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The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition Methodology & Assessment".

Deadline for manuscript submissions: closed (20 March 2022) | Viewed by 28938

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Special Issue Editors

Prof. Dr. Angela Odoms-Young

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Guest Editor

Department of Kinesiology and Nutrition, University of Illinois at Chicago (MC 517), 643 Applied Health Sciences Bldg., 1919 W. Taylor Street, Chicago, IL 60612, USA
Interests: social, cultural, and environmental determinants of dietary behaviors and diet-related diseases in low-income populations, LGBTQ populations, and Black, Indigenous People of Color; community-based participatory research; social justice; discrimination/racism; nutrition

Dr. Tamara Dubowitz

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Guest Editor

Faculty of Pardee RAND Graduate School, Santa Monica, CA, USA
Interests: Neighborhood effects; built and social environment; impact of social policy on diet and diet-related disease; marginalized populations

Special Issue Information

Dear Colleagues,

The unequal burden of poor nutrition within and between countries has been well documented. Despite efforts globally to reduce/eliminate disparities in diet and its related health outcomes, differences in dietary patterns by race/ethnicity, education, socioeconomic position, sexual orientation, and other social factors have continued to persist, and in some contexts, even increase over time. Historically, research has focused strongly on understanding individual-level factors that contribute to disparities in the diet; however, there is growing recognition that social and structural determinants of health are key drivers and have important implications for improving population health, policy, and advancing health equity.

Social determinants of health are the conditions in which people are born, grow, live, play, worship, work, and age. Social determinants are shaped by structural determinants, including the distribution of power and resources at local, national, and global levels. Although evidence indicates that social and structural determinants profoundly affect health and well-being across the lifespan more generally, research highlighting the multiple pathways that link social and particularly structural determinants of health and diet is limited. Additionally, few studies have explored the role nutrition and broader policies (such as policies related to equitable housing, poverty reduction, antiracism) can play in reducing/eliminating inequities in diet and have the potential to provide scalable solutions to close these gaps. International, national, and local evidence can help to inform our understanding of how non-health sectors and social policies may impact the dietary wellbeing of populations. We are especially interested in evidence that seeks to address historically marginalized and oppressed populations, pandemic-related impacts, and policy-relevant solutions.

We invite investigators to contribute original research (empirical and theoretical) and systematic reviews that will further broaden our understanding of the cultural, economic, political, and social factors that contribute to, or may decrease, health inequities. Papers that include qualitative, quantitative, or mixed methods are welcome, as are papers that discuss the design, implementation, and evaluation of behavioral, environmental, systems, and policy interventions. An important aspect of every manuscript selected for inclusion in the Special Issue will focus on social and structural determinants of health and/or applications of research findings to promote health equity. Potential topics include but are not limited to:

Papers that discuss, refine, or test theoretical models specifying the relationship between social determinants and dietary behaviors and related health outcomes;
Papers that emphasize an intersectional approach (e.g., race, gender, and social class) in advancing our understanding of social determinants and dietary behaviors and related health outcomes;
Papers that highlight how social determinants have implications for the individual- (e.g., discrimination), place- (e.g., urbanicity), and community-oriented (e.g., segregation) factors and their contribution to dietary behaviors and related health outcomes;
Papers building on natural experiment designs;
Descriptions of epidemiological studies that examine relationships between social and structural determinants and dietary behaviors and related health outcomes;
Descriptions of intervention studies that target social and structural determinants of health to improve dietary behaviors and related health outcomes;
Papers that advance our understanding of how intrapersonal, cultural, and social, and structural factors work together to shape the health of communities disproportionately impacted by COVID-19.

Prof. Dr. Angela Odoms-Young
Dr. Tamara Dubowitz
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

dietary patterns
structural determinants
health equity
COVID-19
underserved populations
malnutrition
dietary behaviors
pandemic

Published Papers (10 papers)

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Research

10 pages, 257 KiB

Open AccessArticle

What Is Associated with Changes in Food Security among Low-Income Residents of a Former Food Desert?

by Jonathan Cantor, Bonnie Ghosh-Dastidar, Gerald Hunter, Matthew Baird, Andrea S. Richardson, Sameer Siddiqi and Tamara Dubowitz

Nutrients 2022, 14(24), 5242; https://doi.org/10.3390/nu14245242 - 09 Dec 2022

Cited by 1 | Viewed by 2421

Abstract

Lack of geographic access to foods has been postulated as a cause for food insecurity, which has been linked to poor nutrition, obesity, and chronic disease. Building on an established cohort of randomly selected households from a low-income, predominantly Black neighborhood, we examined household food security, distance to where study participants reported doing their major food shopping, and prices at stores where they shopped. Data from the Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health study for years 2011, 2014 and 2018 was limited to residents of the neighborhood that began as a food desert (i.e., low access to healthy foods), but acquired a full-service supermarket in 2013. We calculated descriptive statistics and compared study participants in the former food desert neighborhood whose food security improved to those whose food security did not improve across survey waves. We estimated cross sectional linear regressions using all waves of data to assess food security level among study participants. Distance to major food shopping store was positively associated with food security (p < 0.05) while food-store prices were not significantly associated with food security. Findings suggest that for predominantly low-income residents, food secure individuals traveled further for their major food shopping. Full article

(This article belongs to the Special Issue The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle)

13 pages, 1585 KiB

Open AccessArticle

Assessing the Influence of Food Insecurity and Retail Environments as a Proxy for Structural Racism on the COVID-19 Pandemic in an Urban Setting

by Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Kathryn A. G. Knoff, Hadis Dastgerdizad, Noel Kulik, James Mallare, Kibibi Blount-Dorn and Winona Bynum

Nutrients 2022, 14(10), 2130; https://doi.org/10.3390/nu14102130 - 20 May 2022

Cited by 6 | Viewed by 3036

Abstract

A collaborative partnership launched the Great Grocer Project (GGP) in March 2021 in Detroit, Michigan where health inequities, including deaths due to COVID-19, have historically been politically determined and informed by socially entrenched norms. Institutional and structural racism has contributed to a lack of diversity in store ownership among Detroit grocers and limited access to high-quality, affordable healthy foods as well as disparate food insecurity among Detroit residents. The GGP seeks to promote Detroit’s healthy grocers to improve community health and economic vitality through research, programs, and policies that have the potential to advance health equity. A cross-sectional design was used to explore relationships between scores from the Nutrition Environment Measures Surveys-Stores (NEMS-S) in 62 stores and city-level data of COVID-19 cases and deaths as well as calls to 211 for food assistance. Regression and predictive analyses were conducted at the ZIP code level throughout the city to determine a relationship between the community food environment and food insecurity on COVID-19 cases and deaths. COVID-19 cases and deaths contributed to greater food insecurity. The use of ZIP code data and the small sample size were limitations within this study. Causation could not be determined in this study; therefore, further analyses should explore the potential effects of individual grocery stores on COVID-related outcomes since a cluster of high-scoring NEMS-S stores and calls to 211 for food security resources inferred a potential protective factor. Poor nutrition has been shown to be associated with increased hospitalizations and deaths due to COVID-19. It is important to understand if a limited food environment can also have a negative effect on COVID-19 rates and deaths. Lessons learned from Detroit could have implications for other communities in using food environment improvements to prevent an uptick in food insecurity and deaths due to COVID-19 and other coronaviruses. Full article

(This article belongs to the Special Issue The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle)

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23 pages, 1835 KiB

Open AccessArticle

How Does the Gus Schumacher Nutrition Incentive Program Work? A Theory of Change

by Kirsten H. Leng, Amy L. Yaroch, Nadine Budd Nugent, Sarah A. Stotz and James Krieger

Nutrients 2022, 14(10), 2018; https://doi.org/10.3390/nu14102018 - 11 May 2022

Cited by 10 | Viewed by 3526

Abstract

Increased fruit and vegetable (FV) intake is associated with decreased risk of nutrition-related chronic diseases. Sociodemographic disparities in FV intake indicate the need for strategies that promote equitable access to FVs. The United States Department of Agriculture’s Gus Schumacher Nutrition Incentive Program (GusNIP) supports state and local programs that offer nutrition incentives (NIs) that subsidize purchase of FVs for people participating in the Supplemental Nutrition Assistance Program (SNAP). While a growing body of research indicates NIs are effective, the pathways through which GusNIP achieves its results have not been adequately described. We used an equity-focused, participatory process to develop a retrospective Theory of Change (TOC) to address this gap. We reviewed key program documents; conducted a targeted NI literature review; and engaged GusNIP partners, practitioners, and participants through interviews, workshops, and focus groups in TOC development. The resulting TOC describes how GusNIP achieves its long-term outcomes of increased participant FV purchases and intake and food security and community economic benefits. GusNIP provides NIs and promotes their use, helps local food retailers develop the capacity to sell FVs and accept NIs in accessible and welcoming venues, and supports local farmers to supply FVs to food retailers. The TOC is a framework for understanding how GusNIP works and a tool for improving and expanding the program. Full article

(This article belongs to the Special Issue The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle)

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14 pages, 291 KiB

Open AccessArticle

Analysis of Self-Regulation of Eating Behaviors within Polish Adolescents’ COVID-19 Experience (PLACE-19) Study

by Dominika Guzek, Dominika Skolmowska and Dominika Głąbska

Nutrients 2022, 14(8), 1679; https://doi.org/10.3390/nu14081679 - 18 Apr 2022

Cited by 7 | Viewed by 1867

Abstract

The self-regulation of eating behaviors (suppression of behavioral short-term impulse to consume food products in the interest of pursuing long-term weight goals), has been an important determinant for adopting a healthy lifestyle in the period of the COVID-19 pandemic in adults, but there have been no such studies conducted in the population of adolescents in this period. The aim of the presented study is to analyze self-regulation of eating behaviors in the population-based sample of Polish adolescents within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study. The Self-Regulation of Eating Behavior Questionnaire (SREBQ) was used to assess self-regulation of eating behaviors in the studied population of 1126 Polish adolescents (818 females and 308 males), aged 15–20, recruited based on a random quota sampling within a national sample. Based on the screening questions of the SREBQ, 145 individuals were excluded from the analysis. The participants of the study were categorized based on their gender, body mass index, body mass index change during the COVID-19 pandemic, and food products declared as tempting. The major factors associated with SREBQ score were body mass index change and tempting food products. The respondents losing weight during the COVID-19 pandemic were characterized by a higher SREBQ score than those maintaining stable body mass or gaining weight (3.4 vs. 3.2 vs. 3.2; p = 0.0001). The respondents declaring both sweet and salty food products as tempting were characterized by a lower SREBQ score than those declaring only sweet, only salty, or declaring no tempting products (3.2 vs. 3.4 vs. 3.4 vs. 3.4; p < 0.0001). The major factors associated with SREBQ categories were gender, body mass index change, and tempting food products. A higher share of respondents characterized by a high self-regulation of eating behaviors was observed for males than for females (27.4% vs. 18.8%; p = 0.0142); for respondents losing weight during the COVID-19 pandemic than for respondents gaining weight (25.9% vs. 15.5%; p = 0.0423); as well as for respondents declaring no tempting products than those declaring both sweet and salty food products (38.3% vs. 18.2%; p < 0.0001). It was concluded that the self-regulation of eating behaviors in adolescents is closely associated with food products perceived as tempting by them, as well as with gender. During the COVID-19 pandemic, the low self-regulation of eating behaviors was a significant determinant of the body mass gain. Taking this into account, female adolescents characterized by a low self-regulation of eating behaviors especially should be subjected to a dedicated intervention program to prevent overweight and obesity. Full article

(This article belongs to the Special Issue The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle)

11 pages, 257 KiB

Open AccessArticle

Change in Employment Status Due to the COVID-19 Pandemic, SNAP Participation, and Household Food Insecurity among Black and Latino Adults in Illinois

by Chelsea R. Singleton, Olufemi Fabusoro, Margarita Teran-Garcia and Sandraluz Lara-Cinisomo

Nutrients 2022, 14(8), 1581; https://doi.org/10.3390/nu14081581 - 11 Apr 2022

Cited by 1 | Viewed by 2414

Abstract

The onset of the COVID-19 pandemic resulted in record-high unemployment rates. Black and Latino adults experienced disproportionately higher rates of unemployment. We aimed to examine associations between pandemic-related employment status change and household food insecurity among an economically diverse sample of Black and Latino adults in Illinois during the early months of the COVID-19 pandemic. Furthermore, we evaluated the significance of Supplemental Nutrition Assistance Program (SNAP) participation to determine if it modified associations. We analyzed cross-sectional data collected from 1,809 Black and Latino adults in two waves: May 2020 and June/July 2020. Participants listed their change in employment status as “lost job entirely”, “employed, but paid hours reduced”, “employed, but anticipate job lost”, or “no change”. Participants self-reported their SNAP status and completed the USDA’s six item U.S. Food Security Module to report household food security status. We used logistic regression to assess the significance of associations after controlling for socio-demographics. Approximately 15.5% of participants lost their job entirely, 25.2% were SNAP participants, and 51.8% reported low food security (LFS). All changes in employment were significantly associated with increased odds of LFS after adjusting for socio-demographics. SNAP participants who lost their job had higher odds of LFS (OR: 4.69; 95% CI: 2.69–8.17) compared to non-participants who lost their job (OR: 2.97; 95%: 1.95–4.52). In summary, we observed strong associations between changes in employment and household food insecurity, particularly among SNAP participants, which underscores the pandemic’s impact on low-income and minority populations. Full article

(This article belongs to the Special Issue The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle)

16 pages, 360 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on Food Consumption Behavior: Based on the Perspective of Accounting Data of Chinese Food Enterprises and Economic Theory

by Chung-Cheng Yang, Yahn-Shir Chen and Jianxiong Chen

Nutrients 2022, 14(6), 1206; https://doi.org/10.3390/nu14061206 - 12 Mar 2022

Cited by 14 | Viewed by 3457

Abstract

Since the outbreak of the COVID-19 pandemic, the rapid spread of COVID-19 around the world has become one of the main focuses of concern in almost every country, and governments have taken numerous measures to prevent/mitigate the spread of the disease. As an essential social determinant, COVID-19 has significantly impacted consumers’ food consumption behavior and healthy eating habits/behaviors. The purpose of this study is to analyze the impact of COVID-19 on food consumption behavior, and the main goal was to assess the possible problems (such as food waste and weight gain) caused by changes in food consumption behavior during the pandemic. Based on the accounting data of Chinese enterprises found in the China Stock Market and Accounting Research (CSMAR) database, this study uses economic theory and the translog function to conduct an average partial effect (APE) analysis of the pandemic, and finds that the COVID-19 pandemic has increased Chinese people’s overall food consumption, and the consumption of food from large food enterprises has increased even more (APE = 0.11 vs. APE = 0.31). This study suggests that food waste and weight gain in the Chinese population may be more severe during the pandemic, and it is necessary to enhance food management and weight management through multiple pathways. Full article

(This article belongs to the Special Issue The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle)

15 pages, 1113 KiB

Open AccessArticle

Longer Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children Is Not Associated with Reduced Sugar-Sweetened Beverage Intake among Black Participants

by Christopher E. Anderson, Catherine E. Martinez, Keelia O’Malley, Lorrene D. Ritchie and Shannon E. Whaley

Nutrients 2022, 14(5), 1048; https://doi.org/10.3390/nu14051048 - 28 Feb 2022

Cited by 1 | Viewed by 2261

Abstract

This study assessed relationships of duration of family Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participation with racial/ethnic disparities in child sugar-sweetened beverage (SSB) and water intake. Child beverage intake and family duration on WIC were collected during three cross-sectional surveys of WIC-participating families in Los Angeles County, California (2014, 2017 and 2020; n = 11,482). The associations of family duration of WIC participation, a proxy for the amount of WIC services received, with daily intake of total SSBs, fruit-flavored SSBs and water were assessed in race/ethnicity strata with multivariable negative binomial and Poisson regression models. Among English-speaking Hispanic children, those of families reporting 10 years of WIC participation consumed 33% and 27% fewer servings of total and fruit-flavored SSBs compared to those of families reporting 1 year on WIC. Among Black children, those from families reporting 5 and 10 years of participation in WIC consumed 33% and 45% more daily servings of fruit-flavored SSBs than those from families reporting 1 year on WIC. Disparities in daily total and fruit-flavored SSB intake between Black and White children increased with longer family duration on WIC. Duration of family WIC participation is associated with healthier beverage choices for infants and children, but does not appear to be equally beneficial across racial/ethnic groups in Los Angeles County. Full article

(This article belongs to the Special Issue The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle)

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16 pages, 268 KiB

Open AccessArticle

“Now I Feel a Little Bit More Secure”: The Impact of SNAP Enrollment on Older Adult SSI Recipients

by Katie Savin, Alena Morales, Ronli Levi, Dora Alvarez and Hilary Seligman

Nutrients 2021, 13(12), 4362; https://doi.org/10.3390/nu13124362 - 04 Dec 2021

Cited by 4 | Viewed by 3252

Abstract

In June 2019, California expanded Supplemental Nutrition Assistance Program (SNAP) eligibility to Supplemental Security Income (SSI) beneficiaries for the first time. This research assesses the experience and impact of new SNAP enrollment among older adult SSI recipients, a population characterized by social and economic precarity. We conducted semi-structured, in-depth interviews with 20 SNAP participants to explore their experiences with new SNAP benefits. Following initial coding, member-check groups allowed for participants to provide feedback on preliminary data analysis. Findings demonstrate that SNAP enrollment improved participants’ access to nutritious foods of their choice, contributed to overall budgets, eased mental distress resulting from poverty, and reduced labor spent accessing food. For some participants, SNAP benefit amounts were too low to make any noticeable impact. For many participants, SNAP receipt was associated with stigma, which some considered to be a social “cost” of poverty. Increased benefit may be derived from pairing SNAP with other public benefits. Together, the impacts of and barriers to effective use of SNAP benefits gleaned from this study deepen our understanding of individual- and neighborhood-level factors driving health inequities among low-income, disabled people experiencing food insecurity and SNAP recipients. Full article

(This article belongs to the Special Issue The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle)

14 pages, 790 KiB

Open AccessArticle

The Relationship between Political, Economic, Social, and Cultural Vulnerability and Food Insecurity among Adults Aged 50 Years and Older

by Patrick J. Brady, Natoshia M. Askelson, Sato Ashida, Faryle Nothwehr, Brandi Janssen and David Frisvold

Nutrients 2021, 13(11), 3896; https://doi.org/10.3390/nu13113896 - 29 Oct 2021

Cited by 5 | Viewed by 2836

Abstract

Individuals experience food insecurity when they worry about or have limited access to nutritious foods. Food insecurity negatively impacts older adults’ health. Social exclusion is a theoretical framework describing how unequal access to rights, resources, and capabilities results in political, economic, social, and cultural vulnerability, which leads to health disparities. We used the Health and Retirement Study to cross-sectionally examine associations between vulnerability and experiencing food insecurity in adults 50 years and older using the social exclusion framework. We tested the association between experiencing food insecurity and indicators of political, economic, social, and cultural vulnerability using logistic regression controlling for demographic and health-related factors. Analyses were performed with all respondents and sub-group of respondents with incomes less than 400% of the federal poverty level (FPL). Assets (OR = 0.97 in both samples), income (OR = 0.85, 0.80 in 400% FPL sub-sample), perceived positive social support from other family (OR = 0.86, 0.84 in 400% FPL sub-sample), and perceived everyday discrimination (OR = 1.68, 1.82 in 400% FPL sub-sample) were significantly associated with food insecurity. Perceived positive social support from spouses, children, or friends and U.S. citizenship status were not significantly associated with food insecurity. Further research is needed to define and measure each dimension of vulnerability in the social exclusion framework. Interventions and policies designed to prevent food insecurity should address these vulnerabilities. Full article

(This article belongs to the Special Issue The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle)

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10 pages, 768 KiB

Open AccessCommunication

A Mixed Methods Case Study of Food Shopping in a Community with High Infant Mortality

by Sarah Evenosky, Eleanor Lewis and Katherine I. DiSantis

Nutrients 2021, 13(11), 3845; https://doi.org/10.3390/nu13113845 - 28 Oct 2021

Viewed by 1984

Abstract

In the U.S., preterm birth disproportionately impacts certain racial/ethnic groups, with Black women experiencing preterm birth at a rate 50% higher than other groups. Among the numerous factors that likely contribute to these increased rates are neighborhood characteristics, such as food environment. In this mixed-methods case study, we evaluated how pregnant women living in a predominately minority, lower income community with high preterm birth rates navigate and perceive their food environment. Qualitative interviews were performed to assess perceptions of food environment (n = 7) along with geographic and observational assessments of their food environment. Participants traveled an average of 2.10 miles (SD = 1.16) and shopped at an average of 3 stores. They emphasized the importance of pricing and convenience when considering where to shop and asserted that they sought out healthier foods they thought would enhance their pregnancy health. Observational assessments of stores’ nutrition environment showed that stores with lower nutritional scores were in neighborhoods with greater poverty and a higher percent Black population. Future policies and programmatic efforts should focus on improving nutrition during pregnancy for women living in communities with high rates of poor birth outcomes. Availability, affordability, and accessibility are key aspects of the food environment to consider when attempting to achieve birth equity. Full article

(This article belongs to the Special Issue The Influence of Social Determinants, Nutrition Policy on Healthy Eating Lifestyle)

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