It’s Not Just the Diet: Racism Is at Play in Immigrants’ Poor Health Outcomes


A recent article in the New York Times discussed an important connection between health disparities and demographics in the United States: Immigrants, particularly in the Latino community, often have worse health outcomes after coming to the United States.

Unfortunately, however, the article focused almost exclusively on one lifestyle change that comes along with immigrating to the United States—a change in diet—and overlooked what may be an even more important contributing factor: racism.

The article outlines what many of us already know. The American diet is full of highly processed, cheap, and easily obtained foods, and immigrants are not immune to the pull of these choices, or the economic factors that make these foods so prominent in our diets.

Within the context of the supposed “American dream,” it may seem surprising that people who make major sacrifices to come to this country, often risking their lives to do so, don’t actually experience a better life. But for those of us who know more about the actual lived reality of immigrants, particularly those who are people of color, it may not come as a surprise.

What infuriates me about these kinds of perspectives is that they often overlook the larger systemic elements at play in exchange for a focus on what seems to be a problem resulting from bad choices by individuals. Obesity, although its correlation with shorter life expectancy, as implied in the article, is often disputed, is a convenient scapegoat for a whole host of health disparities. It’s used to explain the growing rates of maternal mortality and morbidity, for example.

Meanwhile, there is a growing body of research documenting the impact of racism on our health, implying that there may be a much more nuanced and systemic answer to the question of why second-generation Mexican-Americans have higher rates of high blood pressure and diabetes than their parents. These possible explanations could include everything from the stress that results from experiencing racism to the ways in which racism affects health care. A recent survey of women who gave birth in the United States, noted, “About one in five black and Hispanic women report poor treatment from hospital staff due to race, ethnicity, cultural background, or language. Compared with 8% of white mothers, 21% of black mothers and 19% of Hispanic mothers perceived such poor treatment while hospitalized to give birth.”

The New York Times article only once hints at how racism may play a factor in immigrants’ health care—in a description about how immigrants in one town stopped walking for exercise because they were afraid of being perceived as undocumented:

The lifestyle takes its toll. The county in which Brownsville is situated, Cameron, has some of the highest rates of obesity and diabetes in the country. The numbers are made worse by a lack of physical activity, including walking. Immigrants said they felt so conspicuous during early attempts to walk along the shoulder of the roads that they feared people would suspect they were here illegally. Ms. Angeles recalled that strolling to a dollar store provoked so many stares that she felt like “a bean in rice.”

This isn’t a question of “lifestyle”—it’s about the lived reality of racism. A white person would likely have no such fears of walking around their neighborhood or to a local business, or fears of being profiled or singled out as undocumented. This is just one example of many that we could likely point to to demonstrate the effects of racism on the health of immigrants and other people of color.

These systemic analyses of health disparities are crucial if we’re ever going to get to the root causes of health disparities. There is even a new movement to shift away from “cultural competency” and toward “structural competency” for medical providers to improve health-care delivery for individuals affected by these disparities.

I can’t wait for the day when estimable journalistic outlets like the New York Times look past the tired tropes of individual choice and toward the larger systemic elements at play. Stop ignoring the elephant in the room.

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  • Fenria

    Wow, this is the biggest piece of “poor me” crap I’ve read in a long time. Here you go again, running from all personal responsibility, blaming whitey because you’re fat and out of shape. Really? Don’t you people ever get embarrassed pulling out the old, worn race card over and over like this? Look, this is easy. Lentils, rice, beans, fresh fruit and vegetables. That’s all. It’s cheap, it’s healthy, it’s damn easy to get. Don’t give me this whiny crap that you can’t get healthy food. The truth is that you don’t TRY to get healthy food. You fill up at the fast food joints, and then you want to turn around and blame the scapegoat of the day, whitey, because you made poor food choices. Seriously, take responsibility for your own actions. Don’t pawn your poor choices off on others. It’s pathetic.

    • Arekushieru

      Hoo boy, here we go with another person doing the same thing that they accuse others of trying to falsely manipulate. If this were about someone who is skinny, it’s for DAMN sure that you wouldn’t be pulling the tired old card about blaming someone for being skinny and out of shape.

      Fast food joints may be the only ACCESSIBLE places in minority neighbourhoods. That IS a result of racism and discrimination. Besides that, telling people that they should do more than what is required of the rest of the population, especially when they are minorities? …Is racism.

      Not recognizing your own privilege, then refusing to accord others the benefit of the doubt, especially when they are minorities IS racism.

      Even eating ALL of the foods you described are not going to provide ANYONE with all the nutrients they require, especially those in impoverished neighbourhoods who are ALREADY malnourished and who are most likely from a minority. Some children, and again it is most likely minority children who are affected by it at even worse rates, have nutrition deficiencies, that require extra care. And, again, some people are allergic to certain food items.

      You really are a moron.

      • Fenria

        Yeah, it’s MY fault that you made poor life choices. MY fault. I held you back. I held you down. I went into your barrios and stopped you from making better choices. Sure. As I said before, don’t you people ever get tired of being so pathetic and blaming others for all your problems? I have my own life issues, but I’m not blaming anyone else for them. My choices are my own, good or bad. I own my choices. That’s called being an adult. Grow up. Leftism is a mental disorder. Half this fecking country is on food stamps. You’re telling me that you can’t get the nutrition that you need? You should have to live in a third world country where there are no food stamps. Do you not want choices? Perhaps we should stop non whites from buying junk food and force you guys to buy healthy food instead. Would you like that? Would you like your choices taken away from you? No, of course not. You just want to make bad choices and blame them on others. Own your choices. Grow up!

    • canaduck

      I would suggest looking up the Food Empowerment Project and their survey of “food deserts”, which showed that impoverished neighborhoods (which frequently do have more minorities and non-English speakers) are indeed lacking in fresh fruit and vegetables, as well as many other necessary foods. (They are inevitably filled with fast food joints.) In many places, healthy foods are neither cheap nor easy to get, and the fact that you say this so glibly makes it obvious that you haven’t looked into the issue at all.

      • Fenria

        And how are these fast food “deserts” the exclusive fault of white people? Sounds like poor city design and planning to me, and that’s everyone’s fault. You want to be mad at someone over food deserts? Be mad at city supervisors, city council members, and the fast greasing of palms that allows developers to build crappy infrastructure that doesn’t provide for the needs of the people who will inhabit it. Once again, blaming “whitey” is a total cop out.

        • canaduck

          Um, I didn’t say it was our fault. Like, at all. I didn’t even mention white people in my comment–not even to say that I’M white. And I am, in fact, quite mad at all the people and institutions you mentioned.

          To a lesser degree, I’m angry at individuals who respond with blind defensiveness to attempts to better the lives of less privileged people among us. Individuals such as these are so caught up in their own issues–the nature of which I won’t speculate on–that they imagine some nefarious anti-white agenda everywhere they look, even when white people aren’t being discussed at all.

          • Fenria

            The anti white agenda is right here! Articles just like this where non whites are encouraged to blame white people for such arcane nonsense as overeating or eating the wrong kinds of foods. THIS is why I’m angry. As a white person, I’ve spent my whole life being blamed for every time a non white person stubs their toe or has a personal life failure, even though I don’t even have nearly enough power to influence ANY of that. I’m sick and tired of being blamed for every little thing that goes wrong with the lives of non white people, so yes, I’m mad. And yes, I’m going to actively confront articles like this because I feel it is my duty to stand up for myself and my race, and let non whites know that, no, we’re NOT going to take the blame for your poor life choices, and, no, we’re NOT going to be scapegoats for the new, in vogue fad of blaming whitey for everything that ever happened to you.

            People make their own privilege in this world. Work hard, delay gratification, get a good education, make smart choices, and you’ll go far no matter what race you are. If you f’ed up, oh well, that’s YOUR fault, not mine, and not whitey’s!

          • O’Keefe Kelly D’Elia

            Poor you.

          • Fenria

            Ah yes, I suppose I should just get with the modern program where I’m a horrible, evil person who holds non whites back from pursuing their dreams. force feeds them junk food, and covertly still owns slaves. On your knees, whitey! On your knees! You liberals are the epitome of pathetic.

          • O’Keefe Kelly D’Elia

            Lame.

          • Fenria

            Yeah, your comment is pretty lame.

          • O’Keefe Kelly D’Elia

            Double lame.

          • Fenria

            I thought you were supposed to be pulling your hair out. Get busy!

          • O’Keefe Kelly D’Elia

            THANK YOU!

  • Paige

    I really disagree with the message of this article. I understand that many immigrants who enter the US are not financially stable so “cheap” food is consumed more often than not, but racism? This article does not list a single reason how racism can contribute to obesity in immigrants, besides quoting the NY Times’ mention of immigrants feeling ostracized as they walk down the street.

    I receive stares when I go jogging as well; should I stop and blame my poor health on the fact that I’m female and I feel uncomfortable jogging?

    Further, I’d really like to read more about those statistics given for poor hospital treatment on mothers of differing races. Because a mother of one race receives subjectively sub-par medical care, it’s automatically racism? There are a number of reasons for varied medical treatments, such as the quality of the hospital, the procedures being done, the opinions of the patients, etc. That conclusion seems jumped to.

    Being healthy is not a matter of race, and it’s frustrating how the obesity epidemic is being shrugged off as a matter of racism. Being healthy is NOT just for rich white people. That is an ignorant message.

    • Arekushieru

      You obviously don’t understand what racism is. The quality of the hospital for the most part is affected by the neighbourhoods it resides in. Most impoverished neighbourhoods have minorities, which is, itself, a result of racism. The procedures being done are also affected by the quality of the hospitals. The health care one receives is ALSO affected by this. Therefore, the variation in their opinions. Voila! The fact that many doctors may be white and not understanding of the privilege that affects them but disaffects their patients can also be a factor in forming one’s opinion. Thanks.

      • Fenria

        And what privilege is that? You DO understand that a doctor goes to school for an average of EIGHT years before he/she can even set foot in an operating room, and during that time often racks up some $100,000 worth of debt, right? Do you honestly think that medical school waives the required fees and time spent just because someone is white? This privilege crap is ridiculous. If you’re jealous of the life that a doctor lives, take your happy butt on to medical school and put in the time required to get a degree. Being non white, you’ll probably be able to take advantage of a grant that a white person doesn’t have access to. Now THAT’S some privilege.

      • Paige

        I agree with Fenria here; it’s erroneous to assume doctors are inherently more privileged than others, when in reality it requires years of effort and sacrifice to earn a medical degree, and years of patience and sacrifice to sustain it. It is not a profession exclusively for the wealthy, either.
        “Most impoverished neighbourhoods have minorities, which is, itself, a result of racism.” Why is this automatically the case? Poverty does not exclusively affect minorities.
        The mindset that you are in is a toxic one, and I urge you to see beyond it. Racism is one of the many -isms that the world is full of, regardless of borders. The United States is a land of opportunity, such as the scholarships Fenria mentioned encouraging students of different backgrounds to further their education. It is not a perfect country, but nowhere is; there will be people who shout racial slurs and make your children feel inadequate at school, just as there will be people discouraging the overweight man from running and telling females like me to settle down and have children before thinking about medical school. If someone is really that unhappy with the quality of life they are living in America, it would be more productive for them to rectify the situation by leaving rather than staying and blaming the masses, ultimately achieving nothing.
        Returning to the main issue: eating healthy is not a privilege reserved for white people, or wealthy people. No one can tell you what you have to put in your body, just as no one can keep you from exercising before bed. I reiterate that this is an ignorant message, an unproductive message. The “tired trope of individual choice” the original author of this article mentioned is the difference between personal health and heart disease.

  • cmarie

    Jesus Christ on a cracker. When my son was born some clueless emg rm. receptionist waved us in the direction of the maternity ward. The elevator wasn’t working. We tried entering the hospital through the main enterence but that was closed. The really bad contractions hit me outside and I thought I was going to deliver right there on the bench. When we got back inside and into a room the nurse brought me into a bathroom, gave me a gown and left. I lifted the toilet lid and found it covered with somebody else’s blood. Racism? No, more likely just the chaos of a hospital in the middle of renovations and a few employees that needed to be reminded that they actually worked in a hospital! As for obesity, I have never ever been forced to consume food against my will and I’d be surprised if people interviewed for this article were either.

    • Fenria

      I’m lily white, and my hospital stay when I had my son was total chaos. The doctor was out of the room for my entire labor and only entered the room to get my name wrong and yank my son out before leaving again. Racism? NO. There were three other women in labor at the same time. That’s life. Meanwhile, my son is healthy and all’s well that end’s well. I don’t blame the hospital of the overworked staff. Everyone’s job is hard to do and I know what it’s like to work in a hectic environment. Chalking that up to “racism” is a ridiculous cop out.

  • O’Keefe Kelly D’Elia

    I am really flabbergasted by the comments on this (excellent) article. Who are these people? The comfortable majority who thinks they are a persecuted minority. The defensive comments/rants and crazy level of denial is astounding. If you can’t see how racism and privilege affects EVERYTHING then I recommend a “listen don’t speak” approach, please. Pardon me while I go pull my hair out. Or maybe I’ll go to medical school. That’s so relevant. Pfft.

    • Fenria

      I am appalled that you liberals actually think that because we’re white, we have to stay silent these days while we’re being accused of insane, outrageous stuff like stopping Latinos from eating healthy. Really? REALLY? We’re stopping a whole race of people from eating healthy??? Listen to yourselves already. The left has lost the plot. Not only do white people NOT have the power to effect how Latinos eat, we DON’T EVEN CARE! Seriously, go pull your hair out because it seems you liberals have no understanding of how the adult world really works, which is typical seeing as liberalism is the ultimate in childish mindsets.

      • O’Keefe Kelly D’Elia

        Listen, you don’t know me. I don’t know you. But I can at very least see that you’re pretty comfy in the whole “us/them” mindset. It’s super cool how you keep referring to “you people” and “you liberals” like you know something we don’t.
        Minds only function when open….if you’ll just look down I think you’ll see the ground rushing up toward you.

        • Fenria

          I refer to you people as liberals and think of you as “them” because I have NOTHING in common with you people. I come from a background of hard work and total personal responsibility. Never once did my parents let me pawn off one of my bad choices on someone else, and that is how I live my life. I’ve made plenty of crappy choices, but they are mine, and mine alone. I wouldn’t dream of blaming some other group for any of them, and so I don’t expect, and won’t allow any other group to blame me or my race in general for the choices they make with their own lives. That’s called being an adult, and that is something that you liberals need a good strong dose of.

          • O’Keefe Kelly D’Elia

            I’m feeding the troll I know. Sorry.
            Once again I ask you to listen Fenria. First off, I guarantee we have plenty in common. For one, I also come from a background of hard work and personal responsibility. It’s insulting, and unnecessarily so, for you to assume I don’t. It’s lovely that you wouldn’t dream of blaming some other group for your crappy choices. Good for you.
            But you know what? That isn’t called “being an adult”. In your case (and mine, I am white) that is what’s known as PRIVILEGE. You don’t seem to realize that you have/have always had the LUXURY of sole ownership of your life circumstances and choices, good and bad. Anything you may have overcome, any bad choice you may have corrected or learned from, is guaranteed to pale in contrast to the daily struggle we as a culture work hard to maintain over non-white people. That is because you get to own your life and are generally assumed to be competent and superior. This is something you may have heard of as well- RACISM. It’s not “gone with the wind”. The worst part of it is not outright, it’s invisible and systemic. It buoys you and advances you without you having to do anything but go along. I acknowledge my privilege. That doesn’t preempt me from having empathy for those who live without it or from advocating for those unlike me or from working to expose it. It doesn’t preempt you either so think about it. Stop being so defensive. Stop using ridiculous hyperbole. Stop entirely using phrases like “you people”. Please. Thank you.

          • Fenria

            Look, you, as a liberal, want to wrap yourself in the terms and narrative of white guilt. That’s your business, but don’t, for one minute, expect other white people join in. I’ve heard this crap my whole life, that I’m the recipient of some sort of magical “privilege”. I assure you, I’m not. I’ve been homeless, poorer than dirt, and have worked the same crappy jobs side by side with non whites. My “privilege” comes from the fact that when I get knocked down, I keep on getting back up, going back to school, going back to work. I keep on trying, and ANYONE, regardless of race, will be able to live a moderately comfortable working class life just like I have if you work hard enough. That’s the truth. The US is a meritocracy, and if you put in the effort and face time, you go far. If you sit around blaming other people and watching tv while stuffing your face, you don’t get anywhere, and this goes the same for whites and non whites alike. There is no special “privilege” for white people. I don’t get a “white people’s discount” on my mortgage. I don’t pay less for my groceries or car or utilities simply because I’m white. I can’t walk into a business and get hired simply because I’m white. This is total leftist nonsense, and it exists solely to create an invisible yoke around the necks of white people, to make us cowed and shameful of ourselves and our race, and I’m not buying it!!!!! My family NEVER owned slaves, we never held non whites down or back, and I won’t accept this idiotic yoke of white guilt that you and your fellow liberals want so badly to saddle me with. If you want to make yourself a psychological slave, you go ahead, but you can count me out of that lunacy. And the fact that you think I’m a troll because I won’t accept white guilt is truly laughable. It just shows how pathological you liberals really are.

          • O’Keefe Kelly D’Elia

            Then let me ask you something: this (RH Reality Check) is a reproductive justice organization/website. Reproductive health and justice and equal rights are the focus here. Do you regularly read (and comment on) articles here? Are you pro-choice? My point is if yes, then there you go we have something else in common. If not, you are a troll.
            Either way, in my educated and privileged opinion you are still delusional. You clearly think the same of me. Whatever. Let’s continue on our merry way.

          • Fenria

            Yes, I am pro choice. I am not a hardline Christian conservative, I’m an atheist. But I am a firm believer that there are NO clean hands in history, and everyone, regardless of race, has their role to play in getting us where we are today, so it is pointless and beyond hypocritical to single out one race as the scapegoat flavor of the day. Since I happen to be part of said scapegoated race, I’m going to be very vocal in my opposition to this agenda, hence the amount of replies I’ve contributed to this thread. I’m more than happy to agree to disagree with you.

          • O’Keefe Kelly D’Elia

            It’s fine that we disagree and it’s good to discuss. Now, I’m going to put it real simple. (No, that’s not a dig at your intelligence, you’re clearly intelligent.)

            Do you concede that racism exists? And has since the founding of this nation?

            Racism exists to create privilege. They are two sides of the same coin. Simple.

            Racism isn’t only a mental quirk or a skewed perspective on the world. It’s a systemic program to create advantages, greater freedom and greater power of one group over another. I get that you don’t feel you have benefited from the privilege that being white affords you. You have, as have I.This doesn’t mean that you must have lived a charmed life with a camaro on your sweet 16 and free passes to medical school. I’ve been poor all my life as well BUT the example does not disprove the rule.

            And the existence of privilege does NOT require you to “feel guilty” or “be silent” or get “on your knees”. In fact, it requires nothing of you. But it is a step toward greater equality for all to simply *acknowledge* it.

            “For to be free is not merely to cast off one’s chains, but to live in a way that respects and enhances the freedom of others.” – Long Walk to Freedom ~ Nelson Mandela

          • Fenria

            I originally wrote you a rather long winded and thought out reply, but this site decided that it wanted to suddenly and randomly think about moderating it, so I’ll give you the abridged version instead.

            No. I don’t accept or acknowledge your white guilt “privilege” otherwise known as psychological slavery. I feel it is akin to a religious person trying desperately to force me to believe in their skygod; even after I have told them I have no intention in doing so, they still find ways to include me against my will in the form of “Jesus loving me regardless”. This is no different, and I liken it to the old adage that miserly loves company. Liberals have devised a very cruel and off putting doctrine for themselves in white guilt, and you guys desperately don’t want to have to go it alone, hence the forced attempts to get other whites to join in.

            Nope. I reject it. You are of course free to feel any way about yourself that you like, but as I said before, you can count me out of your liberal white guilt.

          • O’Keefe Kelly D’Elia

            I appreciate your reply and in fact, this whole discussion. I especially respect your metaphor to religion/witnessing/conversion attempts. I hate that, too. I still very much disagree with you on the rest but that’s fine.

            I do not feel guilty. I want to make that point very strong. I do not feel guilt for/about being a white person. My primary emotion in response to privilege and racism (and any -ism) is anger. I’m furious. That is in part a personality thing, I respond to things I see as out of my control with anger. This is not to be confused with anger about *being* white. That is out of my control but does not cause me anger, regret, guilt or anything of the sort. It just is.

            But guilt requires responsibility. I do not, in any way, shape or form, feel personally culpable for the existence of systemic racism or white privilege. I don’t want you to either. As individuals we do the best we can to be just human beings, to create fairness for ourselves and those in our world by treating others…justly and fairly. I don’t doubt that you do, I couldn’t know and I’m a fan of the benefit of doubt.

            So let’s use a different approach and different phrases. “White guilt” is very stupid, I agree. It’s totally pointless and is not a motivating force, rather a paralyzing one. The *acknowledgement* of privilege is unrelated. It’s simply what it is- acknowledgment.

            Again:

            “Racism isn’t only a mental quirk or a skewed perspective on the world. It’s a systemic program to create advantages, greater freedom and greater power of one group over another.”

            You or I personally didn’t design or institute it, but to deny that it works in the world around us is selective blindness.
            So this is (partly) about the difference between responsibility and culpability. The former is motivating and can stand just fine alone, the latter is paralyzing and leads to foolish, misplaced guilt.

          • Fenria

            But I’m not seeing where non whites are being disadvantaged these days, I’m sorry. I was born and raised in Los Angeles, where I experienced so much “reverse” racism, I could fill a tome with it. Every school that I have attended has had the exact same curriculum for whites and non whites alike. The only difference is who will put in the time to learn and who won’t. There is no racism. It is solely the responsibility of the individual to own his success or failure.

            It’s the same with every job I’ve ever held. There are no outlandish requirements foisted upon non whites that whites don’t have to adhere to. The job is the job, and the only difference is who will show up and work hard and who won’t. Once again, this is in no way race centric and is purely merit based.

            Non whites enjoy EVERY opportunity in society that whites do. They can shop at any store that I can, apply for any job that I can, and I’ve been passed over a couple of times at a job interview for one of them as well, so believe me, the playing field is level. It’s as level as it can ever get in an imperfect world.

            Non whites aren’t being denied anything in this country. There is complete parity in goods, services, and opportunities for all races. I live in a small five by five mile square town, and in this little town in the middle of nowhere, we have multiple ethnic restaurants, ethnic hair salons, ethnic music and food stores, a community college and university with an affirmative action admittance policy, a mosque, a synagogue, and special services set up strictly for use by native Americans. Please do not tell me that non whites are being held down out there today. It’s nonsense.

            Now, of course, there are still crappy people out there of all races who like to call people names and demean them, and believe me, I’ve been called snow white and cracker more times than I can count, but there is NO institutionalized racism out there. Nothing is being denied to non whites. Even in small town USA, a non white can find and do anything he or she might want without difficulty. And this is yet another reason why white “privilege” is a totally outdated and insulting concept.

            When someone tells me that I’m the recipient of privilege, they are negating all the hard work I’ve ever done in my life and are telling me that I was given everything I have simply because I’m white. If you knew how hard I’ve worked in my life, and how many time I’ve had to pull myself back up after getting shot down over and over again, you’d know why this is so unbelievably insulting to me and why I take so much offense to it.