Nearly 6 million Americans are living today with heart failure, according to the American Heart Association. That number is expected to increase to nearly 8 million by 2030.
That may not surprise you, but perhaps this will: A great many of those people live in food deserts, low-income communities where access to healthy, affordable food is hard to come by and where there’s increased risk for developing diabetes, high blood pressure and other health issues.
Remove barriers like transportation to fresh fruits and vegetables and people’s risk for developing such diseases dips to levels similar to that in middle-class neighborhoods where grocery stores and safe places to walk are in abundance.
The disparity has long haunted Dr. Heval Mohamed Kelli, who first noticed the troubling signs after settling with his family in Clarkston, one of Atlanta’s most notorious food deserts.
“I come from a culture that cooked, but we didn’t have a car and the closest grocery store was a couple of miles away,” Mohamed Kelli said. “If we took the bus, it was an hour away.”
Even at age 18, it didn’t take him long to discern the huge divide between the haves and the have-nots.
In Kobane, Syria, Mohamed Kelli was part of a middle-class family headed by his father, a successful attorney, and a stay-at-home mom. No sooner had they arrived in Clarkston than that hopeful beginning seemed to disappear and he and his family were as poor as the rest of Clarkston’s immigrant community.
Mohamed Kelli, though, saw some things. His story is proof positive why diversity, even socio-economic differences, in medicine is so critical.
“When you run from conflict, survival is number one,” he said. “Education was our way out of poverty.”
And so while he worked as a dishwasher to help support his family, Mohamed Kelli excelled at Clarkston High School and after graduating in 2002, headed to Georgia State University and then Morehouse School of Medicine.
If he hadn’t fully understood the negative impact living in a food desert had on his Clarkston neighbors before, there was little room for doubt once he started volunteering at medical clinics in nearby East Point and College Park.
“It was depressing,” Mohamed Kelli said.
Streets were lined with fast-food restaurants, and health clinics were filled with patients suffering from cardiovascular and related diseases.
The picture was the same when he graduated from Morehouse in 2012 and began his residency in internal medicine at Emory.
“The same patients I saw at the clinics, I saw at Grady Hospital,” he said. “Same problems. Same issues. Obesity. Diabetes. High blood pressure. Heart disease.”
Over and over in conversations with patients, the underlying causes were the same. Unhealthy diets. More expensive foods. Lack of transportation to grocery stores. Ninety-nine cents for a bag of chips was a whole lot easier to come by than $3 for a pound of grapes.
As dismal as the details were, Mohamed Kelli found in them the inspiration to begin researching heart disease with a focus on prevention.
On July 1, 2015, his first day as a cardiology research fellow at Emory, he shared his idea with his mentors, Emory cardiologists Arshed A. Quyyumi and Laurence Sperling.
Databases of where people lived in Atlanta already existed. Mohamed Kelli took 1,420 of them, matched them with their ZIP codes and dropped them in the U.S. Department of Agriculture map of food deserts.
What he found confirmed his suspicions. People who lived in a food desert were more likely to be African-American and low-income with low education compared to those who lived in a food oasis and all of them had a higher prevalence for obesity, heart disease and high blood pressure. They also suffered from inflammation and hardened arteries.
Mohamed Kelli’s findings were presented at the American College of Cardiology meeting recently and featured in the April 16 edition of Medscape, an Internet resource for physicians and health professionals.
“The first step was documenting the problem in Atlanta,” Mohamed Kelli said. “Now we’re in the process of trying to determine if we can replicate the research nationwide and use it to help develop policies that will ultimately prevent cardiovascular risk factors and related diseases.”
When we talked recently, he was in the process of leveraging Americans’ obsession with their smartphones — 80 percent of us own one — and using that to push vital health information to patients via an app he is hoping to create soon.
“Sixty-two percent of us use our smartphones to look up health information, according to Pew Research Center,” Mohamed Kelli said. “I was fascinated by that. I see an opportunity to tap into that and use different tools of engagement to reach and educate the patients we see.”