Department of Allied Health Sciences, Storrs, Connecticut, United States of America.
Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, United States of America.
PLoS One. 2020 Oct 21;15(10):e0239778. doi: 10.1371/journal.pone.0239778. eCollection 2020.
Heightened 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.
We 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.
Multiple 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.
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.
食品无保障食品储藏室客户的肥胖风险增加是一个公平问题，因为肥胖和饥饿的同时发生深深地植根于系统性社会劣势和历史压迫。本定性研究探讨了主要利益相关者对美国食品银行系统与食品不安全客户之间肥胖差异之间关系的看法。
我们对 10 名熟悉食品银行运作的主要利益相关者（例如食品银行主任、食品银行董事会成员、倡导者）进行了深入的半结构化访谈。数据逐字转录，在 NVivo [v11] 中进行编码，并使用主题分析进行分析。
多个主题出现，将食品银行系统的结构特征与食品不安全和肥胖的双重负担的差异联系起来：[a] 从捐赠者那里获得不健康的食物；[b] 联邦紧急食品政策和计划；[c] 州一级的紧急食品政策和计划；[d] 基于地理位置的风险概况；[e] 食品供应与客户需求之间的不足。受访者还确定了系统领导者和客户之间的社会挑战，这些挑战维持了极低食品保障个体的肥胖风险差异，包括：[a] 媒体对食品储藏室客户的代表性和刻板印象；[b] 对有色人种社区的不信任；[c] 食品银行系统领导者中缺乏包容性/代表性；[d] 获取信息。
未来缓解长期受食品不安全困扰的客户（尤其是某些特定客户群体）中的肥胖不平等现象的努力应优先考虑政策、系统和环境战略，以克服食品银行系统中的这些结构性和社会挑战。
