Exploring the Social Determinants of Health in Nutrition Care for South Asian Communities: A Narrative Review.

Abstract

The South Asian (SA) diasporic communities in Canada experience a greater burden of diabetes and cardiovascular disease (CVD) compared to white populations. Nutrition interventions often focus on individual behaviours and fail to consider that the social determinants of health (SDH) have a greater impact on chronic disease risk. A narrative review was conducted to identify the SDH in nutrition care interventions for the SA diaspora in Canada. The final analysis included fourteen articles from which SDH were identified and categorized based on the Social Ecological Model (SEM). The study analysis yielded the following needs in dietetic practice based on the SEM: (1) intrapersonal - need for language appropriate services, and representation of cultural foods and non-Western health perspectives in dietary guidelines, (2) interpersonal - understanding family and friends as social supports, (3) community - incorporating peer and community leader influences, (4) institution - importance of faith-based locations as community hubs, and client workplaces as a barrier to attending appointments, and (5) policy - advocacy for transportation and childcare access, adequate and secure income, and equitable care. These findings urge dietitians to move beyond cultural awareness, sensitivity, and competence to practicing cultural safety and humility in their practice, which is integral to providing equitable care.