Research has shown elevated rates of obesity and obesity-related health problems in Detroit, Michigan compared to state and national averages. Using 47 in-depth interviews of African American residents in two Detroit neighborhoods, this dissertation examines the challenges participants face and the strategies they devise to get food and physical activity. I explore the interplay between agency, social structure and community context. Interviewees discussed numerous shortcomings with the grocery stores in their neighborhoods, including cost, quality and availability. However, many devised strategies to address these issues, including carefully examining food before purchase, using multiple food sources to meet different needs, and sharing transportation to get to food sources in other areas. Participants also discussed numerous barriers to physical activity, including concerns about crime, deteriorating sidewalks and parks, and shortcomings with local recreational facilities. Strategies to address these issues included devising home exercise regimens, and sharing equipment and other resources within social networks. Overall, the potential to enact strategies varied, in part, according to community contextual factors, such as the availability of resources within neighborhoods and in surrounding areas. After exploring these barriers and strategies, I compare scholarly understandings of health behaviors with the lived experiences of participants. Many obtained significant amounts of physical activity from walking for transportation, employment, childcare and other forms physical labor, suggesting that the focus of health scholars on ;;leisure-time” physical activity in studies of low-income populations may be misguided. Participants also demonstrated nuanced and sophisticated understandings of nutrition, calling into question the wisdom of policymakers who promote nutritional education, as opposed to addressing lack of access to high-quality food sources. Improvements to structural factors, neighborhoods and health policies are necessary but insufficient steps toward improving eating and exercise behaviors. The importance of agency, social context, and the variation within and between communities suggests a theoretical framework that avoids both individualism and causal determinism. Structural improvements and health interventions must connect with the daily realities and potential of the individuals that they target.
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Captive audience?: Strategies for Getting Food and Physical Activity in Two Detroit Neighborhoods.