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Barriers to Equity in Nutritional Health for U.S. Children and Adolescents: A Review of the Literature

  • Dietary Patterns and Behavior (LM Steffen, Section Editor)
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Abstract

U.S. children and adolescents from low-income and ethnic/racial minority backgrounds experience greater risk for obesity and poor nutrition. In addition, a growing body of evidence documents differences in obesity and dietary patterns between urban and rural areas. Societal efforts to eliminate these disparities in established risk factors for chronic disease will require a comprehensive understanding of the social and physical environmental factors that may be contributing. Recent studies have identified several factors within school environments and residential neighborhoods along with multiple aspects of food marketing and cultural norms that are likely barriers to achieving health equity. To better inform public health improvement strategies, future research efforts are needed to clarify their contribution to disparities and there is an urgent need to build on the more limited research to date addressing the potential for improvements in child care environments and food system policy to promote health equity.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Rundle A, Richards C, Bader M, et al. Individual- and school-level sociodemographic predictors of obesity among New York City Public School children. Am J Epidemiol. 2012;176(11):986–94.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Greves Grow HM, Cook A, Arterburn D, et al. Child obesity associated with social disadvantage of children’s neighborhoods. Soc Sci Med. 2010;71(3):584–91.

    Article  Google Scholar 

  3. Boumtje P, Huang C, Lee J-Y, Lin B-H. Dietary habits, demographics, and the development of overweight and obesity among children in the United States. Food Policy. 2005;30(2):115–28.

    Article  Google Scholar 

  4. Eagle T, Sheetz A, Gurm R, et al. Understanding childhood obesity in America: linkages between household income, community resources, and children’s behaviors. Am Heart J. 2012;163(5):836–43.

    Article  PubMed  Google Scholar 

  5. Mushi-Brunt C, Haire-Joshu D, Elliott M, Brownson R. Fruit and vegetable intake and obesity in preadolescent children. Am J Health Educ. 2007;38(5):258–65.

    Article  Google Scholar 

  6. Brener N, Eaton D, Kann L, et al. Behaviors related to physical activity and nutrition among US high school students. J Adolesc Health. 2013;53(4):539–46.

    Article  PubMed  Google Scholar 

  7. Ogden C, Carroll M, Kit B, Flegal K. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806–14.

    Article  CAS  PubMed  Google Scholar 

  8. Neumark-Sztainer D, Wall M, Larson N, et al. Secular trends in weight status and weight-related attitudes and behaviors in adolescents from 1999 to 2010. Prev Med. 2012;54(1):77–81.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Arcan C, Larson N, Bauer K, et al. Dietary and weight-related behaviors and body mass index among Hispanic, Hmong, Somali, and White adolescents. J Acad Nutr Diet. 2014;114(3):375–83.

    Article  PubMed  Google Scholar 

  10. Kirkpatrick S, Dodd K, Reedy J, Krebs-Smith S. Income and race/ethnicity are associated with adherence to food-based dietary guidance among US adults and children. J Acad Nutr Diet. 2012;112(5):624–35.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Fahlman M, McCaughtry N, Martin J, Shen B. Racial and socioeconomic disparities in nutrition behaviors: targeted interventions needed. J Nutr Educ Behav. 2010;42(1):10–6.

    Article  PubMed  Google Scholar 

  12. Larson N, Hannan P, Fulkerson J, et al. Secular trends in fast-food restaurant use among adolescents and maternal caregivers from 1999 to 2010. Am J Public Health. 2014;104(5):e62–9.

    Article  PubMed  Google Scholar 

  13. Han E, Powell L. Consumption patterns of sugar-sweetened beverages in the United States. J Acad Nutr Diet. 2013;113(1):43–53. This article presents current national data on ethnic/racial and socioeconomic disparities in the heavy consumption of sugar-sweetened beverages, which represents a dietary behavior strongly associated with obesity.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Davy B, Harrell K, King D, Stewart J. Body weight status, dietary habits, and physical activity levels of middle school-aged children in rural Mississippi. South Med J. 2004;97(6):571–7.

    Article  PubMed  Google Scholar 

  15. Goodwin D, Knol L, Eddy J, et al. Sociodemographic correlates of overall quality of dietary intake of US adolescents. Nutr Res. 2006;26(3):105–10.

    Article  CAS  Google Scholar 

  16. Liu J, Jones S, Sun H, et al. Diet, physical activity, and sedentary behaviors as risk factors for childhood obesity: an urban and rural comparison. Child Obes. 2012;8(5):440–8. This article uses national data to comprehensively examine urban/rural disparities in diet, physical activity, sedentary behaviors, and weight status among children and adolescents.

    PubMed  Google Scholar 

  17. Ettienne-Gittens R, McKyer E, Odum M, et al. Rural versus urban Texas WIC participants’ fruit and vegetable consumption. Am J Health Behav. 2013;37(1):130–40.

    Article  PubMed  Google Scholar 

  18. National Institutes of Health Obesity Research Task Force. Strategic plan for NIH obesity research. National Institutes of Health, U.S. Department of Health and Human Services, 2011 NIH Publication No. 11-5493

  19. Centers for Disease Control and Prevention - Division of Community Health. A practitioner’s guide for advancing health equity: community strategies for preventing chronic disease. Atlanta, GA: 2013. This report defines key terms relevant to advancing health equity and provides a discussion of community-level strategies to address limited access to healthful food and beverages in rural areas, low-income communities, and ethnically/racially diverse communities.

  20. Institute of Medicine. Creating equal opportunities for a healthy weight: workshop summary. Washington, D.C.: 2013. This report reviews obesity prevention strategies of relevance for schools and other environments with an emphasis on strategies key to reducing disparities in weight-related health.

  21. Bleich S, Jarlenski M, Bell C, LaVeist T. Health inequalities: trends, progress, and policy. Annu Rev Public Health. 2012;33:7–40. This article describes national commitments to reduce health inequalities and gaps in the scientific literature that need to be addressed in order to better inform intervention and policy action to address these goals.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Metos J, Nanney M. The strength of school wellness policies: one state’s experience. J Sch Health. 2007;77:367–72.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Nanney M, Davey C, Kubik M. Rural disparities in the distribution of policies that support healthy eating in U.S. secondary schools. J Acad Nutr Diet. 2013;113(8):1062–8. This article provides recent data on ethnic/racial, socioeconomic, and urban/rural disparities in the distribution of food and nutrition policies for secondary schools in 28 U.S. states.

    Article  PubMed  Google Scholar 

  24. Finkelstein D, Hill E, Whitaker R. School food environments and policies in U.S. public schools. Pediatrics. 2008;122(1):e251–9.

    Article  PubMed  Google Scholar 

  25. Nanney M, Bohner C, Friedrichs M. Poverty-related factors associated with obesity prevention policies in Utah secondary schools. J Am Diet Assoc. 2008;108(7):1210–5.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Schwartz M, Henderson K, Falbe J, et al. Strength and comprehensiveness of district school wellness policies predict policy implementation at the school level. J Sch Health. 2012;82:262–7.

    Article  PubMed  Google Scholar 

  27. Johnston L, Delva J, O’Malley P. Soft drink availability, contracts, and revenues in American secondary schools. Am J Prev Med. 2007;33(4S):S209–25.

    Article  PubMed  Google Scholar 

  28. Addison C, Jenkins B, White M, Young L. Examination of the food and nutrient content of school lunch menus of two school districts in Mississippi. Int J Environ Res Public Health. 2006;3(3):278–85.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Delva J, O’Malley P, Johnston L. Availability of more-healthy and less-healthy food choices in American schools. A national study of grade, racial/ethnic, and socioeconomic differences. Am J Prev Med. 2007;33(4S):S226–39.

    Article  PubMed  Google Scholar 

  30. Tester J, Yen I, Pallis L, Laraia B. Healthy food availability and participation in WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) in food stores around lower- and higher-income elementary schools. Public Health Nutr. 2011;14(6):960–4.

    Article  PubMed  Google Scholar 

  31. Neckerman K, Bader M, Richards C, et al. Disparities in the food environments of New York City public schools. Am J Prev Med. 2010;39(3):195–202.

    Article  PubMed  Google Scholar 

  32. Kwate N, Loh J. Separate and unequal: the influence of neighborhood and school characteristics on spatial proximity between fast food and schools. Prev Med. 2010;51(2):153–6.

    Article  PubMed  Google Scholar 

  33. Simon P, Dwan K, Angelescu A, et al. Proximity of fast food restaurants to schools: do neighborhood income and type of school matter? Prev Med. 2008;47(3):284–8.

    Article  PubMed  Google Scholar 

  34. Austin S, Melly S, Sanchez B, et al. Clustering of fast-food restaurants around schools: a novel application of spatial statistics to the study of food environments. Am J Public Health. 2005;95(9):1575–81.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Sturm R. Disparities in the food environment surrounding US middle and high schools. Public Health. 2008;122(7):681–90.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Zenk S, Powell L. U.S. secondary schools and food outlets. Health Place. 2008;14(2):336–46.

    Article  PubMed  Google Scholar 

  37. Frampton A, Sisson S, Horm D, et al. What’s for lunch? An analysis of lunch menus in 83 urban and rural Oklahoma child-care centers providing all-day care to preschool children. J Acad Nutr Diet. 2014;114(9):1367–74.

    Article  PubMed  Google Scholar 

  38. Ritchie L, Sharma S, Gildengorin G, et al. Policy improves what beverages are served to young children in child care. J Acad Nutr Diet. doi:10.1016/j.jand.2014.07.019.

  39. Ritchie L, Boyle M, Chandran K, et al. Participation in the Child and Adult Care Food Program is associated with more nutritious foods and beverages in child care. Child Obes. 2012;8(3):224–9. This article describes the most recent data comparing the foods and beverages served to preschool-aged children in different types of child-care settings for a statewide sample.

    PubMed  Google Scholar 

  40. Monsivais P, Kirkpatrick S, Johnson D. More nutritious food is served in child-care homes receiving higher federal food subsidies. J Am Diet Assoc. 2011;111(5):721–6.

    Article  PubMed  Google Scholar 

  41. Whitaker R, Gooze R, Hughes C, Finkelstein D. A national survey of obesity prevention practices in Head Start. Arch Pediatr Adolesc Med. 2009;163(12):1144–50.

    Article  PubMed  Google Scholar 

  42. Dev D, McBride B, Speirs K, et al. Predictors of Head Start and child-care providers’ healthful and controlling feeding practices with children aged 2 to 5 years. J Acad Nutr Diet. 2014;114(9):1396–403.

    Article  PubMed  Google Scholar 

  43. Larson N, Story M, Nelson M. Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med. 2009;36(1):74–81.

    Article  PubMed  Google Scholar 

  44. Hilmers A, Hilmers D, Dave J. Neighborhood disparities in access to healthy foods and their effects on environmental justice. Am J Public Health. 2012;102(9):1644–54.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Walker R, Keane C, Burke J. Disparities and access to healthy food in the United States: a review of food deserts literature. Health Place. 2010;16(5):876–84.

    Article  PubMed  Google Scholar 

  46. Lucan S, Maroko A, Bumol J, et al. Mobile food vendors in urban neighborhoods - implications for diet and diet-related health by weather and season. Health Place. 2014;27:171–5.

    Article  PubMed  Google Scholar 

  47. Bower K, Thorpe R, Rohde C, Gaskin D. The intersection of neighborhood racial segregation, poverty, and urbanicity and its impact on food store availability in the United States. Prev Med. 2014;58:33–9. This article advances the literature on neighborhood-level disparities in food store access by accounting for interactions of racial residential segregation, poverty, and urbanicity in describing disparities among U.S. neighborhoods.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Hosler A, Kammer J. Trends of fruit and vegetable availability in neighbourhoods in Albany, NY, USA, 2003-2012. Public Health Nutr. 2015, in press.

  49. Grimm K, Moore L, Scanlon K, Centers for Disease Control and Prevention. Access to healthier food retailers - United States, 2011. MMWR. 2013;62 Suppl 3:20–6. This article uses recent national data to describe regional variation in the distribution of healthier food retailers (e.g., supermarkets, supercenters) by income, race, and urbanicity.

    PubMed  Google Scholar 

  50. Kersten E, Laraia B, Kelly M, et al. Small food stores and availability of nutritious foods: a comparison of database and in-store measures, Northern California, 2009. Prev Chronic Dis. 2012;9:E217.

    Google Scholar 

  51. Richardson A, Boone-Heinonen J, Popkin B, Gordon-Larsen P. Are neighbourhood food resources distributed inequitably by income and race in the USA? Epidemiological findings across the urban spectrum. BMJ Open. 2012;2:e000698. This article advances the literature on neighborhood-level disparities in access to healthy and unhealthy foods by describing variation in the distribution of food resources by income and race across the U.S. urban spectrum.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Lee H. The role of local food availability in explaining obesity risk among young school-aged children. Soc Sci Med. 2012;74(8):1193–201.

    Article  PubMed  Google Scholar 

  53. Lucan S, Maroko A, Shanker R, Jordan W. Green Carts (mobile produce vendors) in the Bronx - optimally positioned to meet neighborhood fruit-and-vegetable needs? J Urban Health. 2011;88(5):977–81.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Widener M, Metcalf S, Bar-Yam Y. Dynamic urban food environments a temporal analysis of access to healthy foods. Am J Prev Med. 2011;41(4):439–41.

    Article  PubMed  Google Scholar 

  55. Hearst M, Pasch K, Laska M. Urban v suburban perceptions of the neighborhood food environment as correlates of adolescent food purchasing. Public Health Nutr. 2011;15(2):299–306.

    Article  PubMed Central  PubMed  Google Scholar 

  56. Gordon C, Purciel-Hill M, Ghai N, et al. Measuring food deserts in New York City’s low-income neighborhoods. Health Place. 2011;17(2):696–700.

    Article  PubMed  Google Scholar 

  57. Dean W, Sharkey J. Rural and urban differences in the associations between characteristics of the community food environment and fruit and vegetable intake. J Nutr Educ Behav. 2011;43(6):426–33.

    Article  PubMed Central  PubMed  Google Scholar 

  58. Sharkey J, Johnson C, Dean W, Horel S. Focusing on fast food restaurants alone underestimates the relationship between neighborhood deprivation and exposure to fast food in a large rural area. Nutr J. 2011;10:10.

    Article  PubMed Central  PubMed  Google Scholar 

  59. Sharkey J, Horel S, Dean W. Neighborhood deprivation, vehicle ownership, and potential spatial access to a variety of fruits and vegetables in a large rural area in Texas. Int J Health Geogr. 2010;9:26.

    Article  PubMed Central  PubMed  Google Scholar 

  60. Michimi A, Wimberly M. Associations of supermarket accessibility with obesity and fruit and vegetable consumption in the conterminous United States. Int J Health Geogr. 2010;9:49.

    Article  PubMed Central  PubMed  Google Scholar 

  61. Lee R, Heinrich K, Medina A, et al. A picture of the healthful food environment in two diverse urban cities. Environ Health Insights. 2010;4:49–60.

    Article  PubMed Central  PubMed  Google Scholar 

  62. Kwate N, Yau C-Y, Loh J-M, Williams D. Inequality in obesigenic environments: fast food density in New York City. Health Place. 2009;15(1):364–73.

    Article  PubMed  Google Scholar 

  63. Dunn D, Sharkey J, Lotade-Manje J, et al. Socio-economic status, racial composition and the affordability of fresh fruits and vegetables in neighborhoods of a large rural region in Texas. Nutr J. 2011;10:6.

    Article  PubMed Central  PubMed  Google Scholar 

  64. Filomena S, Scanlin K, Morland K. Brooklyn, New York foodscape 2007-2011: a five-year analysis of stability in food retail environments. Int J Behav Nutr Phys Act. 2013;10:46. This article uses records of stores licensed to sell food in the state of New York to provide information on the stability of food retail environments and variations in stability according to race and income.

    Article  PubMed Central  PubMed  Google Scholar 

  65. Neff R, Palmer A, McKenzie S, Lawrence R. Food systems and public health disparities. J Hunger Environ Nutr. 2009;4(3–4):282–314.

    Article  PubMed Central  PubMed  Google Scholar 

  66. U.S. Department of Agriculture. 2014 Farm Bill Highlights [Online]. Washington DC: U.S. Department of Agriculture; 2014 [updated March 2014; cited 2014 August 20]. Available from: http://www.usda.gov/documents/usda-2014-farm-bill-highlights.pdf.

  67. Fleming-Milici F, Harris J, Sarda V, Schwartz M. Amount of Hispanic youth exposure to food and beverage advertising on Spanish- and English-language television. JAMA Pediatr. 2013;167(8):723–30.

    Article  PubMed  Google Scholar 

  68. Harris J, Schwartz M, Munsell C, et al. Fast food FACTS 2013: measuring progress in nutrition and marketing to children and teens. New Haven, CT: Yale Rudd Center for Food Policy and Obesity; 2013 [updated November 2013; cited 2014 August 20]. Available from: http://www.fastfoodmarketing.org/media/FastFoodFACTS_report.pdf. This article describes recent, national data on ethnic/racial disparities in child and adolescent exposure to advertising on websites and both national and cable broadcast television.

  69. Harris J, Schwartz M, Brownell K, et al. Cereal FACTS 2012: Limited progress in the nutrition quality and marketing of children's cereals. New Haven, CT: Yale Rudd Center for Food Policy and Obesity; 2012 [cited 2014 August 20]. Available from: http://www.cerealfacts.org/media/Cereal_FACTS_Report_2012_7.12.pdf.

  70. Powell L, Szczypka G, Chaloupka F. Trends in exposure to television food advertisements among children and adolescents in the United States. Arch Pediatr Adolesc Med. 2010;164(9):794–802.

    Article  PubMed  Google Scholar 

  71. Henderson V, Kelly B. Food advertising in the age of obesity: content analysis of food advertising on general market and African American television. J Nutr Educ Behav. 2005;37:191–6.

    Article  PubMed  Google Scholar 

  72. Powell L, Szczypka G, Chaloupka F. Adolescent exposure to food advertising on television. Am J Prev Med. 2007;33(4S):S251–6.

    Article  PubMed  Google Scholar 

  73. Thompson D, Flores G, Ebel B, Christakis D. Comida en venta: after-school advertising on Spanish-language television in the United States. J Pediatr. 2008;152(4):576–81.

    Article  PubMed  Google Scholar 

  74. Powell L, Wada R, Kumanyika S. Racial/ethnic and income disparities in child and adolescent exposure to food and beverage television ads across the U.S. media markets. Health Place. 2014;29:124–31. This article builds on the existing evidence base relating to the targeted marketing of foods and beverages by using designated market area spot television ratings to assess disparities in child and adolescent exposure.

    Article  PubMed  Google Scholar 

  75. Eaton D, Kann L, Kinchen S, et al. Youth risk behavior surveillance - United States, 2011. MMWR Surveill Summ. 2012;61(4):1–162.

    PubMed  Google Scholar 

  76. Yancey A, Cole B, Brown R, et al. A cross-sectional prevalence study of ethnically targeted and general audience outdoor obesity-related advertising. Milbank Q. 2009;87(1):155–84.

    Article  PubMed Central  PubMed  Google Scholar 

  77. Hillier A, Cole B, Smith T, et al. Clustering of unhealthy outdoor advertisements around child-serving institutions: a comparison of three cities. Health Place. 2009;15(4):935–45.

    Article  PubMed  Google Scholar 

  78. Kwate N, Lee T. Ghettoizing outdoor advertising: disadvantage and ad panel density in black neighborhoods. J Urban Health. 2006;84(1):21–31.

    Article  PubMed Central  Google Scholar 

  79. Chester J, Montgomery K. Interactive food and beverage marketing: targeting children and youth in the digital age. An update Berkeley, CA: Berkeley Media Studies Group; 2008 [updated July 2008; cited 2014 August 20]. Available from: http://www.digitalads.org.

  80. Chester J, Montgomery K. Interactive food and beverage marketing: targeting children and youth in the digital age. Berkeley, CA: Berkeley Media Studies Group, 2007 May.

  81. Institute of Medicine. Speaking of health: assessing health communication strategies for diverse populations. Washington, D.C.: 2002.

  82. Caprio S, Daniels S, Drenowski A, et al. Influence of race, ethnicity, and culture on childhood obesity: implications for prevention and treatment. Diabetes Care. 2008;31(11):2211–21.

    Article  PubMed Central  PubMed  Google Scholar 

  83. Kumanyika S. Environmental influences on childhood obesity: ethnic and cultural influences in context. Physiol Behav. 2008;94:61–70.

    Article  CAS  PubMed  Google Scholar 

  84. Pascoe E, Richman L. Perceived discrimination and health: a meta-analytic review. Psychol Bull. 2009;135(4):531–54.

    Article  PubMed Central  PubMed  Google Scholar 

  85. Zenk S, Schulz A, Israel B, et al. Food shopping behaviors and exposure to discrimination. Public Health Nutr. 2014;17(5):1167–76. This article uniquely describes exposure to discrimination at food retail outlets and relationships with the neighborhood environment.

    Article  PubMed  Google Scholar 

  86. Shonkoff J, Garner A, Siegel B, et al. The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012;129(1):e232.

    Article  PubMed  Google Scholar 

  87. Larson N, Story M. A review of environmental influences on food choices. Ann Behav Med. 2009;38 Suppl 1:S56–73.

    Article  PubMed  Google Scholar 

  88. Fitzgibbon M, Beech B. The role of culture in the context of school-based BMI screening. Pediatrics. 2009;124(Suppl 1):S50–62.

    Article  PubMed  Google Scholar 

  89. Lundahl A, Kidwell K, Nelson T. Parental underestimates of child weight: a meta-analysis. Pediatrics. 2014;133(3):e689–703.

    Article  PubMed  Google Scholar 

  90. Satia-Abouta J. Dietary acculturation: definition, process, assessment, and implications. Int J Hum Ecol. 2003;4(1):71–86.

    Google Scholar 

  91. Mulasi-Pokhriyal U, Smith C, Franzen-Castle L. Investigating dietary acculturation and intake among US-born and Thailand/Laos-born Hmong-American children aged 9-18 years. Public Health Nutr. 2011;15(1):176–85.

    Article  PubMed  Google Scholar 

  92. Liu J-H, Chu Y, Frongillo E, Probst J. Generation and acculturation status are associated with dietary intake and body weight in Mexican American adolescents. J Nutr. 2012;142:298–305.

    Article  CAS  PubMed  Google Scholar 

  93. Batis C, Hernandez-Barrera L, Barquera S, et al. Food acculturation drives dietary differences among Mexicans, Mexican Americans, and Non-Hispanic whites. J Nutr. 2011;141(10):1898–906.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  94. Allen ML, Elliott M, Morales L, et al. Adolescent participation in preventive health behaviors, physical activity, and nutrition: differences across immigrant generations for Asians and Latinos compared with Whites. Am J Public Health. 2007;97(2):337–43.

    Article  PubMed Central  PubMed  Google Scholar 

  95. Viruell-Fuentes E, Miranda P, Abdulrahim S. More than culture: structural racism, intersectionality theory, and immigrant health. Soc Sci Med. 2012;75(12):2099–106. This review article advances the literature on the role of cultural factors in determining health outcomes and proposes a shift in research from individual culture-based frameworks to perspectives that address how multiple dimensions of inequality may intersect.

    Article  PubMed  Google Scholar 

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Acknowledgments

This manuscript was supported in part by the Robert Wood Johnson Foundation Healthy Eating Research Program.

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Nicole Larson and Mary Story declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Nicole Larson.

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This article is part of the Topical Collection on Dietary Patterns and Behavior

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Larson, N., Story, M. Barriers to Equity in Nutritional Health for U.S. Children and Adolescents: A Review of the Literature. Curr Nutr Rep 4, 102–110 (2015). https://doi.org/10.1007/s13668-014-0116-0

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