부산대학교 도서관

Introduction: Poor food environment and disproportionate food insecurity among African Americans represent determinants of chronic disease disparities by race/ethnicity. The presence of a supermarket could lead to a 32 percent increase in fruit and vegetable consumption among AAs, yet a complex set of barriers may make it difficult to participate in healthy nutrition. We examined the food environment in Baltimore, MD, through the perspectives of African Americans with hypertension.Methods: Photovoice is a community-based participatory research tool that uses photography to engage participants in reflection and dialogue regarding their communityʼs strengths, needs, and capacity for social change. We recruited 24 residents of Baltimore who met initial demographic—age (21 years or older), race (African American), and clinical criteria (hypertension) for the Five Plus Nuts and Beans for Kidneys study—a randomized control trial of a dietary intervention, but were ultimately found ineligible. After photography training, participants responded to “Photograph everything related to food in your neighborhood” and discussed their images over 4 sessions. Audiotaped conversations were analyzed for common themes.Results: Through this formative, community-engaged process, residents deemed the food environment reflective of the race of the neighborhood’s occupants with low-income Blacks consistently situated at the disadvantaged end. Participants expressed the lack of access to food—a resource that they deemed should be accessible to all—as a catalyst of crime, a point of racial injustice, and a stumbling block in improving their health. Residents identified both individual- and system-level barriers and facilitators to eating healthy foods.Conclusions: Engaging community voices and taking stock of the nuances of the food environment, including its construction and subsequent impact on residents’ outcomes, may inform clinical practice and health policy. Photos will be exhibited and used during a moderated conversation on the food environment among multiple stakeholders in Baltimore, including viable solutions to the “food desert” conditions and opportunities to address racial disparities in chronic disease.