Community experiment paints new picture of barriers to health

Residents of the "stroke belt," a region in the Southeast with high rates of heart disease and stroke, took photos of what they see as barriers to heart health, revealing a host of disadvantages.

Teen and adult residents of Lenoir County, N.C., volunteered to take photos of what they believe creates barriers to good heart health in their community. Nine adolescents and six adults participated in the study, which was published this week in Preventing Chronic Disease and covered by NPR.

Lenoir County is rural, and most residents are low-income and black. Although heart disease is the leading cause of death in the U.S., participants' discussion of barriers to heart health in their community cited stress related to racial prejudice and "big disparities in income and disease among African Americans" as a main cause.

Volunteers' photos captured many of these deep-set issues. Negative family influences were a major factor. One photograph features hands holding a cigarette with a caption reading, "He wasn't raised where health was an issue in the household. There was nobody talkin' about health, probably nobody talking about not smoking or drinking or unhealthy practices, what it could lead to," according to NPR.

Access to healthy food was another popular subject matter in volunteers' photographs. One photo shows "Fast-Food Avenue," an area where the only options for eating out are pizza shops, Chinese food, Burger King and "greasy sub sandwiches," according to one photographer's caption.

Another photo shows a large candy display at a convenience store. "Have you ever noticed, like when you walk in the store, like most of the time right upfront where the cash registers are it's candy, candy. All the healthy stuff is in the back, and right upfront is the candy, so it's the first thing you see 'cause everybody knows you're gonna buy it 'cause it's good. It's advertised good. People like it!"

The photography experiment launched discussions about the importance of heart health and the challenges many face in maintaining it. Volunteers contributed ideas to encourage residents to choose healthy food in the grocery store and fast-food establishments, initiate nutrition education in school and even encourage rappers to incorporate positive health messages in their lyrics.

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