Community energy balance: a framework for contextualizing cultural influences on high risk of obesity in ethnic minority populations.
BACKGROUND
Increases in the availability, affordability, and promotion of high-calorie foods and beverages and decreased obligations for routine physical activity have fostered trends of increased obesity worldwide. In high-income, plural societies, above average obesity prevalence is often observed in ethnic minority communities, suggesting that obesity-promoting influences are more prevalent or potent in these communities.


METHODS
An interdisciplinary group of scholars engaged in multiple rounds of focused discussion and literature review to develop a Community Energy Balance Framework (CEB). The objective was to explore the nature of the excess obesity risk in African descent and other ethnic minority populations and identify related implications for planning and evaluating interventions to prevent obesity.


RESULTS
A key principle that emerged is that researchers and programmers working with ethnic minority communities should contextualize the food- and physical activity-related sociocultural perspectives of these communities, taking into account relevant historical, political, and structural contexts. This perspective underscores the fallacy of approaches that place the entire burden of change on the individual, particularly in circumstances of social disadvantage and rapid cultural shifts.


CONCLUSIONS
The CEB framework is proposed for use and further development to aid in understanding potential health-adverse effects of cultural-contextual stresses and accommodations to these stresses.
Center for Clinical Epidemiology and Biostatistics (CCEB), University of Pennsylvania Perelman School of Medicine, 8 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA. skumanyi@mail.med.upenn.edu
Shiriki
S
Kumanyika
Wendell C
WC
Taylor
Sonya A
SA
Grier
Vikki
V
Lassiter
Kristie J
KJ
Lancaster
Christiaan B
CB
Morssink
André M N
AM
Renzaho
D001741:Black or African American; D003159:Community-Institutional Relations; D015438:Health Behavior / Q000208:ethnology*; D006291:Health Policy; D006293:Health Promotion; D054624:Health Status Disparities; D006801:Humans; D008019:Life Style / Q000208:ethnology*; D008913:Minority Groups; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control*; D014481:United States