Writing About Cuisines and Health Equity: An Interdisciplinary Lens

The following is a guest blog post by Melissa Fuster, author of Caribeños at the Table: How Migration, Health, and Race Intersect in New York City. Fuster thinks expansively about the multiple meanings of comida, food, from something as simple as a meal to something as complex as one’s identity. She listens intently to the voices of New York City residents with Cuban, Dominican, or Puerto Rican backgrounds, as well as to those of the nutritionists and health professionals who serve them. She argues with sensitivity that the migrants’ health depends not only on food culture but also on important structural factors that underlie their access to food, employment, and high-quality healthcare.

Fuster’s book was also featured on our recent “National Hispanic/Latinx Heritage Month” reading list.

Earlier this month, the United States hit another grim COVID-19 milestone, reaching 700,000 deaths. Latin and Black communities have carried a higher brunt of these numbers. An issue that is not discussed enough, is the role of diet and preventable diet-related diseases in placing our communities at greater risk of COVID-19 complications and death. We need a new approach and understanding to address this problem and one that tackles the structural base of these inequities. In Caribeños at the Table: How Migration, Health, and Race Intersect in New York City, I use food – comidas – as a medium to build a better understanding of issues underlying health inequities affecting Hispanic-Caribbean communities. The project was built from a personal journey as a Puerto Rican scholar, threading various academic disciplines aiming to change how we view and address diet-related conditions (ie. obesity, diabetes, cardiovascular disease) among racialized communities. 

The seed for this work was planted during my doctoral fieldwork in Food Policy and Applied Nutrition at Tufts University. My dissertation examined healthy eating among poor communities in El Salvador, juxtaposing how the community perceived healthy eating and food security against how policies addressed it at a national level. While I was in El Salvador to learn about present-day eating practices, many of my conversations showcased the importance of history in shaping present-day food environments and food-related experiences, through unprompted and emotional discussions related to the 1980s civil war and the repercussions still felt during my visits in the 2000s. Yet at the time, I didn’t have the tools to fully incorporate these important insights into my doctoral research, as they are traditionally beyond the scope of nutrition and public health scholarship. This prompted me to expand my knowledge and explore a different approach which was facilitated by my postdoctoral fellowship in food studies at New York University. 

My time as a food studies faculty exposed me to how various disciplines – historians, sociologists, and those in the humanities – studied food and nutrition, bringing a deeper (and more nuanced) understanding of how to approach research in my field. It also exposed me to the power of books to fully communicate stories and expand conversations beyond academia, as opposed to the scientific manuscripts more commonly written in my field, public health and nutrition. With this, I decided to begin a new project shifting my geographic focus to the Hispanic Caribbean communities in the US, which allowed me to directly engage with my Puerto Rican community. This shift placed my focus on a community that sadly often leads the charts to many pressing health disparities – obesity, asthma, diabetes. I sought to understand why this was the case, through a comparative lens by including Dominicans and Cubans in this project. This approach allowed me to examine food practices and nutrition outcomes within contexts that shared a common history and similar cuisines but with variant political and economic situations that result in different diaspora community experiences and socioeconomic and health outcomes.

Caribeños at the Table was driven by a desire to shift how immigrant or ethnic communities are addressed in both scholarship and practice. My hope is that the voices of the caribeños featured in this work can highlight that we are not a monolithic group to be only understood through stereotyped views of the countries of origin or ancestry. I show how food practices are influenced by other aspects of our identity and lives. I examine the influence of other aspects, such as gender, race, and social class, and the interactions between external global and structural forces as important factors transforming how we relate (or not) with our heritage culture, and by extension, our traditional eating practices. 

I hope this understanding pushes our practice and research shifts focus from individual behavior change to new social and environmental approaches that address food environments and people’s livelihoods to improve economic access to food and health care. For instance, this book has led me to my current research and the creation of the Latin American Restaurants in Action (LARIA) project. Supported by the National Institutes of Health, LARIA engages restaurants to become agents of change within local food environments and social norms concerning cuisines, while recognizing the sector as an important vehicle for income and social mobility in the community. 

I also wrote this book for my community, the caribeños aquí y allá (here and there), honoring the history that binds us, coming from sister islands– one that is too often forgotten when confronted with the structural forces shaping our experiences of movement across borders. 

To further illustrate this, I will leave you with this song by Puerto Rican bolero singer, Pedro Ortiíz Davila (“Davilita”), “Son Tres” – a song that beautifully expresses this sentiment and that was part of my soundscape while writing Caribeños at the Table.

Melissa Fuster is associate professor of public health nutrition at Tulane University.