Food Insecurity among American Indian and Alaska Native People: A Scoping Review to Inform Future Research and Policy Needs

Cassandra J. Nikolaus, Selisha Johnson, Tia Benally, Tara Maudrie, Austin Henderson, Katie Nelson, Trevor Lane, Valerie Segrest, Gary L. Ferguson, Dedra Buchwald, Valarie Blue Bird Jernigan, Ka'imi Sinclair

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Food insecurity, defined as insufficient access to nutritious foods, is a social determinant of health that may underpin health disparities in the US. American Indian and Alaska Native (AI/AN) individuals experience many health inequities that may be related to food insecurity, but no systematic analyses of the existing evidence have been published. Thus, the objective of this scoping review was to assess the literature on food insecurity among AI/AN individuals and communities, with a focus on the prevalence of food insecurity and its relations to sociodemographic, nutrition, and health characteristics. Systematic search and data extraction processes were used. Searches were conducted on PubMed as well as peer-reviewed journal and government websites. Of 3174 identified references, 34 publications describing 30 studies with predominantly AI/AN sample populations were included in the final narrative synthesis. Twenty-two studies (73%) were cross-sectional and the remaining 8 (27%) described interventions. The weighted average prevalence of food insecurity across the studies was 45.7%, although estimates varied from 16% to 80%. Most studies used some version of the USDA Food Security Survey Modules, although evidence supporting its validity in AI/AN respondents is limited. Based on the review, recommendations for future research were derived, which include fundamental validity testing, better representation of AI/AN individuals in federal or local food security reports, and consideration of cultural contexts when selecting methodological approaches. Advances in AI/AN food insecurity research could yield tangible benefits to ongoing initiatives aimed at increasing access to traditional foods, improving food environments on reservations and homelands, and supporting food sovereignty.

Original languageEnglish
Pages (from-to)1566-1583
Number of pages18
JournalAdvances in Nutrition
Volume13
Issue number5
DOIs
StatePublished - Sep 2022

Keywords

  • food access
  • food sovereignty
  • Indigenous
  • literature review
  • Native American
  • nutrition

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