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When María (a pseudonym) was diagnosed with gestational diabetes during her first pregnancy, and again during her second, some might have blamed it on her food choices or lifestyle. She blamed it on her broken heart.
Having migrated to the Bronx in the mid-1990s from rural Puebla, a state in Mexico, María was separated from her mother back in Mexico. Immigration status kept them from being able to see each other. She knew that if she had been in her hometown, her mother would have lovingly nurtured her throughout her pregnancies, preparing home-cooked meals and drawing on a wealth of remedies for every ache or pain. Instead, María suffered in silence. Sadly, her mother was also suffering: She, too, had been diagnosed around 2010 with the initial symptoms of diabetes. But within a few years, the disease would rage out of control, causing her kidneys to fail, her leg to be amputated, and, within a decade, her death. Lacking any known genetic predisposition to diabetes, María and her mother saw the disease as a product of their estrangement.
Global health experts are clear that noncommunicable diseases, such as diabetes, heart disease, and kidney disease, are a critical threat to humanity, causing 72 percent of
premature deaths in 2016. Conventional wisdom tends to blame these "diet-related chronic diseases" on individual behavior, specifically food choices and exercise. Even some who suffer from them tend to blame themselves, imagining that if they had more discipline, ate better, or were more active, their health would improve.
While we all have the power to make changes that can improve our lives, the facile pointing of fingers at the victims of chronic disease overlooks all the important factors that are
not directly under our control to change:
our food system and the larger social, political, and economic landscapes in today's globalized society. Human appetites and exercise have changed less in the last quarter century than our food systems and economic arrangements.
Globalization has enabled a near total diffusion of industrialized and processed foods into the most economically and socially marginalized places in the world, while also disrupting agrarian ways of life and small-scale agriculture.More people than ever are on the move globally-like María, they are often displaced from their home communities, their land, and their extended families, and impeded by borders. These changes not only wreak havoc on eating habits, they also generate stress and trauma, which have been shown to play major roles in the onset and progression of chronic diseases.Blaming personal behavior is just a convenient evasion. The mismatch between "bad" foods that move freely-and people who cannot-is the real culprit behind a global health crisis.
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