Angela Odoms-Young, PhD, Food Insecurity and Obesity IPHA
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Angela Odoms-Young, PhD, Food Insecurity and Obesity IPHA

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  • The African American Collaborative Obesity Research Network ( AACORN ) uses a community-centered approach for thinking through approaches to prevention and treatment of overweight and obesity. The underlying concept is that approaches to intervening on obesity are better framed in very ‘people-oriented’ terms. We ask, How do eating, physical activity and weight reflect the opportunities, constraints, and issues in people’s everyday lives? What aspects of people’s everyday lives and circumstances must be considered in order to develop appropriate, effective, and sustainable intervention approaches? How can interventions on obesity support high quality of life and community priorities that are broader than food, activity, or weight?   In other words, it is not simply a matter of teaching people about how many calories are in their food or how long they have to exercise to burn a certain number of calories. Far from it. Many people in African American communities already know this information. The issue is much more complicated.   The model shown in the diagram calls for reflection of several different types of community-level factors that, in combination, influence: a) eating habits and physical activity and, ultimately, body weight and body fatness; and b) resources available to take positive actions to address health problems that may be associated with some aspects of current eating or activity habits or weight levels. This diagram is a companion to AACORN’s “expanded obesity research paradigm”, a model that is oriented primarily to researchers who design studies of obesity prevention and treatment (link). It has been created to facilitate discussions among community members and between academically based researchers and their community research partners.   The focus on eating, physical activity, and body weight is at the center, because the ultimate goal is to identify how the various influences from daily life influence and reinforce these aspects of health status. The balance scale is a reminder of the reality that extra weight is gained when the amount of calories eaten is too high and the calories used is too low.   Discussion of this model can begin with any of the circles and can go back and forth among the circles to use the questions as prompts to discuss the general issues in each category and to also discuss how they influence eating, activity, and weight.   Like AACORN’s research paradigm, this diagram was developed with a particular focus on African American communities. However, the concepts and the graphic have potential applicability to diverse communities. This model is geared to a collective or group perspective, i.e., what are the behaviors ‘on average’ or that tend to be the most common. The ‘our’ and ‘we’ references in the questions assume that those engaged in the discussion identify as having something in common in a way that makes them participants in the same community. This could be a geographical community (neighborhood) but not necessarily so. This approach recognizes that individuals within the community have a lot of variation in what they eat, how active they are, or whether they are overweight, but focuses on the issue that improvements on these fronts are needed, on average, to foster health and wellness and therefore high quality of life and longevity.

Angela Odoms-Young, PhD, Food Insecurity and Obesity IPHA Angela Odoms-Young, PhD, Food Insecurity and Obesity IPHA Presentation Transcript

  • 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 WEIGHT © African American Collaborative Obesity Research Network Influences of Culture and Mindset Historical 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 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.
  • Conclusion Paradigm 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)