Budgeting and food insecurity among low-income African American caregivers: A qualitative analysis

The highest rates of obesity in the United States are found among the lower-income groups. African Americans and their children are disproportionately at risk. Despite studies that illustrate the relationship between socioeconomic status, race and obesity, researchers continue to have a limited understanding of how various factors impact dietary practices in African-American families. This study uses an ethnographic approach including in-depth interviews and neighborhood assessment to identify multi-level factors that influence dietary practices. African American female primary caregivers (n=12) were recruited to complete approximately 3 individual interviews focused on daily activities, budgeting, and food shopping. Interviews were open coded using constant comparison in ATLAS Ti 6.0, a qualitative data management software. Codes included participant resources, budgeting strategies, food shopping, and food insecurity issues. Participants discussed using budgeting strategies to make ends meet including the use of public assistance, buying in bulk, selective shopping, and purchasing alternative less healthy items. Data analysis also revealed complex relationships between 1) the food environment (safety, food quality, store cleanliness, and affordability) 2) family (food preferences, health beliefs, learned behaviors, and exposure to healthy foods), and 3) one's socioeconomic position (poverty, stress, priorities beyond healthy eating). Health and dietary behaviors are complex and multifaceted. This study demonstrates that multiple factors interact to influence dietary behaviors and obesity risk in low income African American families. Interventions that target this population should move beyond nutrition education, focus on the underlying causes of poverty, assist families with resources to manage multiple stressors, and address the neighborhood environment.