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

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.