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The hunger-obesity paradox: Exploring food banking system characteristics and obesity inequities among food-insecure pantry clients

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  • Kristen Cooksey Stowers
  • Nana Yaa A Marfo
  • Eminet Abebe Gurganus
  • Kim M Gans
  • Shiriki K Kumanyika
  • Marlene B Schwartz

Abstract

Purpose: 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. Methods: 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. Results: 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. Conclusion: 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.

Suggested Citation

  • Kristen Cooksey Stowers & Nana Yaa A Marfo & Eminet Abebe Gurganus & Kim M Gans & Shiriki K Kumanyika & Marlene B Schwartz, 2020. "The hunger-obesity paradox: Exploring food banking system characteristics and obesity inequities among food-insecure pantry clients," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-20, October.
    • Handle: RePEc:plo:pone00:0239778
    DOI: 10.1371/journal.pone.0239778
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    References listed on IDEAS

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    1. Sabrina E. Cuauro & Natalia Santos & Estefania Andrade & Anoushka W. Dani & Saivone N. Sanchious & Savannah C. Hooper & Carolyn Black Becker, 2023. "Internalized Weight Stigma and Weight Discrimination: Associations with Quality of Life and Psychosocial Impairment in a Sample Living with Food Insecurity," IJERPH, MDPI, vol. 20(24), pages 1-17, December.
    2. Adam Pine, 2023. "Ambient struggling: food, chronic disease, and spatial isolation among the urban poor," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 40(3), pages 1105-1116, September.

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