The Challenge Obesity among African

American adults, particularly women, are also very high

A very high percent of African American girls have weight levels in the obese or very obese range.

Obesity has been rising more steeply in African American children compared to children in other ethnic groups.

Poor diets including low intake fruit/vegetable, whole grains, lean meats

Paradigm Shift: Social Determinants

Social determinants of health are the economic and social conditions that influence the health of individuals, communities, and jurisdictions as a whole.

Social determinants of health are about the quantity and quality of a variety of resources that a society makes available to its members.

Questions??? What is an equitable and accessible food

system? What food system supports the health of

African American populations? What food system supports the health of low-

income populations?

Must understand food access and availability from a community perspective!!!!

Food marketing equity research that focuses on African American communities

• Studies to characterize perceptions of the neighborhood food and marketing environments in AA communities

• UAB, UIC, Duke, UMD

• Ongoing local mobilization in African American communities

• Research dissemination activities (e.g., NAASO)

African American Collaborative Obesity Research Network (AACORN)

Researchers across the US with diverse interests and

expertise related to African American health, especially

food, nutrition, weight and weight related health problems

African American and other scholars

Early career scholars, established scholars, and

scholars-in-training

Community research partners

Creating Solutions AACORN’s Mission:

To improve the quality, quantity and effective translation of

research to address weight related issues in African

American communities.

A COMMUNITY-CENTERED VIEW OF INFLUENCES ON EATING, ACTIVITY, AND BODY WEIGHTA COMMUNITY-CENTERED VIEW OF INFLUENCES ON EATING, ACTIVITY, AND BODY WEIGHT

© African American Collaborative Obesity Research Network

Influences of Culture and MindsetInfluences of Culture and Mindset

Historical and Social FactorsHistorical and Social Factors

What are our social values?

What do we believe in?

What gives us pleasure?

What gives comfort?

How do we cope with stresses?

What is fair treatment?

Who earns our trust and our loyalty?

Health and wellness

High quality of life

Do we have money to buy the things we need?

What are our neighborhoods like?

What type of food is available? How much does it cost?

Where are opportunities for recreation and outdoor activities?

Who sponsors community events?

What messages do we get from TV, radio,

outdoor ads, the web?

What is our history? How does it affect the way we live now?

What kinds of social institutions do we have?

How do our faith communities support us?

What are our families like?

What are our community strengths?

What is our collective strength for taking action?

Environments to NavigateEnvironments to Navigate

Long life

What is the Role of Neighborhood Food and Marketing Environments?

“When We Have Better, We Can Do Better”

Methods: Study Design

Focus on Families with Children 0-6 Two Semi-structured Interviews and

Photo Elicitation with African Americans with young children (n=15) or pregnant (n=4)

Recruited from WIC, Healthy Start, Case Management Programs at Englewood Neighborhood Health Center

Interviews Transcribed Verbatim Atlas.ti : Constant Comparative Analysis

Results: Participant Characteristics

Characteristics n=19

Age 17-59 (mean 29 years)

Female 78% (n=15)

Englewood/West Englewood 78% (n=15)

Residence 89% <5 years (n=17)

Education 73% >HS (n=14)

Income 100% < $19,000 per year

Martial Status 78% Single (n=15)

Cash Assistance (TANF, SSI) 26% (n=5)

Food/Nutrition Assistance 63% (n=12)

Social Determinants of Health of the Food System Economics Employment Transportation Perceived Racism Violence

Economics Family economics and community availability

of resources play a key role in shaping food access.

Economics That First Choice may be more nutritious per

se but as it goes nowadays with the economy being as bad as it is I ain’t thinking about all this quality stuff I’m thinking about surviving for the long haul because my money is funny.

Employment Lack of employment opportunities in the

community Traveling out of the community provides more

access Lack of employment limits access

Employment I drop him off at school, then I go back home

and I watch TV. I basically watch TV all the time, I don’t have a job, so I pick him up about three-thirty from the school, I take him to the store and get him a snack, and then we come home and we watch TV. And then I fix dinner about six, six-thirty, we eat, and we go to bed. At about nine. And that’s typically my day.

Transportation Access to personal resources (car), public

resources, and mobility Variable access overtime and between

families

Transportation Transportation that’s why a lot of times we go to

Store A and most of the stuff at Store A my kids will eat but my wife won’t eat. So, she’ll go there and get most of they stuff from there because it’s in walking distance and the stuff that we get we’ll wait. We had a car but it kind of broke down. So, we had transportation to get where we was going but now our car is kind of down. So, now we usually go places where we can walk because we like to walk. So, we’ll try not to get too many bags. If we have to go to Store B, we’ll get on the bus. She’ll carry two bags and I’ll get two bags. So, we’re kind of limited getting our special stores…So, transportation and the cost plays a lot in our decision in how to keep the family happy..

Transportation ..because sometimes I used to have to catch the

bus or catch a cab in order to get to Store C but now that my sister has a car it’s more convenience for me but at the same time they food varieties it just be fresh. I love the fact that they care about their food items, they care about their customers and how they eat and I just love Store C.

Perceived Racism Black vs. White deserve the same services

Not clear if its racism or racial preferences Conflict between Middle Eastern store owners

and community residents Most participants felt that the conflict was based

on store owners’ lack of respect for the community

Others based on unruly customers. Store owners who have a long history in the

neighborhood, help people in the neighborhood, and/or embrace African American culture, have a better reputation compared to owners overall.

Perceived Racism “[In other communities] you see the

vegetables when you first go in. You see the fruit when you first go in. You’re not looking at the Flamin’ Hots and all that stuff which I can’t stand… I see myself just going into different grocery stores especially in the African American community that [the media] is the key. It’s the cake, it’s the chips, it’s the soda… then you have to hunt for the fruits, the vegetables, the bottled water, and things like that.”

Perceived Racism Like in the black folks neighborhood we’ve got

50 liquor stores. Every time you go a block you may see two or three liquor stores. You go in the white people neighborhoods you may not see but one liquor store. They’re not going to sit that close together versus how our liquor stores are. We’ve got one on 39th & Indiana. You ride up four more blocks and you’ve got one on 35th. Then you’ve got another one on 24th & State.

Perceived Racism “ Well, number one I would close down the

corner stickup but like the saying goes, Throughout the city of Chicago most corner stores are run by Arabs or Koreans. I don’t know what happened to the black community. We just don’t have the finances or we can’t have the intelligence to go get them corner lots or we’re fearful of the competition or what have you. But everybody says that when Arabs come over here and Koreans come over here the government gives them free money, free this and free that and then they got one leg up because they’ve got the money.”

Community Violence Safety concerns Hassle related use of risk management

strategies Coping with overall context of deprivation

Community Violence

Dollar store is on the other side of the street. Drug sales go on outside of the doorway

Community Violence You see people hanging out day in and night. I

was approached…me and my son, walking to the store with my boyfriends’ brother and this older man. And it was day time, and [a man on the street] was drunk and everything, and he said something. Bob, the guy I was with said something to him cause he said something to my son….So little stuff like that, you see it come and avoid it.

ConclusionParadigm Shift: Avoid the Lifestyle Trap

Lifestyle choices are heavily structured by life circumstances

Lifestyle choices by themselves account for modest proportions of health status

Lifestyle choices are difficult to change without considering life contexts

Participant Recommendations: Change grocers’ perceptions of community

residents. Increase efforts to reduce community violence to

create a safer environment around stores Offer tax incentives to bring different types of

retailers into the community who offer a variety of foods, services, and other goods

Improve the physical appearance, cleanliness, food quality, and customer service at existing stores

Promote the development of minority-owned food retail businesses in African American neighborhoods.

Next Steps Interview Policy and Business Owners Englewood Health Community Forum (June

18, KKC)