Tuesday, March 25, 2008


(SAN BERNARDINO, Calif.) Blacks in the Inland Empire live with environmental stresses that could have serious consequences for their health, including premature death.

Dr. V. Diane Woods, founding president and CEO of the African American Health Institute of San Bernardino County, has tried to persuade people of this for years. Dr. Woods designed and conducted a countywide health planning project from 2003 to 2005, funded by The California Endowment, called the African American Health Initiative Planning Project.

The study was to investigate from the perspective of Americans of African ancestry in San Bernardino County why they have the poorest health outcomes of all ethnic groups. More African Americans die from the leading causes of death such as heart disease, stroke, cancer and HIV/AIDS than any other group. Even African American infants die two to three times more often than other infants.

Statistics for San Bernardino County show that Americans of African ancestry die 13 years earlier than Whites. “Simply put, African American males die at an average age of 56, and African American females die at an average age of 62,” said Dr. Woods. Since then, the African American Health Institute was created in January 2006, and has been working to combat this statistic.

Now, two documentary filmmakers, Larry Adleman and Llew Smith, have taken a look at health data affecting all races from across the country. The result of the filmmakers’ investigation, a four-part series called Unnatural Causes, airs soon on the PBS network.

Unnatural Causes concludes that lower incomes, racism and other external stresses put people at the greatest risk of health problems. These causes that are outside of a person, and can’t easily be changed by one’s own initiative, are more likely than biology or bad choices to make a person sick.

Los Angeles affiliate KCET will show the documentary on four consecutive Sundays in April, 6 p.m. to 7 p.m. April. 6, 13 and 27, and 4 p.m. to 5 p.m. April 20. San Bernardino affiliate KVCR is tentatively scheduled to show the documentary starting July 8, and air at 9 p.m. July 8, July 15, July 22 and July 29.

“What I like about this series is we have collected our local data. Our results overwhelmingly point to multiple factors in San Bernardino County other than biology and bad choices that lead to persistent trends of premature death for Americans of African ancestry,” said Dr. Woods. “Now public health experts across America support our findings with mounting scientific evidence. Our local situation mirrors the nationwide situation.”

Dr. Woods learned of this film in 2006, and immediately signed the African American Health Institute to be a partner organization with the filmmakers. Many healthcare organizations in the country have joined this partnership, as have national organizations such as the Health Policy Institute of the Joint Center for Political and Economic Studies, the National Association of County and City Health Official (NACCHO), and the American Public Health Association (APHA). The complete list can be viewed at www.unnaturalcauses.org.

As one of the partner organizations, the African American Health Institute held a preview screening of the documentary on Thursday, April 20 at the Norman C. Feldheym Library in San Bernardino. The segment Dr. Woods chose to preview shows how environmental changes over the 20th Century led to a high increase in diabetes and other health problems among two Native American tribes -- the Tohonos and the Pimas -- on reservations in Arizona.

At the preview, Dr. Woods discussed concerns both the series and her organization have raised. There are similarities between the health problems of the Native Americans now living on reservations, and those of Blacks living in the Inland Empire, she said.

Historically, the Native Americans in Arizona lived off their land, the Tohonos eating native vegetation that grew abundantly and the Pimas developing an elaborate irrigation system to draw water from a nearby river for their crops. Both tribes ate healthyly and got lots of exercise. There was absolutely no diabetes among them during this time.

But starting in about 1890, White settlers in Arizona had increased the demand for water so much, the river by the Pimas had run dry and the Tohono’s area was a desert wasteland. A dam built during the Calvin Coolidge administration promised more water for the Pimas, but they saw very little. Instead, because of overt discrimination practiced then, most of that water was diverted to resorts, golf courses and wealthy Whites-only suburbs.

“This is a part of the sad history of America,” said Woods. “The ultimate travesty is that most people do not stop to think about the physical and mental devastation this environmental change has brought to a proud, self-sufficient people, the Native Americans.”

The Native Americans, stripped of their livelihood, had to rely on surplus commodities distributed by the U.S. Department of Agriculture. Usually these commodities are white flour, cheese, lard or other fats and canned food. “Not foods for a healthy diet,” Woods said.

The video points out that while fry bread is now regarded as traditional Native American cuisine, it is not. It is what the early 20th Century Arizonans living on the reservations often made with their commodities, which was all they had. Their typical diet was much healthier.

“Here in the 21st Century Inland Empire, some Americans of African ancestry also rely on USDA surplus commodities to put food on their table,” Dr. Woods said. “African people were brought to America against their will. They were stripped of their dignity and treated lower than animals. The mental and physiological damage done to Americans of African ancestry is unspeakable. Even today, our people are led to believe that our culture is unhealthy and bad, which is not true.”

“Think about the potlucks we have after church,” she said. “These social gatherings represent collective energy for positive fellowship, nurturing of our young, encouragement for the struggling and general support for good will, honesty and integrity. This is the core of the African village, a fundamental premise for the health of Americans of African ancestry.”

Most Inland Empire residents suffer from a lack of exercise, Dr. Woods said. Some live in neighborhoods that aren’t safe for children to play outdoors. And others live in newer suburbs that, while safer, still have only small front and back yards, and almost no space between homes.

“This crowded condition tends to herd people together. When the African American family gathers it is often in large open spaces, such as the back yard at a relative’s home. We are a people of movement, energy and laughter. We enjoy family gatherings. We love people-to-people interaction. We like space. Mentally, the new environmental changes and housing developments in the Inland Empire tend to be stressful. They take away space.

“Continual stress and negativism are environmental factors that put Black people at even greater health risk than bad diets and lack of exercise, as was demonstrated in Unnatural Causes,” Woods said. “The stress factor has been documented in scientific studies as a killer.”

While overt race-based discrimination has been illegal for more than 40 years, many Black people grew up with that oppression and still live with these covert factors, which cause ongoing accumulated stress.

“For instance, some people with rental homes will turn a Black person’s application down even though the home is vacant,” Dr. Woods said. “Likewise, some mortgage companies will invent reasons to deny a 'prime' loan, or any loan to a Black person, or give high interest loans instead of lower interest loans.”

“Another way Blacks are discriminated against,” Dr. Woods said, “is in health and healthcare. Within the last five years inequities against Blacks, the poor and under-represented minorities (URM) have been overwhelmingly documented in the Institutes of Medicine (IOM) report, studies by RAND, the U.S. Department of Health and Human Services (DHHS) and many other scientific academies.”

As a health professional, she has often seen Blacks wait a long time for their doctors and insurance companies to approve a necessary surgery or treatment, while Whites with the same insurance coverage and same health provider obtain the necessary care quickly. “This is a case of inequity and unequal treatment, not inferior providers or a lack of insurance,” Woods said.

This type of stress is created for poor people, irrespective of ethnicity. The results are still the same -- sickness or death. This is why everyone should view the PBS series Unnatural Causes. “We as health professionals need to target root causes of premature death and poor health outcomes in our society. We need to use our scarce money and human resources to change what is wrong in our society. And, what is terribly wrong are stress factors,” Woods said.

As Dr. Woods has been saying for several years, these risk factors create an intolerable situation.

“At this point in America and other places around the world we are in a crisis, a global crisis,” she said. “A crisis requires an aggressive approach and we at AAHI-SBC are committed to following through with what is needed and to work with anyone who truly wishes to eradicate root causes for poor health outcomes.”

What San Bernardino County needs to do most of all, she said, is commit significant money to preventative health and healthcare. We need major change. We need to stop making excuses and stop trying to look good.

“Our county needs to give money and support to those community organizations that are truly working with their people. Organizations need to demonstrate with hard facts that they are working directly with people who need the help. Our county needs to stop using ‘token’ responses to life and death issues. Our county decision-makers need to stop playing with the lives of the people whose health they are responsible for protecting and preserving. We need to get about the business of not maintaining the 'status quo.'

“Our county decision-makers cannot afford to casually look the other way, or ‘play make believe,’ or pretend to create elaborate ‘less than honorable’ attempts in addressing serious societal issues, when people are dying needlessly from preventable conditions. Our county leadership needs to move aggressively ahead and get about the business of investing money and people power into saving lives of all people, and preventing one more needless death, not just saving the lives of the chosen few,” said Dr. Woods.

She hopes the Unnatural Causes PBS national televised series will prick the “moral conscious” and further convince local policy-makers and decision-makers in the health industry of this need. “This is not a time to 'just' stay in business, but to change for the good of the people, or we will all be dead shortly. Unfortunately, when death touches your family, the sting is great. The recovery is slow.”

“Unnatural Causes is not a feel-good production,” she said. “It is not entertainment as usual. It is about a national movement forward to tear down false ideologies, and build up systems in America that will be fair, just and equal for all. Unnatural Causes is about saving lives of Americans.”


About the African American Health Institute of San Bernardino County (AAHI-SBC)
AAHI-SBC is a community-based resource focused solely on improving health among Americans of African ancestry, the poor and under-represented (URM) ethnic minorities in the Inland Empire. Please visit the Web Site at www.AAHI-SBC.org and learn more about what self-help groups and others are doing to improve the conditions of Blacks. You will also find the history of AAHI-SBC, an extensive list of partners, and activities underway.