The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of every day life. These forces and systems include economic policies and institutions, race, development agendas, social norms, social policies and political systems. The SDH have an important influence on health inequities. Within the USA and countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse off the health. SDH can influence health equity in positive and negative ways.
Last week, Mama Glow hosted a webinar in partnership with Flora to shed light on the factors that contributing to health inequity and speak to the solutions we must seek for ourselves and our communities. The conversation looked at iron as an essential nutrient for fertility, pregnancy and postnatal health and the consequences of iron deficiency. Mama Glow founder Latham Thomas moderated the conversation and was joined in the enlightening and action-inciting conversation by registered dietician nutritionist and nationally recognized nutrition expert Maya Feller, MS, RD, CDN, triple board-certified registered holistic nutritionist and health educator Dana Remedios, RHN, RNCP, and founder of MotherBees and author of The First Forty Days and Awakening Fertility Heng Ou.
Here are 5 key takeaways we learned from this powerful conversation:
1. Unstable housing conditions directly impact health outcomes.
Where we live, what we do for work, how we interact with our surroundings, etc. all have a direct impact on our health. If you’re living in housing that stretches your funds so thin, you don’t have the funds necessary to support other areas of your health and wellness – which includes money for health supportive and nutritive foods. It’s all interconnected, and Maya pointed out that if someone is living in unstable housing where they are at constant risk of having their power turned off, that means they are also at risk of having spoiled food, and a stove that doesn’t work, making that “home” one where they are no longer safe and fed.
The neighborhood your you live in directly impacts your health, too. All neighborhoods and towns should have full-service grocery stores stocked with affordable, healthy, quality foods (and it would be all the better still if those stores also included culturally appropriate foodstuffs and ingredients reflective of the demographic). When the leading goal is to just maintain “full bellies,” this often equates to the consumption of unhealthy foods designed to have a long shelf life and curb hunger – which can have a major impacts on your health. Processed foods are high in sugar, sodium, and synthetic fats and can trigger inflammatory responses in the body and lead to dietary issues and other bodily dysfunctions.
2. Race is not a health risk factor, racism is.
While the panelists acknowledged that it is true that BIPOC individuals have higher rates of iron deficiency, they stressed that you have to look at health statistics with an intersectional lens. When it comes to higher rates of health issues like uterine fibroids and anemia in BIPOC women, it’s a phenotype issue, not a genotype issue. To put it simply: racism is the risk factor in health disparities, not race.
Persistent systemic dysfunction that has marginalized communites over generations continues to re-traumatize people and bar them from equitable resources and support, which only worstens health outcomes. Maya points out neighborhood safety and the fear of police brutality as an example: If you feel unsafe where you live, you’re less inclined to go outside to move your body with exercise, to pick up fresh produce, or even socialize in public spaces, which directly impacts mental and physical health.
3. Iron deficiency, the world’s most common nutritional disorder, impacts the reproductive continuum.
With 1 in 4 women are affected by iron deficiency, it’s the most common nutritional disorder in the world. Iron deficiency disproportionally impacts women and children and can be directly linked to achievement gaps as it impacts mood, concentration and contributes to fatigue. Iron deficiency occurs when there aren’t enough healthy red blood cells in the body (anemia). Red blood cells carry oxygen to the body’s tissues.
Ferritin is a blood protein that stores iron, releasing it when your body needs it. Ferritin usually lives in your body’s cells, and very little actually circulates within the blood. When your levels are insufficient and can’t meet the demands of the body, the level of iron in the blood drops, resulting in iron stores becoming depleted. Then ferritin levels decrease. Low iron leads to iron deficiency and if left untreated, anemia develops. Increasing your iron levels has been proven to greatly increase mental clarity, memory, long-term stable energy levels, oxygenated blood and organ support as well as curbing neurodegeneration. Taking Flora’s physician developed Ferritin+ formula can help the body manage iron levels. Ferritin+’s first-of-its-kind, time-release technology gives your body the tools it needs to build your stored iron levels for a long term solution.
Based on statistics and social determinants of health, Dr. Remedios explained that certain people are at risk for iron deficiency:
- Black or Latinx people
- Elderly people
- People who’ve had multiple pregnancies
Iron deficiency and anemia affects over 2 billion people globally, and BIPOC women are 2-3x more likely to have low iron than their white counterparts.
Iron is an essential mineral that we need at every juncture of our reproductive journey. For those who bleed monthly, anemia may be a reality, and taking supplemental iron may keep you fortified during the menstrual cycle. Those who have heavy bleeds tend toward iron deficiency and those with uterine fibroids tend to be anemic as well. Iron is foundational for pregnancy and fetal development. During pregnancy, iron deficiency puts the baby at risk of developmental delays and severe anemia during pregnancy increases the risk of premature birth, having a low birth weight baby and the risk of developing postpartum depression and anxiety increases. Lactating birthing people begin the postnatal period after having iron depleted through the continuum from pregnancy to childbirth and start the postnatal period with an iron deficit. Heng encourages warm and grounding iron rich foods in the form of broths and soups to help restore the nutrients lost during the birth process to support recovery. During menopause, iron supplementation is not generally recommended but if a nutritionist or physician looks at the SDH and how they impact a person’s health trajectory, they might need to recommend iron for someone during menopause. Flora‘s plant-based iron supplement with unparalleled bioavailability, Ferritin+. It has been clinically proven to increase ferritin iron levels without gut irritation or constipation and is organic and gluten-free.
4. Rest in the postpartum period is imperative for long-term health.
After giving birth, a restful postpartum period is vital for both the birthing person’s short and long-term health. Heng spoke to the Chinese postpartum confinement practice of zuo yue zi, which translates to “sitting the moon” and is a 40 period of rest after birth. For many living and working in the U.S., 6 weeks of paid parental leave is not an option. In the U.S. 1 in 4 women return to work 10 days after giving birth.
The menstrual cycle and postpartum health conditions serve as the foundation for longterm health, and can often be at the root of reproductive health-related issues. While society has accepted that perimenopause is doomed to be a difficult and symptomatic time for all people, it doesn’t have to be. Perimenopause can be informed by the postpartum period as well as your monthly cycles throughout the reproductive years. Taking intentional care of your reproductive health holistically after birth can set you up for optimal wellness during and after menopause.
5. Honor your foodways & trust your instincts about your health.
At the conclusion of the webinar, Maya stressed, “you are the driver of your own health and you know yourself better than anyone else”. Adding onto that, Heng said that the only thing we can control is our self-trust and intuition, which is the way forward for our health and for our bodies. Lived experience is a significant indicator of health and it is the responsibility of your medical practitioners and care providers to help craft a story about your health, demystify the data and diagnostics.
Foodways are the cultural, social, and economic practices relating to the production and consumption of food. Foodways refer to the intersection of food in culture, traditions, and history. Many of the ancestral foods we were once told were unhealthy are often the key to unlocking long term wellness. What are the foods that were carried down through your family linage?
Putting what you know into practice when it comes to your nutrition and health is a necessary way to prevent issues from occurring in the first place. Dana pointed out that once you turn the “dysfunction” light switch on, it’s really hard to turn it back off. If you really want to improve your health, integrating foods that are whole and close to their natural state and reacquainting yourself with your kitchen is a must. This doesn’t mean you have to eat grilled chicken, brown rice, and broccoli every day. Do what works for you, honoring your culture, your foodways, and what you need to thrive.
When it comes to the future of health and pushing forward toward equity, we should draw upon community for support. Dana said she draws hope from the witnessing of women looking out for women and sharing knowledge and lifting each other up.
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Watch the Mama Glow Webinar Replay