Health and Medical News and Resources

General interest items edited by Janice Flahiff

‘Burdens Of Place’ Plague Urban Poor; Often Lead To Weight Gain, Obesity

 

From the 12 August Medical News Today article

Most of America’s urban cores were designed for walking but offer little in the way of supermarkets, healthy restaurants and other amenities for residents to walk to, according to a study led by a Michigan State University scholar.

The study is one of the first to show that poor residents living in declining urban neighborhoods want healthy food choices – evidenced by their willingness to travel long distances to find them. Past research has generally assumed that poor people will shop at whatever store is closest.

But compared with suburban residents, the urban poor are more overweight and must travel farther to find healthy food and access personal services, said Igor Vojnovic, associate professor of geography and lead author on the study…

..Other findings included:

  • Fast food restaurants were more plentiful in poor neighborhoods. In addition, residents there reported that 55 percent of all dining-out experiences were at fast food eateries, compared with only 13 percent for those in the suburbs.
  • Poor urban residents had to go nearly twice as far as suburbanites to shop at supermarkets.
  • The urban poor made about five trips per month to convenience stores (which aren’t known for stocking healthy foods) compared with only one trip per month for suburbanites…

..

During the past 30 years, urban planners and business investors have largely ignored poor communities, instead focusing policy, research and investment efforts on wealthier neighborhoods, Vojnovic said. As a result, little is known about resident behaviors in declining communities, even as the number of poor people increases in the United States, he said.

The current study shows that the fundamental principles in city planning and design that have been developed around wealthy communities do not necessarily hold in poor neighborhoods.

Meanwhile, some have advocated an “obesity tax” on unhealthy foods to help pay for the health-care system overhaul or as a policy to curtail obesity. But Vojnovic said such a tax would disproportionately burden the urban poor and noted that this population has little power to influence the location decisions of healthy food suppliers.

Vojnovic said a better option might be for states to give subsidies to major supermarket chains, restaurants serving healthy food and other needed establishments that locate in poor neighborhoods. 

 

August 13, 2012 Posted by | Nutrition, Public Health | , , | Leave a comment

Apply folk wisdom to your family practice patients (How to turn unsolicited advice into positive communication!)12

Great article on communication/relationship skills.
It shows how to show you value advice on your own terms.

This reminds me of a scene in Gone With the Wind. Rhett takes baby Bonnie for a walk in her baby carriage. He passes two older women and asks for their advice on breaking the child’s habit of thumb sucking. Although the advice does not seem good, Rhett smiles and thanks them profusely. After Rhett departs, the women talk amongst themselves what a wonderful father Rhett is.

From the 12 August 2012 article at KevinMD.com

Late in my family practice residency – and very early in my parenting career – I had mentioned the persistent and sometimes uncomfortably intrusive suggestions offered by my mother and mother-in-law. One of our faculty, a seasoned pediatrician and parent, made the suggestion that I call both sets of grandparents regularly and ask for advice. He pointed out that their motivation (to be helpful and involved) was beyond reproach and that they probably had valuable insights to offer, if I could just reframe it to protect my own need to be autonomous and masterful. It worked like magic. The unsolicited advice nearly disappeared – and I learned a great deal from our conversations. The grandparents felt needed. I benefitted. And so did my kids.

Over the years, I have found it a valuable life strategy, and it comes up fairly frequently in practice:

  • I tell all new parents at my first opportunity that they should each call their in-laws regularly to discuss parenting concerns and ask for suggestions, pointing out that the investment in making them feel like a valued contributor will pay huge dividends over time, and making sure that they realize that asking for advice will make it easier to ignore it.
  • I suggest to parents that they play various versions of the “what if” game with their kids, getting the kids to help decide how best to set rules, reward success, and punish transgressions.
  • I tell young adults starting a marriage (or other long term relationship – times have changed) that they should make a point of asking their partner’s opinion and advice often and sincerely, to build a comfortable platform of sharing.
  • I suggest proactive questions and requests for feedback when I see people with job stresses.
  • When patients are diagnosed with a serious illness for which others will be directing their care (cancer, degenerative neurologic disease), I tell them we are going to be proactive rather than reactive, and schedule regular appointments to discuss their progress and concerns. This makes sure that they understand I want to remain involved, and I avoid having to deal with crises and questions in a vacuum. (Since we often have a long term relationship, I also find that they need to have me tell them the same things the specialist has said to understand it and believe it.)
  • When patients reach an age and health status where they are declining and vulnerable, I suggest that we schedule regular visits to talk about how things have gone and what problems we might expect, rather than waiting to things to go wrong.

Try it!

 

 

August 13, 2012 Posted by | Psychology | , , , , | 1 Comment

   

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