Ethnic-Racial Disparities in Food Environments: A Systematic Review and Meta-analyses of Inequities in Food Access and Availability

Ethnic-racial disparities in food environments contribute to diet-related health inequities. This systematic review and meta-analyses aimed to assess ethnic-racial inequities in the community and consumer food environments worldwide. MEDLINE, Embase, Web of Science, and LILACS databases were searched for studies published from inception to October 11, 2024. A total of 104 studies (74 on community food environment, 20 on consumer food environment, and 10 on both dimensions) met the inclusion criteria, with 88.5% conducted in the United States. Findings indicated that Blacks were disproportionately affected by food deserts and food swamps, with lower availability of supermarkets and healthy food stores and greater exposure to unhealthy food retailers and advertising. Latinos/Hispanics and Indigenous/Natives also faced disadvantages, including higher exposure to unhealthy food outlets and increased likelihood of living in food deserts. Asians showed mixed results, with greater access to grocery stores but higher exposure to unhealthy food environments. In the meta-analysis, ethnic-racial minorities were 63% more likely to reside in food deserts (Pooled OR: 1.63; 95% CI: 1.09–2.43), and food deserts [Pooled Mean Difference (MD): 3.63; 95% CI: 1.44–5.81] and food swamps had higher proportion of ethnic-racial minorities (Pooled MD: 2.02; 95% CI: 0.09–3.96) than non-food deserts and non-food swamps, respectively. These findings highlight structural inequalities shaping food environments and the urgent need for policies addressing food access disparities. Future research should expand beyond the U.S. and adopt standardized methodologies to better understand global ethnic-racial food environment disparities and their health implications.