The Black American Amputation Epidemic | Hacker News Reader

The Black American Amputation Epidemic

features.propublica.org

18 pointsadrianhoward15 comments

The amputation epidemic is a diabetes epidemic that's a horrible standard American diet epidemic.

The underlying factors are deeper: in many places (read: along racial and other lines) it is difficult to get fresh fruits, vegetables and other healthy food. Add in a subsidized fast food system, massive amounts of added sugar in the cheapest foods, and so on, and you start to see that a "choice" to eat healthy is unfortunately one of privilege. And one of the driving factors in having that privilege in the US is race.

Add to that being the only developed country with no universal healthcare and even healthcare becomes something the poor have little to no access to (with the added pressure of almost no labor rights - where I live the very notion of missing a day's pay because I went to the doctor would cause a riot).

Some states like VA with expanded Medicaid have incredible free healthcare for low-income residents.

Emphasis in "Some".

> The underlying factors are deeper: in many places (read: along racial and other lines) it is difficult to get fresh fruits, vegetables and other healthy food

I've heard this argument a lot, but personally I've never been to an area in the US where you couldn't get to a Walmart or similar "cheap" supermarket in a reasonable drive and where you couldn't find basic fruits/vegetables.

Sure, it might not be your fancy organic bodega but they've got everything you need to eat right and it's not that expensive.

I mean, hell, even without fresh produce, you can buy rice, canned beans (black, pinto, garbanzo) and (non-syrup) canned fruit and that will be some of the cheapest food in the store.

It's really not that hard to eat healthy for cheap if you know what to buy.

Note that you said "car" and that's not a given. Nor is the time to go shopping and cook if you need to work multiple jobs or take care of kids or etc. It is not impossible, but there are a number of barriers that shouldn't be there.

Those can certainly be barriers but it's not the same argument as arguing there are "food deserts".

? There certainly are, and it is a well-studied topic. Maybe you want to quibble on the definition or how large a role it plays, but it is well established (and also pretty obvious for anyone that has lived in one, which is millions of people).

(Edit: perhaps misunderstood what you were referring to, but if a food desert is say 10 miles without access to fresh groceries, not having a car makes that much more difficult. Even with a car, that means a larger time commitment. So I see that as part of the reasoning of what a food desert is and why that is a barrier to access to healthy food.)

I grew up in one, the closest store with any food at all was an hour drive way. Both parents worked, and still managed to put healthy meals on the table ever day because they were willing to cook and the family meal was a sacred thing. It’s not about access, it’s about priorities.

Food deserts are a myth. The idea has been so thoroughly debunked, I'm always surprised to see it pop up again. NYT gave it a hard look back when it was Michelle Obama's big project. TLDR, it's been well studied, and the available evidence showed that there is no statistical association between proximity to various food types and any measure of health.

http://www.nytimes.com/2012/04/18/health/research/pairing-of...

Anecdotally this makes sense to me. I see lots of parents around me-- poor and moneyed, white and of-color-- teaching their kids to eat shit. The Standard American Diet is a plague on the entire nation, across all demographic lines.

TFA is about racial inequalities in treatment of diabetes and other chronic health problems. There's no need to further adorn this crisis with contrived issues.

Interesting, thanks for the link.

I hav some first hand knowledge, and can say there’s more than a diabetes epidemic.

Doctors only go to medical school once. They learn to practice medicine once. They learn how to treat diabetes once.

Many “old fashioned” doctors give amputation a much higher priority than it should have because “that’s how it’s done.”

Also because you aren’t going to get sued (doctors attitudes towards getting sued also tend to be fossilized, even if legal rules have changed).

This situation hits poor communities hardest.

Doctors are literally required by their societies to have continuing education. Every year they need to take a certain amount of course hours about stuff in their field.

Yes, but these are of uneven quality and influence.

For example, some continuing education courses were financed by the makers of opioids and amounted to “don’t worry about addiction.”

I have personal experience in this: I used to work for a doctor who did these consults - for a very hefty fee. There’s a whole “anti-amputation” industry.

I can’t help wondering whether their PR people had a role in this article.

Reply on news.ycombinator.com