School of Public Health Sciences, University of Waterloo, Waterloo, Canada.
Department of Community Health Sciences, University of Calgary, Calgary, Canada.
J Nutr. 2022 Jun 13;152(Suppl 1):67S-75S. doi: 10.1093/jn/nxac076.
Structural racism and economic marginalization shape dietary patterns in complex ways. Most research examining race and income inequities discount their interactions in shaping dietary intakes. An intersectional approach is needed to identify interconnected sources of social inequities and to more precisely locate dietary inequities.
We examined whether racial identity and perceived income adequacy independently and jointly shape dietary quality, defined using the Healthy Eating Index (HEI) 2015, among a large sample of adults in Canada.
Cross-sectional data from 2540 adults (≥18 years of age) in Canada who participated in the 2019 International Food Policy Study were analyzed. Multivariable linear regression models were executed to test the independent associations and interactions between racial identity and perceived income adequacy with HEI-2015 scores. Models were constructed to examine HEI-2015 total and component scores, adjusting for age, gender, and education.
Perceived income adequacy, but not racial identity, was independently associated with HEI-2015 total scores. The interaction between racial identity and perceived income adequacy was significantly associated with HEI-2015 scores. Compared to the reference group (individuals identifying as White and reporting income adequacy), those identifying as Black and reporting income adequacy were associated with lower HEI-2015 scores (β, -7.30; 95% CI, -13.07 to -1.54) and those identifying as Black and reporting income inadequacy were associated with lower HEI-2015 scores (β, -6.37; 95% CI, -12.13 to -0.60). Individuals who identified as indigenous and reported neither income adequacy nor inadequacy had lower HEI-2015 scores (β, -8.50; 95% CI, -13.82 to -3.18) compared to the reference group.
Findings suggest that racial identity and perceived income adequacy jointly shape dietary quality. Inequities in dietary quality may be missed when intersecting racial identities and socioeconomic positions are not explicitly investigated. To support healthier dietary patterns, strategies must reduce socioeconomic barriers that impose dietary constraints on some racialized groups.
结构性种族主义和经济边缘化以复杂的方式塑造饮食模式。大多数研究在检查种族和收入不平等时，都忽略了它们在塑造饮食摄入方面的相互作用。需要采用交叉方法来确定社会不平等的相互关联的来源，并更准确地定位饮食不平等。
我们研究了在加拿大的一个大型成年人样本中，种族身份和感知收入充足性是否独立且共同塑造了饮食质量，该质量使用 2015 年健康饮食指数（HEI）来定义。
分析了来自加拿大 2540 名成年人（≥18 岁）的 2019 年国际粮食政策研究的横断面数据。执行多变量线性回归模型来检验种族身份和感知收入充足性与 HEI-2015 评分之间的独立关联和相互作用。构建模型以调整年龄、性别和教育后，检验 HEI-2015 的总分和成分得分。
感知收入充足性，而不是种族身份，与 HEI-2015 总分独立相关。种族身份和感知收入充足性之间的相互作用与 HEI-2015 评分显著相关。与参考组（自我认同为白人且报告收入充足）相比，自我认同为黑人且报告收入充足的人 HEI-2015 评分较低（β，-7.30；95%CI，-13.07 至-1.54），而自我认同为黑人且报告收入不足的人 HEI-2015 评分较低（β，-6.37；95%CI，-12.13 至-0.60）。自我认同为原住民且既不报告收入充足也不报告收入不足的人 HEI-2015 评分较低（β，-8.50；95%CI，-13.82 至-3.18）与参考组相比。
研究结果表明，种族身份和感知收入充足性共同塑造了饮食质量。如果不明确调查交叉种族身份和社会经济地位，可能会错过饮食质量方面的不平等。为了支持更健康的饮食模式，必须减少对某些种族群体施加饮食限制的社会经济障碍。
