Transcriber: Alexandra De La Cruz Reviewer: Zsófia Herczeg
Hello everyone and good evening.
Thank you.
Tonight, I'm going to talk about the project
that first drew me to Barbados
and the journey that it has taken me on.
I'm from Seattle,
and in 2013, I saw a graph that would change my life.
Now I have to warn you it's going to be a little underwhelming.
(Laughter)
Here it is.
(Laughs)
So we're looking at obesity rates in Barbados -
in green for males
and in purple for females.
And you'll see that women's obesity rates
are almost double that of men in 2010.
Now as many of you know,
obesity is linked with increased risk of type 2 diabetes,
hypertension and other chronic conditions.
So when I saw this graph, I wondered,
Does this gender differential in obesity rates
translate into a gender difference in disease?
Unfortunately, the answer seems to be yes.
In Barbados, women's diabetes rates are 30% higher than men.
Part of the explanation has to do with physical activity.
Only one out of 10 women get enough activity.
That's only one out of 10.
And to understand why this is such a big problem,
imagine that I could give you a pill.
Now this pill would reduce your risk of colon cancer by 30%,
your risk of breast cancer by 20-40%,
and even if you have a family history of diabetes,
this pill would reduce your risk by 40%.
It sounds pretty good, right?
This is exactly what physical activity can do.
So I set out to try to answer the following question:
Why are women in Barbados not getting enough physical activity?
And you can imagine, as an outsider,
I faced a major disadvantage in trying to answer this question.
I didn't know anything.
But this actually turned out to be helpful
because it meant I really had to look and I really had to listen
to try and figure out what was going on.
So what are some of the things that I saw as an outsider?
For one, when I started this research,
everyone told me that I was wasting my time,
that there was a simple explanation:
Bajan men prefer sweet, thick women.
(Laughter)
Or as -
Or as Captain Sawyer would say,
"Don't want no broomstick girl,
I like them big, and fat, and thick."
(Laughter)
Now there might be some truth to this story,
but I'm going to argue
that there is a much more complicated narrative going on.
For one thing,
most of the women that I spoke with wanted to lose weight.
They told me stories about crazy diets,
expensive surgeries, dangerous pills.
No one wanted to be bony either,
but everyone wanted to shed a few pounds.
So why is it so difficult?
For one thing, girls are socialized to be less active than boys,
from an early age.
We tell young women to become girls,
to stop sweating,
to stop playing around as much.
You can even see in this picture
the boys are kicking around a football
while the girls are standing up, chatting.
This dynamic continues well into adulthood.
Two, a lot of the women that I spoke with were mothers.
And a lot of them were single mothers.
In fact, in Barbados,
30-40% of all households are headed by a single mother.
And as you know, these women are responsible for so much -
from cooking, cleaning, pressing,
taking the children to school,
collecting them, working.
There's just so much for any woman to do.
These gendered ideas
about who is responsible for what within the household
have a very real impact on, A, whether women have any free time
and, B, how they choose to use the limited free time they may have.
Now despite all these barriers, I did find one exciting bright spot.
One of the women that I spoke with told me about a dance fitness class
that she was so excited about.
She talked me into going to it that very night.
And it really was amazing.
Pictured here in yellow is Ms. Heather Drakes,
the woman who teaches this class.
Now Heather only charges three dollars for women to attend.
And the women who do come report less shortness of breath,
increased weight loss
and an increased ability to manage their hypertension and their diabetes.
For me, this is like finding the pot of gold
at the end of the public health rainbow.
I was so excited.
Here is an intervention that's proven to work in the Caribbean
and has a real health impact.
So I partnered with Heather
and the Physical Activity Task Force of the Ministry of Health,
with the help of Maria Holder and PAHO,
to try to scale up this intervention.
We trained a cohort of community-based fitness trainers,
some of whom are pictured here,
to teach their own three-dollar classes
in different parishes across the island.
And so far, it seems like it really is working to attract women
who might not otherwise be active.
This is a quotation from a woman who emailed us about the classes:
"I am a mother of two young boys
with a strong family history of diabetes
and therefore am keen to get some regular exercise
(but am not really a 'gym person')."
This is exactly the kind of woman
that we're hoping this program will appeal to.
A program like this has the potential to be so powerful
because it directly addresses the barriers that women face.
One, as I mentioned,
women are socialized away from being active.
But dancing is a major exception.
Dancing is an activity that women are supposed to be good at,
that we're encouraged to do.
Two,
while exercise is perceived as being expensive and not very fun,
it's no surprise that women wouldn't make it a priority
in the face of so many competing demands.
But if we can make physical activity something
that's affordable, fun and social,
we can make it a little bit more appealing;
we can make it something
that women are willing to squeeze into their busy schedules.
When I first started this research, people implicitly told me
that women were responsible for their own overweight status,
their own obesity, their own inactivity.
But the story that I saw was quite different.
Women face a lot of very real barriers to being active.
And if we want to create physical activity interventions
that are going to be successful,
we have to design them
with women's needs, values and preferences in mind.
And I do believe that if we listen to women
and if we commit to investing in them,
we can create a healthier, happier and more empowered Barbados.
Thank you.
(Applause) (Cheering)