Abstract
PurposeHeightened obesity risk among food-insecure food pantry clients is a health equity issue because the co-occurrence of obesity and hunger is deeply-rooted in systematic social disadvantage and historical oppression. This qualitative study examined key stakeholders’ perspectives of the relationship between the U.S. food banking system and obesity disparities among food insecure clients.MethodsWe conducted in-depth, semi-structured interviews with 10 key stakeholders (e.g., food bank director, food bank board member, advocate) who are familiar with food bank operations. Data were transcribed verbatim, coded in NVivo [v11], and analyzed using thematic analysis.ResultsMultiple themes emerged drawing linkages between structural characteristics of the food banking system and disparities in the dual burden of food insecurity and obesity: [a] access to unhealthy food from donors; [b] federal emergency food policy and programming; [c] state-level emergency food policy and programming; [d] geography-based risk profiles; and [e] inadequate food supply versus client need. Interviewees also identified social challenges between system leaders and clients that maintain disparities in obesity risk among individuals with very low food security including: [a] media representation and stereotypes about food pantry clients; [b] mistrust in communities of color; [c] lack of inclusion/representation among food bank system leaders; and [d] access to information.ConclusionFuture efforts to alleviate obesity inequities among clients chronically burdened by food insecurity, especially among certain subpopulations of clients, should prioritize policy, systems, and environmental strategies to overcome these structural and social challenges within the food banking system.
Highlights
Future efforts to alleviate obesity inequities among clients chronically burdened by food insecurity, especially among certain subpopulations of clients, should prioritize policy, systems, and environmental strategies to overcome these structural and social challenges within the food banking system
According to the United States Department of Agriculture, 11.1% (14.3 million) of American households experience food insecurity with 4.3% (5.6 million) experiencing very low food security characterized by multiple indications of reduced food intake and disrupted eating patterns due to a lack of resources [1, 2]
If we dig even deeper of why certain people are more at risk, these root causes, we get into the racism, the sexism, the other–isms. . . .we really can’t ‘food bank’ our way out of this problem. The results from this qualitative study of key stakeholders offer useful insights regarding both structural and social characteristics of the U.S food banking system that potentially contribute to obesity and hunger among its clients
Summary
According to the United States Department of Agriculture, 11.1% (14.3 million) of American households experience food insecurity with 4.3% (5.6 million) experiencing very low food security characterized by multiple indications of reduced food intake and disrupted eating patterns due to a lack of resources [1, 2]. Most households with very low food security report experiencing hunger at some time during the year and skipping meals because there was not enough money for food [3]. Recent data from a national survey of US adults indicates that these disparities have significantly widened due to COVID-19, with 44% of low-income adults currently reporting food insecurity. Only 1 in 5 adults with very low food security was able to follow emergency guidelines to stock two weeks of food at a time [4]. The 2019 State of Obesity report revealed that over 40% of adults have obesity [5]
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