Racial and ethnic minorities
- Socioeconomic status. Individuals who are members of racial and ethnic minority groups and have lower income may have less healthy food consumption patterns and less access to healthy foods (Turrell, 2002).
- Availability of healthy options. Individuals living in racial and ethnic minority communities, as well as low-income communities, are more likely to have access to small corner grocery or convenience stores than to supermarkets (Morland, 2002). These smaller stores tend to offer less of a selection of high quality produce and typically cost more than a supermarket. In addition, decreased availability of healthy foods is linked with a poorer diet quality (Franco, 2009).
- Availability and consumption of fast food. There is a higher prevalence of fast food restaurants in African American and low income neighborhoods. In addition, evidence shows that low-income and non-white individuals consume more fast food. (Block, 2004).
- Inadequate transportation. Fewer households in racial and ethnic minority communities have access to private transportation. This makes them more reliant on the often less desirable food outlets closest to their homes (Morland, 2002).
- Demand for healthy foods. Low availability of healthy foods in racial and ethnic minority neighborhoods is partially the result of a lower or demand for healthy food options (Yancey, 2004).
- Target food marketing. Advertising for unhealthy foods is often targeted more towards racial and ethnic minority audiences. Likewise, fewer advertisements regarding healthy foods such as fruits, vegetables, and dairy items are directed towards these audiences as compared to general populations (Lewis, 2005).
- Food preparation. Individuals from racial and ethnic minority groups may have traditional culinary practices (e.g., frying instead of baking, use of lard instead of canola oil) that could put them at greater risk for chronic diseases (Gans, 2003).
- Language. Language may be a barrier to working with racial and ethnic minority communities. Interventions will likely be ineffective if participants do not understand the materials or information being provided (Thomas, 2002).
- Body image. Racial and ethnic minority groups have differing ideals of body shape and size. Some may view a larger body size as culturally more desirable or acceptable (Thomas, 2002). These beliefs and norms may lead to different perceptions about the importance of making healthy food choices.
- Belief in diet-disease connection. Evidence suggests there may be different perceptions of disease risk in relation to group membership (Thomas, 2002). Individuals may not view chronic disease as something that can be prevented by healthy food consumption patterns and other lifestyle habits.
- Stress. Ethnic and racial minorities may face multiple life stressors, such as discrimination, violence and poverty. Higher levels of stress often can contribute to unhealthy lifestyles, including poor nutrition (Edwards, 1995).
Strategies to address these considerations
- Improve availability of healthy food choices. Work with local community and faith-based organizations, businesses, and governmental leaders to increase the healthy options available at existing markets and restaurants (Zenk, 2005). Some communities have offered grants, loans, and tax benefits to stimulate the development of neighborhood groceries, farmers’ markets, community gardens, and farm-to-cafeteria programs (Institute of Medicine, 2005).
- Improve access to healthy food choices. Creating a network that includes community groups, local government, nonprofit organizations, local farmers and food processors can help expand accessibility to healthy foods (Institute of Medicine, 2005). Collaborating with city or county officials and urban planners on land use planning can limit the number of fast-food restaurants in a community (Larson, 2009). Improving transportation to venues that offer healthy foods can also improve access. It may be useful to work with city officials, urban planners, transportation departments, and faith-based organizations to develop city- or county-wide strategies to improve transportation options (Yancey, 2004).
- Make use of the power of media. Assess your local community to determine the impact food advertisements and promotional items have on food and nutrition choices (Lewis, 2005). Since media has great potential to play a persuasive role on food and nutrition choices, and ultimately habits, working with a variety of media channels to create healthy eating messages can help combat the unhealthy messages. Point-of-purchase advertising of healthy foods can also inform and entice participants to choose healthier options (Larson, 2009).
- Provide hands-on learning opportunities. Interventions that provide hands-on demonstrations, taste tests, and recipes of how to prepare traditional foods in a healthier way may work well in racial and ethnic minority communities (Thomas, 2002).
- Address barriers related to language. Providing translators or materials that have been translated can help to ensure that information is received and understood (National Center for Cultural Competence, 2009).
- Tailor to culture. Interventions tailored to reflect the diversity of cultures within your community are more likely to be effective than those aimed at a general population (USDHHS, 2000). When designing nutrition intervention activities, materials and incentives, it is important to consider characteristics of the community, such as: the primary language, common phrases and terms used, health beliefs and social norms, colors, photos and symbols that represent the community and its experiences (Bank-Wallace, 2002; Keller, 2006).
- Provide cultural competency training. Strategies to reach racial and ethnic minority populations should be culturally relevant (NCCC, 2009). It may be useful to provide training in cultural competency to individuals who are working with a community so that they can learn more about the differences within and across communities and how these differences influence nutrition interventions. See Cultural Competence for more information.
- Involve the priority populations. It is important that individuals who are from the priority populations and are both bi-lingual and bi-cultural take an active role in planning, implementing and evaluating interventions (Bank-Wallace, 2002). Building social support within the community and offering culturally appropriate incentives can encourage and retain participation.
- Engage community stakeholders. Leadership and active participation by community members, especially health care providers and community and religious leaders from the racial and ethnic minority community, can strengthen the credibility of and respect for the intervention (Bank-Wallace, 2002).
- Address participant needs. Consider providing childcare and transportation to increase participation (Bank-Wallace, 2002). Interventions that focus on small groups in racial and ethnic minority communities may be more effective than massive population-wide approaches.
- Use established settings. Strategies should maximize participation in the intervention by having meetings or events at convenient locations and times (Bank-Wallace, 2002). It may be useful to schedule intervention activities with other church or community social events.
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