As a queer, Indigenous Latina dietitian practicing in Cleveland, I witness daily how systemic inequities—not individual choices—shape the health of our communities. High blood pressure, or hypertension, is one of the most pressing public health concerns we face locally. I see its toll on patients every day.
Hypertension is often called the “silent killer” because it usually has no symptoms until a severe complication—like a stroke, heart attack, or kidney failure—occurs. But the real silence is in how little we talk about the deeper reasons why hypertension disproportionately affects Black and Brown communities in Cleveland and beyond.
According to the National Library of Medicine, in Cuyahoga County, 57% of Black men and 51% of Black women in midlife have high blood pressure–among the highest rates in the country. The CDC reports that in Cleveland, cardiovascular disease accounted for 1,048 deaths in 2021—a staggering 32% of all deaths that year. This isn’t a coincidence. It’s a direct result of generations of structural racism, redlining, disinvestment, and chronic stress from discrimination that have systematically harmed our neighborhoods and our bodies.
Salt consumption is only one piece of the puzzle, but a powerful one. The average American consumes nearly 3,400 milligrams of sodium per day, far above the American Heart Association’s recommended limit of 2,300 milligrams. Most of that salt doesn’t come from a salt shaker, it’s hidden in processed foods, fast food, and restaurant meals. Without realizing it, a person can easily consume nearly double the ideal daily amount. However, we can’t talk about sodium intake without talking about food apartheid and lack of access to affordable, culturally relevant, nutritious foods.
About half of Cleveland residents live in food deserts. When healthy food is hard to find and expensive, people are left with limited options. Our communities deserve better than being told to “eat healthier” without the tools, access, and autonomy to do so.
The financial cost of inaction is staggering. Nationwide, hypertension-related healthcare costs exceed $130 billion annually, and many of these dollars are spent treating avoidable complications like strokes and heart attacks. In cities like Cleveland, where cardiovascular disease is the leading cause of death, local healthcare systems bear the weight of preventable ER visits and hospital stays. Preventing just a fraction of these hospitalizations through simple, community-focused policies could save millions and more importantly, save lives.
This is where local policy can make a real impact. The “Cut the Salt, Keep the Flavor” coalition is proposing a sodium warning label on restaurant menus in Cleveland to identify items high in sodium. This policy doesn’t shame or restrict people. It simply empowers them with information and helps people make choices based on their own needs, values, and health goals. Especially those managing conditions like high blood pressure or heart disease.
We’re not alone in this vision. Cities like New York City and Philadelphia have already adopted sodium labeling policies and 75% of New Yorkers surveyed supported the initiative. These cities have shown that such policies are both feasible and popular. Cleveland has the opportunity to be the first city in Ohio to lead this change and join a growing national movement for health equity and food transparency!
Let’s be clear: this is not about controlling bodies. I practice from a weight-inclusive, trauma-informed, Health at Every Size (HAES) approach that centers care not compliance. This is about supporting people in making informed decisions while holding institutions accountable for the conditions they create.
As frightening as the statistics are, they represent a call to action. Cleveland can lead the way with a policy that supports transparency, equity, and public health. Let’s honor our communities with policies rooted in justice, healing, and collective care.
It’s time to cut the salt—and keep the flavor, the culture, and the power.
Andrea Hinojosa MS RDN LDN CLC
