Abstract
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Diet-related conditions such as obesity, diabetes mellitus, cardiovascular disease, and hypertension disproportionately impact minority and low-income populations compared to their White and more affluent counterparts. In 2010, an estimated 18.7% of African Americans ages 20 and older suffered from diabetes verses 10.2% of the Whites (U.S. Department of Health and Human Services, 2011
). Community-based participatory research has been increasingly viewed as an effective approach to address disparities and improve nutrition outcomes in communities of color. To better understand the successes and challenges of such initiatives, this special issue highlights studies that critically analyze community–university projects related to nutrition education and food access that attempt to promote health in communities of color.
KEYWORDS
health disparities,
diet,
food access,
community–university partnerships,
race,
health promotion
There is increasing scholarly interest in the importance of community-academic partnerships in U.S. health research, particularly in addressing health disparities and improving health among African American and Latino populations. Although communities of color have been historically targeted for participation in health research, they continue to be disproportionately impacted by a variety of diet-related diseases—including diabetes mellitus, cardiovascular disease, and hypertension. In 2010, an estimated 18.7% of African Americans ages 20 and older suffered from diabetes verses 10.2% of the White population (U.S. Department of Health and Human Services, 2011). Diabetes death rates for African Americans are a staggering 40.4% compared to 18.4% for non-Hispanic Whites (Kochanek et al., 2012
). Given these disparities, many university health researchers have reached beyond traditional health research paradigms toward transformative research that employs community engagement and practice to improve health equity. Community-based participatory research (CBPR), a form of research that promotes benefits to targeted research populations through collaboration, recognition of power dynamics between researchers and those researched, and mutually determined goals and objectives, is quickly changing approaches to knowledge production for health research. The importance of CBPR and translational research moves beyond localized interventions and has implications for policymaking to address the historical social, cultural, economic, and political origins of racial health disparities.
Community organizations and residents, in partnership with university researchers, are increasingly engaged in health promotion projects and research efforts focused on nutrition education and expanding healthy food access. This special issue explores a variety of community–university projects focused on improving access to and consumption of healthy foods within communities of color. The issue seeks to better understand factors that contribute to the development and implementation of effective interventions, and most importantly, how universities and colleges can work in collaboration with communities of color to engage in mutually beneficial health research. The six articles outlined below analyze a variety of CBPR partnerships that collaboratively engage university researchers with community groups to understand barriers to healthy food access and innovative responses to such challenges. All the articles in this special issue help provide additional insight into the role of community engaged research in expanding food access, nutrition literacy, and health equity.
In rural Pennsylvania, Dailey et al.’s study reports outcomes of their partnership with a local food policy council to promote participation among low-income Latino immigrants in a farmers market and food and nutrition-based community activities using financial incentives. Results of this mixed-method study suggest the importance of collaboration for increasing community capacity to promote the consumption of fresh produce.
In Southern Louisiana, Kennedy et al.’s study looks at how interventions implemented at community centers play an important role in promoting health for African Americans struggling with high rates of obesity and food security. Their findings have implications for further understanding of how preventing weight gain can be supported through center programs that contribute to stress reduction and building self-esteem and to improving community residents’ quality of life.
Scammell et al.’s study demonstrates how communityengaged research in partnership with community-based organizations produces a clearer understanding of the barriers to healthy eating and physical activity for public housing residents in Boston. The study highlights how residents perceive the need to balance the quality and cost of food with challenges with transportation necessary to reach perceived healthy food options. These challenges are exacerbated by the ubiquity of unhealthy foods and local fast food outlets in close proximity to residents’ housing.
Spaulding et al.’s reports on their study targeting predominantly African-American youth in the urban southwestern United States. The study highlights challenges with understanding and using food labels to guide the youth’s eating decisions. African-American youth particularly had difficulty interpreting the concepts of calories and energy balance. Spaulding et al.’s central finding emphasizes the connection between levels of education achievement, literacy, and numeracy and the making of informed healthy food choices among urban youth of color.
In Chicago, Hatchett, Brown, Hopkins, Larsen, and Fournier provide insights into the impact of urban agriculture programs on those who participate as gardeners and staff. As part of a multiprogrammatic partnership, the study illuminates how cultural complexities surrounding the concept of growing ones own food are understood in the context of social and economic challenges faced by research participants. Most importantly, the study emphasizes that urban agriculture programs have the potential to do much more than improve food access in economically distressed African-American communities. They help residents reconnect with place and heritage and encourage entrepreneurship and community leadership development.
Lastly, Goddu, Roberson, Raffel, Chin, and Peek’s contribution seeks to address the critical challenges faced by African-American patients with diabetes in Chicago. Diabetes-related deaths on the South Side of Chicago are almost three times higher than on the predominantly White North Side. Their project utilizes Food Rx, a prescription to encourage healthy eating, provide nutrition education, link participants to community resources, and reduce financial barriers to accessing nutritious foods. The first publication to describe a food prescription program, the article concludes this special issue by highlighting how community–university partnerships can offer innovative forms of collaborative intervention that promote culturally appropriate behavior change aimed at reducing growing racial health disparities related to food.
REFERENCES
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1. Kochanek, K. D., Xu, J., Murphy, S. L., Jiaquan, X., Sherry, L., Murphy, B. S., … Hsiang-Ching, K. (2012). Deaths: Final Data for 2009. National Vital Statistics Reports, 60(3). Hyattsville, MD: National Center for Health Statistics.
2. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2011). National diabetes fact sheet: National estimates and general information on diabetes and prediabetes in the United States, 2011. Retrieved on from http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf