‘It's a full time job being poor’: understanding barriers to diabetes prevention in immigrant communities in the USA

Chaufan, Claudia; Constantino, Sophia; Davis, Meagan

doi:10.1080/09581596.2011.630383

Cited by 32 publications

(43 citation statements)

References 19 publications

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“…There is, in fact, evidence that children who walk or bike to school tend to be lower income (Harten & Olds, 2004;McMillan, 2007;McDonald, 2008;Metcalf, Voss, Jeffery, Perkins, & Wilkin, 2004) and that poor children bear a disproportionate burden of obesity (Phipps, Burton, Osberg, & Lethbridge, 2006). A study conducted by the first author in a low-income neighborhood found transportation barriers -lack of car ownership or appropriate public transportation substitutes -to purchasing healthy foods, suggesting that lack of car ownership due to poverty may lead both to barriers to accessing healthy foods and to higher rates of AST among children (Chaufan, Constantino, & Davis, 2011). Similarly, a study of low-income mothers indicated that compulsory walking due to lack of car ownership undermined the health and well-being of mothers and their children (Bostock, 2001).…”

Section: Discussionmentioning

confidence: 96%

“…This perspective proposes that the SDH are the key drivers of poor health and health inequalities -mediated often, but not always, by health behaviors (Marmot, 2002). It follows that more redistributive policies should lead to better health indices (Navarro & Shi, 2001) and that without major structural changes in the distribution of health-relevant social resources, the chances of improving population health and decreasing health inequalities are bleak (Chaufan, Constantino, & Davis, 2011;Link & Phelan, 2005;Raphael, 2007;Raphael et al, 2011).…”

mentioning

confidence: 97%

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You can’t walk or bike yourself out of the health effects of poverty: active school transport, child obesity, and blind spots in the public health literature

Chaufan

Yeh

Ross

et al. 2014

Critical Public Health

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Mainstream public health theories of obesity attribute current, unprecedented numbers of obese youth to changes in eating practices and levels of physical activity, in turn leading to greater energy consumption and lesser energy expenditure. While substantial research has examined energy consumption among school-age children, key modes of energy expenditure such as active school transport (AST) remain underexplored. Using AST data obtained from the California Safe Routes to Schools program and child health data from the California Physical Fitness Test, we examined the association between AST and child obesity among school-age children and disambiguated this relationship introducing the variable poverty. We found that greater AST correlated with higher rates of child obesity and higher rates of child poverty, which in turn correlated with worse child health and obesity rates. Our findings suggest that child poverty explains the positive relationship between AST and child obesity that has puzzled investigators. Our analysis also reveals recurring blind spots in the public health literature, which often acknowledges that poverty begets poor health yet calls for environmental changes while rarely calling for eliminating poverty, one critical social determinant of health, even as these determinants have become legitimate objects of scientific inquiry. We propose that while environmental changes may improve the health of the poor, the only effective way to improve child health and reduce child obesity is to eliminate or dramatically reduce child poverty, a sociopolitical issue. This study is part of a larger project evaluating socio-political determinants of child health.

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Section: Discussionmentioning

confidence: 96%

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confidence: 97%

You can’t walk or bike yourself out of the health effects of poverty: active school transport, child obesity, and blind spots in the public health literature

Chaufan

Yeh

Ross

et al. 2014

Critical Public Health

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“…7 This study results showed barriers that were similar to other minority populations in the continental U.S. such as cost of healthy foods, taste preference, and low availability of healthy food choices. 19,25–27 Moreover, participants related their decisions choose imported processed food versus plant-based local foods was due to aforementioned reasons plus positive emotions (such as comfort). Other researchers found emotions as the driving force behind consumers’ decisions and actions.…”

Section: Discussionmentioning

confidence: 99%

“…19 This type of information is not available for the Chuukese population which underscores the need for this type formative research. Scholars and practitioners consistently recommend the consideration of culture and context in diabetes interventions to assist minority populations in their management of T2DM.…”

Section: Introductionmentioning

confidence: 99%

Formative Research to Inform Nutrition Interventions in Chuuk and the US Pacific

Aitaoto

Campo

Snetselaar

et al. 2015

Journal of the Academy of Nutrition and Dietetics

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The type 2 diabetes epidemic is a global health issue, and it is especially severe in the U.S. Pacific. Although there are nutrition interventions in Hawai’i and the Pacific, success is limited due in part to the lack of tailoring for the Pacific context. The Pacific context is inclusive of environment, political and economic situation; historical (pre-contact, colonial and post-colonial) background; cultural practices; and spiritual orientation. This study used Grounded Theory and Community Based Participatory Research (CBPR) processes to identify influences that hinder or facilitate adherence to nutrition recommendations. Data were gathered through key informant interviews (faith leaders and health care providers) and focus group discussions (individual with diabetes and care takers). Results showed barriers to nutrition recommendations adherence that were similar to other minority populations in the U.S. such as cost of healthy foods, taste preference, low availability of healthy food choices, lack of ideas for healthy meals/cooking, and lack of culturally appropriate options for dietary modification. It also elucidated behaviors that influences adherence to nutrition recommendations such as preparing and consuming meals for and with extended family and church members; patient and group motivation; and access to healthy, affordable and palatable foods. Participants expressed the need for interventions that are tailored to the local culture and context and a holistic view of health with a focus on motivation (spiritual and emotional support). These findings could be used to develop culturally and contextually appropriate programs. For example, adapting Motivational Interviewing (MI) techniques and materials by adding family members to MI sessions versus patients only as Pacific Islanders have a collectivistic culture and family members play an important role in adherence; conducting MI in the community in addition to the clinical setting; utilizing church leaders as MI counselors in addition to healthcare providers; and changing MI narratives and tools (e.g., a confidence scale of 1 to 10 will be unfamiliar to many Pacific Islanders, therefore, counselors need to develop another method to indicate levels of confidence, such as the color of the lagoon/ocean that goes from turquoise [the color of shallow water] to navy blue [the color of deep water].

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“…Retter vi blikket mod epidemiologien, angives type 2-diabetes at vaere forårsaget af overlappende risikofaktorer, hvoraf den mest fremtraedende er overvaegt og fedme. Mindre opmaerksomhed rettes mod de mindre naturaliserede risikofaktorer som genetik, fattigdom, sundhedspolitik og politiske barrierer (Chaufan, Constantino og Davis, 2011;McNaughton, 2013). For at kunne etablere et kausalt forhold mellem sundhedspaedagogik og borgeres sundhedsrelaterede adfaerd kraever det derfor, at man konstituerer sundhedspaedagogikken/undervisningen såvel som den enkeltes adfaerd som objekter.…”

Section: Diagnosticering Som Klassifikationsredskabunclassified

Kritiske perspektiver i helsefagene: Utdanning, yrkespraksis og forskning

Feiring

Knutsen²,

Juritzen

et al. 2017

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‘It's a full time job being poor’: understanding barriers to diabetes prevention in immigrant communities in the USA

Cited by 32 publications

References 19 publications

You can’t walk or bike yourself out of the health effects of poverty: active school transport, child obesity, and blind spots in the public health literature

You can’t walk or bike yourself out of the health effects of poverty: active school transport, child obesity, and blind spots in the public health literature

Formative Research to Inform Nutrition Interventions in Chuuk and the US Pacific

Kritiske perspektiver i helsefagene: Utdanning, yrkespraksis og forskning

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