THREE PAPERS ON DIETARY ACCULTURATION: A REVIEW OF THE LITERATURE AND TWO EMPIRICAL APPLICATIONS TO THE BLACK CARIBBEAN POPULATION
Restricted (Penn State Only)
- Author:
- Bacon, Rachel Jeannine
- Graduate Program:
- Sociology
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- November 18, 2019
- Committee Members:
- Stephen Augustus Matthews, Dissertation Advisor/Co-Advisor
Stephen Augustus Matthews, Committee Chair/Co-Chair
Jennifer Lynne Van Hook, Committee Member
Roger Finke, Committee Member
Eric Plutzer, Outside Member
Jennifer Lynne Van Hook, Program Head/Chair - Keywords:
- Dietary acculturation
Caribbean immigrants
Segregation
Race
Health Disparities
Adventist Health Study - Abstract:
- This dissertation contributes to the literature on dietary acculturation in three papers. The literature on dietary acculturation is large, and several articles identify that immigrant diets become more similar to the typical American diet the longer they live in the United States and are exposed to its obesogenic environment, and become less healthy in the process. I therefore begin by assessing the state of the dietary acculturation literature with a systematic review of articles from the past 18 years. I identify generalizations in findings across 35 quantitative articles and differences by racial-ethnic groups, as well as several methodological shortcomings. Among these shortcomings is how few studies focus on the dietary acculturation of Black immigrants, a reliance on an excessive number of individual food items as outcomes instead of composite measures and indices, the lack of geographic variation in samples, and infrequent consideration of neighborhood composition and contexts for influencing diet. I then address these particular areas of improvement in subsequent chapters, by focusing on the dietary patterns of Black Caribbean immigrants in the Adventist Health Study-2 (AHS2). In one set of analyses, I use the AHS2 Calibration sub-sample (AHS2C) to test the flexibility of the Food Similarity Index (FSI) as an empirical measure of dietary acculturation using a reference group from the National Health and Nutrition Examination Surveys to characterize the typical American diet, and both a 24hr recall and food frequency questionnaire as the dietary assessment. The findings from the current chapter highlight the flexibility of the FSI, and introduce the possibility of constructing the measure in unique samples with FFQs and an out-of-sample reference group to characterize the American diet. I used data from the AHS2 Calibration study, which include both 24hr recall and FFQ diet assessments for a population of Caribbean and non-Caribbean Seventh-day Adventists. Both the dietary recall and FFQ versions of the FSI are associated with Caribbean ethnicity and immigrant generation, as well as eating fast food more frequently and a larger percentage of American food, but also less Caribbean and Adventist food, and fewer fruits and vegetables. In my second analysis, I use the AHS2 Baseline (AHS2B) survey data of Black Caribbean immigrants and African Americans linked to tract and county-level measures to examine the influence of both racial residential segregation and ethnic enclaves on fruit and fast food intake. Because Black Caribbean immigrants frequently live with co-ethnics, but are also segregated by race along with African Americans, this immigrant group is well placed to assess the distinction between racial segregation and ethnic enclaves. The logistic regression analyses also take into account several individual-level and other socio-contextual confounders such as the food environment, neighborhood disadvantage, and co-ethnic interaction, and further considers how those relationships may be modified by generational status and ethnicity. Results identify neighborhood disadvantage as driving the association between segregation and unhealthy diets among both African Americans and Black Caribbean immigrants regardless of their generational status. Findings from this research can be used to guide interventions that are culturally-relevant and engage at-risk populations in pursuing healthy diets that incorporate familiar ingredients and dishes.