Last week Oprah and her phalanx of health advisers--Dr. Mehmet Oz, who they never let appear in anything but his surgical scrubs; Bob Greene, Oprah's long-time trainer, and a new guy, Dr. Ian Smith, a Black physician--did a "Diabetes 101" program. An entire hour devoted to taking care of yourself and dealing with diabetes and living your best life and all that woowoo. But you know Oprah, even if you don't watch her show. She makes you feel like you can be a better person, but she also lets you know you've let yourself down when you fail to live up to your fullest potential. Except the look in her eyes says: you've disappointed me. On Oprah's "Diabetes: America's Silent Killer" show last week, who was the subject of Oprah's wrath? Why, a big 'ol group of Black church ladies from Dayton, Ohio! The entire episode was about the dangers of diabetes, which are very real. From Oprah's website:
It's estimated that 80 million people in the United States have diabetes or are on the verge of developing this disease. Diabetes is particularly prevalent in the African-American community, where it claims nearly 100 lives every single day. "It's time to get out of denial," Oprah says. Says Winfrey, "Diabetes is a ticking time bomb. It's a silent killer. It's annihilating the African American community. Literally."
This is Oprah Winfrey talking about race. And the rest of it doesn't get any better. Because even though all of these facts about diabetes in the Black community are demonstrably true, this isn't the whole story. Nowhere did Oprah mention that these scary statistics about the high incidence of heart disease among people of color have structural roots. Let's start with the basics: Blacks and Latinos are uninsured at rates one and a half to three times higher than their white counterparts. Our own Kai Wright, writing at The Root last year, said:
Forty percent of Black Americans reported being uninsured for some portion of 2007-2008, compared to 1 in 4 whites. And it’s not just about income, nearly a quarter of Blacks making more than $84,000 a year lacked coverage at some point, compared to 16 percent of whites in that income bracket.
And yet Oprah's one-sided focus on Blacks' and the responsibility they bear for the way diabetes is rushing through the Black community continued. This show synopsis from Best Syndication narrates what happened next:
Dr. Ian Smith said African Americans are twice as likely to have type 2 Diabetes and suffer complications from the disease. Smith visited the women members of the church in Dayton Ohio. There was a large number of these women that have been diagnosed with Type 2 Diabetes. The ladies at the church start with a blood glucose test, followed with Dr. Ian Smith counseling them on how serious a matter high blood sugar levels can be. Dr. Ian Smith spoke with the audience and Oprah about why it is hard to get people with diabetes to change their lifestyle and eating habits. He said that habits are tough to break and African Americans don't want to change their eating habits and can be quite stubborn about it. He added that it is a disease about attitudes and that is what needs to change to treat Type 2 diabetes.
And that was it. Oprah talked to the church ladies, who kept their chins held high while they got publicly shamed for what was portrayed as their obstinance in the face of certain death. The women promised to exercise and change their diets. But the fact is that forcing people to take personal responsibility for their health outcomes is only half the issue. The other half is something much more insidious, something so much bigger than just these Sunday church events that involve fried chicken and french fries and salad dressing. From the Dept. of Health and Human Services:
AHRQ-funded researchers in Boston examined the quality of care provided to hospital patients with congestive heart failure or pneumonia. Quality of care was measured both by physician review and by adherence to standards of care. The researchers found no difference in quality of care for patients from poor communities compared with other patients, after adjusting for other factors. They did find, however, that African American patients received a lower quality of care than white patients.
How you gonna explain that one, Oprah? Stop scolding these women. We look to you for leadership and encouragement, but don't put the blame on individuals alone. You do us a disservice when you leave out the rest of the picture of all the structural factors that contribute to these very scary statistics. From a woman of color (with my own very deep family history of heart disease and diabetes) who stands a pretty decent chance at getting diabetes one day, I want to tell Oprah: we can take your scolding. But why don't you first try to be half as harsh on the institutions, policies and people who condone unfair treatment of people of color in the healthcare system.