one in six, overweight adolescents aged 12 to 19 have pre-diabetes.

Chambers admits weight control has been a challenge since her adolescence. She remembers kids calling her fat in school which made her retreat and become less physically active. Despite her parents’ efforts to help her lose weight with Weight Watchers and diet camps in her youth, as an adult, Chambers used food as a sedative to cope with life’s adversities, such as stress and the emotional pain of relationship breakups. Prior to her diagnosis, she admits to primarily eating foods that offered little or no nutritional value. Her nutritionist explained the importance of a balanced diet including more whole foods––foods with little or no refinement and processing, such as vegetables, fruits, and certain meats and poultry. “Moderation is key. If people control their serving size and eat in moderation, we wouldn’t have the obesity problems we have now,” asserts Briscoe. “But we’re just a super-sized generation that promotes overeating.”

Chambers also uses dance and yoga to help her keep the weight off. “I hate the gym,” she groans. “The whole, ‘no pain, no gain’ is not me. But I love dancing.” So she takes classes, including Zumba, a popular Latin aerobics dance, four times a week.  She even organizes group outings with her friends to various dance aerobics classes such as belly dancing. “It’s about making a have-to-do thing enjoyable,”  says Chambers.

The Everyday Battle
Chambers, now 42, believes when crisis strikes, it’s an invitation for people to step up. “I realize now that my body is not indestructible,” she says. “Life is shifting and I’m becoming more authentic, more open as a person.” Her spiritual practices of prayer and Reiki, a form of Japanese meditation, help her manage mood swings and emotional stresses that had previously driven her to comfort foods. Parker asserts that Chambers, like many professional women, is on the bottom of her very own to-do list. But since her diagnosis, Chambers says she has made her health a No. 1 priority. “It took me a long time to become overweight. If it’s a process to lose weight, I’m willing to do that [and] I don’t want to get discouraged,” says Chambers. “[Today] I feel different; I feel better physically.”

This article originally appeared in the November 2009 issue of Black Enterprise magazine.

The difference between the cardiovascular treatment received by whites and minorities is increasing. To combat the problem, some of the country’s leading physicians have joined forces to develop an initiative called Close the Gap, which raises awareness of the issue and ensures that eligible candidates receive the medical attention they deserve, regardless of background.

“These disparities exist even when we adjust for insurance, age, or income. Minorities continue to fall short in terms of less access,” says Leggett who serves as a member of the Close the Gap steering committee.

A collaborative effort between the medical company Boston Scientific and its partners, including the Association of Black Cardiologists and Black Coaches and Administrators, Close the Gap was launched in February with the goal of defining the disparity problem on a national level while simultaneously developing the necessary tools to provide local solutions.  “If you eliminated the disparities and brought the standard of healthcare in African American populations up to the standard of the Caucasian population, you would essentially save 900,000 lives,” says Dr. Charles Noble, an Ohio-based electrophysiologist who also serves on the steering committee.

With pilot projects in 10major cities, including, New York City; Atlanta; and St. Paul, Minnesota, the focus is on community education. Through seminars and brochures, Close the Gap reaches out to both patients and physicians, addressing the issues of healthcare awareness and cultural sensitivity.

Citing patient culture as one of the hurdles to be conquered, Leggett says it is necessary for minorities to not only familiarize themselves with diseases that plague their communities, but also to be open to and educated about the various treatment options available. “Sometimes the appropriate treatment could be recommended by the physician but refused by the patient,” says Leggett.

On the other hand, doctors cannot avoid the role physician bias plays in widening the gap that divides minority cardiovascular care from that of the white population. “We as doctors have to own up to being participants in this disparity,” says Leggett, who accepts that the bias may not be intentional on the part of most physicians, but a side effect of socialization that should not be ignored.

The doctors anticipate that soon there will be visible evidence of progress. Both Leggett and Noble are looking forward to a decline in the number of cardiovascular-related deaths among minorities and an increase in the number of patients receiving adequate treatment. In the end, they hope to completely eliminate all disparities in cardiovascular healthcare and reduce the number of minorities being affected by such diseases to the same level as white Americans.

“If we can achieve that goal, Close the Gap will not only be successful,” Leggett says, “but the country will be healthier, and people will get the treatment they deserve.” For more information on the initiative, visit www.heart-healthdisparities.
com.

THE FACTS ON BLACK AMERICANS AND HEART DISEASE

Based on data from the Census Bureau and Centers for Disease Control and Prevention, it is estimated that there are approximately 700,000 black Americans with heart failure in the United States, and this number is expected to grow to 900,000 by 2010.

Black Americans between the ages of 45 and 64 are 2.5 times more likely to die from heart failure than white Americans in the same age range.

Black Americans have almost twice the risk of first-ever stroke compared with whites.

Black Americans are 2 times more likely than white Americans to be diagnosed with diabetes and 1.5 times more likely to be diagnosed with hypertension—important risk factors for heart disease.

The prevalence for Peripheral Artery Disease (PAD) increases dramatically with age and disproportionately affects black Americans.

Black Americans are at greater risk for cardiovascular disease and stroke than white Americans.

The prevalence of hypertension in black Americans in the United States is among the highest in the world.

The annual rate of first heart attacks is higher for black Americans than for white Americans.

SOURCE: BOSTON SCIENTIFIC

GENERAL HEART DISEASE STATISTICS

More women than men die of heart disease, although more men have heart attacks.

As you age, your risk for heart disease increases.

At age 40, the lifetime risk for developing heart disease is 2 in 3 for men and more than 1 in 2 for women.

Heart disease causes more deaths in Americans of both genders and all racial and ethnic groups than any other disease.

Black Americans, American Indians, Alaskan Natives, Asian/Pacific Islanders, and Latino Americans die at earlier ages from heart disease.

This story originally appeared in the July 2008 issue of Black Enterprise magazine.