Journal of urban health : bulletin of the New York Academy of Medicine
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The purpose of this study was to use participatory systems thinking to develop a dynamic conceptual framework of racial/ethnic and other intersecting disparities (e.g., income) in food access and diet in Philadelphia and to identify policy levers to address these disparities. We conducted three group model building workshops, each consisting of a series of scripted activities. Key artifacts or outputs included qualitative system maps, or causal loop diagrams, identifying the variables, relationships, and feedback loops that drive diet disparities in Philadelphia, Pennsylvania. ⋯ Consistent with existing frameworks, addressing disparities will require a focus on upstream social determinants. However, existing frameworks should be adapted to emphasize and disrupt the interdependent, reinforcing feedback loops that maintain and exacerbate disparities in fundamental social causes. Our findings suggest that promising policies include those that empower minoritized communities, address socioeconomic inequities, improve community land control, and increase access to affordable, healthy, and culturally meaningful foods.