Disparities in Diet Quality and Food Security Across Ethnic-Immigration Status and Lengths of U.S. Residency.

TENNESSEE; UNITED States

Multiple factors may intersect to influence nutritional outcomes among diverse population groups. This study explores how ethnic-immigration status and lengths of residency in the United States (US nativity) influence diet quality and food security among adults in the US. Secondary analysis of population-based data among 7539 adults >18 years, drawn from the US National Health and Nutrition Examination Survey, 2017-2020 pre-pandemic data. The outcome variables were food security status and diet quality using HEI-2015. HEI scores were calculated for total HEI and component HEI scores. Food security status was categorized as either food secure or food insecure, while ethnic-immigrant status has US-born and immigrant groups for Whites, Asians, Blacks, Hispanics, and multi-race. US nativity was categorized as natives, < 5, 5-14, 15-30 and > 30 years of residency. Logistic regression models determined associations between ethnic-immigrant status/US nativity and food security status. ANOVA was used to examine the association between ethnic-immigrant status/US nativity and diet quality. The significance level was set at P < 0.05. US-born Blacks (OR=1.5; Cl=1.48-1.49), US-born Hispanics (OR=1.7; Cl=1.62-1.63), and immigrant Asians (OR=1.2; Cl=1.19-1.20), immigrant Blacks (OR=1.3; Cl=1.26-1.27), and immigrant Hispanics (OR=2.2; Cl=2.17-2.17) were more likely to be food insecure compared to US-born Whites. Compared to the natives, individuals with < 5, 15-30 and > 30 years of residency were more likely to be food insecure. Immigrant Whites, Asians, Blacks and Hispanics had significantly higher overall diet quality (total HEI score) compared to US-born Whites (all p<0.001). The adequacy and moderation component HEI scores varied by ethnic-immigrant groups across the food groups. Despite the higher likelihood of food insecurity among ethnic-immigration groups and individuals with differing lengths of residency, evidence indicates their overall diet quality surpasses that of the US-born Whites and natives. However, disparities persist in diet quality across specific food groups. Targeted public health initiatives aimed at promoting equitable access to nutritious and healthy foods for all are crucial to addressing the disparities effectively. None [ABSTRACT FROM AUTHOR]

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