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Nisbett N, Harris J, Backholer K, Baker P, Jernigan VBB, Friel S. Holding no-one back: The Nutrition Equity Framework in theory and practice. GLOBAL FOOD SECURITY 2022; 32:100605. [PMID: 36873709 PMCID: PMC9983632 DOI: 10.1016/j.gfs.2021.100605] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Equity remains poorly conceptualised in current nutrition frameworks and policy approaches. We draw on existing literatures to present a novel Nutrition Equity Framework (NEF) that can be used to identify priorities for nutrition research and action. The framework illustrates how social and political processes structure the food, health and care environments most important to nutrition. Central to the framework are processes of unfairness, injustice and exclusion as the engine of nutrition inequity across place, time and generations, ultimately influencing both nutritional status and people's space to act. The NEF illustrates conceptually how action on the socio-political determinants of nutrition is the most fundamental and sustainable way of improving nutrition equity for everyone everywhere, through 'equity-sensitive nutrition'. Efforts must ensure, in the words of the Sustainable Development Goals, that not only is "no one left behind" but also that the inequities and injustices we describe do not hold anyone back from realising their right to healthy diets and good nutrition.
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Affiliation(s)
- Nicholas Nisbett
- Institute of Development Studies at the University of Sussex, UK
| | - Jody Harris
- Institute of Development Studies at the University of Sussex, UK.,World Vegetable Centre, Thailand
| | - Kathryn Backholer
- Deakin University, Geelong, Institute for Health Transformation, Victoria, Australia
| | - Philip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | | | - Sharon Friel
- School of Regulation and Global Governance, Australian National University, Australia
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Christiansen K, Gadhoke P, Pardilla M, Gittelsohn J. Work, worksites, and wellbeing among North American Indian women: a qualitative study. ETHNICITY & HEALTH 2019; 24:24-43. [PMID: 28393559 DOI: 10.1080/13557858.2017.1313964] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to understand what factors influenced work-family balance and related health behaviors among a sample of rural North American Indian women. We interviewed 89 women through both in-depth interviews and focus groups across four tribal communities in the American Southwest and Upper Midwest between July 2010 and August 2011. Interviews were transcribed, coded, and analyzed for emerging themes related to work- family demands placed on women and resources available to cope with those demands. Three prominent themes emerged: structural characteristics (the context of rural reservation life), role stressors (women's multiple and conflicting roles) and the influence of social support (communal nature of care in the family and institutional support in the workplace). We found that women in participating rural reservation communities often acted as primary caregivers for both immediate and extended family, and often placed the needs of others before themselves. The context of rural reservations, with high rates of unemployment, poverty, and chronic illnesses associated with the collective trauma of colonization, placed high demands on female caregivers. Social support from within the workplace, family, and cultural traditions helped some female caregivers balance the demands of home and work. Tribal worksites could be a resource for promoting health and work-life balance by being responsive to the particular demands placed on women that often interfere with engaging in positive health behaviors in general and tribal wellness programs in particular.
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Affiliation(s)
- Karina Christiansen
- a Department of Health Policy and Management , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Preety Gadhoke
- b Department of Pharmacy Administration and Public Health , College of Pharmacy and Health Sciences of St. John's University , Queens , USA
| | - Marla Pardilla
- c Center for Human Nutrition within the Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Joel Gittelsohn
- c Center for Human Nutrition within the Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
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Scott S, D'Silva J, Hernandez C, Villaluz NT, Martinez J, Matter C. The Tribal Tobacco Education and Policy Initiative: Findings From a Collaborative, Participatory Evaluation. Health Promot Pract 2016; 18:545-553. [PMID: 27744374 DOI: 10.1177/1524839916672632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While the reduction in the overall U.S. smoking prevalence has been declared one of the top 10 public health achievements of the past century, the growing disparity in smoking between American Indians and the general population is one of the biggest challenges of the 21st century. Minnesota in particular has very high smoking rates among American Indians (59%). Tribal Nations in Minnesota share a past of attempted cultural genocide and a present of restoring the strength of their cultural teachings, including the prominence of traditional tobacco as a sacred "first medicine." The Tribal Tobacco Education and Policy initiative works to address this complex and challenging context. This article describes results of a participatory evaluation from 2010 to 2013 in four Minnesota Tribal Nations-three Ojibwe and one Dakota. Tribal Tobacco Education and Policy coordinators used their cultural knowledge to develop community-level strategies, identifying appropriate strategies from best practices on tobacco advocacy, while drawing on the strengths of their own sovereignty and sacred tobacco traditions. Tribal coordinators generated support for policy change by conducting culturally relevant education, engaging tribal members, and nurturing relationships. This approach resulted in norm changes, practices toward restoring traditional tobacco, informal policies, and tribal resolutions to advance smoke-free policies.
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Affiliation(s)
- Sheryl Scott
- 1 Scott Consulting Partners LLC, Richland Center, WI, USA
| | | | | | | | | | - Chris Matter
- 4 Blue Cross and Blue Shield of Minnesota, Eagan, MN, USA
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Chief C, Sabo S, Clark H, Nez Henderson P, Yazzie A, Nahee J, Leischow SJ. Breathing clean air is Są'áh Naagháí Bik'eh Hózhóó (SNBH): a culturally centred approach to understanding commercial smoke-free policy among the Diné (Navajo People). Tob Control 2016; 25:i19-i25. [PMID: 27697944 PMCID: PMC5099227 DOI: 10.1136/tobaccocontrol-2016-053081] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/17/2016] [Indexed: 11/18/2022]
Abstract
Introduction Indigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide. Objective We describe the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy. Methods Focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy. Results Diné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments. Conclusions Indigenous-centred approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people.
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Affiliation(s)
- Carmenlita Chief
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Samantha Sabo
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Hershel Clark
- Black Hills Center for American Indian Health, Rapid City, South Dakota, USA
| | | | - Alfred Yazzie
- Black Hills Center for American Indian Health, Rapid City, South Dakota, USA
| | - Jacqueline Nahee
- Black Hills Center for American Indian Health, Rapid City, South Dakota, USA
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Klepeis NE, Dhaliwal N, Hayward G, Acevedo-Bolton V, Ott WR, Read N, Layton S, Jiang R, Cheng KC, Hildemann LM, Repace JL, Taylor S, Ong SL, Buchting FO, Lee JP, Moore RS. Measuring Indoor Air Quality and Engaging California Indian Stakeholders at the Win-River Resort and Casino: Collaborative Smoke-Free Policy Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13010143. [PMID: 26805860 PMCID: PMC4730534 DOI: 10.3390/ijerph13010143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 01/11/2016] [Accepted: 01/13/2016] [Indexed: 11/24/2022]
Abstract
Most casinos owned by sovereign American Indian nations allow smoking, even in U.S. states such as California where state laws restrict workplace smoking. Collaborations between casinos and public health workers are needed to promote smoke-free policies that protect workers and patrons from secondhand tobacco smoke (SHS) exposure and risks. Over seven years, a coalition of public health professionals provided technical assistance to the Redding Rancheria tribe in Redding, California in establishing a smoke-free policy at the Win-River Resort and Casino. The coalition provided information to the casino general manager that included site-specific measurement of employee and visitor PM2.5 personal exposure, area concentrations of airborne nicotine and PM2.5, visitor urinary cotinine, and patron and staff opinions (surveys, focus groups, and a Town Hall meeting). The manager communicated results to tribal membership, including evidence of high SHS exposures and support for a smoke-free policy. Subsequently, in concert with hotel expansion, the Redding Rancheria Tribal Council voted to accept a 100% restriction of smoking inside the casino, whereupon PM2.5 exposure in main smoking areas dropped by 98%. A 70% partial-smoke-free policy was instituted ~1 year later in the face of revenue loss. The success of the collaboration in promoting a smoke-free policy, and the key element of air quality feedback, which appeared to be a central driver, may provide a model for similar efforts.
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Affiliation(s)
- Neil E Klepeis
- Education, Training, and Research, Inc., Scotts Valley, CA 95066, USA.
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
- Neil Klepeis and Associates, Environmental Health Research and Consulting, Aromas, CA 95004, USA.
| | - Narinder Dhaliwal
- Education, Training, and Research, Inc., Scotts Valley, CA 95066, USA.
| | - Gary Hayward
- Win-River Resort & Casino, Redding Rancheria, Redding, CA 96001, USA.
| | - Viviana Acevedo-Bolton
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
| | - Wayne R Ott
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
| | - Nathan Read
- Shasta County Public Health Tobacco Education Program, Shasta County Public Health, Redding, CA 96001, USA.
| | - Steve Layton
- Shasta County Public Health Tobacco Education Program, Shasta County Public Health, Redding, CA 96001, USA.
| | - Ruoting Jiang
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
| | - Kai-Chung Cheng
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
| | - Lynn M Hildemann
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
| | - James L Repace
- Repace Associates, Inc., Secondhand Smoke Consultants, Bowie, MD 20720, USA.
| | - Stephanie Taylor
- Shasta County Public Health Tobacco Education Program, Shasta County Public Health, Redding, CA 96001, USA.
| | - Seow-Ling Ong
- Education, Training, and Research, Inc., Scotts Valley, CA 95066, USA.
| | | | - Juliet P Lee
- Prevention Research Center, Pacific Institute for Research and Evaluation (PIRE), Oakland, CA 94612, USA.
| | - Roland S Moore
- Prevention Research Center, Pacific Institute for Research and Evaluation (PIRE), Oakland, CA 94612, USA.
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Blue Bird Jernigan V, Peercy M, Branam D, Saunkeah B, Wharton D, Winkleby M, Lowe J, Salvatore AL, Dickerson D, Belcourt A, D'Amico E, Patten CA, Parker M, Duran B, Harris R, Buchwald D. Beyond health equity: achieving wellness within American Indian and Alaska Native communities. Am J Public Health 2015; 105 Suppl 3:S376-9. [PMID: 25905823 DOI: 10.2105/ajph.2014.302447] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Valarie Blue Bird Jernigan
- Valarie Blue Bird Jernigan and Alicia L. Salvatore are with the College of Public Health, University of Oklahoma Health Sciences Center, Tulsa. Michael Peercy and Bobby Saunkeah are with the Health Services Division, Chickasaw Nation of Oklahoma, Ada. Dannielle Branam and David Wharton are with the Health Services Division, Choctaw Nation of Oklahoma, Talihina. Marilyn Winkleby is with the Stanford Prevention Research Center, Stanford School of Medicine, Stanford, CA. John Lowe is with the Christine E. Lynn College of Nursing, Florida Atlantic University, Gainesville. Daniel Dickerson is with the Integrated Substance Abuse Programs, University of California School of Medicine, Los Angeles. Annie Belcourt is with the Department of Health Services, University of Montana, Missoula. Elizabeth D'Amico is with the RAND Corporation, Santa Monica, CA. Christi A. Patten is with the Mayo Clinic, Rochester, MN. Myra Parker and Bonnie Duran are with the Indigenous Wellness Research Institute, University of Washington, Seattle. Raymond Harris and Dedra Buchwald are with the Partnerships for Native Health, University of Washington
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Pritsos CA, Muthumalage T. The impact of commonly used air filters in eliminating the exposure to secondhand smoke constituents. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2015; 17:543-551. [PMID: 25586051 DOI: 10.1039/c4em00479e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Exposure to secondhand tobacco smoke (SHS) also known as environmental tobacco smoke (ETS) has been well established scientifically as a human health hazard. Despite this and warnings from health agencies, concerns over the economic impact of smoke-free bans have limited political resolve to enact these regulations. Arguments against smoke-free bans include the contention that air filters can eliminate the health risks from SHS exposure. In this study, we assessed the effectiveness of air filters (MERV 4 and MERV 8) commonly used in homes and businesses in reducing the concentrations of total suspended particulates, fine particles and carbon monoxide from SHS as a measure of their potential to reduce the toxicity associated with SHS exposure. Our results demonstrate that these filters are not effective at reducing carbon monoxide levels or PM 2.5, which have been correlated with human health toxicity/disease. Thus, our findings, from a public health perspective, do not support the use of common air filters as a viable alternative to smoke-free bans.
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Affiliation(s)
- Chris A Pritsos
- Department of Agriculture, Nutrition and Veterinary Sciences, University of Nevada, Reno, MS 0202, 1664 N Virginia St, Reno, NV 89557, USA.
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Soler RE, Whitten KL, Ottley PG. Communities putting prevention to work: local evaluation of community-based strategies designed to make healthy living easier. Prev Med 2014; 67 Suppl 1:S1-3. [PMID: 25150384 PMCID: PMC4476513 DOI: 10.1016/j.ypmed.2014.08.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 08/11/2014] [Indexed: 10/24/2022]
Abstract
This introduction is an overview of the articles presented in this supplement that describe implementation and evaluation activities conducted as part of the Centers for Disease Control and Prevention's (CDC's) Communities Putting Prevention to Work (CPPW) initiative. CPPW was one of the largest federal investments ever to combat chronic diseases in the United States. CPPW supported high-impact, jurisdiction-wide policy, systems, and environmental changes to improve health by increasing access to physical activity and healthy foods, and by decreasing tobacco use and exposure to secondhand smoke. The articles included in this supplement describe implementation and evaluation efforts of strategies implemented as part of CPPW by local awardees. This supplement is intended to guide the evidence base for public health interventions on the basis of jurisdiction-wide policy and environmental-level improvements and to encourage rigorous evaluation of the public health interventions.
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Affiliation(s)
- Robin E Soler
- Division of Community Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Kathleen L Whitten
- Public Health and Survey Research Division, ICF International, Atlanta, GA, USA
| | - Phyllis G Ottley
- Public Health and Survey Research Division, ICF International, Atlanta, GA, USA
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