Nutrition interventions addressing structural racism: a scoping review

Area of Science:

• Public Health
• Nutrition Science
• Health Equity

Background:

• African Americans face disproportionately high rates of obesity and food insecurity.
• Structural racism, encompassing systemic discrimination in housing, education, employment, and healthcare, significantly contributes to these health disparities.
• The food environment is a critical area where structural racism manifests, impacting access to nutritious food.

Purpose of the Study:

• To conduct a scoping review of existing literature on nutrition interventions for African Americans that address structural racism within the food environment.
• To compare identified interventions with the 'Getting to Equity in Obesity Prevention' framework.
• To identify gaps in current research and practice regarding interventions targeting structural barriers to healthy eating.

Main Methods:

• An extensive electronic literature search was performed across six major databases (MEDLINE, PsycINFO, AGRICOLA, ERIC, SocINDEX, ProQuest Dissertations & Theses) with librarian assistance.
• Thirty sources detailing interventions aimed at overcoming structural barriers to healthy eating were identified and analyzed.
• Interventions were categorized based on their approach, including policy, systems, environmental changes, and nutrition education.

Main Results:

• The majority of reviewed nutrition interventions focused on policy, systems, and environmental changes combined with nutrition education, primarily addressing proximal causes of racial health disparities.
• A limited number of interventions targeted broader aspects of the 'Getting to Equity in Obesity Prevention' framework, such as 'reduce deterrents' and 'improve social and economic resources'.
• These broader strategies may hold greater potential for addressing the root causes of structural racism in the food environment.

Conclusions:

• Current nutrition interventions for African Americans often address immediate factors rather than the underlying structural racism impacting the food environment.
• There is a critical need for more research and public health initiatives that focus on policy and resource-based interventions to dismantle structural barriers to healthy eating.
• Addressing structural racism is essential for reducing obesity and food insecurity among African Americans and achieving health equity.