Nutrition Interventions Addressing Structural Racism: A Scoping Review.

African Americans experience high rates of obesity and food insecurity in part due to structural racism, or overlapping discriminatory systems and practices in housing, education, employment, health care, and other settings. Nutrition education and nutrition-focused policy, systems, and environmental changes may be able to address structural racism in the food environment. This scoping review aimed to summarize the available literature regarding nutrition interventions for African Americans that address structural racism in the food environment and compare them to the "Getting to Equity in Obesity Prevention" framework of suggested interventions. An electronic literature search was conducted with the assistance of a research librarian encompassing 6 databases-MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX, and ProQuest Dissertations & Theses. A total of 30 sources were identified detailing interventions addressing structural barriers to healthy eating. The majority of nutrition interventions addressing structural racism consisted of policy, systems, and/or environmental changes in combination with nutrition education, strategies focused on proximal causes of racial health disparities. Only two articles each targeted the "reduce deterrents" and "improve social and economic resources" aspects of the framework, interventions which may be better suited to addressing structural racism in the food environment. Because African Americans experience high rates of obesity and food insecurity and encounter structural barriers to healthy eating in the food environment, researchers and public health professionals should address this gap in the literature.

The Healthy Communities Initiative: Gathering Community Input During COVID-19

The Louisiana Healthy Communities Initiative, led by the LSU AgCenter, guides SNAP-Ed policy, systems, and environmental change efforts. Prior to COVID19, agents held in-person community forums to gather input and community priorities for interventions. COVID19 spurred innovation in this process. Although many states have used videoconferencing services to host meetings, lack of functional internet access posed a barrier for many communities in Louisiana.To gather broad community input through Qualtrics surveys in order to assess needs and assets, guide project prioritization, and gather feedback on previous projects.Qualtrics surveys were distributed via email to community members, stakeholders, and partners serving low-income audiences. Three surveys solicited feedback for existing Healthy Communities coalitions (n = 45), 1 survey gathered initial input for a newly formed Healthy Communities coalition (n = 63). The overall response rate across all surveys was 23.6%.Survey responses to community health and engagement questions were separated by counties and analyzed through qualitative content analysis. The research team worked with Extension agents to conduct member checking through discussing survey results with participants.One hundred and eight responses were received from 4 communities. Extension agents reported high satisfaction with the process. Surveys provided action items and potential new coalition members. Across all 4 communities, common themes included acknowledging racial health disparities, a need for greater community involvement in coalition efforts, and a lack of healthy food options.Qualtrics surveys were an effective way to gather community input and allowed wider participation than would have been possible with a virtual meeting. Post-COVID, agents plan to continue to solicit community input through Qualtrics surveys, in addition to face-to-face forums. This method is a valuable tool for lower-income and rural communities. Results reflected an awareness of low community engagement, racial health disparities and limited healthy food access.

Improving Fruit and Vegetable Accessibility, Purchasing, and Consumption to Advance Nutrition Security and Health Equity in the United States.

In recent years, national and local efforts to improve diet and health in the United States have stressed the importance of nutrition security, which emphasizes consistent access to foods and beverages that promote health and prevent disease among all individuals. At the core of this endeavor is fruit and vegetable (FV) consumption, a dietary practice that is integral to attaining and sustaining a healthy diet. Unfortunately, significant inequities in FV accessibility, purchasing, and consumption exist, particularly among populations that are socially and economically disadvantaged. To achieve nutrition and health equity in the United States, the field must center the goal of nutrition security and initiatives that aim to increase FV consumption, specifically, in future work. The International Journal of Environmental Research and Public Health (IJERPH) Special Issue titled "Nutrition and Health Equity: Revisiting the Importance of Fruit and Vegetable Availability, Purchasing, and Consumption" features several scholarly publications from experts conducting timely research on these topics. In this commentary, we (1) summarize the U.S.-based literature on inequities in FV accessibility, purchasing, and consumption, (2) describe how the contributions to this IJERPH special issue can advance nutrition security and health equity, and (3) outline future research questions from our perspective.