Have a look at the image below. Rap video? Check. Street-smart poetry? Check. Medical professionals on board with facts you need to know about diabetes? Double-check.
It ain't your typical diabetes awareness PSA (pubic service announcement).
Nope -- a relatively new video campaign in California called The Bigger Picture is "stepping outside the box" to raise awareness about diabetes through a unique partnership between healthcare professionals and artists, working together to create innovative, in-your-face PSA videos that might actually catch the attention of those who need to see them most. Specifically, those in minority and low-income communities where typical public awareness messages often don't come through.
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Using rap lyrics and poetry to make their point, the Bigger Picture PSAs are bold and intense, driving home the point that food choices and lifestyles are creating unhealthy situations for people in this country -- especially for minorities and those in low-income populations. This new California campaign is a joint effort by the non-profit youth development group Youth Speaks and the UCSF Department of Medicine's Center for Vulnerable Populations. It's specifically meant to raise eyebrows and change the conversation when it comes to reducing the risk of type 2 diabetes and just prompting people to live healthier.
This is quite relevant given that we just marked the 26th annual Diabetes Alert Day earlier this week -- the American Diabetes Association's big one-day "wake-up call" that pushes D-awareness to the general public and urges people to know their risk for developing type 2. It's also timely given that we're inching into April, official National Minority Health Month, with a theme of prevention this year.
What The Bigger Picture is doing is shaking up the world of health communication.
"This is a very unique partnership between medical professionals and poets," said Jose Vadi (pictured above) a non-diabetic 20-something in Oakland, CA, who's created Bigger Picture PSA videos and has taken his advocacy to colleges and detention facilities throughout the country. "It's very rare that poets are given a platform that isn't a soapbox. We're turning research material into different forms of art."
Right now, the program's only focused on California, but the organizers have plans to expand nationwide, to take these in-your-face messages to the mainstream. Our youngest team member, Cait Patterson, talked with program organizers and participants recently to get more detail on what this campaign is all about.
What is The Bigger Picture?
Here's a sampling of the verses from a few of their video PSAs:
"Drowning us in corrosive pools of sugar water."
"They turned our bodies into battlefields, our cookbooks into combo-meals, and told us to drive through."
"We ain't never learned to pull maize from the soil, but we did learn to pull the tab of a Coke can. Don't it sound like the linchpin of a grenade? Both explode under pressure. Ain't we just time bombs then?
Many of them are intense, gripping personal messages filled with passion, anger and sadness about how the American culture is so saturated with unhealthy behavior.
They're very powerful and they make a point.
Like this one, from a Panama-American family where the grandfather fought for our country and now suffers from what appears to be type 2 complications like so many others from his country:
Sure, we've learned that type 2 diabetes isn't caused solely by lifestyle factors like food and exercise. There are a lot of misconceptions about that, and too often people blame the patients for being "fat and lazy" -- the stereotypical type 2 who is to blame. Obviously, there's more to it than that, such as genetics, etc. But at the same time we do have to acknowledge that lifestyle choices are tied to type 2 risk and that minority populations are more vulnerable to developing the disease.
And seriously, the way American rich foods and sedentary lifestyle tend to influence so much of today's world, it's no wonder that our T2 incidence has skyrocketed during the past three decades. That is the point of this Bigger Picture campaign.
Each video PSA cleverly mixes the poet's words with facts about diabetes and the food or beverage industry and the overall impact of type 2 diabetes and how it's hitting people earlier in life, even kids as young as 13.
That trend is what kickstarted this campaign about four years ago.
Dr. Dean Schillinger, a general physician at the University of California San Francisco Center for Vulnerable Populations who's been practicing for 20+ years, says he saw that type 2 story play out in his own practice. He says that on any given day about half of his patients are those with type 2.
"When I was training, people were dying from AIDS here," he said. "Now, the AIDS ward is closed (in the hospital) and that same ward is now full of diabetes patients. That's happened in one generation."
Schillinger is troubled that despite the more traditional awareness campaigns (like the ADA's) that we've all seen encouraging us to eat better and be aware of type 2 risk, the diabetes rates haven't stopped rising — especially in those "hard-to-reach" populations of minorities and other subgroups.
So he and his team stepped back and looked at how this disease affects these people overall, examining the types of foods and drinks and studying how social, environmental and economic factors impact health.
In 2010, Schillinger and James Kass of the non-profit Youth Speaks organization teamed up to create The Bigger Picture.
Designed to take an innovative and different perspective on the type 2 epidemic, Schillinger tells us that he felt the need to change the conversation about diabetes in California. He wanted to focus not only on individual behavior change, but more importantly the social and environmental conditions that are driving this epidemic in poor and low income and minority communities.
The program gets youth involved through two main programs:
* High school assemblies and outreach events, the project is displayed in a one-hour presentation with PSAs, a poet mentor who speaks in person, and many other facts and activities to get the crowd engaged.
* Writing workshops for youths, in which participants are given a one-hour educational lecture about type 2 diabetes, and then spend a second hour reflecting and writing about the topic. During the educational portion of the workshops, Dr. Schillinger and program director Sarah Fine present maps and videos about type 2 diabetes to the participants and ask them questions such as "What do you notice? Why do you think there are higher rates in these communities? Who has the least amount of access to healthy foods? Who has the highest amount of sugar-sweetened beverage consumption?"
The youth participants then take these facts and personalize them, ultimately working with video editors to turn those personalized poems and lyrics into the risquÃ©, in-your-face PSAs that you'll find on the Bigger Picture website.
One example is a PSA called The Corner, in which Jose Vadi talks about his personal struggle with food choices when he was living in downtown Oakland.
You catch him: "deciding between cheap fast food that will fill me up temporarily, or do I buy kale across the street and try to eat something more healthy and sustainable for myself?"
All of the organizers involved in this project say they've been very impressed by the young poets' presentations.
"Seeing how they can take research that is incredibly boring and become these messengers of health and communicate is amazing. They do it in a way that's better than any health professional going in with a survey or recent paper or Powerpoint possibly could," said program director Fine. "It's an innovative approach that can hopefully make a difference and change conversations, and move away from victim-blaming and instead point out the important social determinants."
Impact and 'You Can Do This'!
So far, about 15 of these video PSAs have been made and published online.
Others can get involved, too. The Bigger Picture website says it's offering more than $14,000 in educational scholarships to reward young people who make these exceptional statements to persuade others to join the conversation. High school students can win $4k, $2k or $1k in a few different categories. There are also educator kits for teachers to take into classrooms, and presentations can be arranged at San Francisco Bay Area high schools.
To Jose, The Bigger Picture is doing something huge in society, that hasn't been addressed properly before.
"Diabetes is an issue that is directly affecting -- if not killing -- our young people," he said. "And if we really believe in the future of young people in America, we need to talk about type 2 diabetes."
In the future, The Bigger Picture hopes to not only expand nationwide but also produce videos in different languages (they currently have English and Spanish).
It's clear to see that all of those involved are motivated to change, if not stop, the current trend in type 2 diabetes. And while we talk a lot about hating scare tactics, a "wake-up call" when done right can really make difference in directing someone's attention to a life-changing, inspiring message -- allowing education and empowerment to follow.
Interestingly, the Bigger Picture is pretty much pushing the same message that ADA is sending out about "prevention" and D-awareness in the general public, except it's doing so in a much more interesting and dynamic way that will certainly capture more attention. In fact, it's a bit ironic that this new campaign would be a better fit with the natural style of Southern rapper and diabetes celebrity ambassador Lil Jon, whose current advocacy campaign with ADA is taking a much more conservative approach.
Still, the more awareness the better -- and this one is a smaller focused campaign of videos for the younger set, while the ADA's stuff is more cookie-cutter and aimed at the broad national audience. No reason the two can't work hand-in-hand, and as long as the message gets through, that's a victory for all.