RFK Jr.'s focus on nutrition misses one main ingredient | Opinion

The doctors we train today will spend their careers treating patients whose greatest health threats will not always come from a virus or a gene – they'll come from a grocery store, fast-food restaurant, a ZIP code or a paycheck.

Health and Human Services Secretary Robert F. Kennedy Jr. has called for medical schools to include at least 40 hours of nutrition education in their curricula – a proposal that has generated controversy in academic medicine. 

Some of the wariness is warranted. The medical community is right to scrutinize any government pressure on curriculum, as academic freedom is a core principle in higher education. That being said, underneath the politics lies a question worth asking: Why not teach our physicians more about nutrition?

This is not a new question. In 1962, the American Medical Association convened a conference after its survey concluded that nutrition was receiving "inadequate recognition" in the country’s medical schools. More than half a century later, American medical schools offer less than 1% of total lecture hours on nutrition and its medical consequences. 

The scientific case for nutrition education is ironclad and has been for some time. There is a broad consensus across the medical community that diet is among the most significant drivers of human health and disease. Diet-related chronic disease has become the leading cause of morbidity and mortality in the United States, including obesity, diabetes, cardiovascular disease and kidney disease. The public health catastrophe is evident in hospital waiting rooms across the country. 

Diet-related health issues do not impact all Americans equally. People of color and those living in poverty are disproportionately impacted by diet-related diseases – and the disparity is not accidental.

Health outcomes aren't coincidence, but consequence

These outcomes result from the social determinants of health: the conditions in which people are born, live, work and age. The social determinants of health include social factors that affect health, such as poverty, social marginalization, access to health care and good nutrition.

These factors shape health outcomes as powerfully – if not more than – as any other components of the health care system. Research consistently shows that social determinants account for roughly 50% of all health outcomes. A physician who understands nutrition science but not a patient's lived experience can only help them improve their health to a certain extent.

Food insecurity, food deserts and structural inequities do not fall evenly across our society. They particularly impact communities of color who continue to experience cardiovascular disease, type 2 diabetes, obesity and cancer at higher rates than their White peers. A 2022 National Institutes of Health study found that high-poverty, non-White, particularly Black, neighborhoods have the least access to supermarkets with fresh foods.

Health outcomes are not coincidences – they are the consequences of social structures. 

The medical community has begun to connect these dots. An expert-backed framework of competencies for physicians in training has underscored the importance of screening for food insecurity, which essentially asks whether patients have consistent access to nutritious food. Forty hours of nutrition science without attention to the social determinants of health risks trains physicians to prescribe salads in communities that don't have fresh food in their grocery stores.

At Xavier University of Louisiana, one of the nation's leading producers of Black physicians, understanding the social determinants of health is fundamental to who we are and what we do.

Why can't Americans access nutritional food?

Xavier approaches health education holistically. Our Department of Public Health Sciences was recognized by the U.S. Department of Education as a standout program preparing students for impactful careers in public health. Our College of Pharmacy's health sciences program explicitly educates to find solutions for health disparities. Our students are trained to see not only the patient in front of them but also the social determinants of health that have shaped their lives.

Xavier University is also developing the Xavier Ochsner College of Medicine, focused on training the next generation of physician leaders committed to health equity and reimagination of health care ‒ physicians with the knowledge and skills to address nutrition-related health issues and the social determinants of health.

The growing consensus that nutrition belongs in medical education is valuable, but that consensus will only translate into healthier communities if paired with an equally serious commitment to understanding why so many Americans cannot access nutritious foods that support good health in the first place.

Xavier University, shaped by a mission of justice and humanity, has long held that well-being arises from healthy communities. We have embedded the social determinants of health throughout our health science and premedical curriculum because we know, as research confirms, that where and how patients live shape their health as much as the care they receive. 

Our call to academic institutions – and to Secretary Kennedy – is this: Nutrition education and the social determinants of health are not separate conversations. They are one conversation, and they belong at the center of every medical curriculum in America.

Reynold Verret is the sixth president and second lay leader of Xavier University of Louisiana, the nation's only Catholic historically Black college or university.