Exploring Food-Based Cultural Practices to Address Food Insecurity in Rural Appalachia

Background: Health behaviors, like diet, are influenced by a person’s culture and the society where they reside, contributing to the presence of health disparities within a unique region. Such disparities are evident in Central Appalachia where a unique cultural identity exists. Culture-based initiatives focused on improving food security and other nutritional challenges have had success in other diverse groups, yet similar interventions considering geographically tied culture, like Appalachia, are limited. Aim: This study aims to identify specific aspects of Appalachian culture that address food insecurity to inform future initiatives that may improve adult dietary habits and food security status. Methods: Qualitative data were collected from five focus groups in one rural Central Appalachian community in 2021 (n=59). Data were analyzed using Grounded Theory Approach. Results: Four primary themes related to culture and food insecurity emerged: 1) Community decline and economic hardship 2) Shifts in multigenerational food traditions 3) Response to limited food access and 4) Community decline and economic hardship. Participants revealed adaptations they have made in the face of geographic isolation and poverty and the pride they take in providing for themselves and one another. Conclusion: These findings indicate the people of Appalachia are unknowingly leveraging cultural practices to address food insecurity, yet the impact of these practices on nutritional status remains unknown. These results have implications for future studies and interventions in Appalachia which may have greater success by accounting for cultural influences compared to traditional approaches for reducing food insecurity in the region.