Sodium-Filled Fast Food Is Driving High Blood Pressure Among Black Americans

The overabundance of fast-food restaurants in poor black neighborhoods is partly to blame for high rates of high blood pressure among black Americans.

Growing up, I learned to hate the blood pressure machine at the Kroger by my house. Once a week my mom, my brother, and I would walk through the automatic doors, past the produce, and down the aspirin aisle toward the wretched contraption. After a deep breath, Mom would sit down, slide her arm in, and push start. With a soft hum, the machine hemmed and hawed as the black tube contracted around her bicep like a boa.

Together we’d watch the monitor with the same mixture of angst and hope that a gambler does a slot machine. For us, “jackpot” would’ve been something around 120/80, but all too often it was higher. That meant more stress (bad for blood pressure), more pharmacy prescriptions, and more bouts with a smaller, though no less sinister, portable blood pressure machine in my mother’s bedroom at home.

For black families like ours, hypertension is often as inescapable as death, taxes, and racism. Besides my mom, my brother, my grandma, and most of my aunts and uncles all manage the condition too. According to the American Heart Association, the prevalence of high blood pressure in black Americans is the highest in the world, with 75% of African Americans likely to develop the condition by age 55. But even grave statistics like these fail to capture the visceral nature of hypertension — the way it stops hearts, ruptures blood vessels, corrodes kidneys, and suffocates brains.

All too often for us, hypertension’s complications degenerate our bodies and deplete our communities. But all too often, our communities are what drive us to have hypertension in the first place.

On the way home from my family’s weekly trip to the grocer’s, I’d press my nose against the car window and stare at each fast-food joint we passed. There were many, and my heart fluttered as we rolled by each one. The toys, the playgrounds, the World Famous Fries® — like every other kid in my neighborhood, I loved everything about these restaurants. But what I didn't know then was that the same brands that were filling my heart with joy were filling my body with salt.

Fast food has about 27% more salt than home-cooked food, according to the USDA. And since these retailers saturate black communities, experts say they are a key driver of the chronic high salt consumption and high blood pressure among African Americans. But after years of absorbing the negative health costs of fast-food restaurants, these communities have caught the eye of politicians looking to reform the industry.

For black families like ours, hypertension is often as inescapable as death, taxes, and racism.

In June, Philadelphia became the second city behind New York to pass legislation requiring chain restaurants to display hazard signs on items containing more sodium than the total daily recommended amount, with a caption warning: “Sodium content higher than daily recommended limit (2,300 mg). High sodium intake can increase blood pressure and the risk of heart disease and stroke.”

In a statement initially explaining the bill, Councilwoman Blondell Reynolds Brown noted that while Philadelphia as a whole has some of the worst blood pressure statistics in the country, “African-American Philadelphians have even higher rates of hypertension (48%) and premature death from heart disease.” Likewise, Dr. Sonia Angell, Deputy Commissioner of the New York City Department of Health, also cited black New Yorkers’ “staggering disparities in morbidity and mortality” to justify New York’s salt law.

But while groups like the American Medical Association have championed these new regulations, restaurants like Popeyes, KFC, and McDonald's are fighting them tooth and nail. In opposition to new sodium warnings, these companies have pursued a multipronged lobbying and advertising campaign that seeks to fight the new laws while continuing to promote their food in black neighborhoods.

In 2015, when New York first announced its version of the salt measure, the National Restaurant Association, a lobbying organization representing the nation’s largest chain restaurants, sued the city, calling the proposal "arbitrary and capricious" and "not supported by the underlying science and consumer research."

Indeed, rivaling a climate change denier standing atop a melting glacier, the group's lawyers argued that people could consume up to 4,945 milligrams of sodium a day — more than twice the federal government's guidelines — with no side effects, and cited a study that concluded "sodium intake is not related to blood pressure."

Whether the NRA actually believes this is hard to say, but it's clear that they are fearful that the salt regulations could tank their bottom line. In their 2017 annual financial report, Popeyes, Burger King, and Tim Hortons warned investors that "adverse publicity related to litigation” and “health campaigns against products we offer in favor of foods that are perceived as healthier may affect consumer perception of our product offerings and impact the value of our brands."

And while these restaurants are surely concerned with consumer perception across the board, they are particularly sensitive toward African American patrons, whom these restaurants spend an inordinate amount of time and money targeting.

In a 2012 report for AdAge, McDonald’s then-chief marketing officer Neil Golden, explained how strategic “engagement with African-American consumers in their communities” was crucial to the company's growth, saying that racially targeted marketing “generates a strong return in terms of business performance.” From sponsoring the Inspiration Celebration Gospel Tour to supporting the Essence Music Festival, Golden outlined how McDonald’s builds rapport with black customers by applying “ethnic consumer perspectives at every point in the marketing process.”

Fast-food restaurants concentrate disproportionately in predominantly African American neighborhoods.

And according to the research lawyers cited from the American Journal of Public Health, fast-food restaurants concentrate disproportionately in predominantly African American neighborhoods in cities like New York. Moreover, related research from the Archives of Internal Medicine and the Journal of Urban Health highlight how residents living in these areas also lack access to grocery stores and eat more fast food because of the closer proximity. Arguing in an amicus brief supporting the sodium mandate in New York, health experts charted how all this happens, and how “the health burdens of fast food restaurants’ high sodium offerings fall disproportionately on vulnerable communities.”

Together these studies illuminate how companies like McDonald’s and Popeyes have been able to cultivate black Americans into a lucrative demographic in which young adults consume more than one-fifth of their calories from fast food.

This dependency on black customers is why many fast-food commercials feel ripped straight from a BET original movie: The black boy hitting the Cha Cha Slide while dipping his McNuggets. The Brian McKnight wannabe crooning over getting "dipped out on." The Houston and Chingy jingle. Together, they all forge a Trojan horse of black culture, designed to pump in sodium while pulling out profits.

Over the years, fast-food marketing has taken such outlandish aim at black patrons, they've drawn the ire of the black comic class. In his 2014 special Love at the Store, Jerrod Carmichael joked that “Nobody loves McDonald’s. Nobody.” Then he paused to feign remorse. “There’s a part of me that feels bad about shitting on McDonald’s, because they love the black community," he confessed to the audience. "They’re the only people that celebrate Black History Month. They have like a picture of Dr. King with some fries underneath.”

Pulling on the same thread in his 2018 Netflix special Great America, Katt Williams decried the way fast-food companies like Taco Bell and Arby’s were “trying to trap niggas.” Saving his most vitriolic scorn for Popeyes’ black spokeswoman “Annie,” he ripped how “every time she do a commercial, there’s got to be some coonery and shit! She got Jerry Rice looking like Scatman Crothers with Vaseline on his face, with a helmet on, eating chicken wings and dancing and shit.”

For over 40 years, these restaurants have spent millions mastering the language and imagery of black life. The same way Brown & Williamson Tobacco Corporation used “Kool Jazz Festivals” to pitch cigarettes, the same way Teacher’s Scotch produced The Black Athlete documentary to promote liquor, the same way Wells Fargo attended black churches with"wealth building seminars" to peddle subprime mortgages, today's fast-food restaurants like McDonald’s and Popeyes trade on race to profiteer hazardous food.

I was forced to visibly contend with the impact of this marketing when I first moved to New York in 2016. Walking into the Popeyes that littered black Brooklyn, I saw menus that offered more salt than chicken — almost every item bore the warning symbol indicating it contained more salt than the 2,300 milligrams recommended by federal guidelines. But as disturbing as this sight was, I had come to grasp an approximation of this truth years before, working as a teenager at McDonald's in the black suburbs just south of Atlanta.

Today's fast-food restaurants like McDonald’s and Popeyes trade on race to profiteer hazardous food.

Donning a blue shirt and black cap, every noon I’d stand ready behind the counter at Mickey D's, dreading the lunch hour rush. As the customers poured in, me and my fellow minimum wage compatriots would begin a frantic dance. Some flipped burgers. Others worked the drive-thru. For my role, which ultimately proved to be tragic, I made the fries.

Before I got that job, there was no treat that I loved more than McDonald's World Famous Fries®. As a child I cried for those fries, fought my older brother for those fries, dug to the bottom of the bag for those fries, and, God forbid, should a few of the golden morsels ever slip out of my hands and fall from grace to the minivan floor, I’d invoke the five-second rule for those fries, but the love faded when I had to make those fries.

In my greaseproof sneakers, I’d dash from the freezer to the greaser, and from the greaser to the silver tray where the fries would be stacked in bags and cartons. There were times when that fry tray got so salty it resembled a beach. It would become most apparent when a customer (either slyly seeking to get fresher food or legitimately concerned about their blood pressure) would walk in and ask for fries with no salt. We’d have to stop. Make a fresh batch, and take a towel to wipe the tray clean. By the end, the towel would be covered with a thick white grit from the caked-up residue.

I remember feeling like a guilt-stricken assassin every day. I’d hold the hourglass-shaped salt dispenser in my hands, watching the grains fall as if they were the sands of time cascading away from our customers' lives. And the fact that most of those customers were black was not happenstance, but the natural upshot of a decades-long effort on the behalf of fast-food vendors to dominate the black consumer market.

And even today, now that the public health cost of these retailers has become clear and lawmakers are proposing new regulations, the restaurants have remained steadfast in their tactics. The denial of empirical blood pressure science, the copious purveyal of sodium dense "food," the mercenary-like racialized marketing — combined they all expose the true nature of Big Fast Food's business model for what it is: Promote advertising that celebrates black life and sell food that drives black death. ●

Aaron Ross Coleman is a New York City–based journalist. He writes at the intersection of race, business, and economics. He has written for CNBC, the Nation, the Marshall Project, HuffPost Black Voices, and elsewhere.

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