Obesity and certain nutritional deficiencies are global health problems that emerge in systems of interdependent individual biological and historical factors and social environmental determinants of health. Nutrition security is a framework that assumes stable access to sufficient innocuous and nutritious food (i.e., food security), health care, and sanitation, and information that in conjunction allows self-care-oriented behavior for health protection. To understand the social environment of nutrition insecurity, the object of study was the food distribution and consumption system of a marginalized community in Hermosillo, Mexico. We assessed the distribution of food establishments by social marginalization level in basic geo-statistical areas and the nutrition security status of women in underserved neighborhoods. We found that in Hermosillo >90% of food establishments included for analysis (grocery stores, supermarkets, convenience stores, and beer deposits) were distributed outside of areas with high levels of social marginalization. The nutrition security assessment suggests that low intakes of fruit and vegetables and high intakes of fat and sugar may be associated with food accessibility and acceptability factors in individual decision-making processes. Future research should take into account the variability of food system environments and address the particular needs of communities in terms of food and nutrition security.
Objectives The main objective was to identify determinants of food choice linked to the community food environment in a marginalized consumer population in the city of Hermosillo, Mexico. The specific objectives were to develop group interviews with women and to frame the data analysis within the field of research in food and nutrition security. Methods In this qualitative study design, we employed the focus group technique to ask participants “How do you decide which foods to obtain for your family's diet?”. To investigate further we asked, “What are those reasons that explain the selection of those foods?” Women who regularly attended a community center localized in a neighborhood with a very high grade of urban marginalization participated in the focus groups. Interviews were transcribed verbatim and three distinct methods were used to perform analysis: (1) content analysis (2) data organization, using software QSR NVivo, in relation to five dimensions of food and nutrition security: affordability, accessibility, acceptability, food quality, and care; and (3) triangulation between five co-authors (A.C.N., P.B.C., A.D.C.P., G.E.P.A., and M.I.O.V.). Results From May to November of 2019, four focus groups were conducted by a single facilitator in two community centers of Hermosillo (n = 27 participants). Reasons that explained the participant's food choices within the community food environment and that showed the highest number of mentions in the interviews were identified in relation to acceptability factors: children's food preferences, partner's food preferences, all household-members’ food preferences. The following extract reflects the main study findings: “When I can't do a certain thing it is because it's very expensive, but if there is a way, even if it's a little… for example, my middle-aged son really likes peppers and he eats them alone. So, I know that when I go to the store, I have to bring at least one, for him to eat other things.” Conclusions The study of food choice in this group of women denotes that their role as caregiver of food and nutrition in relation to their children-and-partner's food preferences are key elements of food decision-making processes, preceding the socioeconomic factors and constraints, they certainly face. Funding Sources Institutional small grant C.I.A.D., A.C.
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