Fighting diabetes with hip-hop, poetry

By Daniel Weintraub

Dr. Dean Schillinger spent much of his life fighting a losing battle against a preventable epidemic that has taken millions of American lives. Now, for the first time, he has hope.

The disease is Type 2 Diabetes, an illness driven largely by bad diets and sedentary lifestyles and which has ravaged people in poverty and ethnic minorities in numbers far greater than the rest of the population.

Schillinger battled the disease as head of California’s Diabetes Prevention and Control program and founded the Center for Vulnerable Populations at UC San Francisco, where he is a professor and researcher.

He is also a student of language. And he has watched, and listened, as the messages preached by his fellow doctors and health experts have failed to reach people overwhelmed by the stresses in their lives and the slick marketing of companies pushing fast food, processed foods and sugar-sweetened beverages.

“I’ve always been interested in the power of language,” Schillinger says. “A lot of my career in medicine has been focused on language and communication and how they influence health management and health outcomes.”

As a primary care doctor at San Francisco General Hospital, Schillinger noticed that his patients were doing worse than similar patients he had treated at the university clinics. He also noted that a significant number of them had trouble reading. That led to research focused on the connection.

“We found a strong link between literacy and health,” he said.

Later, playing pick-up soccer games in San Francisco, he became friends with the director of Youth Speaks, a project that helps young people develop their skills in rap and slam poetry into voices of personal empowerment. At a fundraiser, he heard then- 17-year-old Erica McMath perform “Death Recipe” – a poem about her food and sugar addiction.

“I still get goosebumps thinking about it,” he says. “It was so incredibly powerful. I thought, ‘She’s the one.’ She has what it takes to really change the conversation about diabetes.”

Schillinger arranged a state grant to Youth Speaks for a pilot project to turn that poem and two others into short videos.

“It took off from there,” he said. “It captured people’s interest and enthusiasm because the art is so very good. To see young people getting up and telling the truth in ways we have been conditioned to not talk about is a very powerful experience.”

The partnership, now known as “The Bigger Picture,” has produced 25 videos that have been seen by almost 2 million viewers. The young poets sponsored by the program have performed for more than 5000 students at school assemblies in the Bay Area. This month Schillinger is being recognized by the James Irvine Foundation, which is giving him a $200,000 leadership award to expand the project and broaden its reach.

There are at least two audiences for the art. One is youth who can relate to a message about standing up to “the man” – in this case corporate America – by refusing to buy and eat the products that cause obesity and diabetes. The other audience is policymakers who for years saw Type 2 Diabetes as a disease caused by bad behavior – without looking at the social conditions behind those behaviors.

“A big thing that comes out in the poems is the effect of stress, so-called toxic stress,” Schillinger says. “Growing up in traumatic environment where violence is prevalent and drug abuse is commonplace changes the physiology of the child. Those stress hormones and all that adrenaline floating around lead to diabetes in and of itself, and leads them to choose to do things that in the long run are not healthy but in the short run relieve their stress.”

Among the partners with whom the Bigger Picture has collaborated is Keith Tucker, a Seattle-based Hip Hop DJ and promoter who is infusing a message of wellness into the culture and its art.

Tucker partnered with The Bigger Picture to produce three “Hip Hop Green Dinners” in California last year, including one in Sacramento. Hundreds of young people who attended the dinners were exposed to vegan food and information about healthy eating through the performances of Hip Hop musicians and poets. The sessions include classes on growing and cooking healthy foods.

“The stuff is delivered to them in the way they speak,” Tucker says. “After they leave they never think about food in the same way again.”

Schillinger hopes that events like those and the viral spread of the Youth Speaks videos will begin to change the way young people act. But he also believes that a national “war on diabetes” is necessary – and it needs to be a war that alleviates the stress and trauma that afflict young lives.

“The immediate release that sugar provides for all of us is a real oasis for young kids exposed to stress on a chronic basis,” he says. “Unless we get to the stress that’s in children’s lives we won’t really tackle the diabetes epidemic.”

Daniel Weintraub is editor of the California Health Report at Email him at

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