Nutrition interventions addressing structural racism: a scoping review

Abstract

African Americans experience high rates of obesity and food insecurity in part due to structural racism, or overlapping discriminatory systems and practices in housing, education, employment, health care, and other settings. Nutrition education and nutrition-focused policy, systems, and environmental changes may be able to address structural racism in the food environment. This scoping review aimed to summarize the available literature regarding nutrition interventions for African Americans that address structural racism in the food environment and compare them to the “Getting to Equity in Obesity Prevention” framework of suggested interventions. An electronic literature search was conducted with the assistance of a research librarian encompassing 6 databases—MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX, and ProQuest Dissertations & Theses. A total of 30 sources were identified detailing interventions addressing structural barriers to healthy eating. The majority of nutrition interventions addressing structural racism consisted of policy, systems, and/or environmental changes in combination with nutrition education, strategies focused on proximal causes of racial health disparities. Only two articles each targeted the “reduce deterrents” and “improve social and economic resources” aspects of the framework, interventions which may be better suited to addressing structural racism in the food environment. Because African Americans experience high rates of obesity and food insecurity and encounter structural barriers to healthy eating in the food environment, researchers and public health professionals should address this gap in the literature.

Improving Fruit and Vegetable Accessibility, Purchasing, and Consumption to Advance Nutrition Security and Health Equity in the United States

“…Public consciousness of structural barriers to health have increased in recent years [ 20 , 21 , 22 , 23 ], primarily magnified by the COVID-19 pandemic and national protests against racial injustice [ 24 , 25 , 26 , 27 ]. The retail food environment, a social determinant of health, is one setting where consumers interface with an unjust food system [ 28 ].…”

A Scoping Review of the Community Health Worker Model Used for Food Systems Interventions Within the United States

“…Food systems education to influence individual behavior change can be a tool for health promotion in underserved communities, however, root causes of health disparities must be addressed through interventions that address policies, systems, and environments of food systems and the broader social determinants of health. 78,79 This review confirms that the CHW model can connect with underserved communities and identifies how the CHW model has been used as an educator in food systems interventions for public health. Food systems and health promotion researchers and practitioners should prioritize future exploration of the CHW model as community change agents within food system structures.…”

Changing sustainable diet behaviours during the COVID-19 Pandemic: inequitable outcomes across a sociodemographically diverse sample of adults

“…These changes may be due to the fact that Black or African American people were disproportionately affected by the COVID-19 pandemic and may have been shifting their behaviour to improve their nutrition as a way to prevent falling severely ill from COVID-19. ( 45 , 46 ) To address the inequities at the root of the pandemic’s greater impact on Black and African American communities, future interventions for dietary change may need to grapple with structural racism in the US food environment, ( 47 ) as it is in part responsible for nutrition and health inequities, including those that widened during the COVID-19 pandemic.…”