Inequities in food access during the COVID19 pandemic: a multilevel, mixed methods pilot study.

Background Innovative data integration may serve to inform rapid, local responses to community needs. We conducted a mixed methods pilot study among communities of color or low-income in the San Francisco Bay Area amid the COVID-19 pandemic to assess a hypothesized data model to inform rapid response efforts. Methods Between 2020-2021, we collected (1) qualitative data through neighborhood reports submitted via Streetwyze, a mobile neighborhood mapping platform; (2) survey data on social and economic circumstances; and (3) geospatial data among residents of three counties. Qualitative data were coded and then integrated with survey and geospatial data. We used descriptive analyses to examine participants' experiences with food in their neighborhoods. Results Seventy percent of participants reported food insecurity before and after the pandemic began in March 2020. Within neighborhood reports, food was the most frequently occurring sub-theme within the Goods and Resources parent themes (68% and 49% of reports, respectively). Security (88%), resource programs (88%), outdoor space (84%), and equity (83%) were more likely to be mentioned by participants who were food insecure compared to those who were not (12%, 12%, 16%, 17%, respectively). Mentions of food in neighborhood reports more often occurred in census tracts with lower socioeconomic status and more area-level food insecurity. Conclusion Individuals who were food insecure reported a constellation of needs beyond food, including needs related to safety and greater social equity. Our data model illustrates the potential for rapid assessment of community residents' experiences to provide enhanced understanding of community-level needs and effective support in the face of changing circumstances.

Acculturating to multiculturalism: a new dimension of dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander women in the San Francisco Bay Area, USA.

BACKGROUND: Dietary acculturation is the process by which diet and dietary practises from the environment of origin are retained or changed and/or those prevalent in a new environment are adopted. Despite rapid population growth the U.S., knowledge gaps exist on characterising dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander communities (AANHPI). This study characterise dietary patterns in a sample representative of AANHPI on key demographic characteristics. METHODS: Data were from a 2013-2014 population-based case-control study in the San Francisco Bay Area, U.S. Survey items were adapted from dietary acculturation scales developed for AANHPI populations. Validated measures assessed social capital, social standing, discrimination and immigration experiences. A principal components factor analysis was conducted to characterise dietary patterns of acculturation. RESULTS: Three dietary patterns were identified: "Asian," "Western," and a distinct "Multicultural" factor. Respondents reporting a high-Asian diet tended to also report smaller social networks, higher levels of stress, and, among those born outside of the U.S., an educational standing that was better before immigration. Respondents reporting a high-Western diet tended to also report the highest level of discrimination. Those reporting a high-Multicultural diet tended to report higher neighbourhood collective efficacy. CONCLUSIONS: The finding of a distinct "Multicultural" factor beyond the typical "Asian" and "Western" factors may reflect the multidirectional relationships between culture, diet, and dietary behavior, in which origin and destination cultures interact in complex ways and where foods from multiple ethnicities intermix.

A validation study for measuring Asian- and Hispanic-serving sociocultural institutions in neighborhoods using business listing data and potential implications for health.

Ethnic enclaves influence the health of Asian American and Hispanic or Latinx/a/o populations, likely via neighborhood social, economic, and built environments. To facilitate studies aiming to disentangle these specific neighborhood mechanisms, we describe the creation and validation of two novel measures-Asian-serving and Hispanic-serving sociocultural institutions (SCIs)-to estimate the social, cultural, and economic character of ethnic enclaves in California. Business listing data were used to identify SCIs or businesses that promote cultural and social identity, including arts, civic, historical, religious, social service, and membership organizations. Keyword searches of business names were used to identify potential Asian- or Hispanic-serving SCIs. An online audit of 1,627 businesses within 12 cities confirmed the validity of using keyword searches to assess whether census tracts were high or low in Asian- or Hispanic-serving SCIs (sensitivity: 63%-100%, specificity: 86%-95%; positive predictive value: 63%-89%). In exploratory regression analyses, high presence of SCIs (compared to low presence) may be associated with neighborhood-level health indicators, including greater percentages of residents who had an annual checkup in majority Asian census tracts and lower percentages of residents who were current smokers in majority Asian and Hispanic census tracts. This approach advances methodology in measurement of neighborhood sociocultural environments.

Lessons Learned from Immigrant Health Cohorts: A Review of the Evidence and Implications for Policy and Practice in Addressing Health Inequities among Asian Americans, Native Hawaiians, and Pacific Islanders.

The health of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) is uniquely impacted by structural and social determinants of health (SSDH) shaped by immigration policies and colonization practices, patterns of settlement, and racism. These SSDH also create vast heterogeneity in disease risks across the AANHPI population, with some ethnic groups having high disease burden, often masked with aggregated data. Longitudinal cohort studies are an invaluable tool to identify risk factors of disease, and epidemiologic cohort studies among AANHPI populations have led to seminal discoveries of disease risk factors. This review summarizes the limited but growing literature, with a focus on SSDH factors, from seven longitudinal cohort studies with substantial AANHPI samples. We also discuss key information gaps and recommendations for the next generation of AANHPI cohorts, including oversampling AANHPI ethnic groups; measuring and innovating on measurements of SSDH; emphasizing the involvement of scholars from diverse disciplines; and, most critically, engaging community members to ensure relevancy for public health, policy, and clinical impact.