Contributions of Structural Racism to the Food Environment: A Photovoice Study of Black Residents With Hypertension in Baltimore, MD.
Contributions of Structural Racism to the Food Environment: A Photovoice Study of Black Residents With Hypertension in Baltimore, MD.
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DOI：
10.1161/circoutcomes.122.009301
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发表时间：
2022-11
影响因子：
6.9
通讯作者：
Crews, Deidra C.
中科院分区：
文献类型：
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作者：
Hines, Anika L.;Brody, Rebecca;Zhou, Zehui;Collins, Sarah V.;Omenyi, Chiazam;Miller, Edgar R.;Cooper, Lisa A.;Crews, Deidra C.
关键词：
美国黑人过度暴露于恶劣的食品环境和粮食不安全状况，可能部分解释了种族和族裔之间严重的慢性病差异。黑人居民和他们的食物环境之间的一系列复杂的结构因素和相互作用，包括商店类型、数量、距离和商品质量以及商店内消费者的相互作用，可能会影响营养行为，并导致更高的心血管和肾脏疾病风险。我们使用Photovoice方法，通过2019年8月至11月期间患有高血压的黑人居民的视角，探索马里兰州巴尔的摩的食物环境。24名参与者参加了这项研究（平均年龄：65.1岁，67%为女性）。在短暂的摄影训练后，参与者拍摄了他们的食物环境的照片，他们在五周的时间里以小的焦点小组讨论这些照片。对讨论进行录音，并使用逐行归纳方法对紧急主题进行分析。然后，主题被组织成一个集体叙事。研究结果描述了食物环境的物理和社会特征，以及参与者对其起源和整体和世代健康影响的看法。该研究说明了更广泛的社会政治环境、食品领域商店的质量和数量以及由于种族和/或社会阶层而被边缘化的居民和消费者与食品环境接触的方式之间的相互关系。从数据中可以得出以下元主题：a)社会不公正；B)结构性种族主义和阶级主义；C)人际种族主义；D)代际效应；e)不信任;F)社会项目；g)基于社区资产的方法，包括宣传和公民参与。了解居民对食品环境对其健康的基础和影响的看法，可能有助于利益相关者与居民共同制定多层次干预措施，以改善受差异影响人群获得健康食品和健康结果的机会。
Disproportionate exposure to poor food environments and food insecurity among Black Americans may partially explain critical chronic disease disparities by race and ethnicity. A complex set of structural factors and interactions between Black residents and their food environments, including store types, quantity, proximity, and quality of goods and consumer interactions within stores, may affect nutritional behaviors and contribute to higher cardiovascular and kidney disease risk. We used the Photovoice methodology to explore the food environment in Baltimore, MD, through the perspectives of Black residents with hypertension between August to November 2019. Twenty-four participants were enrolled in the study (mean age: 65.1 years; 67% female). After a brief photography training, participants captured photos of their food environment, which they discussed in small focus groups over the course of 5 weeks. Discussions were audiotaped and analyzed for emergent themes using a line-by-line inductive approach. Themes were, then, organized into a collective narrative. Findings describe physical and social features of the food environment as well as participants’ perceptions of its origins and holistic and generational health effects. The study illustrates the interrelationships among the broader socio-political environment, the quality and quantity of stores in the food landscape, and the ways in which they engage with the food environment as residents and consumers who have been marginalized due to their race and/or social class. The following meta-themes emerged from the data: a) social injustice; b) structural racism and classism; c) interpersonal racism; d) generational effects; e) mistrust; f) social programs; and g) community asset-based approaches, including advocacy and civic engagement. Understanding residents’ perceptions of the foundations and effects of the food environment on their health may help stakeholders to co-create multi-level interventions alongside residents to improve access to healthy food and health outcomes among disparities affected populations.