Healthy eating and wellbeing among Somali, Cambodian, Mexican, and Sudanese immigrants and refugees in the u.s.: A focus group study

Background: Immigrants and refugees to the United States exhibit lower dietary quality than the general population, but reasons for this disparity are poorly understood.

Methods: We examined the meanings of food, health, and wellbeing through the dietary preferences, beliefs, and practices of Somali, Cambodian, Mexican, and Sudanese immigrants and refugees in the Midwestern United States. We conducted 16 audio-recorded focus groups with 127 adults and adolescents to understand eating patterns, healthy diet perceptions, good eating in their country of origin and in the U.S., barriers and facilitators, and gender and generational differences. A qualitative research team analyzed all transcripts before reducing data to codes. All transcripts were coded by at least two researchers. NVivo-9 was used to facilitate analysis.

Results: Results show that participants have similar perspectives about benefits of healthy eating (‘junk food is bad) and the barriers (personal, environmental, structural) associated with it. We observed generational differences and differences between men and women. We identified three themes: Ways of Knowing (‘What it means to eat healthy,' ‘Effects of healthy/unhealthy food'), Eating Habits (‘You eat what you like,' ‘You eat what is easy,' ‘You eat what is served,' ‘You eat to fit in'), and Barriers to Healthy Eating (‘Healthy food is expensive,' ‘Easy access to junk food').

Conclusion: Our study demonstrates how personal, structural, and environmental factors influence meanings of food and dietary patterns across immigrant and refugee populations. We conclude that cultural factors are not fixed variables that occur independently from the contexts in which they are embedded.