“I think if we moved more towards policies that frame access to healthy and culturally appropriate food and healthcare as a right we would see a big shift in these issues.”
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In this episode, Alyshia Gálvez discusses the implications of economic and food policy on food systems. She talks about how diet-related chronic diseases such as obesity and type 2 diabetes are influenced by trade agreements and political forces, rather than just individual decisions. Listen to this episode to learn about what food policies need to be created to combat current issues in public health policy.
Alyshia Gálvez is a cultural and medical anthropologist. She is professor of Latin American and Latino Studies at Lehman College and of anthropology at the Graduate Center of the City University of New York. She is the author of Eating NAFTA: Trade, Food Policies and the Destruction of Mexico on changing food policies, systems and practices in Mexico and Mexican communities in the United States, including the ways they are impacted by trade and economic policy, and their public health implications.
Shireen: This episode is part of our series dedicated to addressing health inequalities in nutrition and diabetes for the month of January. During the series, we hope to educate listeners about how structural and cultural factors impact health care and nutritional practices. This month, we will bring in experts to discuss topics, including food sovereignty, the whiteness of the Mediterranean diet, reimagining Hispanic, Caribbean nutrition, and how public health food policy gives rise to chronic disease.
In this episode, Alyshia Gálvez discusses the implications of economic and food policy on food systems. She talks about how diet-related chronic diseases such as obesity and type 2 diabetes are influenced by trade agreements and political forces, rather than just individual decisions. Listen to this episode to learn about what food policies need to be created to combat current issues in public health policy.
Podcasting from Dallas, Texas. I am Shireen and this is the Yumlish podcast. Yumlish is working to empower you, to take charge of your health through diet and exercise and reduce the risk of chronic conditions like type two diabetes and heart disease. We hope to share a unique perspective and a culturally relevant approach to managing these chronic conditions with you each week.
Alyshia Gálvez is a cultural and medical anthropologist. She is professor of Latin American and Latino Studies at Lehman College and of anthropology at the Graduate Center of the City University of New York. She is the author of Eating NAFTA: Trade, Food Policies and the Destruction of Mexico on changing food policies, systems and practices in Mexico and Mexican communities in the United States, including the ways they are impacted by trade and economic policy, and their public health implications. Welcome Alyshia.
Alyshia: Thank you so much. It's such a pleasure to be here.
Shireen:. And the pleasure is absolutely mine. Alyshia, how did you become passionate about public health and medical anthropology?
Alyshia: It was sort of a circle, circuitous journey. I started out. I would have to say really my political and social formation growing up in California had a lot to do with the ways that our community and our nation were treating central American migrants at the time, even though my family doesn't have Latin American ties, I was a part of communities that were working to serve the refugee community from central America.
And that really helped shape my understanding of human rights and the relationship between the US and Latin America. And, you know, being so close to Mexico growing up in California, it was, you know, very, um, I was very exposed to Mexican culture and appreciative of Mexican culture. And so later, as an anthropologist, focusing on migration and human rights and immigrant rights, I developed very strong ties with particular communities, particularly in the state of Puebla.
And it was there that I began to observe the changes, between the late nineties and today in which a lot of people began to experience chronic disease. And that really led me to ask myself what was happening in these communities that had historically been places where people ate a lot of fresh, you know, farm produced food to suddenly have this epidemic experience of chronic disease. And so that was kind of how I backed my way into public health and medical anthropology, really from having very strong ties to communities that were impacted,
Shireen: How social ideologies shaped the definition of what we call healthy foods?
Alyshia: Well, I think this is something that I find very mysterious. Actually. Maybe you can tell me the answer to that question. Um, it's something that I think we all need to try to figure out because there's a very paradoxical thing that's happened where a lot of people who, um, migrate to the United States or have grown up in the United States, um, belonging to cultures with very powerful culinary traditions have somehow been given the idea their ways of eating are incompatible with good health. And that to me is tragic, but it's also very strange because the data that we have is actually the opposite. That when people come to the United States or they're exposed to the so-called standard American diet, which has the accidental acronym, SAD, uh, that it has negative impacts on health.
And so it's very strange that people who historically in their communities of origin, don't have long histories of exposure to chronic disease suddenly come to think of their own food ways as somehow being incompatible with health. And so I think that is an example of social ideologies, I think white supremacist thinking social hierarchies that privilege, you know, Eurocentric white middle class patterns of food and health maintenance. tend to denigrate whatever, you know, immigrant families do or people of color do. If you look at, you know, there's some incredible documents from the 1920s and which social workers are bemoaning, um, the attachment that Italian immigrants have to tomatoes and talking about how, you know, those Italians and their tomatoes, how it's just such a giant health problem. How are we going to teach them to eat fewer tomatoes and the interest of their own health? And it's absurd. If we think about it from a health perspective, tomatoes are obviously wonderful for health. But the way we can understand it is that Italians at the time were racialized. They were stigmatized. And so anything Italians did was considered bad. A
nd so now we have sort of the same thing happening and it's, it's really quite sad because there are so many traditional food ways that people bring with them to the United States that are so much better than, you know, the, the way that most of us eat.
Shireen: So, what are the implications? How have these constructions of health really translated into food policies created by medical and government institutions?
Alyshia: Well, I think what happens is that it's very clear that if you want to really push the needle on chronic disease, if you want to really address issues like diabetes, At the population level type two diabetes, it really requires an attention to social inequality.
When people have greater access to health care, when they have greater access to the economic needs of life, when they have reduced exposure to trauma and violence, they tend to have lower rates of diabetes. Type two diabetes rates go up. With social inequality, with exposure to globalization. There isn't a public appetite on the part of policy makers, government institutions to really address issues like poverty. Those are pretty difficult issues to address. It's a lot easier and it's a lot cheaper to simply tell people, wag a finger and say that people should get more exercise or, you know, Eat better or to even invest in nutrition education, which very often reproduces this notion of individual responsibility as the be all end, all of addressing chronic disease.
And while there's certainly a role for people to be empowered to do what they can in their own lives and to maximize their health. That's a wonderful message when it's done in an empowering, um, and supportive fashion. I think there's something really much more sinister going on, which is a lack of appetite on the part of policy makers to address the tough issues and just try to offload it onto individuals because that deflecst the blame from their own participation and creation of the structures of inequality that produce large scale health disparities.
Shireen: And some of those would be like social determinants of health type resources. Okay. Can you talk a little bit about your book Eating NAFTA: Food Policies and the Destruction of Mexico and what current issues exist in public health food policy today?
Alyshia: Sure. Thank you for the question. As I mentioned, I kind of backed into this project because I was really interested. I've always been interested in the relationship between the United States and our neighbors. And I've been curious about the conditions in which we in the United States receive people from Latin America and having, uh, previously done quite a lot of research on the flows of Mexican migration to the United States. I hadn't quite put together the dots, connected the dots to realize that a lot of the people who came into New York city, a lot of the people who came from Mexico to New York city in the nineties, which is when you know, New York really became a destination for Mexican migrants. They were fleeing NAFTA. I didn't quite understand that they were NAFTA refugees. And I don't think people can kind of realize a lot of people who were experiencing these pressures to migrate didn't necessarily realize that they were part of this larger system, that other people were, you know, making the same decisions as they were at the same time.
But if you look at the aftermath of the North American Free Trade Agreement, within a decade, one in 10 Mexicans left Mexico and came to the United States. That's a massive outflow of people. And it's really because the trade agreement was designed in such a way to destabilize rural economies, to destabilize agricultural production.
And while the eventual goal was to quote unquote modernize the Mexican economy and bring people into manufacturing and other kinds of economic participation. That didn't quite fulfill its promise. Uh, and really what did happen was people just got pushed out. And so, because we didn’t adequately plan for that. We didn't allow for human mobility, even though we could have anticipated that it would have happened. What ended up happening is that so many people came without documentation. They came without the protection of a mechanism by which to migrate. And so this produced just a massive epidemic. Really. We can use that term of family separation and trauma It produced on both sides of the border. In fact, a lot of issues, including, um, chronic disease and diabetes.
Now we can look at just the food system and we can see that the Mexican diet was really transformed. Today, they eat more processed foods, more animal protein, more, you know, ultra processed, sugar-sweetened beverages than they used to, and they have less access to, you know, farm fresh produce to beans, um, to corn, uh, fresh ground corn tortillas, you know, kind of the staples of the traditional diet. We can see that those things happened as well, but we can see that this was a part of a bigger transformation. And so the book really examines that and tries to contextualize it and see how Mexico's government is responding to the incredibly rapid increase in diabetes and other chronic diseases in the last two decades. And what it's doing to really address these issues.
Shireen: So I want to dive into that a little bit, because I want to understand what is the connection between food policy and chronic diseases such as obesity and diabetes, especially in Mexico.
Alyshia: This is something that's a little bit complicated and there, and there are ways that people try to push back against even drawing the connection between trade policy and public health. There is a phenomenon globally. If we look at globalization scholars, like Corena Hawks, have documented quite clearly that around the world, Everywhere that a trade deal is signed. Everywhere that foreign direct investment increases chronic disease increases right along with it.
So there is a pretty well-established link between our globalized economy and chronic disease. Getting down to the grassroots level to try to see what are the mechanisms by which that happens is a little bit complicated because someone will always push back and say “Point to me somewhere that someone is forcing, you know, X family to put three liter bottles of Coca-Cola into their shopping cart at the supermarket.” And obviously no one is forcing anyone to put three liter bottles of Coca-Cola into their shopping market at the supermarket shopping cart. However, what we see is a process by which some foods become easier to access and more available and more ubiquitous. And some foods become harder to access, less available, less accessible.
And so if we look at that traditional Mexican diet of fresh ground corn, chiles beans, squash, the things that people would produce in the corn field, That's a very health sustaining diet that has sustained Mesoamerican populations from millennia. Um, since thousands of years before the conquest. And even though things have changed, obviously when the Spanish arrived, they brought pork, they brought wheat, you know, we see changes to that diet, radical changes over time. We've never seen anything as radical as nasty. In terms of how rapidly people left the corn tortilla behind, how rapidly people adopted things like instant noodle soup, or eating a packaged muffin instead of having something else for breakfast on the way to school.
And so it's not that there's an immediate switch that people suddenly decide to eat differently or people suddenly are more sedentary, but there's an overall shift and all of society that brings certain things into reach and takes other things out of reach. So we can see, for example, the paradoxical situation here in New York City. It seems like every week in the New York times, there's a review of a hot new restaurant that grinds their own corn and makes fresh tortillas with heirloom corn imported from indigenous corn growers and rural Mexico. And I love that. I mean I lived in New York for many years when I couldn't get a good tortilla.
And so I'm quite happy that I have many options to get good tortillas, but it's become a status symbol available to global cosmopolitan elite that I can now more easily eat a fresh ground corn tortilla than a lot of my friends in Mexico who live in rural communities and have lost their local tortilla maker who is migrated to the United States or no one has grown locally anymore, or they're eating corn that comes from a sack that's been imported from Iowa. And so it's a slow process, but it really contributes to an overall shift in people's way of life and status symbols have something to do with it, you know, young people, you know, see. Fast food or they see, you know, food with labels or children's seafood with cartoon characters.
And, you know, marketing is working double time to try to attract them to that way of eating. And that's powerful, but it doesn't explain everything. It's really, you know, this larger economic and social shift that makes certain ways of life, somewhat unbuyable and other ways of life, a lot more.
Shireen: You know, when you, when you mentioned that no one is holding a gun to their head to get the, you know, three liters, whatever Coke, um, and what I'm hearing from you is if there is no other option, you are going to reach for that. And I also liked that you drew that connection that not only did they, they, you know, migrate here and sort of leave the cultural foods, Acculturate with the fast foods, ultra processed foods, all of those. And some of those cultural foods got taken away along the way, but now became an elitist symbol. And so that I find that I find that very fascinating in that we sort of know leaving that behind only to then sort of be like, that's something to almost aspire to next, you know.
Alyshia: It's really sad and it's, and it's, it's paradoxical, right? It sort of becomes, you know, we've seen kale has kind of become a joke in the United States. Like if you really want to look elitist and out of touch, then you eat kale or you talk about kale. Or if you want to accuse someone of being out of touch, you say they must have like Kale, like Obama when he was president.
And I don't even know if he likes kale, but you know, it's sort of a symbolic weapon and we sort of see this, you know, sometimes people will say things like, well, who has time? You know, it's so old fashioned, or even to imagine somebody at home eating corn or making tortillas from hand, no one has time for that. That's not compatible with a modern way of life. And so, you know, those chefs who are, you know, in many cases, charging 20 or 50 times for their home brown corn tortillas in New York city to what it would, you know, it would cost and in its place of origin, they can only, you know, kind of make a business out of this, turn it into, uh, an elite status symbol because it's fallen out of reach of the average person.
So that level of kind of speculative frenzy on the part of global tastemakers relies on it, kind of falling away from the people to whom it historically belongs. And so. Pretty tragic because I don't know anyone in Mexico who doesn't like eating a nice, fresh tortilla. You know, it's not like people decided that these are not good things to eat. It's just that, you know, people have longer commutes than ever. People in Mexico city are more likely than any other place in the world to have a super commute, meaning more than three hours, one way. And so, you know, it's just incompatible with a lot of the ways that people formerly used to organize themselves to eat.
And so of course, soda, you know, we'll get you through, you know, a three hour commute. Yeah. In a way that, you know, a lot of people can't access other foods, foods, or beverages, but the problem is that, you know, consumption of soda doesn't make water any more accessible or affordable. There are still lots of people who don't have access to potable water. And so it's really not a question of educating people to, you know, enjoy different things or to know that soda isn't healthy. People know, you know, that's a pretty prevalent message. People are aware. It's just that, you know, the economic and social conditions of their lives don't allow them to eat the way they used to eat.
Shireen: You know, you mentioned earlier about, um, this sort of this, uh, shame game, right? So, although it is well documented that racism and other social stressors can trigger metabolic immune pathways that lead to chronic conditions, healthcare systems have a long history of assigned individual responsibility for diet related disease. How can we reimagine chronic disease to examine larger economic, lyrical forces rather than blaming the individual for their nutrition?
Alyshia: This is a great question. I think that's actually the biggest question we can ask ourselves as a society because it's not just with health care, it's with everything.
Our brains have been infected by marketing slogans, and one of the marketing slogans that has been most kind of insidiously vailable to us in this society is that we are autonomous individuals who move through the world, making choices, um, you know, exercising our freedom. And you know, what this does is it kind of takes away the pressure, both from our public sector to ensure that we all have access to the resources needed to survive and thrive, but it also takes the onus off of private corporations for what they do to give us. Health damaging if not deadly, uh, products toxic and, and sometimes, you know, health damaging products. And so what happens is, you know, you can see the soda companies, for example, saying things like “we have, you know, good for you and fun for you products.” So if you, if you want soda, you can have soda, but if you don't, we also have water or we have zero calorie soda, um, or we have juices or vitamin waters, or, you know, there's this vast product diversity urges us to see the solution to any health problems we have in the marketplace. If I am damaged by making that choice, let me make a different choice in the marketplace, in the supermarket aisle, in the shopping cart. And what that does is it continuously draws our attention away from the larger structural conditions, which all of our research shows play. The lion's share role in shaping our wellbeing and our life expectancy. And so we just have to continue fighting that wherever it occurs.
And it's really different. You know, Instagram, Facebook, you know, they're continuously kind of giving us choices. You can click on this. You can like that. You can not follow this person. You can choose not to follow that person. You can subscribe to this, subscribe to that. And so it's this messaging about individual choice and if you're unhealthy, The corollary of that is that, well, you must not have made good choices.
And so we blame ourselves and we have this tremendous stigmatization that happens when people have anything that can be classified as remotely, quote, unquote, diet related. We blame ourselves. We blame those who are sick for having the illnesses that they have. And so we really have to come back to the structure every time and just see how we can better orient our society so that everyone can survive and thrive.
Shireen: And so where do we go from here? What nutritional policies related to diabetes and obesity, and chronic diseases would like to be created or even modified in this country?
Alyshia: We are still subsidizing. We're giving billions of dollars a year every year to corn growers to grow, not corn that we can eat. Not nice. Some are sweet corn that you put butter on, but industrial corn that goes largely to animal feed, um, to starches and the sugar, sweeteners, sugar substitutes, um, cookies and crackers. You know, all of those things, uh, we subsidize soy and we subsidize wheat. Why are we not subsidizing fruits and vegetables?
Why is a pound of grapes sometimes the most important, most expensive thing in a shopping cart? That's a policy choice. And I think if we actually want to address diabetes and obesity, we should just either eliminate subsidies entirely. If interest of quote, unquote free market economics actually allow things to cost what they cost. And that would drive up the cost of processed foods, but it might bring down the cost of their things. Or we flip the subsidies and put them in areas that are health sustaining instead of helping industrial food corporations and animal processors. Flip the subsidy so that if you're growing broccoli, you get a subsidy and that therefore your broccoli is going to be really affordable when it hits the shelves of the supermarket, your apples and your grapes and your chilis and your beans and make all of those things affordable, a universal, basic income, you know, better food benefits that are accessible to all irrespective of immigration status.
All of these things, you know, we're, we're a country that really doesn't see access to health or access to food as a right. And I think if we moved more towards policies that frame access to healthy and culturally appropriate food and healthcare as a right we would see a big shift in these issues.
Shireen: Well, this is, this has been a very interesting conversation, Alyshia, thank you so much at this point. Can you tell our listeners how they can connect with you and learn more about you?
Alyshia: Oh, thank you so much.
This has been such a pleasure to talk to you, and I love the work that you all are doing. And I really encourage your listeners to keep exploring these issues. I have a website, it's my name, www.Aliciagalvez.com. And I would be more than happy to continue to chat with any listeners who would like to reach out to me. I'm happy to share any resources. And you know, I just think you're building a community. That's going to really push, push these issues. Greater conversation. And I think, you know, mobilizing around them, telling our elected officials that we care about these things is one of the best things that we can do.
Shireen: Thank you again, Alyshia. It has been an absolute pleasure. And to our listeners out there, we have a question of the week for you. Do you see a relationship between trade agreements and chronic disease? Head over to our social media on our Facebook, on our Instagram. Let us know what you think. Let us know what you think about this episode. We will see you there after this episode, Alyshia, thank you.
Alyshia: Thank you!
Shireen: Thank you for listening to the Yumlish Podcast. Make sure to follow us on social media @Yumlish_ on Instagram and Twitter and @Yumlish on Facebook and LinkedIn. For tips about managing your diabetes and other chronic conditions and to chat and connect with us about your journey and perspectives. You can also visit our website Yumlish.com for more recipes advice and to get involved with all of the exciting opportunities Yumlish has to offer. If you like this week's show, make sure to subscribe so you can hear more from us every time we post. Thank you again, and we'll see you next time. Remember your health always comes first. Stay well.