Perspective: Nutrition Health Disparities Framework: A Model to Advance Health Equity

IF 8 1区 医学 Q1 NUTRITION & DIETETICS
Tanya Agurs-Collins , Jennifer Alvidrez , Sanae ElShourbagy Ferreira , Mary Evans , Kimberlea Gibbs , Bramaramba Kowtha , Charlotte Pratt , Jill Reedy , Marissa Shams-White , Alison GM Brown
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引用次数: 0

Abstract

Disparities in nutrition, such as poor diet quality and inadequate nutrient intake, arise from multiple factors and are related to adverse health outcomes such as obesity, diabetes, cardiovascular disease, and some cancers. The aim of the current perspective is to present a nutrition-centric socioecological framework that delineates determinants and factors that contribute to diet and nutrition-related disparities among disadvantaged populations. The Nutrition Health Disparities Framework (NHDF) describes the domains (biological, behavioral, physical/built environment, sociocultural environment, and healthcare system) that influence nutrition-related health disparities through the lens of each level of influence (that is, individual, interpersonal, community, and societal). On the basis of the scientific literature, the authors engaged in consensus decision making in selecting nutrition-related determinants of health within each domain and socioecological level when creating the NHDF. The framework identifies how neighborhood food availability and access (individual/built environment) intersect with cultural norms and practices (interpersonal/sociocultural environment) to influence dietary behaviors, exposures, and risk of diet-related diseases. In addition, the NHDF shows how factors such as genetic predisposition (individual/biology), family dietary practices (interpersonal/behavioral), and food marketing policies (societal) may impact the consumption of unhealthy foods and beverages and increase chronic disease risk. Family and peer norms (interpersonal/behavior) related to breastfeeding and early childhood nutrition interact with resource-poor environments such as lack of access to preventive healthcare settings (societal/healthcare system) and low usage of federal nutrition programs (societal/behavioral), which may increase risk of poor nutrition during childhood and food insecurity. The NHDF describes the synergistic interrelationships among factors at different levels of the socioecological model that influence nutrition-related outcomes and exacerbate health disparities. The framework is a useful resource for nutrition researchers, practitioners, food industry leaders, and policymakers interested in improving diet-related health outcomes and promoting health equity in diverse populations.

透视:营养健康差异框架:促进健康公平的模式
饮食质量差和营养摄入不足等营养不均现象由多种因素造成,并与肥胖、糖尿病、心血管疾病和某些癌症等不良健康后果有关。目前的观点旨在提出一个以营养为中心的社会生态框架,该框架描述了导致弱势人群饮食和营养相关差异的决定因素和影响因素。营养健康差异框架(NHDF)通过各个影响层面(即个人、人际、社区和社会)的视角,描述了影响营养相关健康差异的领域(生物、行为、物理/建筑环境、社会文化环境和医疗保健系统)。在科学文献的基础上,作者在创建 NHDF 时参与了共识决策,在每个领域和社会生态层面选择与营养相关的健康决定因素。该框架确定了邻里食物供应和获取(个人/建筑环境)如何与文化规范和习俗(人际/社会文化环境)相互交织,从而影响饮食行为、暴露和饮食相关疾病的风险。此外,NHDF 还显示了遗传倾向(个人/生物学)、家庭饮食习惯(人际/行为)和食品营销政策(社会)等因素如何影响不健康食品和饮料的消费并增加慢性病风险。与母乳喂养和儿童早期营养有关的家庭和同伴规范(人际/行为)与资源匮乏的环境相互作用,如缺乏预防性医疗保健机构(社会/医疗保健系统)和联邦营养计划使用率低(社会/行为),这可能会增加儿童期营养不良和粮食不安全的风险。NHDF 描述了社会生态模型不同层次的因素之间的协同相互关系,这些因素影响营养相关结果并加剧健康差异。该框架是营养研究人员、从业人员、食品行业领导者以及对改善饮食相关健康结果和促进不同人群健康公平感兴趣的政策制定者的有用资源。
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来源期刊
Advances in Nutrition
Advances in Nutrition 医学-营养学
CiteScore
17.40
自引率
2.20%
发文量
117
审稿时长
56 days
期刊介绍: Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.
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