Black Food History and Public Health

On this occasion of the twenty-fifth anniversary of Gastronomica, it’s worth considering how food studies, relatively in its youth in the US academy fifteen years ago, offers humanistic perspectives on public health challenges. Back in 2009, I didn’t think of myself as any kind of expert in food studies, as my complete lack of professional training in nutrition and dietetics didn’t seem to me suitable for a partnership with colleagues at my, or any, university’s medical school. An article in my school’s alumni magazine about my research on cookery, meals, and Black Americans, however, led to my doing just that: joining with faculty from Washington University’s medical campus to speak to St. Louis community members about diabetes and obesity. As I would go on to share with these Arch City1 neighbors, our cultural attachment—our love—of certain foods can have unintended consequences. Such a reaching-out appealed to me not only because a member of my own African American family had “the sugar,” as my grandmother called diabetes, but also because I wanted to see some concrete, actionable outcomes from my scholarship.2 Back in grad school I’d said my primary goal wasn’t to write long books with lots of footnotes, yet it’s been my later work in foodways that has allowed me to sidestep the chalkboard. Although applied scholarship was even then motivational to me, I now see more clearly how taking my research into the community cohered with the wider, foundational goals of Black Studies departments. From its beginnings Black Studies asserted that the knowledge produced by its scholars must benefit communities local, national, and global.3Dr. Bernard Miller, at the time and like me one of our university’s relatively few African American faculty members, reached out to me from his med school office following his perusal of that WashU magazine article. St. Louis, a city at the cusp of the Midwest and southern United States, has a long history of racial tensions and segregation; it’s most infamously linked to the Supreme Court’s Dred Scott decision (1857) in which African Americans were deemed to have no rights European Americans had to respect. Doctors like Miller practice medicine with personal knowledge of that history, a social bifurcation leading to major disparities in health outcomes.4 Miller joined his colleague Dr. Rick Stein, in the division of nutritional science, in what was informally called The BODDY Study, aka the “Community-Based Therapy for Obese African Americans with Diabetes and Depression.”5 I was a bit nervous about joining a research group in medicine, especially after arriving for my first team meeting after wandering around some on ‘their’ side of Forest Park. Once I found their decidedly unglamorous conference room, I was surprised: as a humanist, I’d imagined that everything at our Medical School was sleek and newly renovated, but the space seemed about as spiffy as ours over in Arts & Sciences (as in, not very spiffy). For their parts, Drs. Miller and Stein appeared as professor-like as any of my colleagues in African & African American Studies and English, putting me at my ease, even though the team included colleagues from social work, nursing, and other medical campus specialists. Introductions were made, and I listened as the team explained what they had been doing and what they hoped to accomplish further. They hoped I, with my humanities training, could add something that they, oriented toward medicine, could not (we might add to this day, nutritional studies are rarely highlighted in medical education). So I was flattered and humbled, unsure whether I really could add value to their work but ready to perform as requested.What convinced me that I could indeed ‘add value’ was my inspection of a couple of the diabetes and high blood pressure cookbooks often suggested to their patients. Aha, I thought, here’s where I come in: though the recipes I read weren’t awful, in my opinion they tended toward the uncreative and less compelling: steamed broccoli and broiled chicken breasts seasoned without salt represented a typical menu. The authors quite reasonably attended to matters of lower sodium, fat, and sugar, and exciting flavor profiles or intriguing historical contexts were not prioritized. Within these books was no joy of discovery touted by new spice blends, no acknowledgement that ‘alternative’ healthy modes of dining could join the mainstream—the kind of excitement that could spur needed dietary change.Within a few months of those meetings with Drs. Miller and Stein, I made a tentative debut in public health. During two sessions at a downtown St. Louis YMCA, I offered what I hoped would be an educational and inspiring talk about ‘heritage’ foodways. My audience was comprised of older adults, African Americans like me; I don’t recall how many people with whom I actually met during my participation. Of course, I was nervous: I wasn’t a nutritionist, much less a nurse or physician, yet the attentive faces turned to me still seemed to expect life-changing, or at least notable, information. Could I adapt my lectures on the African roots of American cookery in a way that could point to healthier outcomes?What I did was share with them what I thought would be useful, engaging, and—significant for regular folks interacting with the medical establishment—‘culturally relevant’ information. My approach was to emphasize our connections as people of the African diaspora in ways both straightforward and complex. As I would later do in my classes in foodways of the African diaspora, I shared with them various “did you know” facts as well as some of the history of contemporary meal habits: these mature adults possibly knew about okra’s origins, but did they know our beloved Coca-Cola had its origins from a caffeine-bearing West African nut, or how we learned what early African Americans ate from broken crockery and fossilized meals, among other interesting facts? That in fact while eating “Black” has changed over the centuries, it has retained some cooking styles and ingredients? Using one of those giant-sized paper pads beloved for corporate presentations, I listed various items under headings like ‘fast foods’ and ‘traditional meals,’ noting that the earliest Africans in America, like their families across the Atlantic, consumed stews, soups, and sauces replete with greens and complex carbohydrates like yams and peanuts, containing smaller amounts of meats and fish for flavoring and protein content. I suggested we could all eat more adventurously and still satisfy new dietary parameters by preparing “heritage” food. At the time I wasn’t conversant with the array of modern African cuisines, so I pointed them in the direction of extant cookbooks, such as Dr. Jessica B. Harris’s Iron Pots and Wooden Spoons. At the close of each session, I couldn’t swear I’d changed people’s kitchen habits, but I knew I’d shown the possibilities of exploring a more nutritionally aware, historically nuanced, and just plain tasty way of eating. Though student evaluation forms were not offered to my auditors, I later heard that “the participants loved it, and [Dr. Stein personally] thought it was fascinating.”About a decade later, Dr. Stein reached out to me again regarding another study, “A Pragmatic Family-Centered Approach to Childhood Obesity Treatment” also known as “Treatment Efforts Addressing Child Weight Management by Unifying Patients, Parents & Providers” or TEAM UP; in that work Dr. Stein and his colleagues sought the “best intervention approach for the behavioral treatment of childhood obesity.”6 He wondered, would I record a short webinar based on my previous talks? By joining one of a series of one-hour recordings known as “ECHOs,” I could help pediatric health coaches who joined a multisite study of treatments for pediatric obesity; his BODDY Study colleague Shaina Costello, MPH, would coach me with some how-tos.7 My perspective, he said, would help these medical professionals better support their patients. The ensuing presentation comprised a fifteen-minute digest of my in-person “Boddy” talks. And once again I was happy to hear the participants found my presentations engaging, with Shaina Costello sending a follow-up email to all with further reading I’d suggested, as well as a useful online resource for healthy, heritage cooking she had sourced.8What would I do today if I were again asked to join such a study? If anything, I would be more willing to do so, what with the changes in my own life (retirement) and public health practices (stemming from financial cuts to research and infrastructure). I might tweak in-person presentations further, incorporating more detail and more explicitly linking contemporary issues of food justice and apartheid back to US culinary history. I could inject more humor, noting that while enslaved African diasporans have been credited with introducing an important style of fried foods to the United States, Scottish immigrants have also been said to pioneer American fried chicken.9 We can think of Black food as a syncretic cuisine that has obvious connections as well as some surprises. I’d tell them that fried and carbohydrate-heavy foods are not only targeted by today’s physicians but were also frowned upon a century and more ago by race men like Booker T. Washington and W.E.B. Du Bois. That vegetable-forward meals—Black Americans are said to comprise the fastest growing group of vegans in the United States—are in the diasporan DNA.10 And that the sugary, high calorie foods now common in US households were once rarities, sharing that a St. Louis-based Nigerian caterer once asked me why Americans—her cross-Atlantic cousins—‘put sugar in everything.’ Finally, to bring home the enjoyably accessible aspects of Black foodways, I’d do more show and tell, bringing in spice blends to sniff and packages of new ‘superfoods’ such as fonio to pass around. Recalling my collaborations with medical school colleagues almost makes me wish to rescind my 2024 retirement. Yet having laid aside my chalk and blue books doesn’t mean I’ve lost my desire to put what I know to everyday use: Sign me up.