Examining Structural Barriers to Health: Moving Beyond Individual Choice and Personal Responsibility.

摘要

In the summer of 2012, I worked to evaluate the Hermosa Vida Market program, a community-based project developed to fight childhood obesity by improving access to affordable fresh fruits and vegetables in the Sunnyside neighborhood in east Flagstaff. I used qualitative and quantitative research methods to explore barriers to increasing consumption of fruits and vegetables on an individual, social, and structural level. My goal was to determine how well the program addressed the barriers to a healthier diet that exist in the community and identify changes that could help make the Market program more effective and efficient in helping residents make sustainable dietary improvements.;Obesity prevention programs designed to improve nutrition education, individual motivation, and personal choice, as though they are isolated determinants of food behavior, are largely unsuccessful. In Sunnyside, and in many other communities challenged by a lack of resources, the social, political, and economic barriers to obesity prevention are pervasive and should be recognized as a major constraint on individuals' food and health choices. Obesity prevention and intervention programs can be improved by exploring and addressing these barriers.