The proof of Anderson County’s live-hard, die-young culture is in the bread pudding — and the all-you-can-eat fried catfish, the drive-through tobacco barns and the dozens of doughnut shops that dot this East Texas county of about 57,000.
In a community where heavy eating and chain smoking are prevalent, where poverty, hardheadedness and even suspicion hinder access to basic health care, residents die at an average age of 73 — seven years earlier than the healthiest Texans, according to a preliminary county-by-county analysis by the University of Washington Institute for Health Metrics and Evaluation. Black males live to be just 65. And white men outlive black men by roughly six years, one of the largest disparities by race in the state. Indeed, life expectancy lags across most of East Texas, which lives up to the grim medical nickname the Stroke Belt.
The early deaths are the result of high rates of obesity, diabetes, cardiovascular disease and cancers, afflictions directly linked to lifestyle choices, including poor diet and smoking. Anderson County’s hospitalizations for preventable conditions like congestive heart failure, high blood pressure and adult asthma far outpace the state average.
Such maladies are tied firmly to race and poverty. East Texas has top-notch health care facilities for those with the money and insurance to have access to them. For the impoverished, predominantly minority residents without medical insurance, transportation or trust in the health care system, life takes another path.
“I feel like life does get cut short,” said Michael Bolton, 47, a black man with perilously high blood pressure whose father died of a heart attack at 49. “I’ve lost a lot of people I grew up with. I didn’t even think they were sick.”
Battered and Buttered
It was lunchtime in Palestine, the county seat, and the D.J. on 106.5 FM would not let listeners forget it. “Caller Mary Beth is the winner of a free dinner from Texas Roadhouse!” he crooned. “Her favorite is steak and potatoes and chili!”
A chalkboard menu at a diner advertised dishes “deep fried,” “battered” and “buttered.” Waistlines were wide, even on young children.
“Y’all want dessert?” a waitress refilling sweet teas asked, her drawl as sugary as the cobbler she was serving.
It is the Old South diet — the staple of every church picnic and backyard barbecue from Anderson County to Alabama. And it is a leading contributor to the uncontrolled high blood pressure, obesity and diabetes plaguing much of the region. Gyms often sit empty, day and night. The corner coffee shops are all Donut Palaces. In neighboring Cherokee County, the East Texas Medical Center Jacksonville brochure features a recipe for Barbara’s Buttermilk Pie, with two cups of sugar and five eggs.
“It’s the old biscuits and gravy that sticks to the arteries,” said Connie Fiser, a nurse who runs the hospital’s intensive-care unit and inpatient-care center, and sees an endless stream of patients with complications from diabetes.