Abstract
Introduction
Obesity disproportionately affects rural communities, and Appalachia has some of the highest obesity rates in the nation. Successful policy, systems, and environmental (PSE) interventions to reduce obesity must reflect the circumstances of the population. We used a health equity lens to identify barriers and facilitators for healthy food access in Martin County, Kentucky, to design interventions responsive to social, cultural, and historical contexts.
Methods
We conducted 5 focus groups in Martin County, Kentucky, in fall 2019 to obtain perspectives on the local food system and gauge acceptability of PSE interventions. We used grounded theory to identify perceived barriers and facilitators for healthy eating.
Results
Thirty-four adults (27 women; median age, 46 years) participated in 5 groups. One prominent theme was declining interest in farming; many participants believed this decline was generational. One participant noted, “Most of my adult male relatives worked in the coal mines, and they worked 6 days a week. . . . My grandpa had the garden, but then my dad’s generation is the one quit gardening.” Another shared, “You would probably have to have someone to teach [gardening].” Instead of enhancing farmers markets, participants suggested building community capacity for home gardens to increase vegetable consumption.
Conclusion
Our findings demonstrate the importance of obtaining community input on the development of PSE interventions to mitigate inequities in obesity. Although farmers market interventions were deemed not feasible, other solutions to enhance access to produce were identified. Developers of community-responsive PSE interventions to improve healthy eating in rural, food-insecure locations should consider using an equity-oriented prevention framework to ensure acceptable interventions.
Document Type
Article
Publication Date
12-24-2020
Digital Object Identifier (DOI)
https://doi.org/10.5888/pcd17.200340
Funding Information
This study was supported by cooperative agreement 1NU58DP0065690100 by the Centers for Disease Control and Prevention.
Repository Citation
Cardarelli, Kathryn; DeWitt, Emily M.; Gillespie, Rachel; Norman-Burgdolf, Heather; Jones, Natalie; and Mullins, Janet Tietyen, "“We’re, like, the Most Unhealthy People in the Country”: Employing an Equity Lens to Reduce Barriers to Healthy Food Access in Rural Appalachia" (2020). Dietetics and Human Nutrition Faculty Publications. 30.
https://uknowledge.uky.edu/foodsci_facpub/30
Included in
Dietetics and Clinical Nutrition Commons, Food Security Commons, International and Community Nutrition Commons, Public Health Commons
Notes/Citation Information
Published in Preventing Chronic Disease, v. 17, e165.
The United States Government commits this article to the public domain and allows it to be used and reproduced by anyone without permission.