Background: Obesity is persistent in small island states. The food system, a determinant of health, plays an important role in nutrition-related health outcomes such as obesity. The food system includes all institutions, environments, infrastructure and activities that relate to the production, processing, distribution, marketing, preparation and consumption of food. The Bahamas is one such small island state that is challenged by the prevalence of obesity, but there is little evidence about the structure of its food system or how it contributes to this prevalence. This research responds to this gap by examining the structure of the food system in The Bahamas and explores how it shapes the persistence of obesity in the island context.
Methodology: This multi-method study, conducted between 2019 and 2021, adopted a case study approach. It combined 40 semi-structured interviews with key actors (policymakers, health workers, scholars and members of the public) and document review of relevant government policies for data collection. The food system framework was used to support data analysis.
Results: Seven key factors were found to impact the food system in The Bahamas and contribute to health and nutrition outcomes such as obesity. These factors include: (i) the island place; (ii) gender relations; (iii) socio-cultural influences; (iv) colonisation; (v) the national political environment; (vi) global affairs, and (vii) climate. Food production, acquisition, preparation and consumption are affected by how these factors intersect, and influence individual behavioural practices in the food environment.
Contributions: This research has theoretical and policy implications. Theoretically, it contributes a context-informed island-based food system framework applicable to other small island contexts. In terms of policy, the framework emphasises the importance of addressing nutrition-related health issues in a comprehensive, multilevel and sustainable way.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)