The Dr. Hyman Show - Redesigning Our Food System To Make Health Accessible For All

Episode Date: May 20, 2022

This episode is brought to you by Athletic Greens and Rupa Health.   We are living in an epidemic of chronic disease that is destroying our health, our communities, and our economy. The common denominator between all of these things is food, or more specifically, our food system. The way our food is grown, transported, processed, and consumed is making us sick and driving health disparities related to income and race, especially among marginalized groups.   In today’s episode, I talk with Dr. Marcia Chatelain, Dr. Rupa Marya, Raj Patel, and Karen Washington about creating a society that cultivates health, how our existing social structures predispose us to illness, and how we can make great changes to our food system through grassroots efforts.    Dr. Marcia Chatelain is a professor of history and African American studies at Georgetown University. The author of South Side Girls: Growing up in the Great Migration, she teaches about women’s and girls’ history, as well as black capitalism. Her latest book, Franchise: The Golden Arches in Black America, examines the intricate relationship among African American politicians, civil rights organizations, communities, and the fast food industry.   Dr. Rupa Marya is an associate professor of medicine at the University of California, San Francisco, where she practices and teaches Internal Medicine. Her research examines the health impacts of social systems, from agriculture to policing. She is a cofounder of the Do No Harm Coalition, a collective of health workers committed to addressing disease through structural change.    Raj Patel is a research professor at the University of Texas at Austin’s Lyndon B Johnson School of Public Affairs, a professor in the university’s department of nutrition, and a research associate at Rhodes University, South Africa. He is the author of Stuffed and Starved, the New York Times bestselling The Value of Nothing, and coauthor of A History of the World in Seven Cheap Things.   Karen Washington is a farmer, activist, and food advocate. She is the co-owner and farmer at Rise & Root Farm in Chester, New York. Karen cofounded Black Urban Growers (BUGS), an organization supporting growers in both urban and rural settings. In 2012, Ebony magazine voted her one of the 100 most influential African Americans in the country, and in 2014 Karen was the recipient of the James Beard Leadership Award.   This episode is brought to you by Athletic Greens and Rupa Health.   Right now when you purchase AG1 from Athletic Greens, you will receive 10 FREE travel packs with your first purchase by visiting athleticgreens.com/hyman.   Rupa Health is a place where Functional Medicine practitioners can access more than 2,000 specialty lab tests. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com.   Full-length episodes of these interviews can be found here: Dr. Marcia Chatelain Dr. Rupa Marya and Raj Patel Karen Washington

Coming up on this episode of The Doctor's Pharmacy. When people have the financial resources, when they have the security and stability of housing, when they know that their kids are going to a good school where they're safe, they're able to make the best possible choices. Hey everyone, it's Dr. Mark. People are always surprised when I tell them that even with a whole foods diet rich in plants, we can still be nutrient deficient. And addressing nutrient deficient. And addressing

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This is really a much-needed option in the functional medicine space, and it means better service for you and your patients. You can check it out with a free live demo, with a Q&A, or create an account at rupahealth.com. That's R-U-P-A health.com. Now let's get back to this week's episode of The Doctor's Pharmacy. Hi, this is Lauren Feehan, one of the producers of The Doctor's Pharmacy podcast. Food is a way to empower people and create change. Unfortunately, however, our current food system is rooted in an archaic model which has created layers of social, economic, and health disparities. In today's episode, we feature three conversations from the doctor's pharmacy about what is needed to turn our food system around so that it supports all people. Dr. Hyman speaks with Marsha Chatelain about creating social

systems that support healthy cooking, with Raj Patel and Dr. Rupa Mariah about colonialism and how it has affected marginalized communities, and with Karen Washington about the reality of food apartheid and what to do about it. Let's dive in. There are a number of ways to look at this. I think the first one is that we have to get serious about the public sector responding to the needs of the public good. Businesses are not in any position to determine the fates of people. And I think that all of the issues that you touch upon, I think it's about quality of life. And so if someone says,

well, what do we do? And I said, well, what if we have healthcare for all free college, living wage, and some type of paid family leave and childcare? And someone says, well, what does that have to do with food? And I said, well, the expectation that people could live in a food system that is varied, that is robust and productive, where's the time? Where's the money? Where's the ability to do it? You know, a lot of, you know, I'm not, you know, I'm not a medical doctor. So I try to stay in my lane. So I, you know, I don't, I read, you know, a lot of conflicting things about all sorts of health comes and, you know, social determinants of health and public health. But this is what I do know. When people have the financial resources,

when they have the security and stability of housing, when they know that their kids are going to a good school where they're safe, they're able to make the best possible choices. And so I think that it isn't just about the food. It's about all of the stressors in a society that allows injustice to continue and benefits from it, that exacerbates the problem. You know, I can cook every night because I'm a college professor. I have plenty

of money and I have a giant kitchen. And if I feel like eating something, I can cook it. The implications, right, are different for me because of the position I have. Well, everyone should have that ability. Everyone should have an hour or two to make something if they want it. But, you know, in the communities in which fast food has thrived, I would say that fast food is a sensible choice for people who are constrained with work and responsibilities and don't have the freedom to have choice and to have a quality of life where things can be equally prioritized. I think that's true. And I also think that I've had some experiences in the South and other places

and underserved communities. And what strikes me in Cleveland Clinic, where I work, we work a lot with the African-American communities around their chronic health issues, around the food issues. And, you know, one, it seems to me there's a couple of things. One is just a lack of awareness and education about the importance of nutrition in terms of determining health outcomes and determining, you know, your ability to actually function in life. And two is the, obviously, lack of access. And three is just the sort of embedded beliefs and experiences that

prevent them from actually even knowing what to do. So you're saying you can cook a meal because you know what to do. But if you don't have the education, if you don't have the family background, if you don't have the exposure, you don't know what to do with the food. So in Cleveland, I taught a cooking class for 300. We thought a few people would show up. 300 African-American women showed up for this cooking class to make kale smoothies, you know? And I was sort of shocked because I thought, wow, you know, they really have not gotten access to the right information. And they're just exposed to a food culture that's driving poor choices where the healthy choice is a really hard choice, or they're not even aware what the healthy choice is, and the bad choice is the easy choice. I mean, I think that individual relationship to food is so complicated. And I think that

there's all sorts of influences on what we eat and what we consume. I think that, you know, from my perspective, the food is often an indicator. The food that is available to us in our most proximate locations is an indicator of what society has determined is right for us or good for us or what we're allowed to have. And so, you know, I think that there are people who, you know, they, they would, they would love an opportunity for food to be something they can engage with in a kind of fullness, right? You know, I've talked to a lot of, you know, young professionals who are in the space of food justice. And we talk about things like community gardens, nutrition, and cooking classes and education. And I say, I think all of these are great opportunities. I said, but let me ask you this. How many of the people that you're working with, how do you know if they have electricity to keep their foods stored in a fresh place?

Like, how do you know that they have the heating gas and the cooking gas that they need all winter long? And I said, you know, the information about food, I think, is key. And then we take a step back and say, what are the conditions in which people are living and fighting for? You know, I'm a Midwesterner. When it gets very cold, the gas company won't cut off your gas, but once the weather gets to 60 degrees, they will. And so if we have people who are in arrears on their utilities, we can tell them to make all sorts of stuff, but we have to make sure that those needs can actually be met.

Absolutely. You know, I want to kind of loop back to something you said that I think is pretty important and I don't want to pass over it, which is the idea that business can solve social problems. From listening to it, it sounds like you're not a big fan of Adam Smith and the Invisible Hand, trickle-down economics, and the idea that we have to look at the structure of the society that we live in. And I spent a lot of time in Haiti and work with Paul Farmer, and he talks about this concept of structural violence. What are the social, economic, and political conditions that drive disease? We talk now about the social determinants of health. They're the primary drivers of chronic disease. And a lot of that has to do with the issues you're discussing in your

book and the disenfranchisement through the franchising of all these fast food restaurants everywhere. And I think it's a very important point because we have a pretty strong cultural view that capitalism and innovation and business will solve all of our problems and that, and that social problems can be solved through business solutions. And you're challenging that orthodoxy. And I love you to unpack that a little bit, because from your perspective, looking into the details of this, what needs to change in terms of our social policies and our government policies that actually can, can,

can actually change that trajectory of the ill health and the consequences of that health on everything from childhood development to, you know, economic success and viability and the ability to actually get ahead and get out of the circumstance that people find themselves in. Because I, I, I do think, and I do believe, you know, given what I've seen in other research, that the ongoing sort of plight of underserved communities, whether they're poor white communities or African-American communities or Hispanic communities, is really driven off of the underlying inability to actually get good nutrition and that food sort of is the

center of the beginning of building a healthy human who's functional and capable. And I'll just give you a quick example of what I mean by that. In juvenile detention centers, when they swap out healthy food for bad food that the kids are eating, there's over a 91% reduction in violence in the juvenile detention centers, a 75% reduction in restraints, 100% reduction in suicides, which affects their behavior. And so people's thoughts, feelings, behaviors, actions, capacity to function is really inhibited by the toxic nutritional landscape that we live in. And so I'm curious from your perspective, looking at this and the history of fast food and its intersectionality with racism and civil rights, how do we get out of this?

Because, you know, you've done a great job of explaining what happened. How do we sort of move through to what we actually need to do to reclaim the health of our communities and society. Living wage, free college, free childcare, Medicare for all. I mean, you know, it's all of these things, right? Get in the way of people being able to take a beat and make wide decisions about their lives, right? So I, you know, I don't have very strong positions on, you know, we also have to care about the supply chain, because our I mean, this is also an environmental issue that I don't get into in the book. But you know, if I had endless pages to write, I mean, this is this is, it is incredible to me. And I tell my students this, and they say,

okay, Professor Chatlin, we hear this all the time. When I was a kid, you couldn't get food everywhere. And now food is everywhere. There wasn't food bookstores. There wasn't food everywhere. There wasn't prepared food everywhere. is a there was a landscape that that I am troubled by, not just by, you know, kind of our ability to make choices in a in a very diet, but someone has to produce and harvest all of this food that we are either consuming or wasting, or, you know, or using to transform into chemical products to put back into food. This is not good.

And so we should not, I shouldn't be able to get a pineapple at my local grocery right now. It's, it's January, but I can, right. And so all of this is to say that we have to kind of make different choices about investments in people's lives. So, you know, whether, you know, it could be the corn subsidies, or it could be military spending, you know, everything needs to be on the table to say, what are we going to do to improve the quality of people's lives? Because, you know, food isn't just about fuel, food is about emotion, food is about, you know, love and affection. I mean, I try to have a very kind of nuanced, non-judgmental view of how people use food in their lives. But the reality is, is that food can become a low priority when you are under the stress and under the gun of so many

of these other concerns. So once we have a strong social safety net, that actually is geared towards caring for people, I think these other issues will slowly start to fade in our view. Because it isn't just the toxic foods, right? Like it isn't just the things that may make a person ill, it's about the stress that they live under, and the inability to do anything else but consume and work and worry about your livelihood. So, I mean, you know, it's expensive, but I think we've seen that the cost of ignoring these issues is also quite expensive. So the question is, on what end are we going to pay? I think you're absolutely right. I mean, it seems like it's a cost driver to do these things, free education, free healthcare,

basic living wage. But I think it's actually a bargain when you look at the downstream benefits of doing these things. The only thing I'd say to challenge this a little bit is that when you say Medicare for all, healthcare for all, that only works if we can figure out how to stop the population from being so sick. And it speaks to the issue of the supply chain, which is all the food that's being produced that's driving this. So 60% of the calories Americans eat are processed foods.

67% of the calories that kids eat are ultra-processed food. And that is being produced by a food system that's incentivized by our current policies that really prevent the ability to actually choose and get the right food. So if we do, what I worry about with Medicare for all particularly is that we're just going to like create healthcare coverage, and then we're not going to address the reason why people are going into healthcare system in the first place. And we're just going to be crushed. And I think that's sort of the challenge. You have to fix all of it at the same time. I mean, look at food stamps, which is great, you know, safety net. But, you know, we say with the dietary guidelines, stop eating sugar and don't drink your calories and,

you know, don't eat processed food. And yet 75% of the food stamps are spent on processed food and 10% on soda. So, and how do you sort of navigate? Can you use food assistance on soda? I thought there were foods that were marked as touch. I didn't know that. No, no, no. You cannot buy a rotisserie chicken in the grocery store because it's cooked. Because it's prepared.

But you can buy a two liter. Yeah. Yes, but you can buy a two liter bottle of soda. But here's the thing. I don't know if I I don't know if I object to the purchasing of the soda so much as because I that probably was the work of some type of lobbyist who was working for the corn industry, for the corn lobby. Right. And so, I mean, I think that this is, again, like people can have choices, I guess, in these markets. That's the choice is not what vexes me so much.

It's the mechanism that makes that makes the call on the choices. Right. It's the no household products. But you can, you know, certain foods. It's deciding that, you know, ketchup is a vegetable. When we're playing with these types of kind of upside down thinking, it really does speak to the heart of the imbalance and influence. And this is why businesses should not be in the game of uplifting people's lives. I mean, they should be regulated to the point where they have to participate in a free and fair economy and focus on what they do, right? They make products and we as a society are tasked with taking care of each other. Yeah. I mean, you look at countries, you know, that actually have these strong social safety nets that have healthcare, that have free education, that, you know, provide, you know, economic opportunity, their numbers are dramatically better all across the board in terms of obesity,

the health of the population, and much more. So it's pretty interesting to see that. And I feel like we're really afraid in this country of doing anything like that because it speaks of socialism, it speaks of this idea that we're all going to become communists or something. But I don't see a way out unless we actually create a true fair market where the true costs of the food and the food system and everything else are embedded in the price. Because right now, the price you pay at checkout is not the true cost of the food. The Rockefeller Foundation produced a report recently about the true cost of food that showed

that basically three times the cost of the actual price that you pay at the checkout counter for the food in terms of its effect on health, on the economy, on climate, on social justice issues. And that's a staggering number. So actually, if we actually had the food companies accountable for the externalities, and they're really not externalities, they're embedded in the very way that we have the food system, then if we don't do that, we're really kind of not going to be able to solve the crisis we have now of chronic disease and obesity and all.

And I think which is all linked to injustice across the board, economic injustice, racial injustice. It's all like one intersecting problem, right? And I think that it's a shift in focus. I think that what the past 50 years has done is created a space in which the lines between public and private are so blurred that we actually imagine a world where we go to companies to solve these problems and we forget that people actually have power. And I think that one of the reasons why I wanted to write this book was to talk about the fact that none of these things that we see are inevitable. There is a period of time where, you know, corporations are grooming people, they're ingratiating themselves,

they're finding people at their most desperate moments, and they're capitalizing on that. And so in that process, when we see it happening, perhaps we have the tools to make sure it doesn't, that we aren't living in the United States of Coca-Cola or McDonald's, that we're actually, you know, in our position as people who advocate for each other and can actually push back against the corporations. Okay. So, you know, Marcia, you talked about the ways in which these food companies aren't really held accountable and they're actually influencing our communities in ways that are often invisible. And I think, you know, talk about in the book, for example, how McDonald's, you know, gives money to the NAACP or, you know, I know Coca-Cola

does that and they fund the King Center in Atlanta and they provide a lot of support for social programs and they do it as their corporate social responsibility activities. But there's a dark side to it, which actually creates indebtedness in these communities to these food companies that are actually killing them. So it's like, you know, how do you navigate that? And how do you educate the communities to say, hey, you know, how do we sort of thread that needle? Because yes, they need the services and the support. Who else is going to give it to them? The government isn't, right? So they're turning to these, you know, food corporations to actually support their communities. But on the other hand, they're also killing them. Well, I mean, I think that it requires two things. One, I think, in trying to engage the conversation about the relationship between corporations and community, the first thing, you know, that I hope I did in this book was to come from a place of empathy to say, these are tough choices. If presented with a million

dollars in order for your organization to achieve its goals, I think it's a really hard thing to turn down. And what power do we unlock in turning down? What does it mean for us to say, no, we are not comfortable with the way that this money is made, and we're going to make a different choice. And I think that the tough sell isn't just don't take money from this corporate entity, but rather why does this corporate entity have so much power in the first place? Why, if we want to memorialize Dr. King, that we need Coca-Cola to help us do that? Why is it when we need these resources that this is the place where the resources come? And so I think that, you know, this is not about telling people who have constrained choices, you made the wrong choice, but rather to say, okay, how can we create a vision of a world where you're not in this bind anymore? And who do we need to talk to? And how do we need

to come together to imagine a different way of proceeding in the future? You know, you talk about this idea that seems to be a little bit hard for people to digest and swallow, this idea of colonization, that our food system and our society has been colonized. And we're like, oh, well, you know, yeah, we were, the British had the colonies and we were colonizing America. And, you know, we had India being colonized by the British. And, you know, yeah, we were, the British had the colonies and we were, we were colonizing America and, you know, we had India being colonized by the British and, you know, it was a huge era of colonialism, which essentially was taking and stealing all the natural resources from countries that were new and unexplored and using them for the wealthy in these nations. But in our country, we don't really think of our country being colonized that much, but it really is.

If you look at the extraordinary health disparities, if you look at the challenges in certain communities where life expectancy can be anywhere from 10 to 40 years less. I mean, we have the developing world statistics right here in America. I mean, the Pima Indians, their life expectancy is, I think, 46, right? And they get diabetes at the age of 30 years old. About 80% of them have diabetes. You know, that's a symptom of colonization. And I really didn't sort of really fully understand this concept of structural changes that you talked about. Because I've experienced a lot about this, and I want to share my experience and then sort of take off on that. And I went to Haiti after

the earthquake, and I met Paul Farmer, who wrote a lot about this idea called structural violence. And this is really what you're talking about. What are the social, economic, and political conditions that drive disease? And he found in Haiti, he could cure tibian AIDS not by better drugs or surgery, but by simply having community health workers. He called found in Haiti, he could cure TB needs, AIDS, not by better drugs or surgery, but by simply having community health workers. He called it accompaniment. We accompany each other to health. And he dealt with the structural issues of poverty and lack of water and sanitation and lack of having a watch. They don't want to take your TB meds, which have to be on a certain schedule. And he really showed the world that this model of addressing the structural changes really works for infectious disease.

And Bill Gates and the Clinton Foundation, all these have used his model. But what occurred to me down there, and I think you clearly have outlined this in your book, Inflamed, which really has just come out. Incredible book. Everybody should get it. You talk about the chronic disease pandemic being also one that's related to structural violence. And it's not just infectious disease and lack of water, sanitation, and poverty, but it's also all these obesity-related issues, heart disease, diabetes, cancer, all these things that are really breaking our system and are causing economic havoc

and making COVID so much worse, and you talk about that, you know, those are really structural issues. And that sort of got me thinking about it. And a few years ago, I was also on a rafting trip on the Green River with a Native American Hopi chief and a Ute chief. And the Hopi chief was very overweight. He and his wife were severely overweight, diabetic, on insulin shots, drinking Coca-Cola, and just kind of, I mean, he was the head of one of his clans and did all these incredible traditional ceremonial rituals in his culture. And I said to him, you know, Howard, you can change your diabetes.

You can reverse it. He's like, what do I have to do? And I said, well, you have to not eat sugar and all the starchy stuff you're eating. And he's like, oh, well, that's going to be a problem. I said, why? He said, well, because we have our traditional Hopi ceremonies and we have our traditional Hopi ceremonial foods.

And I'm like, well, what are they? And he's like, well, what are they? And he's like, well, Coke, cookies and cake and pies. Like, those are not your traditional foods or the Indian fried bread, which is deep fried flour and trans fats and lard. And another woman was on that trip. It was was the youth community. So, you know, they have a word for people who become really large on the Native American reservations.

They call it commodity bod, meaning they've eaten all the commodities that the government surplus has shipped to them. So the government, all the food that is just leftover food, flour, sugar, you know, Crisco, basically trans fats, they sent to the reservations and that's what they started eating and they became more religious. So these are the real changes and we cannot address our healthcare crisis. We cannot address our economic crisis, our social crisis, unless we address the food system issues that underlie the structural problems that are driving disease. So I can't tell you how excited I am by your book because it really is the first

time I've seen this laid out so clearly and so well and in such a simple way to understand and calling out things that really need to get called out. So thank you for writing it. Thank you. I'd like you, you know, we're going to talk about the two decades you've spent studying how these social structures, this structural violence predisposes

these marginalized groups to illness. And how is health and these, how are these two things connected? Yes. So I think you hit the nail on the head when you're looking at the Kamad bod. But I just want to emphasize that this isn't just a problem of marginalized people, people who are suffering under the brunt of colonialism, the worst. So our indigenous friends, our undocumented community, black community in

the United States, people who are suffering the worst social oppression have the most profound expression of inflammatory disease. But in fact, everybody in industrialized nations is subject to getting these diseases. And what we looked at in this book is really going back 600 years to where a cosmology of thought came from Europe to this land to what was now called the United States of America. This understanding of or the misunderstanding of life as humans over here and everything that's wild in nature over here, us being separate from the web of life, or man over here and woman

over here, or mind over here and body over here. These errors of Cartesian dualism that were part of the ways of organizing structures of power in an era of colonial conquest of the rest of the world. So it's much easier to take someone's land and take their wealth and take their resources and enslave them if they're seen as subhuman or actually they're not really doing anything with that land in the first place. So let's just go take it over. And so that error of thought really has set us up to having very shallow medicine, shallow ways of addressing how we're getting sick and why we're getting sick. So when someone who is part of the elite or wealthy or white, let's say, gets diabetes, we offer medicines, we offer insulin, we offer injections, pharmaceuticals. We don't offer an

analysis of all the ways that critical relationships that support our health and well-being have been disrupted by colonial capitalism. And that is what we're looking at in this book is really the root causes of the rise of inflammatory disease around the world. And that is, you know, when you're talking about diabetes and obesity and cardiovascular disease and Alzheimer's and cancer and even depression and suicide, all of these things have been tied to inflammatory phenomena in the body. And so we see that in our research and analysis, Raj and I, what we have seen is that the social structures and the

environmental structures around the body are the place where the disease is. And the body's immune system is just reacting in an evolutionarily conserved way, in a proper way to damage and the threat of damage. And that response is the inflammatory response. So it's not like we're doing something that's abnormal or wrong. The body is simply trying to correct itself in the face of this damage, whether the damage is coming from glyphosate in our cereals, whether the damage is coming from payday loans, whether the damage is coming from historical trauma of having your land stolen, such as the Pima folks, that these toxicities in the world around the body are the damage that is provoking an inflammatory response in the body. And so usually the inflammatory response when there's damage is activated to correct the damage to restore what we call homeostasis, the body's optimum working condition, and then it turns off. Unfortunately, in a colonial capitalist society, all of us are

subject to ongoing damage, because the air is polluted. And because the water, the groundwater, even if you're growing organic wine, you're pulling from groundwater that's been contaminated by glyphosate. So there's actually no way to avoid the insinuations of environmental poisoning that has happened through the corporate control of our food system and our policies. And so this is what we looked at very deeply in this book is the summation of exposures, whether it's police violence, whether it's breathing the air here in East Oakland, whether it's being able to afford healthy food, these kinds of things add up into a toxic combination. When you talk about the Pima folks having 80% of them having diabetes, it reminds me of the impact of colonial expression in Lakota, Dakota territory,

where I'm working to help set up a clinic with the community there. The Mini Wichoni Health Circle is what we're calling it now. It's a clinic and a farm. Which, by the way, is a radical idea. Bringing healthcare and farming together should be universal, but it's something that's really radically new. Well, it's actually radically old. And so for these communities- Well, for sure, but not in America. Well, yeah. So these folks, when the Missouri River was dammed, so when that dam went up, it flooded the cottonwood forests that the Lakota, Dakota, Nakota people used to get their food and medicine from. So they used to go and have this relationship with these forests. And once they were flooded, they became completely dependent upon the commodities that

were sent by the state. So they became more sedentary. They didn't go out and harvest. The buffalo were exterminated. I think something like 60 million buffalo, the largest genocide on this land. And so they lost those crucial contacts with their food and medicine ways. And they always knew that medicine and food were connected. It was never separate. And so that is really an exciting connection to see that it is actually in the literal changing of the flow of rivers. So it's not abstract. It's not metaphorical. It's the literal changing of the flow of rivers. So it's not abstract. It's not metaphorical. It's, it's the literal changing of the way rivers run has changed the way our bodies are responding. And indigenous people and, you know, have been most impacted here in this land.

Yeah, it's so true. And, you know, you talk about the idea of inflammation. I mean, the same story happened in the Hopis where the Colorado River was dammed and all their related growth food and their traditional food ways were all disrupted. And again, they're so obese like the guy I met on the rafting trip. Because what you're really intimating here is that as a society, we have a soul sickness and that our souls have been disconnected from the origins of life, from our land, from our food, from our communities. And that we're seeing this epidemic of both mental health issues that you talked about earlier, Raj, from the suicide rates. Or was that you? I can't remember. sort of the disconnection and the isolation and the sort of the social disempowerment as really being a soul sickness that needs to be healed by finding our place in the family of things. And that's what you're talking about. And I think it's a beautiful notion, a beautiful idea.

And for someone who's been working in the food system for years and thinking about it for years, the challenge to me is I don't have any argument with the framework of what you're talking about. But given the way our society has been completely dominated by this colonialist capitalist model and the way in which our populations have been so disenfranchised and aren't even aware that they're disenfranchised, the internalized racism, the internalized structural violence. How do we emerge from that? Because other than just radically changing our society and radically changing our policies and radically changing our economic structures, how do we begin to address this pandemic? Because as someone who's on the front lines of chronic disease, it's a staggering phenomenon. I can tell you, I started doing this 25 years ago. And I look at my slides from like 1996.

And I'm like, wow, I keep having to change the slides. Because it's like, there was, you know, 30% obese, then 40, then 50, then 60, then 75. And, you know, diabetes, chronic disease should be like maybe three out of 10 people. Then it's four out of 10. Then it's five out of 10. Then it's six out of 10. It's like every year I have to change my slides and it's getting worse and worse. And yet we understand it more and more.

And somehow we're not able to bridge that gap. How do we do that? I would say, first of all, I just want to give a shout out to- Everybody read your book. No, to Jack Forbes. Read another book called Columbus and Other Cannibals. He was a Native American scholar here at UC Davis. And he talks about the spirit sickness, which is called, he calls it wetiko or windigo,

which is an Algonquin word. And it's literally the spirit sickness of colonial society and societies that dominate each other. He calls it like a vampire, that you're sucking the soul off of other living creatures or other entities in a non-reciprocal, non-respectful way in order to support your own life, in order to support your own. And that this society is sick. He calls it a spirit sickness. And so the cure, Mark, is a radical reimagining of our society. And the good news is, is that will address not just the rising rates of inflammatory

disease that you've noticed, but also the burning of our planet. And so there is no tiny tweak we can do. There is no little, you know, just to move this around. There are things we can push for right now, Medicare for all, a Green New Deal. There are large policies we can try to move with. But truly what we need to do is reimagine every way in which we relate to each other in the web of life because the ones that we've inherited, the ones that we have been handed to us through a colonial capitalist cosmology are making us sick and making the planet uninhabitable for human life. Where does the cheap, subsidized, processful go into? They know. I mean, it's not rocket science. They know for a fact that it goes into poor neighborhoods, mostly neighborhoods of color.

So, you know, let's cut the BS when he has this conversation because everyone knows because it's not going to their neighborhoods. So everyone knows that there is a difference between what is in white, affluent neighborhoods and what is in poor black and brown neighborhoods. That's number one. And, you know, I'm infuriated by that conversation because all of a sudden people act like they're dumb, like they don't know. And they know exactly the difference

when it comes to food and housing and education based on color, demographics, and how much money you make. And so when the term food deserts was first brought to our attention in my community, I sort of like backed off of that. I'm saying, wait a second. We live in a food desert? You know, like, first of all, who coined the term that's number one? White people probably. Wise people. Some woman in the UK coined it. And then of course the USDA and everyone picked up on it because when you say food desert, it's sort of like softens the tone of the food disparities we see

in our society. And so for me, it says forget food desert because people in the desert would say, wait a second, we got food? And so I coined the term food apartheid only because I wanted people to, first of all, what does that mean? But also look at the food system along race, the color of one's skin. Look at the food system, demographic, where does one live? And look at the food system or how much money you make your affluence you know and economics and wealth and when you start talking about food apartheid i wanted people to start having that conversation around these issues because if time and time

again we go over and over again about this food system when we all know for a fact where does a cheap and subsidized food enter each and every day and i'm sick and tired of having that conversation because for me it's about action how do we change it how do we stop spinning our wheels talking about hunger and poverty and food deserts and pre-existing diseases and diet-related diseases. You know, at one time, you look at this country, and even to the world, it was more plant-based. And as we started to add more animals, we become more animal-based in our food. And as a result, at one time we were 2,000 calories per capita. Now over 3,800 calories per capita. And you can see what was happening in other countries as we've gone from plant-based

to animal-based, the intake of calories. And as a result- It's mostly starchy, sugary calories. That's it sugary calories how we pay how we pay farmers to grow subsidies such as corn corn is a billion dollar business to turn into high fructose corn syrup that corn that you see is that for us it's for food and it's for feeding cows that really can't digest it. And ethanol, which is stupid. So let's get off this bandwagon about the food system,

and yeah, it needs to be fixed. No one needs it, doesn't need to be fixed, because it's not exactly what it's supposed to be doing, because we know for a fact. You ask any person in this country, well, would you rather shop at a low-income neighborhood? Or would you like to go to like the Whole Foods, which are in the African neighborhood, Trader Joe's, and see? So, I'm done.

It's fascinating. of a woman talking to a largely white audience, I think most all white audience, saying, how many of you in this audience would like to be treated in the way that African-Americans are in this country and have their experience? And not a single person stood up. She said, stand up. She said, I don't think you understood my question.

Would anybody who would like to be treated as an African-American in this country just stand up? No one stood up. She said, well, you all know the problem. You're just pretending you don't know. And I think it's easy to look aside and ignore it. It's easy to blame people. And I think there's a lot of focus on personal responsibility.

You know, people just aren't eating well because they don't want to. But there really are structural issues of access, structural issues of skills, of knowledge, of tradition that are just sort of obscure the ability for people to reclaim their health and their traditional food waste. And I think that's what you're doing in the Bronx. That's what you're doing with your farm. And I think it's interesting to hear from you, what has that experience been like over the last few decades of being in those communities and trying to change the way people think about food and their health and access? How has that given you insight into maybe how to solve this problem on a bigger scale? and agitate as well. I've been gifted, I guess, with the ability to say what I want to say. I've never been beholden to like a nonprofit or a job that's sort of like,

you know, Karen, you can't say that, or, you know, the funders are not going to like that. So I've always been a person of very independent in what I've been able to say and do. And so that conversation I would have with my patients was really, really mind-blowing because, you know, after a while they would sit down and say, Ms. Washington, you're right. You know, my parents would never sit a day in their life and look at me,

you know, and they would want to change. And I would bring them fresh fruits and vegetables from my farmer's market at the end of the day because I think I wanted them to care, to have someone to care about them, but then also to take action. I mean, talk is cheap. People talk about food justice and food sovereignty. But for me, in order to do this work, you have to be actively involved in dismantling some of the social injustices that you see. And so for me, doing like the farmer's market,

going around and speaking at different venues, I think my biggest accomplishment has been through the Bugs Conference is the impact that it has on young people, on the younger generation of black and brown youth. And I say that because growing up as a youth, if I was to tell my parents that I wanted to be a farmer or anybody, they would look at me like I was crazy. I mean, even to think about going on a farm or visiting a farm or wanting to be a farm, because for so long growing up, farming was equal to slavery. You know, you're working for the man. And so now, and that was a history that was embedded in my head, you know, but since I've been older and really been in the food world and to

really understand the history of the African-American experience in this country and how African-American enslaved people built the agricultural system in this country with seeds in our hairs and knowledge around crop rotation and irrigation and medicinal herbs and tools, all of a sudden there's a resurgence of inquiry, especially from our youth, getting the history right. And once you plant that seed in their head and understand that what we've done wrong as African-Americans is that we moved away from the land. And as we moved away from the land, you can see what has happened to us. Our history is that we are

agrarian people. This is in our DNA. This is our blood. We are people of land and food. And so when you start talking to young people and have them understand their place in history, their place in agriculture, all of a sudden a light bulb goes off. And it says, wait a second, I've been taught that farming has been slavery when in fact, it's my people who brought farming to this country. I should embrace it. I want to embrace it. I want to understand more. And then I don't want to be like my parents and grandparents who are now stroke, end-stage renal diseases, amputations, you name it. I want to lead a more healthier life. That's number one. But then I also want to go back to the land. I want to go back to land because there's a history

around stolen land. There's a history around stolen land, there's a history around wealth building that has been taken from us. And so we're trying to right that wrong and put that knowledge back into the hands of young people so they understand the importance of growing food, the importance of growing back to the land, the importance of what it means to be a community, what social capital and communal wealth means to us. And so the whole dialogue has shifted, and the concentration has been on our youth.

So for me to see the overwhelming youth that want to farm is extraordinary. You know, when you think about what happened after Reconstruction, after the Civil War, I mean, Lincoln promised the freed slaves 40 acres and a mule, and that land today would be worth $6.4 trillion. But Rutherford Hayes, to get his election secured after Grant was president, who was very much against, you know,

a lot of the sort of institutions of slavery. I mean, he actually created a whole movement against the Ku Klux Klan when it was on an upsurge after the Civil War. But Rutherford Hayes basically had to agree to move out the troops from the South, which allowed all the segregationists and the Jim Crow stuff to happen and they kind of went back on the whole 40 acres and a mule deal and that led to you know the farmers that were getting going about 14 percent of the farms back then were African American farms to now one percent of farmers being African American and and not having access to land and there's all the economic, you know, the economic struggles around getting access, right? It's not easy to own land. It's expensive. There's an

economic issue around it. So how do we sort of break through that and get people back on the farm? Because I think it seems to me with all the levels of unemployment in those communities, with all the levels of poverty, with all the levels of lack of access to, you know, food and sovereignty, wouldn't it make sense for a sort of a resurgence of a farming movement to actually happen? They need to fix the heirs' property laws that is really stifling families that have land in the South, especially those that don't have a will. I'm struggling that with my family.

We have 18 acres down in South Carolina and looking for the will from my grandmother. It's hard. And so, you know, you have to go to probate. There's so many things you have to do and they need to fix it so that people that are on the land have a way of succession, have a way of getting that land and holding on to that land um that's people know that's in their family without all the hurdles of trying to find a will and trying to go to probate and trying to um to to testify that you know it belongs to your family because as we speak black black land loss is being done each and every day and And so we need to fix that system, the heirs' property system, so that Black families can maintain and maintain the legacy of the land

that has been given to them. That's number one. Number two, I try to have this conversation with young people, Black and brown young people, if they have land in the South, if they have land in Puerto Rico, Latin America, you name it, is to hold on to that land because a lot of times the land also is being lost for nonpayment of taxes. And so getting people to understand, you know,

pay those taxes, even if you live up in the North and your land is in the South or your land is in Latin America or the Caribbean, make sure that you pay those taxes. And I think people are starting to understand the importance of land ownership. Also, we're talking about reparations now.

That's something that is a conversation that's being brought up. I know whites don't like to hear that conversation, but it's going to happen anyway. There is land that people know, stolen land that people have in their family, and there's a lot of whites that There is land that people know, stolen land that people have in their family. And there's a lot of whites that understand that need of reparation and are willing to give back land ownership to people of color.

Let's talk about reparations because I think there you know, there are different concepts of it, right? One is, you know, like in the Nazi Germany, there were reparations paid to the Jews in monetary compensation to each family. But, you know, it seems to me that, you know, that you've talked about a different way of helping these communities by empowering them with investment, with entrepreneurship training, with helping them start businesses, with creating autonomy within their communities and providing the services that allow them to thrive and be autonomous as opposed to being dependent on social services and all these other prop ops that don't empower these communities to emerge from their situation, right? And wouldn't reparations be better served by paying for those types of investments in those communities and empowering those communities to do it for themselves?

Well, I think it's a double-edged sword. I mean, you know, my mantra has always been economic development, fiscal responsibility, communal wealth, and social capital. I've always talked about that. I always say, you know, give us three things. Give us opportunity. Give us access to capital. And give us land and people who once deemed powerless become powerful. But I think also there are people that know that they, within their

family, that that land has been stolen. You know what I'm saying? I mean, there's a new generation that's starting to surface. Again, Black Lives Matter. And so I think in the best interest of history, that those people that feel that they would like to give back land or, you know, have land that they feel that they can part with, why not? Why not have that opportunity of family members, especially if there's no legacies? You know, you're one person, you have no children, you have no one to leave that land to. Why not leave it to black and brown people who know that they will take that land and do well with it by farming it? And so when we talk about the reparation conversation, a lot of people are fearful, number one, is that, oh, it's the monetary value.

But I'm trying to look at it as, you know, get back the land, you know, get back the land. You know, there's so many people with so many acres of land. You mean to tell me if you have 1,000, 1,000 acres of land, you can't give at least a tenth of that land back to people who want to grow full, especially young people. Or if you are the lone survivor of a family, instead of having that land go to a state, why not donate that land to young farmers, especially farmers of color that want to farm that land? So there's different ways of looking at reparations.

But at the end of the day, you know, I mean, we're having this conversation about stolen land. We're having this conversation now about land equity and what that means. And we need to have those hard conversations. We need to have those hard conversations about how this country was built on, you know, and it's going to be a difficult conversation, but it's a conversation that we need to have. And right now we're in the midst of taking back the history that for so long has been taught in our schools that have been drilled into our minds about attitudes around land and racism and wealth, and getting people to understand that the history of this country was built on

the backs of indigenous enslaved people. It's a difficult conversation to have, but we must have that conversation because we have to right a wrong that for so long has been going on with false narratives. So do you think, Karen, that we can do this through grassroots efforts like yours alone? Or do we need to address some of the structural problems on a policy level? Because you've got, for example, our agricultural system that is designed to do exactly what it's doing, to produce a lot of cheap disease-causing calories in a way that's harmful

to humans and harms the environment and climate. And it's not broken. It actually is working exactly the way it's designed. And in order for the kind of thing you're talking about to take hold, it really requires a change in the financing of our agricultural system and the ways in which farmers are supported to do the right things as opposed to the wrong things, and in changing some of the sort of policies that are undermining the development of a new agricultural system that's regenerative as opposed to destructive and extractive. And how do you see that happening in a way that's sort of parallel to what you're doing? I think it needs the grassroots voices to change policy. Look what is happening now.

I mean, it took the grassroots movement for people to realize, wait a second, we need to look at the system as a whole. We need to look at race in this country and the implications race has woven itself throughout our institutions, our way of life, our history, you name it. And so in order for a policy shift to happen, you have to have the voices of the people, the people coming together and being outraged at what is happening for politicians to listen.

Because listen to me, this has been for 400 years, like all of a sudden black lives matter. And the only reason why black lives matter is because of the fact of the outcry, the outcry of grassroots people saying enough is enough for all of a sudden the policy and politicians to sort of wait a second, we have this huge movement of people voicing their frustration of the system, of a political system, of an economic system.

We need to start to listen. And so what you're starting to see is a shift in policies starting to listen. This is why it's so important on the grassroots level that we're trying to get people to understand the power of voting. The power of voting, and not only in the federal level, but also the local level. understanding the politics around policy and that starts with educating people, having their voices at a local level. Vote. Make sure

that when you do vote, that you make the candidates, first of all, you have them come out and speak on their issues and then whoever is elected, make them accountable. You know, people ask me for so long, they say, Ken, why don't you run for office? Why don't you run for office? And I say, heck no, because you need people to make politicians accountable. And so even though there's policies and laws that are set,

that are made, it's the people, you know, what we've done, we have given up our power. We've given up our power to the government, to politicians. We have given up our power and it's time folks for us to take back that power because the only reason why they're in office, the only reason why they can do the things that they do, because we let them. We let them. We're not holding people accountable. And so what I try to educate people at a local level is that when we have people who are running for office, go out, hear them, ask questions,

and when they are in office, make sure that they are accountable for the things that they said that they were going to do for your community once they got into office. Two things that will stop any movement is silence and complacency. Yeah.

Because just because you voted somebody and now you're going to sit back and allow them to do whatever they want to do without the checks and balances that is needed to make sure that they're doing the right things. And I think that is going to change. I think people are going to be more accountable in the people that they put in office. And then if they're not doing their job, get them out. I hope you enjoyed today's episode. One of the best ways you can support this podcast

is by leaving us a rating and review below. Until next time, thanks for tuning in. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from.

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