Poor, predominantly minority and African-American neighborhoods tend to have a limited number of supermarkets and large grocery stores. Such neighborhoods do not have easy access to fresh, affordable food. Instead, residents rely on corner stores that typically stock highly processed, low nutritional value food. Previous research has linked living in these so-called food deserts with a nutritionally poor diet. To find solutions to this problem, researchers need to understand how residents of these neighborhoods make decisions about where to shop and what goes on the grocery list.
Uriyoán Colón-Ramos, ScD, MPA, an Associate Professor of Global Health at Milken Institute School of Public Health at the George Washington University, and her colleagues did a qualitative study using the Photovoice approach to gain a deeper understanding about how parents and other caregivers navigate the nearby desert or go outside the neighborhood to find a better variety of foods.
The research team interviewed 16 African American primary caregivers of children under the age of 10 who lived in one or two adjacent low-income neighborhoods in Washington, D.C. Most people living in these neighborhoods were from single-parent female households, and 50 percent receive benefits from the federal government’s Supplemental Nutrition Assistance Program, formerly called the Food Stamp Program.
The Photovoice approach is a participatory qualitative research method in which participants were asked to take photographs documenting and describing their lives. The researchers initially conducted a 40-minute interview with each parent or caregiver—often a grandparent. Afterward, the caregivers took photos over a 3-to-4-day period that documented what made it easier or harder for them to provide foods that they wanted for their families. Researchers then conducted a secondary interview with caregivers for them to examine the photos and describe the scenes they depicted.
The qualitative findings describe how resourceful caregivers were in obtaining foods they thought were best.
“For those working to address healthy food access and quality experiences, we began to dig at the cultural influences of what helps or hinders caregivers in navigating these experiences,” said Tambra Raye Stevenson, founder and CEO of WANDA (Women Advancing Nutrition Dietetics and Agriculture) and a research collaborator on the paper. Stevenson and her family live in Anacostia in D.C.’s Ward 8, which is a neighborhood with limited access to quality, nutritious foods in stores.
For example, many described a long journey by public transportation to grocery stores outside the District where they could find what they were looking for at a better price and quality. They also said they preferred to shop at stores where they felt valued as African American customers.
The foods they shopped for could include processed foods or treats, such as popsicles, but participants also placed a high value on foods that they considered nutritious, such as fresh vegetables and fruits.
“One mother mentioned that she may try to purchase items with whole-grain bread,” Colón-Ramos said. “Or they would describe using strawberry preserves with real fruit instead of strawberry jelly to make a peanut butter and jelly sandwiches.”
The participatory approach also aims to find out how to engage community residents around nutrition, even though there are other priorities in the lives of these residents. To improve nutrition in food desert neighborhoods, the participants in this study said that researchers should first tackle the root causes of nutrition disparities, such as the lack of affordable housing, jobs and transportation.
Participants said they were unlikely to participate in nutrition programs unless they felt that these aligned with an agenda to improve the overall quality of life in the neighborhoods.
The paper, “How do African-American caregivers navigate a ‘food desert’ to feed their children? A Photovoice narrative” appeared online in the Journal of the Academy of Nutrition and Dietetics on June 19.