Three years ago, I came to the United States (U.S.) from Bangladesh with new hopes and dreams. Being a public health professional, I was expecting to see a healthy environment. Many fast-food chain restaurants are famous globally, but my first experience trying this food was here in the U.S. I tried fried chicken at Popeyes, and was surprised by how salty it was. It was too salty for me and I would not want to eat it again. I wondered why no one else seemed to complain about the saltiness of the fried chicken. Perhaps, I was the only one who had a problem with the high salt content of Popeyes. Next, I tried a tuna footlong at Subway, this was unique because I was able to select what I wanted on my sandwich. But the tuna was also full of salt!
Before moving to the U.S. I was a nutritionist in Bangladesh. I understood that high salt intake could increase the risk for certain conditions, such as cardiovascular disease. After trying all this salty food, I became curious about the prevalence of chronic diseases in the U.S. and decided to look up more information online. From the CDC website, I found that the prevalence of cardiovascular diseases is quite high here in the states, which surprised me. I expected that a developed country that has the best doctors, health insurance, and the best research and funding in medical fields would have lower rates of non-communicable diseases. My journey in the U.S. has come with lots of discovery and many new experiences.
After coming to New York, I started my first job in the U.S. as an optical assistant at a doctor’s office and I checked patients' eligibility to get the services and performed basic eye exams. I was open to learning and meeting new people. One of the first things I noticed was that my co-workers were accustomed to eating breakfast they ordered from restaurants. A typical breakfast consisted of a sandwich, hash browns, and hot chocolate. This is different from what I was used to, as I preferred to eat breakfast from home. Sometimes, I packed my breakfast if I woke up late and I had to rush to the office. One day, I was eating oats with some fruits. Some of my co-workers asked how I ate oats. They were nice and said it is hard for them to eat oats as a meal for breakfast. I took it positively because I know that food habits are controlled by many factors, including culture, tradition, and purchasing capacity, and this showed that my coworkers were curious.
To my surprise, some of the doctors in my office also purchased food from restaurants for breakfast and lunch. I soon realized that people preferred to purchase prepared foods because they had little time to prepare the foods and cleaning up after eating and buying food meant that they did not have to carry food from home. Though fast foods are unhealthy and can increase the risk for diet-related diseases, health was not the priority. In my country, healthcare professionals are more conscious about their health, and they usually avoid unhealthy behaviors. We expect that the person who advises others about health will follow the healthy lifestyle they are suggesting.
I became interested in knowing more about healthy food options. I went to a supermarket and was happy to see a variety of fruits and vegetables. But I was surprised to see that the prices of vegetables were sky-high, and red meat seemed cheaper than vegetables. Healthy foods are not affordable!. This is tough especially in an area like New York where rent is high and people do not have much money to spare. People are bound to limit their food expenditure. When I looked for ready-to-eat healthy foods, I found some salads, but the starting price was $8 USD. This is when I realized that it is not easy to have healthy foods for people who have no time to cook. It is easier to turn to fast foods that are cheaper and already prepared.
Coming to the U.S. came with many new experiences for me. As a Muslim, I do not drink alcohol. I never even saw a bottle of wine until an office Thanksgiving potluck party. As my co-workers were complementing the Bangladeshi and Indian foods I brought, I noticed that one of the doctors brought soda and alcoholic beverages to share. I knew it was normal for parties in the U.S. to serve alcohol, but this was a first for me. I liked the culture at my workplace because they did not ask questions and they respected my decision to abstain from drinking by offering me soda instead of wine.
I still remember the first day of the COVID-19 lockdowns in 2020. I went to the nearest supermarket to buy some necessary food items and essential household goods. While I was shopping I noticed that while I was busy thinking about getting enough fruits, vegetables, and legumes, other people were busy buying alcoholic beverages. It concerned me that people seemed to prioritize alcohol over the foods they would need to eat three times a day during a pandemic. I thought it was more responsible for me to save money for the future, rather than to purchase unnecessary things because there was so much uncertainty in the world at that time.
Another new experience was learning that women could be fired from work after returning from maternity leave. A co-worker had shared a story with me about a woman who had been forced by her manager to work the day before she had delivered her baby. The new mother came back after two months, but the manager did not allow her to work. As I had worked on different nutrition projects encouraging exclusive breastfeeding while living in Bangladesh, I knew that maternity leave is very important for a mother and baby’s life. This incident hurt me and left me questioning how the threat of being fired can impact the life of both the mother and the baby. If a mother has to return to work soon after her baby is born, for fear of losing her income, how will she ensure that her baby is exclusively breastfed? Moreover, she might fail to purchase enough food for her family and she might choose to eat unhealthy and cheap ultra-processed foods which can be harmful to health.
In one of my classes, I asked a professor about mandatory maternity leave in the U.S. and was shocked by the answer. The duration of maternity leave is 12 weeks, and it is not guaranteed that employers will pay throughout this period. It was distressing to hear that the U.S, a developed country, does not have strict maternity leave rules while many developing countries have paid maternity leave. When a mother has guaranteed maternity leave, it is easier to take care of the baby and ensure breastfeeding.
While the U.S. was behind many developing countries with regards to federal maternity leave requirements, they were ahead in other ways. In my country, tap water is not safe to drink. To purify the tap water we would have to boil it for 30 minutes to kill any bacteria or viruses, before drinking. In developing countries, many children become malnourished due to water-borne diseases and repetitive infection. Safe drinking water, hand washing, and hygiene are very important to prevent diarrhea, jaundice, and typhoid. It was a new experience for me to drink water directly from the tap here in New York and I was impressed.
Overall, I had different expectations from a developed country. I thought people would be more conscious of maintaining a healthy lifestyle, however, there are still many public health problems here in the U.S that are made worse by social injustice and health disparities. I am respectful of others' cultures and food habits. But I would like to request to be more conscious of dietary practices and healthy cooking styles to avoid diet-related chronic diseases. We can enjoy a party without alcohol and we can start from this St. Patrick's day.
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