Exploring the Lived Experience of Food Insecure African Americans with Type 2 Diabetes Living in the Inner City

Abstract

Purpose: Despite evidence that food insecure African Americans with type 2 diabetes are at particularly high risk for poor health outcomes, there is currently a lack of information on their lived experience. This qualitative study aimed to identify chal­lenges, facilitators, and barriers to effective diabetes care for food insecure African Americans with type 2 diabetes residing in an inner city.Methods: In fall 2018, we conducted two focus groups attended by a total of 16 food insecure adults with type 2 diabetes residing in the inner city of Milwaukee, Wisconsin. A standardized moderator guide included questions to explore the role of food inse­curity in managing diabetes, and facilitators that improve diabetes management within the context of food insecurity. Focus groups were audio recorded and recordings were transcribed by a professional transcription service. A grounded theory approach was used for analysis.Results: Six major challenges existed at the individual level (diet/nutrition, exercise, dia­betes knowledge and skills, complications from diabetes, a family history of diabe­tes, and a preoccupation with food). Five major barriers and facilitators existed both internally and externally to the individuals (access to food, medications, stress, cost of health-related needs and religion/spiritual­ity).Conclusions: This study identified multiple challenges, barriers, and facilitators to effec­tive care for food insecure African American adults with type 2 diabetes. It is impera­tive to incorporate this understanding in future work by using an ecological approach to investigate strategies to address food insecurity beyond a singular focus on access to food. Ethn Dis. 2021;31(4):527-536; doi:10.18865/ed.31.4.527