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Dualle MA, Robinette LM, Hatsu IE. Food Related Challenges and Mental Health Among U.S. African Migrants: A Narrative Review. J Immigr Minor Health 2024; 26:371-384. [PMID: 37400706 DOI: 10.1007/s10903-023-01512-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 07/05/2023]
Abstract
The United States' (US) African immigrant (AI) population is growing, yet they are underrepresented in health and nutrition research. This population experiences difficulties finding culturally appropriate foods and navigating the US food environment (FE), is highly food insecure (FI), and vulnerable to mental disorders. This review examined the current evidence for AIs' food and mental health outcomes and connections; and identified gaps in the literature and future research opportunities. A literature search was conducted using Google Scholar, PubMed, CINAHL, MEDLINE, and SCOPUS. Twenty-one studies were identified, reporting high (37-85%) FI rates, poor diet quality, and increased risk of mental disorders among participants. Challenges in the FE, lack of transportation, limited access to ethnic foods, low SES, and language barriers were associated with FI and poor diet quality. Similarly, discrimination, substance use, and immigration status were associated with depression and anxiety. However, studies examining the connection between AI's food experience and mental health are lacking. AIs are at a higher risk for FI, poor diet quality, and mental disorders. Ethnic-specific research to understand the connection between their food and mental health is needed to reduce nutrition and mental health disparities.
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Affiliation(s)
- Maryan A Dualle
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Lisa M Robinette
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Irene E Hatsu
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA.
- College of Education and Human Ecology, Department of Human Sciences | Human Nutrition Program, 341 Campbell Hall, 1787 Neil Ave, Columbus, OH, 43210, USA.
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Chan SWC, Chin M, Suss R, Kui K, Lam SZ, Dowd E, Bosen C, Mei S, Barth K, Hughes M, Yi SS. A Culturally Specific Community Supported Agriculture (CSA) Program to Improve Diet in Immigrant Communities in Brooklyn, New York. Health Promot Pract 2024:15248399241234058. [PMID: 38415651 PMCID: PMC11349926 DOI: 10.1177/15248399241234058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Anti-Asian and anti-immigrant sentiment has surged in the country in the last 3 years. Food insecurity is also on the rise; in our local needs assessment of n = 1,270 Asian American adults in New York City, accessing food was cited as the number 1 priority among those who needed help. Finally, racial discrimination and food access are related to fear of being attacked-driving feelings of safety and therefore willingness to travel for food. To combat these narratives and leveraging pivots by our community partners, we implemented a community-supported agriculture pilot program (n = 38) to assess whether culturally appropriate food access can improve diet and foster cross-cultural learning among immigrant families in Brooklyn, NY. Over a 20-week period from June to October 2022, participants received Chinese-specific produce and nutrition education. Participants reported eating more and a greater variety of vegetables and had higher vegetable intake measured via skin carotenoid scores. This pilot may inform the adaptation of nutrition interventions to reduce inequities in chronic diseases in immigrant communities.
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Affiliation(s)
| | - Matthew Chin
- NYU Grossman School of Medicine, New York, NY, USA
| | - Rachel Suss
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Kiran Kui
- Tufts Medical Center, Boston, MA, USA
| | | | | | | | - Steve Mei
- Chinese American Planning Council, New York, NY, USA
| | | | - Michelle Hughes
- Glynwood Center for Regional Food and Farming, Cold Spring, NY, USA
| | - Stella S Yi
- NYU Grossman School of Medicine, New York, NY, USA
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3
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Lu I, Suss R, Lanza DV, Cohen S, Yusuf Y, Yi SS. A qualitative study to inform the development of a subsidized community-supported agriculture program for Chinese Americans in Brooklyn, New York, U.S. Prev Med Rep 2023; 36:102480. [PMID: 37920594 PMCID: PMC10618813 DOI: 10.1016/j.pmedr.2023.102480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023] Open
Abstract
The objective of this study was to inform the development of a subsidized, culturally adapted Community-Supported Agriculture (CSA) program for the Chinese American (CA) community in Brooklyn, New York (NY), USA. We conducted interviews with CA adults to understand their eating and shopping behaviors, interests in CSAs, and recommendations for educational content to inform the development of a subsidized and culturally adapted CSA. We then conducted thematic analysis of those interviews and identified major themes. CA adult participants shared interest in a CSA primarily to support their own health, interact socially with farmers and other participants, and gain access to fresh, culturally appropriate produce. Major concerns for participation, especially among older adults, included language barriers, transportation, and mobility. The unique needs and motivations of CAs should be centered in the development of alternative food access interventions for this population. CA adult participants living in Brooklyn, NY may be interested in a subsidized culturally adapted CSA that includes health information about the produce and provides in-language support. Engaging communities in the development of a health program may be important to ensure accessibility and acceptability for CA populations.
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Affiliation(s)
- Isabel Lu
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States
| | - Rachel Suss
- Department Population Health, NYU Grossman School of Medicine, New York University Langone Health, United States
| | - Dalila Victoria Lanza
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, United States
| | - Sarah Cohen
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States
| | - Yousra Yusuf
- Department Population Health, NYU Grossman School of Medicine, New York University Langone Health, United States
| | - Stella S. Yi
- Department Population Health, NYU Grossman School of Medicine, New York University Langone Health, United States
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4
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Ali SH, Lin NF, Yi SS. Challenging Dietary Research Measures, Concepts, and Definitions to Promote Greater Inclusivity of Immigrant Experiences: Considerations and Practical Recommendations. J Acad Nutr Diet 2023; 123:1533-1540. [PMID: 37348677 PMCID: PMC10592485 DOI: 10.1016/j.jand.2023.06.280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Shahmir H Ali
- Department of Population Health, New York University Grossman School of Medicine, New York, NY.
| | - Nelson F Lin
- Department of Population Health, New York University Grossman School of Medicine, New York, NY; Brown University, Providence, RI
| | - Stella S Yi
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
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5
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Park JK, Yi SS. Transportation and language access as crucial pillars for an immigrant-inclusive 21st-century food security program. Public Health Nutr 2023; 26:1925-1929. [PMID: 37016771 PMCID: PMC10478048 DOI: 10.1017/s1368980023000575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/09/2023] [Accepted: 02/24/2023] [Indexed: 04/06/2023]
Abstract
Though food insecurity has long been recognised to impact health, population-specific determinants of food insecurity have recently been studied systematically as an important public health concern. Indeed, while immigrant populations face particular challenges to equitable access to the food system, many of these concerns have not been systematically described. To this end, we critically review recent work that demonstrates the importance of transportation and language access as independent determinants of access to food for immigrant populations. Furthermore, we highlight proposals to mitigate barriers to access, including both academic and community-driven approaches to create overlapping institutional commitments for inclusive policymaking that meets the specific needs of diverse populations.
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Affiliation(s)
| | - Stella S Yi
- Department of Population Health, NYU Grossman School of Medicine, New York, NY10016, USA
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6
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LeCroy MN, Suss R, Russo RG, Sifuentes S, Beasley JM, Barajas-Gonzalez RG, Chebli P, Foster V, Kwon SC, Trinh-Shevrin C, Yi SS. Looking Across and Within: Immigration as a Unifying Structural Factor Impacting Cardiometabolic Health and Diet. Ethn Dis 2023; 33:130-139. [PMID: 38845741 PMCID: PMC11145733 DOI: 10.18865/ed.33.2-3.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Introduction Immigration has been identified as an important social determinant of health (SDH), embodying structures and policies that reinforce positions of poverty, stress, and limited social and economic mobility. In the public health literature with regard to diet, immigration is often characterized as an individual-level process (dietary acculturation) and is largely examined in one racial/ethnic subgroup at a time. For this narrative review, we aim to broaden the research discussion by describing SDH common to the immigrant experience and that may serve as barriers to healthy diets. Methods A narrative review of peer-reviewed quantitative, qualitative, and mixed methods studies on cardiometabolic health disparities, diet, and immigration was conducted. Results Cardiometabolic disease disparities were frequently described by racial/ethnic subgroups instead of country of origin. While cardiovascular disease and obesity risk differed by country of origin, diabetes prevalence was typically higher for immigrant groups vs United States (US)-born individuals. Common barriers to achieving a healthy diet were food insecurity; lack of familiarity with US food procurement practices, food preparation methods, and dietary guidelines; lack of familiarity and distrust of US food processing and storage methods; alternative priorities for food purchasing (eg, freshness, cultural relevance); logistical obstacles (eg, transportation); stress; and ethnic identity maintenance. Conclusions To improve the health of immigrant populations, understanding similarities in cardiometabolic health disparities, diet, and barriers to health across immigrant communities-traversing racial/ethnic subgroups-may serve as a useful framework. This framework can guide research, policy, and public health practices to be more cohesive, generalizable, and meaningfully inclusive.
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Affiliation(s)
- Madison N. LeCroy
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Rachel Suss
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Rienna G. Russo
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Sonia Sifuentes
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Jeannette M. Beasley
- Department of Nutrition and Food Studies, NYU Steinhardt School of Culture, Education, and Health, New York, NY
- Department of Medicine, NYU Grossman School of Medicine, New York, NY
| | - R. Gabriela Barajas-Gonzalez
- Department of Population Health, Center for Early Childhood Health and Development, NYU Grossman School of Medicine, New York, NY
| | - Perla Chebli
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Victoria Foster
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Simona C. Kwon
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Chau Trinh-Shevrin
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Stella S. Yi
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
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Isaacs A, Halligan J, Neve K, Hawkes C. From healthy food environments to healthy wellbeing environments: Policy insights from a focused ethnography with low-income parents' in England. Health Place 2022; 77:102862. [PMID: 35926370 DOI: 10.1016/j.healthplace.2022.102862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 05/31/2022] [Accepted: 07/01/2022] [Indexed: 12/30/2022]
Abstract
Overweight and obesity continue to increase globally. In England, as in many other countries, this disproportionately affects people who experience socioeconomic deprivation. One factor blamed for inequalities in obesity is unhealthy food provisioning environments (FPEs), leading to a focus on policies and interventions to change FPEs. This paper aims to provide insights into how FPE policies could more effectively tackle inequalities in obesity by addressing a key research gap: how the structural contexts in which people live their lives influence their interaction with their FPEs. It aims to understand how low-income families engage with FPEs through in-depth focused ethnographic research with 60 parents across three locations in England: Great Yarmouth, Stoke-on-Trent, and the London Borough of Lewisham. Analysis was guided by sociological perspectives. FPEs simultaneously push low-income families towards unhealthy products while supporting multiple other family needs, such as social wellbeing. FPE policies and interventions to address obesity must acknowledge this challenge and consider not just the makeup of FPEs themselves but how various structural contexts shape how people come to use them.
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Affiliation(s)
- Anna Isaacs
- Centre for Food Policy, City University of London, UK.
| | - Joel Halligan
- Centre for Food Policy, City University of London, UK
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Russo RG, Ali SH, Mezzacca TA, Radee A, Chong S, Kranick J, Tsui F, Foster V, Kwon SC, Yi SS. Assessing changes in the food retail environment during the COVID-19 pandemic: opportunities, challenges, and lessons learned. BMC Public Health 2022; 22:778. [PMID: 35436904 PMCID: PMC9014275 DOI: 10.1186/s12889-022-12890-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 03/01/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND COVID-19 mitigation strategies have had an untold effect on food retail stores and restaurants. Early evidence from New York City (NYC) indicated that these strategies, among decreased travel from China and increased fears of viral transmission and xenophobia, were leading to mass closures of businesses in Manhattan's Chinatown. The constantly evolving COVID -19 crisis has caused research design and methodology to fundamentally shift, requiring adaptable strategies to address emerging and existing public health problems such as food security that may result from closures of food outlets. OBJECTIVE We describe innovative approaches used to evaluate changes to the food retail environment amidst the constraints of the pandemic in an urban center heavily burdened by COVID-19. Included are challenges faced, lessons learned and future opportunities. METHODS First, we identified six diverse neighborhoods in NYC: two lower-resourced, two higher-resourced, and two Chinese ethnic enclaves. We then developed a census of food outlets in these six neighborhoods using state and local licensing databases. To ascertain the status (open vs. closed) of outlets pre-pandemic, we employed a manual web-scraping technique. We used a similar method to determine the status of outlets during the pandemic. Two independent online sources were required to confirm the status of outlets. If two sources could not confirm the status, we conducted phone call checks and/or in-person visits. RESULTS The final baseline database included 2585 food outlets across six neighborhoods. Ascertaining the status of food outlets was more difficult in lower-resourced neighborhoods and Chinese ethnic enclaves compared to higher-resourced areas. Higher-resourced neighborhoods required fewer phone call and in-person checks for both restaurants and food retailers than other neighborhoods. CONCLUSIONS Our multi-step data collection approach maximized safety and efficiency while minimizing cost and resources. Challenges in remote data collection varied by neighborhood and may reflect the different resources or social capital of the communities; understanding neighborhood-specific constraints prior to data collection may streamline the process.
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Affiliation(s)
- Rienna G Russo
- Department of Population Health, NYU Grossman School of Medicine, New York, USA.
| | - Shahmir H Ali
- Department of Social and Behavioral Sciences, School of Global Public Health, NYU, New York, USA
| | | | | | - Stella Chong
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Julie Kranick
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Felice Tsui
- Columbia Mailman School of Public Health, New York, USA
| | - Victoria Foster
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Simona C Kwon
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Stella S Yi
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
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Wang VHC, Foster V, Yi SS. Are recommended dietary patterns equitable? Public Health Nutr 2022; 25:464-470. [PMID: 34602107 PMCID: PMC8883773 DOI: 10.1017/s1368980021004158] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Dietary recommendations (DR) in the USA may be inadequate at improving diets in racial/ethnic minority communities and may require redesign of the systems driving their development over the long term. Meanwhile, cultural adaptation of evidence-based DR may be an important strategy for mitigating nutrition disparities, but less is known about the adaptability of these recommendations to meet the needs of diverse groups. We examined the content and origin of major DRs - aspects that provide context on their potential universality across populations and evaluated their potential for cultural adaptation. DESIGN Case studies of Dietary Approaches to Stop Hypertension (DASH), the Mediterranean diet (MD), the EAT-Lancet diet (EAT) and the NOVA classification system. SETTING United States. PARTICIPANTS Racial/ethnic minority populations. RESULTS Current DR differ in their origin/evolution but are similar in their reductionist emphasis on physical health. DASH has been successfully adapted for some cultures but may be challenged by the need for intensive resources; MD may be more beneficial if applied as part of a broader set of food procurement/preparation practices than as just diet alone; EAT-Lancet adaptation may not honor existing country-specific practices that are already beneficial to human and environmental health (e.g. traditional/plant-based diets); evidence for cultural adaptation is limited with NOVA, but classification of levels of food processing has potential for widespread application. CONCLUSIONS For DR to equitably support diverse populations, they must move beyond a Eurocentric or 'general population' framing, be more inclusive of cultural differences and honour social practices to improve diet and reduce disparities.
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Affiliation(s)
- Vivian Hsing-Chun Wang
- Department of Public Health Policy and Management, School of Global Public Health, New York University, 708 Broadway, New York, NY10003, USA
| | - Victoria Foster
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Stella S Yi
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
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Russo RG, Li Y, Ðoàn LN, Ali SH, Siscovick D, Kwon SC, Yi SS. COVID-19, Social Determinants of Health, and Opportunities for Preventing Cardiovascular Disease: A Conceptual Framework. J Am Heart Assoc 2021; 10:e022721. [PMID: 34889110 PMCID: PMC9075236 DOI: 10.1161/jaha.121.022721] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic has disrupted the social, economic, and health care systems in the United States and shined a spotlight on the burden of disease associated with social determinants of health (SDOH). Addressing SDOH, while a challenge, provides important opportunities to mitigate cardiovascular disease incidence, morbidity, and mortality. We present a conceptual framework to examine the differential effects of the COVID-19 pandemic on SDOH across demographically diverse populations, focusing on the short- and long-term development of cardiovascular disease, as well as future research opportunities for cardiovascular disease prevention. The COVID-19 pandemic exerted negative shifts in SDOH and cardiovascular risk factors (ie, smoking, body mass index, physical activity, dietary behavior, cholesterol, blood pressure, and blood sugar). For example, evidence suggests that unemployment and food insecurity have increased, whereas health care access and income have decreased; changes to SDOH have resulted in increases in loneliness and processed food consumption, as well as decreases in physical activity and hypertension management. We found that policy measures enacted to mitigate economic, social, and health issues inadequately protected populations. Low-income and racial and ethnic minority communities, historically underserved populations, were not only disproportionately adversely affected by the pandemic but also less likely to receive assistance, likely attributable in part to the deep structural inequities pervasive in our society. Effective and culturally appropriate interventions are needed to mitigate the negative health impacts of historical systems, policies, and programs that created and maintain structural racism, especially for immigrants, racial and ethnic minorities, and populations experiencing social disadvantage.
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Affiliation(s)
- Rienna G. Russo
- Department of Population HealthNYU Grossman School of MedicineNew YorkNY
| | - Yan Li
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNY
- Department of Obstetrics, Gynecology, and Reproductive ScienceIcahn School of Medicine at Mount SinaiNew YorkNY
| | - Lan N. Ðoàn
- Department of Population HealthNYU Grossman School of MedicineNew YorkNY
| | - Shahmir H. Ali
- Department of Social and Behavioral SciencesNYU School of Global Public HealthNew YorkNY
| | | | - Simona C. Kwon
- Department of Population HealthNYU Grossman School of MedicineNew YorkNY
| | - Stella S. Yi
- Department of Population HealthNYU Grossman School of MedicineNew YorkNY
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Food environment interactions after migration: a scoping review on low- and middle-income country immigrants in high-income countries. Public Health Nutr 2021; 25:136-158. [PMID: 34509180 PMCID: PMC8825972 DOI: 10.1017/s1368980021003943] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objective: To map and characterise the interactions between the food environment and immigrant populations from low- and middle-income countries living in high-income countries. Design: A scoping review was carried out following the framework outlined by Arksey and O’Malley, as well as Levac et al. Peer-reviewed studies in English published between 2007 and 2021 were included. Two reviewers screened and selected the papers according to predefined inclusion criteria and reporting of results follows the PRISMA-ScR guidelines. A ‘Best fit’ framework synthesis was carried out using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. Setting: High-income countries. Participants: Immigrants from low- and middle-income countries. Results: A total of sixty-eight articles were included, primarily based in the USA, as well as Canada, Australia and Europe, with immigrants originating from five regions of the globe. The analysis identified three overarching themes that interconnected different aspects of the food environment in addition to the four themes of the ANGELO framework. They demonstrate that in valuing fresh, healthy and traditional foods, immigrants were compelled to surpass barriers in order to acquire these, though children’s demands, low incomes, time scarcity and mobility influenced the healthiness of the foods acquired. Conclusion: This study brought together evidence on interactions between immigrant populations and the food environment. Immigrants attempted to access fresh, traditional, healthier food, though they faced structural and family-level barriers that impacted the healthiness of the food they acquired. Understanding the food environment and interactions therein is key to proposing interventions and policies that can potentially impact the most vulnerable.
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