Population-based solutions are needed to stabilize and then reverse the continued upward trends in obesity prevalence in the US population and worldwide. This review focuses on the related, urgent issue of disparities in obesity prevalence affecting US racial/ethnic minority and other socially marginalized populations. The review provides background on these disparities from a health equity perspective and highlights evidence of progress in equity-focused obesity efforts. Five recommendations for advancing equity efforts are offered as potential approaches to build on progress to date: () give equity issues higher priority, () adopt a health equity lens, () strengthen approaches by using health equity frameworks, () broaden the types of policies considered, and () emphasize implementation science concepts and tools. Potential challenges and opportunities are identified, including the prospect of longer-term, transformative solutions that integrate global and national initiatives to address obesity, undernutrition, and climate change.


Article metrics loading...

Loading full text...

Full text loading...


Literature Cited

  1. 1.
    Adler NE, Stewart J. 2009. Reducing obesity: motivating action while not blaming the victim. Milbank Q. 87:49–70
    [Google Scholar]
  2. 2.
    Agurs-Collins T, Persky S, Paskett ED, Barkin SL, Meissner HI et al. 2019. Designing and assessing multilevel interventions to improve minority health and reduce health disparities. Am. J. Public Health 109:S86–93
    [Google Scholar]
  3. 3.
    Alcántara C, Diaz SV, Cosenzo LG, Loucks EB, Penedo FJ, Williams NJ. 2020. Social determinants as moderators of the effectiveness of health behavior change interventions: scientific gaps and opportunities. Health Psychol. Rev. 14:132–44
    [Google Scholar]
  4. 4.
    Alcaraz KI, Sly J, Ashing K, Fleisher L, Gil-Rivas V et al. 2017. The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity. J. Behav. Med. 40:23–38
    [Google Scholar]
  5. 5.
    Alvidrez J, Castille D, Laude-Sharp M, Rosario A, Tabor D 2019. The National Institute on Minority Health and Health Disparities research framework. Am. J. Public Health 109:S16–20
    [Google Scholar]
  6. 6.
    Alvidrez J, Nápoles AM, Bernal G, Lloyd J, Cargill V et al. 2019. Building the evidence base to inform planned intervention adaptations by practitioners serving health disparity populations. Am. J. Public Health 109:S94–101
    [Google Scholar]
  7. 7.
    Am. Psychol. Assoc 2017. Stress and health disparities: contexts, mechanisms, and interventions among racial/ethnic minority and low socioeconomic status populations Rep. APA Working Group on Stress and Health Disparities Washington, DC: https://www.apa.org/pi/health-equity/resources/stress-report.pdf
  8. 8.
    Anderson CE, Crespi CM, Wang MC, Whaley SE, Chaparro MP. 2020. The neighborhood food environment modifies the effect of the 2009 WIC food package change on childhood obesity in Los Angeles County, California. BMC Public Health 20:678
    [Google Scholar]
  9. 9.
    Antonio MG, Petrovskaya O. 2019. Towards developing an ehealth equity conceptual framework. Stud. Health Technol. Inform. 257:24–30
    [Google Scholar]
  10. 10.
    Appel JM, Fullerton K, Hennessy E, Korn AR, Tovar A et al. 2019. Design and methods of Shape Up Under 5: integration of systems science and community-engaged research to prevent early childhood obesity. PLOS ONE 14:e0220169
    [Google Scholar]
  11. 11.
    Assari S. 2020. Protective effects of maternal education against low birth weight deliveries: Blacks' diminished returns. Res. Health Sci. 5:1–17
    [Google Scholar]
  12. 12.
    Assari S, Boyce S, Caldwell CH, Bazargan M, Mincy R. 2020. Family income and gang presence in the neighborhood: diminished returns of Black families. Urban Sci. 4:229
    [Google Scholar]
  13. 13.
    Assari S, Cochran SD, Mays VM. 2021. Money protects White but not African American men against discrimination: comparison of African American and White men in the same geographic areas. Int. J. Environ. Res. Public Health 18:52706
    [Google Scholar]
  14. 14.
    Backholer K, Beauchamp A, Ball K, Turrell G, Martin J et al. 2014. A framework for evaluating the impact of obesity prevention strategies on socioeconomic inequalities in weight. Am. J. Public Health 104:e43–50
    [Google Scholar]
  15. 15.
    Backholer K, Gupta A, Zorbas C, Bennett R, Huse O et al. 2021. Differential exposure to, and potential impact of, unhealthy advertising to children by socio-economic and ethnic groups: a systematic review of the evidence. Obes. Rev. 22:e13144
    [Google Scholar]
  16. 16.
    Bailey ZD, Feldman JM, Bassett MT. 2021. How structural racism works—racist policies as a root cause of U.S. racial health inequities. N. Engl. J. Med. 384:768–73
    [Google Scholar]
  17. 17.
    Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. 2017. Structural racism and health inequities in the USA: evidence and interventions. Lancet 389:1453–63
    [Google Scholar]
  18. 18.
    Bardin S, Washburn L, Gearan E. 2020. Disparities in the healthfulness of school food environments and the nutritional quality of school lunches. Nutrients 12:2375
    [Google Scholar]
  19. 19.
    Benach J, Malmusi D, Yasui Y, Martínez JM. 2013. A new typology of policies to tackle health inequalities and scenarios of impact based on Rose's population approach. J. Epidemiol. Community Health 67:286–91
    [Google Scholar]
  20. 20.
    Bleich SN, Ard JD. 2021. COVID-19, obesity, and structural racism: understanding the past and identifying solutions for the future. Cell Metab 33:234–41
    [Google Scholar]
  21. 21.
    Boelsen-Robinson T, Peeters A, Beauchamp A, Chung A, Gearon E, Backholer K. 2015. A systematic review of the effectiveness of whole-of-community interventions by socioeconomic position. Obes. Rev. 16:806–16
    [Google Scholar]
  22. 22.
    Braveman PA, Kumanyika S, Fielding J, Laveist T, Borrell LN et al. 2011. Health disparities and health equity: the issue is justice. Am. J. Public Health 101:Suppl. 1S149–55
    [Google Scholar]
  23. 23.
    Brown AF, Ma GX, Miranda J, Eng E, Castille D et al. 2019. Structural interventions to reduce and eliminate health disparities. Am. J. Public Health 109:S72–78
    [Google Scholar]
  24. 24.
    Brownson RC, Kumanyika SK, Kreuter MW, Haire-Joshu D. 2021. Implementation science should give higher priority to health equity. Implement. Sci. 16:28
    [Google Scholar]
  25. 25.
    Cairns JM, Bambra C, Hillier-Brown FC, Moore HJ, Summerbell CD. 2015. Weighing up the evidence: a systematic review of the effectiveness of workplace interventions to tackle socio-economic inequalities in obesity. J. Public Health 37:659–70
    [Google Scholar]
  26. 26.
    Carey G, Crammond B, De Leeuw E. 2015. Towards health equity: a framework for the application of proportionate universalism. Int. J. Equity Health 14:81
    [Google Scholar]
  27. 27.
    Castro FG, Yasui M. 2017. Advances in EBI development for diverse populations: towards a science of intervention adaptation. Prev. Sci. 18:623–29
    [Google Scholar]
  28. 28.
    Cent. Dis. Control Prev 2013. A practitioner's guide for advancing health equity: community strategies for preventing chronic disease Rep. CDC Division of Community Health Atlanta, Georgia: https://www.cdc.gov/nccdphp/dch/pdf/healthequityguide.pdf
  29. 29.
    Cent. Dis. Control Prev 2021. Overweight & obesity. US Department of Health & Human Services Accessed Apr. 14, 2022. https://www.cdc.gov/obesity/index.html
    [Google Scholar]
  30. 30.
    Cent. Dis. Control Prev 2020. Racial and Ethnic Approaches to Community Health (REACH) 20th anniversary. US Department of Health & Human Services, Division of Nutrition Physical Activity, and Obesity Accessed September 14, 2021. https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/20th-anniversary/index.html
    [Google Scholar]
  31. 31.
    Cent. Dis. Control Prev 2021. DCH twin approach to health equity Rep. National Center for Chronic Disease Prevention and Health Promotion, Division of Community Health Atlanta, Georgia: Accessed Sept. 15, 2021. https://aahd.us/wp-content/uploads/2015/05/IntegratingHealthEquity-CDC-DCHTwinApproach.pdf
  32. 32.
    Cent. Dis. Control Prev 2015. Planning for and selecting high-impact interventions to improve community health: a guide to applying logic models to community health interventions Rep. National Center for Chronic Disease Prevention and Health Promotion, Division of Community Health Atlanta, Georgia: Accessed Sept. 15, 2021. https://www.cdc.gov/nccdphp/dch/pdfs/planning-high-impact-interventions.pdf
  33. 33.
    Chaparro MP, Anderson CE, Crespi CM, Wang MC, Whaley SE. 2020. The new child food package is associated with reduced obesity risk among formula fed infants participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in Los Angeles County, California, 2003–2016. Int. J. Behav. Nutr. Phys. Act 17:18
    [Google Scholar]
  34. 34.
    Chaparro MP, Whaley SE, Anderson CE, MC Wang, Crespi CM. 2021. The role of income and neighbourhood poverty in the association between the 2009 Special Supplemental Nutrition Program for Women, Infants and Children (WIC) food package change and child obesity among WIC-participating children in Los Angeles County, 2003–2016. Public Health Nutr 24:4212–19
    [Google Scholar]
  35. 35.
    Chin MH, Clarke AR, Nocon RS, Casey AA, Goddu AP et al. 2012. A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care. J. Gen. Intern. Med. 27:992–1000
    [Google Scholar]
  36. 36.
    Clarke AR, Goddu AP, Nocon RS, Stock NW, Chyr LC et al. 2013. Thirty years of disparities intervention research: What are we doing to close racial and ethnic gaps in health care?. Med. Care 51:1020–26
    [Google Scholar]
  37. 37.
    Clin. Transl. Sci. Awards Consort 2011. Principles of Community Engagement. Second Edition NIH Publication No. 11–7782 CTSA Community Engagement Key Function Committee Task Force on the Principles of Community Engagement Bethesda, Maryland: Accessed Sept. 15, 2021. https://www.atsdr.cdc.gov/communityengagement/pdf/PCE_Report_508_FINAL.pdf
  38. 38.
    Cohen J, Schwartz MB. 2020. Documented success and future potential of the Healthy, Hunger-Free Kids Act. J. Acad. Nutr. Diet. 120:359–62
    [Google Scholar]
  39. 39.
    Cooksey-Stowers K, Schwartz MB, Brownell KD. 2017. Food swamps predict obesity rates better than food deserts in the United States. Int. J. Environ. Res. Public Health 14:1366
    [Google Scholar]
  40. 40.
    Daepp MIG, Gortmaker SL, Wang YC, Long MW, Kenney EL. 2019. WIC food package changes: trends in childhood obesity prevalence. Pediatrics 143:e20182841
    [Google Scholar]
  41. 41.
    Davidson EM, Liu JJ, Bhopal RAJ, White M, Johnson MRD et al. 2013. Behavior change interventions to improve the health of racial and ethnic minority populations: a tool kit of adaptation approaches. Milbank Q. 91:811–51
    [Google Scholar]
  42. 42.
    Dawkins-Lyn N, Greenberg M. 2015. Signs of progress in childhood obesity declines. Site Summary Report. Philadelphia, PA. Rep., Robert Wood Johnson Foundation, NCCOR Childhood Obesity Declines Project. https://www.nccor.org/downloads/CODP_Site%20Summary%20Report_Philadelphia_public_clean1.pdf
  43. 43.
    Dietz WH. 2019. We need a new approach to prevent obesity in low-income minority populations. Pediatrics 143:e20190839
    [Google Scholar]
  44. 44.
    Dooyema C, Jernigan J, Warnock AL, Dawkins-Lyn N, Harris C et al. 2018. The Childhood Obesity Declines Project: a review of enacted policies. Child Obes 14:S22–31
    [Google Scholar]
  45. 45.
    Duggan CP, Kurpad A, Stanford FC, Sunguya B, Wells JC. 2020. Race, ethnicity, and racism in the nutrition literature: an update for 2020. Am. J. Clin. Nutr. 112:1409–14
    [Google Scholar]
  46. 46.
    Eslava-Schmalbach J, Garzón-Orjuela N, Elias V, Reveiz L, Tran N, Langlois EV. 2019. Conceptual framework of equity-focused implementation research for health programs (EquIR). Int. J. Equity Health 18:80
    [Google Scholar]
  47. 47.
    Fielding J, Kumanyika S. 2009. Recommendations for the concepts and form of Healthy People 2020. Am. J. Prev. Med. 37:255–57
    [Google Scholar]
  48. 48.
    Fleischhacker SE, Woteki CE, Coates PM, Hubbard VS, Flaherty GE et al. 2020. Strengthening national nutrition research: rationale and options for a new coordinated federal research effort and authority. Am. J. Clin. Nutr. 112:721–69
    [Google Scholar]
  49. 49.
    Flórez KR, Payán DD, Palar K, Williams MV, Katic B, Derose KP. 2020. Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review. Nutr. Rev. 78:304–22
    [Google Scholar]
  50. 50.
    Foltz JL, May AL, Belay B, Nihiser AJ, Dooyema CA, Blanck HM. 2012. Population-level intervention strategies and examples for obesity prevention in children. Annu. Rev. Nutr. 32:391–415
    [Google Scholar]
  51. 51.
    Ford CL, Airhihenbuwa CO. 2018. Commentary: Just what is critical race theory and what's it doing in a progressive field like public health?. Ethn. Dis. 28:223–30
    [Google Scholar]
  52. 52.
    Frerichs L, Lich KH, Dave G, Corbie-Smith G. 2016. Integrating systems science and community-based participatory research to achieve health equity. Am. J. Public Health 106:215–22
    [Google Scholar]
  53. 53.
    Gearan EC, Fox MK. 2020. Updated nutrition standards have significantly improved the nutritional quality of school lunches and breakfasts. J. Acad. Nutr. Diet. 120:363–70
    [Google Scholar]
  54. 54.
    Graham DA. 2021. George Floyd's murder changed Americans’ views on policing. But will those shifts lead to lasting reforms?. The Atlantic May 25. https://www.theatlantic.com/ideas/archive/2021/05/george-floyds-murder-changed-how-americans-views-police/618992/
    [Google Scholar]
  55. 55.
    Grier SA, Kumanyika SK. 2008. The context for choice: health implications of targeted food and beverage marketing to African Americans. Am. J. Public Health 98:1616–29
    [Google Scholar]
  56. 56.
    Grier SA, Lassiter V 2013. Understanding community perspectives: a step towards achieving food marketing equity. Advances in Communication Research to Reduce Childhood Obesity JD Williams, KE Pasch, CA Collins 343–66 New York: Springer Science and Business Media
    [Google Scholar]
  57. 57.
    Grier SA, Schaller TK. 2020. Operating in a constricted space: policy actor perceptions of targeting to address U.S. health disparities. J. Public Policy Mark. 39:31–47
    [Google Scholar]
  58. 58.
    Hahn RA. 2021. What is a social determinant of health? Back to basics. J. Public Health Res. 10:2324
    [Google Scholar]
  59. 59.
    Hales CM, Carroll MD, Fryar CD, Ogden CL. 2020. Prevalence of obesity and severe obesity among adults: United States, 2017–2018 NCHS Data Brief 360, Natl. Cent. Health Stat. Hyattsville, MD:
  60. 60.
    Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. 2018. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007–2008 to 2015–2016. JAMA 319:1723–25
    [Google Scholar]
  61. 61.
    Hammonds EM, Reverby SM. 2019. Toward a historically informed analysis of racial health disparities since 1619. Am. J. Public Health 109:1348–49
    [Google Scholar]
  62. 62.
    Hannah-Jones N. 2019. The 1619 project. New York Times Mag. Aug. 14. https://www.nytimes.com/interactive/2019/08/14/magazine/1619-america-slavery.html
    [Google Scholar]
  63. 63.
    Harris JL, Frazier W III, Kumanyika S, Ramirez AG. 2019. Rudd report. Increasing disparities in unhealthy food advertising targeted to Hispanic and Black youth Rep., UConn Rudd Cent Food Policy Health Hartford, CT: https://media.ruddcenter.uconn.edu/PDFs/TargetedMarketingReport2019.pdf
  64. 64.
    Haughton CF, Silfee VJ, Wang ML, Lopez-Cepero AC, Estabrook DP et al. 2018. Racial/ethnic representation in lifestyle weight loss intervention studies in the United States: a systematic review. Prev. Med. Rep. 9:131–37
    [Google Scholar]
  65. 65.
    Hogan V, Rowley DL, White SB, Faustin Y. 2018. Dimensionality and R4P: a health equity framework for research planning and evaluation in African American populations. Matern. Child Health J. 22:147–53
    [Google Scholar]
  66. 66.
    Hogan VK, Rowley D, Bennett T, Taylor KD. 2012. Life course, social determinants, and health inequities: toward a national plan for achieving health equity for African American infants—a concept paper. Matern. Child Health J. 16:1143–50
    [Google Scholar]
  67. 67.
    Hudson D, Sacks T, Irani K, Asher A. 2020. The price of the ticket: health costs of upward mobility among African Americans. Int. J. Environ. Res. Public Health 17:41179
    [Google Scholar]
  68. 68.
    Inst. Medicine 2005. Preventing Childhood Obesity: Health in the Balance Washington, DC: National Academies Press
  69. 69.
    Inst. Medicine 2006. WIC Food Packages: Time for a Change Washington, DC: National Academies Press
  70. 70.
    Inst. Medicine 2012. Accelerating Progress in Obesity Prevention. Solving the Weight of the Nation Washington, DC: National Academies Press
  71. 71.
    Jackson JS, Knight KM, Rafferty JA. 2010. Race and unhealthy behaviors: chronic stress, the HPA axis, and physical and mental health disparities over the life course. Am. J. Public Health 100:933–39
    [Google Scholar]
  72. 72.
    Jernigan J, Kettel Khan L, Dooyema C, Ottley P, Harris C et al. 2018. Childhood Obesity Declines Project: highlights of community strategies and policies. Child Obes 14:S32–39
    [Google Scholar]
  73. 73.
    Jones CP. 2000. Levels of racism: a theoretic framework and a gardener's tale. Am. J. Public Health 90:1212–15
    [Google Scholar]
  74. 74.
    Joshi PK, Geronimo K, Romano B, Earle A, Rosenfeld L et al. 2014. Integrating racial/ethnic equity into policy assessments to improve child health. Health Aff 33:2222–29
    [Google Scholar]
  75. 75.
    Jull J, Whitehead M, Petticrew M, Kristjansson E, Gough D et al. 2017. When is a randomised controlled trial health equity relevant? Development and validation of a conceptual framework. BMJ Open 7:e015815
    [Google Scholar]
  76. 76.
    Kenney EL, Barrett JL, Bleich SN, Ward ZJ, Cradock AL, Gortmaker SL 2020. Impact of the Healthy, Hunger-Free Kids Act on obesity trends. Health Aff 39:112229
    [Google Scholar]
  77. 77.
    Khan LK, Sobush K, Keener D, Goodman K, Lowry A et al. 2009. Recommended community strategies and measurements to prevent obesity in the United States. MMWR Recomm. Rep. 58:1–26
    [Google Scholar]
  78. 78.
    Kinderknecht K, Harris C, Jones-Smith J. 2020. Association of the Healthy, Hunger-Free Kids Act with dietary quality among children in the US National School Lunch Program. JAMA 324:359–68
    [Google Scholar]
  79. 79.
    Kleinman DV, Pronk N, Gómez CA, Wrenn Gordon GL, Ochiai E et al. 2021. Addressing health equity and social determinants of health through Healthy People 2030. J. Public Health Manag. Pract. 27:Suppl. 6S249–57
    [Google Scholar]
  80. 80.
    Koh HK, Piotrowski JJ, Kumanyika S, Fielding JE. 2011. Healthy People: a 2020 vision for the social determinants approach. Health Educ. Behav. 38:551–57
    [Google Scholar]
  81. 81.
    Kreuter MW, Lukwago SN, Bucholtz RD, Clark EM, Sanders-Thompson V. 2003. Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches. Health Educ. Behav. 30:133–46
    [Google Scholar]
  82. 82.
    Krieger N. 2021. Structural racism, health inequities, and the two-edged sword of data: structural problems require structural solutions. Front. Public Health 9:655447
    [Google Scholar]
  83. 83.
    Krieger N, Davey Smith G. 2004.. “ Bodies count,” and body counts: social epidemiology and embodying inequality. Epidemiol. Rev. 26:92–103
    [Google Scholar]
  84. 84.
    Kumanyika S. 2018. The sociocultural context for obesity prevention and treatment in children and adolescents: influences of ethnicity and gender. Pediatric Obesity: Etiology, Pathogenesis and Treatment MS Freemark 695–713 Cham, Switz.: Springer International Publishing
    [Google Scholar]
  85. 85.
    Kumanyika S, Dietz WH. 2020. Solving population-wide obesity—progress and future prospects. N. Engl. J. Med. 383:2197–200
    [Google Scholar]
  86. 86.
    Kumanyika SK. 2018. Supplement overview: what the Healthy Communities Study is telling us about childhood obesity prevention in U.S. communities. Pediatr. Obes 13:Suppl. 13–6
    [Google Scholar]
  87. 87.
    Kumanyika SK. 2019. A framework for increasing equity impact in obesity prevention. Am. J. Public Health 109:1350–57
    [Google Scholar]
  88. 88.
    Kumanyika SK. 2019. Unraveling common threads in obesity risk among racial/ethnic minority and migrant populations. Public Health 172:125–34
    [Google Scholar]
  89. 89.
    Kumanyika SK, Obarzanek E, Stettler N, Bell R, Field AE et al. 2008. Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (formerly the Expert Panel on Population and Prevention Science). Circulation 118:428–64
    [Google Scholar]
  90. 90.
    Kumanyika SK, Whitt-Glover MC, Gary TL, Prewitt TE, Odoms-Young AM et al. 2007. Expanding the obesity research paradigm to reach African American communities. Prev. Chronic Dis. 4:A112
    [Google Scholar]
  91. 91.
    Kumanyika SK, Whitt-Glover MC, Haire-Joshu D. 2014. What works for obesity prevention and treatment in black Americans? Research directions. Obes. Rev. 15:Suppl. 4204–12
    [Google Scholar]
  92. 92.
    Lacko A, Maselko J, Popkin B, Ng SW. 2021. Socioeconomic and racial/ethnic disparities in the nutritional quality of packaged food purchases in the U.S., 2008–2018. Public Health Nutr 24:5730–42
    [Google Scholar]
  93. 93.
    LaVeist TA, Fullilove M, Fullilove R. 2019. 400 years of inequality since Jamestown of 1619. Am. J. Public Health 109:83–84
    [Google Scholar]
  94. 94.
    LeBlanc EL, Patnode CD, Webber EM, Redmond N, Rushkin M, O'Connor EA. 2018. Behavioral and pharmacotherapy weight loss interventions to prevent obesity-related morbidity and mortality in adults: an updated systematic review for the U.S. Preventive Services Task Force Evid. Synth. 168, AHRQ Publ. 18-05239-EF-1 Agency Healthc. Res. Qual. Rockville, MD:
  95. 95.
    Liao Y, Siegel PZ, Garraza LG, Xu Y, Yin S et al. 2016. Reduced prevalence of obesity in 14 disadvantaged Black communities in the United States: a successful 4-year place-based participatory intervention. Am. J. Public Health 106:1442–48
    [Google Scholar]
  96. 96.
    Liburd LC, Hall JE, Mpofu JJ, Williams SM, Bouye K, Penman-Aguilar A. 2020. Addressing health equity in public health practice: frameworks, promising strategies, and measurement considerations. Annu. Rev. Public Health 41:417–32
    [Google Scholar]
  97. 97.
    Loring B, Robertson A. 2014. Obesity and inequities. Guidance for addressing inequities in overweight and obesity Policy Guid., World Health Organ. Reg. Off. Eur. Copenhagen, Denmark:
  98. 98.
    Lovasi GS, Hutson MA, Guerra M, Neckerman KM. 2009. Built environments and obesity in disadvantaged populations. Epidemiol. Rev. 31:7–20
    [Google Scholar]
  99. 99.
    Mah CL, Luongo G, Hasdell R, Taylor NGA, Lo BK. 2019. A systematic review of the effect of retail food environment interventions on diet and health with a focus on the enabling role of public policies. Curr. Nutr. Rep. 8:411–28
    [Google Scholar]
  100. 100.
    Marmot M. 2009. Closing the health gap in a generation: the work of the Commission on Social Determinants of Health and its recommendations. Glob. Health Promot. 16:Suppl. 123–27
    [Google Scholar]
  101. 101.
    Mazzucca S, Arredondo EM, Hoelscher DM, Haire-Joshu D, Tabak RG et al. 2021. Expanding implementation research to prevent chronic diseases in community settings. Annu. Rev. Public Health 42:135–58
    [Google Scholar]
  102. 102.
    McDonald YJ, Grineski SE, Collins TW, Kim YA. 2015. A scalable climate health justice assessment model. Soc. Sci. Med. 133:242–52
    [Google Scholar]
  103. 103.
    McGill R, Anwar E, Orton L, Bromley H, Lloyd-Williams F et al. 2015. Are interventions to promote healthy eating equally effective for all? Systematic review of socioeconomic inequalities in impact. BMC Public Health 15:457
    [Google Scholar]
  104. 104.
    McGowan AK, Lee MM, Meneses CM, Perkins J, Youdelman M. 2016. Civil rights laws as tools to advance health in the twenty-first century. Annu. Rev. Public Health 37:185–204
    [Google Scholar]
  105. 105.
    Moran AJ, Gu Y, Clynes S, Goheer A, Roberto CA, Palmer A. 2020. Associations between governmental policies to improve the nutritional quality of supermarket purchases and individual, retailer, and community health outcomes: an integrative review. Int. J. Environ. Res. Public Health 17:7493
    [Google Scholar]
  106. 106.
    Movsisyan A, Arnold L, Evans R, Hallingberg B, Moore G et al. 2019. Adapting evidence-informed complex population health interventions for new contexts: a systematic review of guidance. Implement. Sci. 14:105
    [Google Scholar]
  107. 107.
    Natl. Acad. Sci. Eng. Med 2019. Global trends in obesity. Current Status and Response to the Global Obesity Epidemic: Proceedings of a Workshop, pp. 5–26 Washington, DC: National Academies Press
    [Google Scholar]
  108. 108.
    Natl. Acad. Sci. Eng. Med 2019. Disparities in the prevalence of obesity. A Health Equity Approach to Obesity Efforts: Proceedings of a Workshop11–24 Washington, DC: National Academies Press
    [Google Scholar]
  109. 109.
    Natl. Acad. Sci. Eng. Med 2021. Exploring Strategies for Sustainable Systems-Wide Changes to Reduce the Prevalence of Obesity: Proceedings of a Workshop in Brief Washington, DC: National Academies Press https://doi.org/10.17226/26260
  110. 110.
    Natl. Cent. Health Stat 2018. Health, United States, 2017: with special feature on mortality Rep. Natl. Cent. Health Stat. Hyattsville, MD: https://www.cdc.gov/nchs/data/hus/hus17.pdf
  111. 111.
    Natl. Inst. Health 2021. NIMHD sponsors special issue on link between structural racism and discrimination and health disparities News Release, May 20 Natl. Inst. Health Bethesda, MD: https://www.nimhd.nih.gov/news-events/news-releases/2021/pr-2021-05-20-nimhd-sponsors-supplement-srd-and-health-disparities.html
  112. 112.
    Nickens H. 1986. Report of the Secretary's Task Force on Black and Minority Health: a summary and a presentation of health data with regard to blacks. J. Natl. Med. Assoc. 78:577–80
    [Google Scholar]
  113. 113.
    O'Mara-Eves A, Brunton G, McDaid D, Oliver S, Kavanagh J et al. 2013. Public health research. Community Engagement to Reduce Inequalities in Health: A Systematic Review, Meta-Analysis and Economic Analysis Southampton, UK: NIHR Journals Library
    [Google Scholar]
  114. 114.
    OECD (Organ. Econ. Co-op. Dev.) 2017. OECD obesity update 2017. Organ. Econ. Co-op. Dev. https://www.oecd.org/health/obesity-update.htm
    [Google Scholar]
  115. 115.
    OECD (Organ. Econ. Co-op. Dev.) 2021. Health at a glance 2021. Organ. Econ. Co-op. Dev. https://www.oecd.org/health/health-at-a-glance/
    [Google Scholar]
  116. 116.
    Oetzel J, Scott N, Hudson M, Masters-Awatere B, Rarere M et al. 2017. Implementation framework for chronic disease intervention effectiveness in Māori and other indigenous communities. Glob. Health 13:69
    [Google Scholar]
  117. 117.
    Ogden CL, Fakhouri TH, Carroll MD, Hales CM, Fryar CD et al. 2017. Prevalence of obesity among adults, by household income and education—United States, 2011–2014. MMWR Morb. Mortal. Wkly. Rep. 66:1369–73
    [Google Scholar]
  118. 118.
    Ogden CL, Fryar CD, Martin CB, Freedman DS, Carroll MD et al. 2020. Trends in obesity prevalence by race and Hispanic origin—1999–2000 to 2017–2018. JAMA 324:1208–10
    [Google Scholar]
  119. 119.
    Olstad DL, Ancilotto R, Teychenne M, Minaker LM, Taber DR et al. 2017. Can targeted policies reduce obesity and improve obesity-related behaviours in socioeconomically disadvantaged populations? A systematic review. Obes. Rev. 18:791–807
    [Google Scholar]
  120. 120.
    Ottley PG, Dawkins-Lyn N, Harris C, Dooyema C, Jernigan J et al. 2018. Childhood Obesity Declines Project: an exploratory study of strategies identified in communities reporting declines. Child Obes 14:S12–21
    [Google Scholar]
  121. 121.
    Pan L, Blanck HM, Park S, Galuska DA, Freedman DS et al. 2019. State-specific prevalence of obesity among children aged 2–4 years enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children—United States, 2010–2016. MMWR Morb. Mortal. Wkly. Rep. 68:1057–61
    [Google Scholar]
  122. 122.
    Petkovic J, Jull J, Yoganathan M, Dewidar O, Baird S et al. 2020. Reporting of health equity considerations in cluster and individually randomized trials. Trials 21:308
    [Google Scholar]
  123. 123.
    Powell-Wiley TM, Ayers C, Agyemang P, Leonard T, Berrigan D et al. 2014. Neighborhood-level socioeconomic deprivation predicts weight gain in a multi-ethnic population: longitudinal data from the Dallas Heart Study. Prev. Med. 66:22–27
    [Google Scholar]
  124. 124.
    Pratt CA, Loria CM, Arteaga SS, Nicastro HL, Lopez-Class M et al. 2017. A systematic review of obesity disparities research. Am. J. Prev. Med. 53:113–22
    [Google Scholar]
  125. 125.
    Reskin B. 2012. The race discrimination system. Annu. Rev. Sociol. 38:17–35
    [Google Scholar]
  126. 126.
    Riley WT. 2021. NIH launches UNITE initiative to address structural racism in biomedical research News Release, Mar. 5 Natl. Inst. Health Bethesda, MD: https://obssr.od.nih.gov/news-and-events/news/director-voice/nih-launches-unite-initiative-address-structural-racism
  127. 127.
    Rundle AG, Suglia SF, Susser ES, Factor-Litvak P, March D et al. 2019. Body mass index across the life course: emergence of race-by-sex disparities in early childhood. Ann. Epidemiol. 33:44–48
    [Google Scholar]
  128. 128.
    Schneider EC, Shah A, Doty MM, Tikkanen R, Fields K, Williams RD II. 2021. Mirror, mirror 2021reflecting poorly: health care in the U.S. compared to other high-income countries Rep. The Commonwealth Fund New York: https://www.commonwealthfund.org/sites/default/files/2021-08/Schneider_Mirror_Mirror_2021.pdf
    [Google Scholar]
  129. 129.
    Seifu L, Ruggiero C, Ferguson M, Mui Y, Lee BY, Gittelsohn J. 2018. Simulation modeling to assist with childhood obesity control: perceptions of Baltimore City policymakers. J. Public Health Policy 39:173–88
    [Google Scholar]
  130. 130.
    Siegel M, Critchfield-Jain I, Boykin M, Owens A, Nunn T, Muratore R. 2021. Actual racial/ethnic disparities in COVID-19 mortality for the non-Hispanic Black compared to non-Hispanic White population in 353 US counties and their association with structural racism. J. Racial Ethn. Health Disparities. https://doi.org/10.1007/s40615-021-01109-1
    [Crossref] [Google Scholar]
  131. 131.
    Spitzer-Shohat S, Chin MH. 2019. The “Waze” of inequity reduction frameworks for organizations: a scoping review. J. Gen. Intern. Med. 34:604–17
    [Google Scholar]
  132. 132.
    Spring B, Champion KE, Acabchuk R, Hennessy EA. 2020. Self-regulatory behaviour change techniques in interventions to promote healthy eating, physical activity, or weight loss: a meta-review. Health Psychol. Rev. 15:508–39
    [Google Scholar]
  133. 133.
    Statista Res. Dep 2021. Percentage of people who live below the poverty level in the most populated cities in the U.S. in 2019. Statista Accessed Sept. 14, 2021. https://www.statista.com/statistics/205637/percentage-of-poor-people-in-the-top-20-most-populated-cities-in-the-us/
    [Google Scholar]
  134. 134.
    Strauss WJ, Nagaraja J, Landgraf AJ, Arteaga SS, Fawcett SB et al. 2018. The longitudinal relationship between community programmes and policies to prevent childhood obesity and BMI in children: the Healthy Communities Study. Pediatr. Obes. 13:Suppl. 182–92
    [Google Scholar]
  135. 135.
    Swinburn B, Egger G, Raza F. 1999. Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev. Med. 29:563–70
    [Google Scholar]
  136. 136.
    Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI et al. 2019. The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission report. Lancet 393:791–846
    [Google Scholar]
  137. 137.
    Swinburn BA, Dietz WH, Allender S, Atkins VJ, Baker PI et al. (Lancet Comm. Obes.). 2019. The global syndemic. A policy brief Rep. Lancet London, UK: https://marlin-prod.literatumonline.com/pb-assets/Lancet/stories/commissions/obesity-2019/GlobalSyndemicCommission_policybrief.pdf
  138. 138.
    Tabak RG, Khoong EC, Chambers DA, Brownson RC. 2012. Bridging research and practice: models for dissemination and implementation research. Am. J. Prev. Med. 43:337–50
    [Google Scholar]
  139. 139.
    U.S. Census Bur 2021. QuickFacts. Philadelphia County, Pennsylvania. United States Census Bureau Accessed Sept. 14, 2021. https://www.census.gov/quickfacts/fact/table/philadelphiacountypennsylvania/AGE775219
    [Google Scholar]
  140. 140.
    U.S. Dep. Agric 2021. WIC eligibility and coverage rates - 2018. USDA Food Nutr. Serv Accessed Sept. 14, 2021. https://www.fns.usda.gov/wic/eligibility-and-coverage-rates-2018
    [Google Scholar]
  141. 141.
    U.S. Dep. Agric 2020. WIC eligibility requirements. USDA Food Nutr. Serv. Accessed Sept 14:2021 https://www.fns.usda.gov/wic/wic-eligibility-requirements
    [Google Scholar]
  142. 142.
    U.S. Dep. Agric 2021. National School Lunch Program. USDA Food Nutr. Serv. Accessed Sept. 14, 2021. https://www.ers.usda.gov/topics/food-nutrition-assistance/child-nutrition-programs/national-school-lunch-program
    [Google Scholar]
  143. 143.
    U.S. Dep. Agric 2021. Supplemental Nutrition Assistance Program. USDA Food Nutr. Serv. Accessed Sept. 14, 2021. https://www.ers.usda.gov/topics/food-nutrition-assistance/supplemental-nutrition-assistance-program-snap/
    [Google Scholar]
  144. 144.
    Welch V, Petticrew M, Petkovic J, Moher D, Waters E et al. 2016. Extending the PRISMA statement to equity-focused systematic reviews (PRISMA-E 2012): explanation and elaboration. J. Clin. Epidemiol. 70:68–89
    [Google Scholar]
  145. 145.
    Williams DR, Lawrence JA, Davis BA. 2019. Racism and health: evidence and needed research. Annu. Rev. Public Health 40:105–25
    [Google Scholar]
  146. 146.
    Wilson KB, Thorpe RJ Jr., LaVeist TA. 2017. Dollar for dollar: racial and ethnic inequalities in health and health-related outcomes among persons with very high income. Prev. Med. 96:149–53
    [Google Scholar]
  147. 147.
    Wiltsey Stirman S, Baumann AA, Miller CJ. 2019. The FRAME: an expanded framework for reporting adaptations and modifications to evidence-based interventions. Implement. Sci. 14:58
    [Google Scholar]
  148. 148.
    World Health Organ 2000. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ. Tech. Rep. Ser. 894: i–xii 1–253
    [Google Scholar]
  149. 149.
    World Health Organ 2004. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363:157–63
    [Google Scholar]
  150. 150.
    World Health Organ 2016. Report of the Commission on Ending Childhood Obesity. Implementation plan: executive summary Rep. World Health Organ. Geneva, Switzerland: https://apps.who.int/iris/bitstream/handle/10665/259349/WHO-NMH-PND-ECHO-17.1-eng.pdf#:∼:text=established%20the%20Commission%20on%20Ending%20Childhood%20Obesity%20in,of%20recommendations%20to%20guide%20countries%20to%20address%20childhood
  151. 151.
    World Health Organ 2021. Obesity and overweight. World Health Organization Accessed Sept. 18, 2021. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
    [Google Scholar]
  152. 152.
    Yudell M, Roberts D, DeSalle R, Tishkoff S. 2020. NIH must confront the use of race in science. Science 369:1313–14
    [Google Scholar]
  153. 153.
    Zorbas C, Browne J, Chung A, Baker P, Palermo C et al. 2020. National nutrition policy in high-income countries: is health equity on the agenda?. Nutr. Rev. 79:101100–13
    [Google Scholar]

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error