"We Want to Eat and be Healthy just like Everybody Else:" How Social Infrastructures Affect Nutrition Equity in a Racialized Urban Community in the United States

Gabby Headrick; Kiera Abdul; Shireen Guru; Allison DeHonney; Alyssa J Moran; Pamela J Surkan; Samina Raja; Yeeli Mui

doi:10.1016/j.cdnut.2024.102106

"We Want to Eat and be Healthy just like Everybody Else:" How Social Infrastructures Affect Nutrition Equity in a Racialized Urban Community in the United States

Curr Dev Nutr. 2024 Feb 21;8(3):102106. doi: 10.1016/j.cdnut.2024.102106. eCollection 2024 Mar.

Authors

Gabby Headrick¹, Kiera Abdul², Shireen Guru³, Allison DeHonney⁴, Alyssa J Moran², Pamela J Surkan², Samina Raja³, Yeeli Mui²

Affiliations

¹ The Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
² The Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
³ The University at Buffalo School of Architecture and Planning, The University at Buffalo State University of New York, Buffalo, NY, United States.
⁴ Urban Fruits & Veggies, Buffalo, NY, United States.

Abstract

Background: Food security and nutrition equity, 2 social determinants of health, are impacted by the coronavirus disease 2019 (COVID-19) pandemic and the racialization of urban communities. Few studies to date have examined how the use of social infrastructures in the United States during COVID-19 affected the ability to achieve food security and nutrition equity.

Objectives: To describe how the use of social infrastructures impacts food security and nutrition equity in a majority Black and urban community in the United States.

Methods: Semistructured in-depth interviews were conducted with 40 low-income, urban, and predominately Black people living in Buffalo, New York in May-July 2022.A thematic analysis using a phronetic iterative approach informed by the Social Ecological Model, Walsh's Family Resilience Framework, and a framework focused on the advancement of nutrition equity.

Results: We identified 9 themes mapped across 3 interrelated domains that impact nutrition equity, including 1) meeting food needs with dignity, 2) supply and demand for fresh and healthy foods, and 3) community empowerment and food sovereignty. We found that people used coping strategies, such as food budgeting and cooking skills, paired with different social infrastructures to meet food needs. People commonly used the Supplemental Nutrition Assistance Program and food pantries to meet food needs over receiving support from family members or friends outside of the household. Poverty, challenges accessing and affording healthy food, and the inability to reciprocate support to others undermined the advancement of nutrition equity despite social infrastructures being available for use. Historical and ongoing acts of disempowerment and disinvestment also hindered the advancement of nutrition equity.

Conclusions: Sustained, community-led investment is needed to address structural inequities preventing the advancement of nutrition equity. Social infrastructures should be expanded to inclusively support low-income populations, so wealth generation is possible to address the root cause of food insecurity.

Keywords: SNAP; equity; food security; social infrastructures; social networks; urban.