Food insecurity, overweight and obesity among low-income African-American families in Baltimore City: associations with food-related perceptions

Abstract

Objective To examine associations between food insecurity, excess body weight, psychosocial factors and food behaviors among low-income African-American (AA) families. Design Cross-sectional survey of participants in the baseline evaluation of the B’More Healthy Communities for Kids (BHCK) obesity prevention trial. We collected data on socioeconomic factors, food source destinations, acquiring food, preparation methods, psychosocial factors, beliefs and attitudes, participation in food assistance programs, anthropometry and food security. We used principal component analysis to identify patterns of food source destinations and logistic regression to examine associations. Setting Fourteen low-income, predominantly AA neighborhoods in Baltimore City. Subjects 298 adult caregiver-child (10–14 years old) dyads. Results 41.6% of households had some level of food insecurity, and 12.4% experienced some level of hunger. Food insecure participants with hunger were significantly more likely to be unemployed and to have lower incomes. We found high rates of excess body weight (overweight and obese) among adults and children (82.8% and 37.9% food insecure without hunger; 89.2% and 45.9% with hunger, respectively), although there were no significant differences by security status. Food source usage patterns, food acquisition, preparation, knowledge, self-efficacy and intentions did not differ by food security. Food security was associated with perceptions that healthy foods are affordable and convenient. Greater caregiver body satisfaction was associated with food insecurity and excess body weight. Conclusions In this setting, obesity and food insecurity are major problems. For many food insecure families, perceptions of healthy foods may serve as additional barriers to their purchase and consumption.

Factors Associated with Home Meal Preparation and Fast-Food Sources Use among Low-Income Urban African American Adults

“…Response options were on a 5-point Likert-type scale ranging from strongly agree to strongly disagree with a neutral midpoint (Vedovato et al 2015). We summed all subscales to generate the Healthy Food Beliefs and Attitudes Scale, which had scores that ranged from 15 to 48 with a mean of 36.1 (SD = 5.1; Cronbach’s alpha = .52; n = 293).…”

“…Self-efficacy scores ranged from 11 to 30, with a mean of 24.8 (SD = 3.8, Cronbach’s alpha = .68). The development of these subscales has been previously described (Vedovato et al 2015). …”

Psychosocial Determinants of Food Acquisition and Preparation in Low-Income, Urban African American Households

“…For household frequency of purchasing at prepared food sources, the caregivers reported the number of times they purchased or got food from different food sources 30 days prior to the interview date (Trude et al, 2016; Vedovato et al, 2016). A list of 18 different food sources (e.g.…”

“…Healthier items were foods and drinks that were lower in fat and/or sugar, or were “light” or “diet” versions of less healthy foods and beverages. Examples of healthier items included water, pretzels, sugar-free fruit drink, yogurt, low-sugar cereal, fruits, and vegetables (Vedovato et al, 2016). …”

Development and Implementation: B’More Healthy Communities for Kid’s Store and Wholesaler Intervention

“…Obesity during childhood can lead to metabolic syndrome, type 2 diabetes, an increased risk for obesity in adulthood, as well as other comorbidities (Biro & Wien, 2010; Estrada et al, 2014). Among food insecure households in Baltimore City who experience hunger, 73% of adults and 19% of children are obese (Vedovato et al, 2016). African American residents have disproportionately poor access to healthy foods, compared to Caucasian residents and a corresponding high rate of obesity (Baltimore City Health Department, 2014; Buczynski, Freishtat, & Buzogany, 2015; Franco, Roux, Glass, Caballero, & Brancati, 2008).…”