TY - JOUR
T1 - Food system dynamics structuring nutrition equity in racialized urban neighborhoods
AU - Freedman, Darcy A.
AU - Clark, Jill K.
AU - Lounsbury, David W.
AU - Boswell, Lena
AU - Burns, Marilyn
AU - Jackson, Michelle B.
AU - Mikelbank, Kristen
AU - Donley, Gwendolyn
AU - Worley-Bell, La Queta
AU - Mitchell, Jodi
AU - Ciesielski, Timothy H.
AU - Embaye, Milen
AU - Lee, Eun Kyung
AU - Roche, Abigail
AU - Gill, India
AU - Yamoah, Owusua
N1 - Publisher Copyright:
© 2021 The Author(s). Published by Oxford University Press on behalf of the American Society for Nutrition.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Background: The food system is a social determinant of health and a leverage point for reducing diet-related racial inequities. Yet, food system interventions have not resulted in sustained improvement in dietary outcomes for underrepresented minorities living in neighborhoods with a history of disinvestment. Research is needed to illuminate the dynamics structuring food systems in racialized neighborhoods to inform intervention development. Objectives: To conduct participatory research examining the complexity and inequity of food systems in historically redlined neighborhoods to identify feedback mechanisms to leverage in efforts to transform system outcomes for racial equity. Methods: We conducted a mixed-methods study in Cleveland, Ohio, USA from 2018 to 2021 using participatory system dynamic modeling with 30 academic and community partners, in-depth qualitative interviews with 22 key stakeholders, and public convenings with 250 local food policy council affiliates. Data were synthesized into causal loop diagrams depicting feedback mechanisms reinforcing or balancing neighborhood-level food system dynamics. Results: We identified 10 feedback mechanisms structuring nutrition equity, which was identified as a meta-goal for food systems in racialized neighborhoods. Feedback mechanisms were organized in 3 domains: 1) meeting basic food needs with dignity (i.e., side hustle, government benefits, emergency food assistance, stigma, and stereotypes); 2) local food supply and demand dynamics (i.e., healthy food retail, job security, food culture, and norms); and 3) community empowerment and food sovereignty (i.e., community power, urban agriculture, risk of gentrification). Five exogenous factors moderate feedback dynamics: Neighborhood crisis, neighborhood investments, household costs, government benefit funding, and voter participation. Conclusions: We identified nutrition equity as an overarching goal for local food systems, which reflects a state of having freedom, agency, and dignity in food traditions resulting in people and communities healthy in body, mind, and spirit. It is a transformative goal designed to spur system-level interventions that further racial equity through improved local food system dynamics.
AB - Background: The food system is a social determinant of health and a leverage point for reducing diet-related racial inequities. Yet, food system interventions have not resulted in sustained improvement in dietary outcomes for underrepresented minorities living in neighborhoods with a history of disinvestment. Research is needed to illuminate the dynamics structuring food systems in racialized neighborhoods to inform intervention development. Objectives: To conduct participatory research examining the complexity and inequity of food systems in historically redlined neighborhoods to identify feedback mechanisms to leverage in efforts to transform system outcomes for racial equity. Methods: We conducted a mixed-methods study in Cleveland, Ohio, USA from 2018 to 2021 using participatory system dynamic modeling with 30 academic and community partners, in-depth qualitative interviews with 22 key stakeholders, and public convenings with 250 local food policy council affiliates. Data were synthesized into causal loop diagrams depicting feedback mechanisms reinforcing or balancing neighborhood-level food system dynamics. Results: We identified 10 feedback mechanisms structuring nutrition equity, which was identified as a meta-goal for food systems in racialized neighborhoods. Feedback mechanisms were organized in 3 domains: 1) meeting basic food needs with dignity (i.e., side hustle, government benefits, emergency food assistance, stigma, and stereotypes); 2) local food supply and demand dynamics (i.e., healthy food retail, job security, food culture, and norms); and 3) community empowerment and food sovereignty (i.e., community power, urban agriculture, risk of gentrification). Five exogenous factors moderate feedback dynamics: Neighborhood crisis, neighborhood investments, household costs, government benefit funding, and voter participation. Conclusions: We identified nutrition equity as an overarching goal for local food systems, which reflects a state of having freedom, agency, and dignity in food traditions resulting in people and communities healthy in body, mind, and spirit. It is a transformative goal designed to spur system-level interventions that further racial equity through improved local food system dynamics.
KW - food security
KW - food systems
KW - health equity
KW - participatory research
KW - racial disparities
KW - system dynamics modeling
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U2 - 10.1093/ajcn/nqab380
DO - 10.1093/ajcn/nqab380
M3 - Article
C2 - 34792095
AN - SCOPUS:85128160755
SN - 0002-9165
VL - 115
SP - 1027
EP - 1038
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 4
ER -