Disparities in Diet Quality and Food Security Across Ethnic-Immigration Status and US Nativity

This study examines separate relationships between ethnic-immigration status, length of residence (US nativity), dietary quality, and food security status among US adults. Data from the National Health and Nutrition Examination Survey between 2017 and 2020 were used. The study sample included 6933 adults aged 18 and above. Food security status was categorized as either food secure or food insecure. Dietary quality was assessed using the Healthy Eating Index (HEI-2015) component scores. The ethnic-immigration status comprised US-born and immigrant groups, including Whites, Asians, Blacks, Hispanics, and multi-racial group. The US nativity was categorized as native, less than 5 years, 5-14 years, 15-30 years, and above 30 years of residency. Associations between ethnic-immigration status, US nativity, and food security were analyzed using logistic regression. Their associations with dietary quality used linear regression. The results showed that US-born Hispanics, multi-racial group, and immigrant Hispanics had about twice the odds of being at a risk of food insecurity compared to their US-born White counterparts, while US-born Blacks had about one and half odds. Food insecurity was higher among respondents with less than 5 years and over 30 years of residency in the USA, with odds slightly less than two. Immigrants had better overall dietary quality than US-born Whites and natives (p-values < 0.001). The study highlights the importance of nutrition interventions that consistently promote equitable access to affordable and nutritious foods while fostering the exchange of valuable dietary practices among groups and encouraging cross-cultural learning to improve overall health.