COLUMBIA — Prominent members of Columbia's African-American community are dying prematurely from a preventable, yet devastating disease.
On Oct. 21, Almeta Crayton, Columbia's first black councilwoman, died at age 53 of complications from dialysis. Diabetes had ravaged her kidneys.
The Boone County Minority Health Network offers free educational sessions about diabetes care and prevention to groups of eight people or more. Contact Paula Williams at firstname.lastname@example.org for more information.
Boone Hospital Center offers nutritional counseling and courses on how to manage diabetes. Call 573.815.7146 to schedule an appointment or visit the website.
Centro Latino de Salud offers free diabetes tests and counseling and helps low-income or uninsured patients connect with local physicians and obtain medication. Staff speak English and Spanish. Call 573-449-9442 to learn more or visit the website.
MU Health Care offers diabetes treatment and education at its nationally recognized Cosmopolitan International Diabetes and Endocrinology Center. Call 573-882-3818 to schedule an appointment or visit the website for more information.
The Second Missionary Baptist Church offers free monthly health screenings and fitness classes. Call 573-449-4703 to learn more or email email@example.com.
A month later, John Wayne Turner, a black business owner and leader known for helping minority contractors, died from complications from diabetes, according to his longtime friend, William "Gene" Robertson, 78, professor emeritus of community development at MU.
Crayton's friend, Wynna Faye Elbert, also is "extremely ill," Robertson said. A Facebook Group and fundraising page entitled Friends of Wynna Faye Elbert started by Tyree Byndom, seeks donations and support for Elbert as she "fights for her health and well-being."
Elbert has been well-known in the black community for decades. According to a Missouri House resolution from 2004, Elbert is a noted civic leader and activist who served for 30 years with Columbia Parks & Recreation, sat on numerous boards and hosted the longest running talk show on KOPN-FM, "Straight Talk."
Contacted for this story, Elbert's son, Kevin, said his mother didn't want to talk to reporters. Nor did he.
Diet, health and disease aren't easily discussed in the African-American community, Robertson said. But someone has to start the conversation about diabetes. The silence is killing people, he said.
Funerals are a common event on Robertson's calendar. He estimates he attends at least five a month, he said. He noted that many of the foods served at Turner's funeral last month were the ones that contributed to his death from diabetes.
Tracy Edwards, 51, a leader in the community since his mid-20s, told his son, Tracy, Jr.: "Son, we got to make changes. The fast food is killing us."
For nearly two decades, Edwards worked 15-hour days, seven days a week and often stopped for fast food on the way home. He didn't give his diet much thought until eight or 10 years ago when a doctor diagnosed him with diabetes.
At 350 pounds, he decided to change his eating habits. He started baking instead of frying and ate one piece of chicken instead of three.
His girlfriend at the time started bringing salads by Douglass Park, where he mentored and coached youth, rather than the regular candy bars and chips. His friends teased him, but clearly admired the changes he was making in his life.
"We never took care of ourselves health-wise," said Scott Williams, 47, a longtime friend of Edwards and fellow leader in the community. "We were watching out for everybody else."
Williams, who has diabetes himself, works full-time as a student-parent liaison at Frederick Douglass High School. He was supervising a prom when he first noticed a problem with his vision.
"I was outside and couldn't see the stop sign," he said. "I couldn't focus." His doctor diagnosed him with type II diabetes.
He was only 35.
African-Americans experience diabetes at a much higher rate than their white counterparts. "If you are an African-American in Boone County, you are 40 percent more likely to have diabetes," said Paula Williams, president of the Boone County Minority Health Network.
According to a report by the Department of Health and Senior Services, nearly 20 percent of African-American men and 14.5 percent of African-American women have diabetes, while 8.7 percent of white men and women are diabetic.
According to the Centers for Disease Control and Prevention, diabetes can have devastating complications, including blindness, heart disease, kidney failure and nerve damage. Weak circulation in the extremities can also lead to amputations.
Edwards had both of his legs amputated below the knee in October.
Nutrition, food & culture
"Of all the chronic diseases for which diet is a factor, diabetes is probably the simplest one to control," said Mary McDonald, a retired assistant professor of nutrition and dietetics at MU.
The prevalence of diabetes in the African-American community may be traced back to slavery.
"During the slave days, women typically took care of the men and midwives took care of the women," Edwards said.
"As black men, we don't see doctors because we don't trust them," Edwards said. "It's because of what happened at Tuskegee"— a deceptive and unethical medical experiment meant to determine the effects of untreated syphilis on African-American men.
Le Greta Hudson, a clinical dietician and MU instructor, added that these days, women tend to overlook their own health and focus on taking care of everyone else.
"They forget that they can't be any good to anyone else if they are not taking care of themselves," Hudson said.
Gene Robertson also traces food habits in his community back to slavery.
"They didn't eat off the top of the hog," he said. "They ate what was left over."
The less valuable food was relegated to the slaves so they used sugar, salt and lots of grease to improve the taste, he said. Chitlins, pig intestines that are boiled and then fried, are one example of a Southern meal eaten by slaves and passed down through the generations.
"When I used to go home for Christmas, my aunt would say, 'Here's the chitlins, now go kill yourself,' because she knew I loved chitlins and the only time I could get them was when I came home, and home made me think of them," Robertson said.
People are addicted to familiarity, Robertson said. "They still gravitate to this food because that's the comfort food."
McDonald said comfort foods in the African-American diet include fried chicken, macaroni and cheese, sweet potatoes and turnip and collard greens, which can contribute to obesity, a risk factor for diabetes.
Robertson believes that diabetes and poverty go hand-in-hand. According to the report from the Department of Health and Senior Services, the lower a person's income is, the more likely they are to develop diabetes.
Diabetes "looks more like it's a black phenomenon, but it's a poor phenomenon," he said. "Our tastes in food are the same. Pig feet, and all those foods that we consider to be black foods — they're poor peoples' foods, too."
After the diagnosis
Hudson said a lot of factors go into effective diabetes control, including a healthier diet and more exercise.
Boone Hospital Center and University Hospital offer self-management courses to people newly diagnosed with diabetes, Hudson said. In the Boone Hospital Center program, participants meet for two hours a week for four weeks to learn about the disease, the dietary changes they need to make and how to integrate exercise into their daily schedule, she said.
"People can live well and be healthy with the disease, but it's about self-management and they have to understand all of the variables," Hudson said.
Diabetes is a disease that gets worse if left unmanaged. If people stop showing improvement or their condition worsens, they need to be sure to reach out to their doctor or a diabetes health educator, Hudson said.
Paula Williams, a nurse with Truman Memorial Veterans Hospital, started a nonprofit called the Boone County Minority Health Network in 2007 with Hudson and a few others.
Paula Williams and Hudson each volunteer five to 10 hours a month to educate minorities about the risks of diabetes.
"We want to help start the conversation about diabetes," Hudson said. Diabetes is so prevalent in the African-American community that people tend to minimize the effects and complications of the disease. "Often, people don't know what they don't know," Hudson said.
The Boone County Minority Health Network offers free educational sessions at homes, churches and community centers, and Williams estimates more than 100 people have been taught so far. The women offer a six- to eight-hour course over four weeks to teach people about how to prevent and manage diabetes and become their own health advocate.
Preaching health and wellness
For the past 14 years Phyliss Golden, the health and wellness minister at Second Missionary Baptist Church and a registered nurse at Boone Hospital Center, has urged church members to stick around after the service for a free blood pressure and blood glucose screening.
On average, about six to eight people show up out of the hundred or so who attended the service.
"I would like people to be motivated because they are concerned about their health — not for the edible reward," Golden said, motioning to the table full of cookies, cupcakes and granola bars a person can choose from once they have been screened for hypertension or diabetes.
"Surprisingly, some people had critically high hypertension," she said. "We refer them to a physician if they don't already have one."
In addition to health screenings, the church also hosts fitness classes, which consist of 45 minutes of non-stop aerobic exercises and stretching.
"An average of about four people show up to these classes," she said. "Sometimes another group within the church will be meeting at the same time we are exercising, and instead of joining us they will just stand there and watch."
Hudson also noted a problem with attendance at her diabetes education classes, but she's not sure why attendance isn't better. "We have been trying to figure that out," she said. "And if we could figure that out, we would have reached a lot more people."
Fitness classes are held inside the church or outdoors if the weather is nice, but Golden said the search is on for a permanent place to host class.
It's not uncommon for churches to become involved with their members' health concerns. Second Baptist handed out three pamphlets during an October service to promote their November fitness classes and encourage members to take their health more seriously.
"We always strive to help people prevent illness instead of treating them," Golden said. "Our focus is on young people. We want to prevent these illnesses early and the best way to do that is with a healthy lifestyle."
Next steps for Edwards
Edwards and Williams continue to promote a healthy lifestyle to young people through coaching and mentoring. Despite his recent double amputation, Edwards is still mentoring African-American youth at Douglass High School and the Armory Sports & Recreation Center on weeknights, he said.
He goes to rehabilitation three times a week and also receives dialysis three times a week.
In late January or early February, he will be fitted for prosthetic limbs and said he hopes to be taking his first steps by March. "With hard work, I'll be walking in three months," he said.
"I'm going to be making progress every day. Good Lord willing."
Supervising editor is Katherine Reed.