Collecting, Using, and Reporting Race and Ethnicity Information: Implications for Research in Nutrition Education, Practice, and Policy to Promote Health Equity

Published:March 26, 2022DOI:


      This report will describe approaches for collecting, analyzing, and reporting race and ethnicity information in nutrition education and behavior research, practice, and policy to advance health equity. Race and ethnicity information is used to describe study participants and compare nutrition and health-related outcomes. Depending on the study design, race and ethnicity categories are often defined by the research question or other standardized approaches. Participant self-reported data are more acceptable than researcher adjudicated identification data, which can add bias and/or error. Valid methods to collect, use, and report race and ethnicity information are foundational to publication quality, findings of value, contribution to the knowledge base, and health equity.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access

      SNEB Member Login

      SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.


      Subscribe to Journal of Nutrition Education and Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Goodman AH.
        Why genes don't count (for racial differences in health).
        Am J Public Health. 2000; 90: 1699-1702
        • Du Bois WEB
        Dusk of Dawn: An Essay Toward an Autobiography of a Race Concept.
        1st ed. Harcourt, Brace and Company, 1940
        • Bell D.
        Faces at the Bottom of the Well: The Permanence of Racism.
        Basic Books, 1992
      1. Jones N, Marks R, Ramirez R, Ríos-Vargas M. U.S. Census Bureau, Improved race and ethnicity measures reveal U.S. Population is much more multiracial. 2020 Census illuminates racial and ethnic composition of the country. Accessed January 14, 2022.

        • Baye TM
        • Wilke RA.
        Mapping genes that predict treatment outcome in admixed populations.
        Pharmacogenomics J. 2010; 10: 465-477
        • Cheng YJ
        • Kanaya AM
        • Araneta MRG
        • et al.
        Prevalence of diabetes by race and ethnicity in the United States, 2011–2016.
        JAMA. 2019; 322: 2389-2398
        • Ogden CL
        • Fryar CD
        • Martin CB
        • et al.
        Trends in obesity prevalence by race and Hispanic origin-1999-2000 to 2017-2018.
        JAMA. 2020; 324: 1208-1210
        • Pool LR
        • Ning H
        • Lloyd-Jones DM
        • Allen NB
        Trends in racial/ethnic disparities in cardiovascular health among US adults from 1999–2012.
        J Am Heart Assoc. 2017; 6: 1-16
        • Borrell LN
        • Rodríguez-Álvarez E
        • Dallo FJ.
        Racial/ethnic inequities in the associations of allostatic load with all-cause and cardiovascular-specific mortality risk in US adults.
        PLoS One. 2020; 15e0228336
        • Beydoun MA
        • Beydoun HA
        • Mode N
        • et al.
        Racial disparities in adult all-cause and cause-specific mortality among US adults: mediating and moderating factors.
        BMC Public Health. 2016; 16: 1113
        • Bailey ZD
        • Krieger N
        • Agénor M
        • Graves J
        • Linos N
        • Bassett MT.
        Structural racism and health inequities in the USA: evidence and interventions.
        Lancet. 2017; 389: 1453-1463
        • Ford CL
        • Griffith DM
        • Bruce MA
        • Gilbert KL.
        in: Ford CL Griffith DM Bruce MA Gilbert KL Racism: Science & Tools for the Public Health Professional. American Public Health Association Press, 2019
        • Bower KM
        • Thorpe RJ
        • Rohde C
        • Gaskin DJ.
        The intersection of neighborhood racial segregation, poverty, and urbanicity and its impact on food store availability in the United States.
        Prev Med. 2014; 58: 33-39
        • Glanz K
        • Sallis JF
        • Saelens BE
        • Frank LD.
        Nutrition environment measures survey in stores (NEMS-S): development and evaluation.
        Am J Prev Med. 2007; 32: 282-289
        • Adeigbe RT
        • Baldwin S
        • Gallion K
        • Grier S
        • Ramirez AG.
        Food and beverage marketing to Latinos: a systematic literature review.
        Health Educ Behav. 2015; 42: 569-582
        • Conching AKS
        • Thayer Z.
        Biological pathways for historical trauma to affect health: a conceptual model focusing on epigenetic modifications.
        Soc Sci Med. 2019; 230: 74-82
        • Ford CL
        • Airhihenbuwa CO
        Critical race theory, race equity, and public health: toward antiracism praxis.
        Am J Public Health. 2010; 100: S30-S35
        • Kumanyika SK.
        A Framework for increasing equity impact in obesity prevention.
        Am J Public Health. 2019; 109: 1350-1357
        • Wong MS
        • Steers WN
        • Hoggatt KJ
        • Ziaeian B
        • Washington DL.
        Relationship of neighborhood social determinants of health on racial/ethnic mortality disparities in US veterans-mediation and moderating effects.
        Health Serv Res. 2020; 55: 851-862
        • Walker RJ
        • Williams JS
        • Egede LE.
        Impact of race/ethnicity and social determinants of health on diabetes outcomes.
        Am J Med Sci. 2016; 351: 366-373
        • Butler AM.
        Social determinants of health and racial/ethnic disparities in type 2 diabetes in youth.
        Curr Diab Rep. 2017; 17: 60
        • Phelan JC
        • Link BG
        Is racism a fundamental cause of inequalities in health?.
        Annu Rev Sociol. 2015; 41: 311-330
      2. Office of Management and Budget. Standards for maintaining, collecting, and presenting federal data on race and ethnicity. Accessed June 13, 2021.

        • Mays VM
        • Ponce NA
        • Washington DL
        • Cochran SD.
        Classification of race and ethnicity: implications for public health.
        Annu Rev Public Health. 2003; 24: 83-110
        • US Department of Health and Human Services
        Implementation guidance on data collection standards for race, ethnicity, sex, primary language, and disability status.
        2011 (Accessed July 18, 2021)
        • National Institutes of Health
        NIH Policy on Reporting Race and Ethnicity Data: Subjects in Clinical Research.
        National Institutes of Health, Bethesda, Maryland2001
        • United States Department of Agriculture
        National Institute of Food and Agriculture. Office of Equal Opportunity and Civil Rights FAQs, equitable distribution training.
        2020 (Accessed July 19, 2021)
      3. United States Census Bureau. Research to improve data on race and ethnicity. 2017. Accessed July 13, 2021.

      4. United States Census Bureau. U.S. Summary: 2000. Census 2000 Profile. US Census Bureau; 2001. Accessed January 15, 2022.

        • United States Census Bureau
        2010 Census Demographic Profile Summary File.
        Census of Population and Housing, 2010 (US Census Bureau; 2011.) (Accessed January 15, 2022)
        • Benmarhnia T
        • Hajat A
        • Kaufman JS.
        Inferential challenges when assessing racial/ethnic health disparities in environmental research.
        Environ Health. 2021; 20: 7
        • Davenport L.
        The fluidity of racial classifications.
        Annu Rev Polit Sci. 2020; 23: 221-240
        • Rowe W
        in: Coghlan D Brydon-Miller M The SAGE Encyclopedia of Action Research. SAGE Publications Ltd, 2014 (:628)
        • Jacobson D
        • Mustafa N.
        Social identity map: a reflexivity tool for practicing explicit positionality in critical qualitative research.
        Int J Qual Methods. 2019; 18: 1-12
        • Flanagin A
        • Frey T
        • Christiansen SL
        • AMA Manual of Style Committee
        Updated guidance on the reporting of race and ethnicity in medical and science journals.
        JAMA. 2021; 326: 621-627
      5. Graetz N, Boen CE, Esposito MH. Structural racism and quantitative causal inference: a life course mediation framework for decomposing racial health disparities [published online ahead of print, January 8, 2022]. J Health Soc Behav.

        • Liu P
        • Ross JS
        • Ioannidis JP
        • Dhruva SS
        • Vasiliou V
        • Wallach JD.
        Prevalence and significance of race and ethnicity subgroup analyses in Cochrane intervention reviews.
        Clin Trials. 2020; 17: 231-234
        • Cheng TL
        • Goodman E
        • Bogue CW
        • et al.
        Race, ethnicity, and socioeconomic status in research on child health.
        Pediatrics. 2015; 135: e225-e237
        • Boehmer U
        • Kressin NR
        • Berlowitz DR
        • Christiansen CL
        • Kazis LE
        • Jones JA.
        Self-reported vs administrative race/ethnicity data and study results.
        Am J Public Health. 2002; 92: 1471-1472
        • Perez AD
        • Hirschman C.
        The changing racial and ethnic composition of the US population: emerging American identities.
        Popul Dev Rev. 2009; 35: 1-51
        • Saperstein A
        • Penner AM.
        Beyond the looking glass: exploring fluidity in racial self-identification and interviewer classification.
        Sociol Perspect. 2014; 57: 186-207
        • Howard JA.
        Social psychology of identities.
        Annu Rev Sociol. 2000; 26: 367-393
      6. Agency for Healthcare Research and Quality. Race, ethnicity, and language data: standardization for health care quality improvement. Accessed January 15, 2022.

        • Stepanikova I
        • Oates GR.
        Dimensions of racial identity and perceived discrimination in health care.
        Ethn Dis. 2016; 26: 501-512
        • Ford KS.
        Observer-identification: a potential threat to the validity of self-identified race and ethnicity.
        Educational Researcher. 2019; 48: 378-381
        • National Center for Education Statistics
        Racial and Ethnic Classifications Used by Public Schools.
        (US Department of Education; 1996)1996 (Accessed July 18, 2021)
        • Gomez SL
        • Glaser SL.
        Misclassification of race/ethnicity in a population-based cancer registry (United States).
        Cancer Causes Control. 2006; 17: 771-781
        • Hahn RA
        • Truman BI
        • Barker ND.
        Identifying ancestry: the reliability of ancestral identification in the United States by self, proxy, interviewer, and funeral director.
        Epidemiology. 1996; 7: 75-80
        • Kelly JJ
        • Chu SY
        • Díaz T
        • Leary LS
        • Buehler JW.
        Race/ethnicity misclassification of persons reported with AIDS. The AIDS Mortality Project Group and The Supplement to HIV/AIDS Surveillance Project Group.
        Ethn Health. 1996; 1: 87-94
        • FitzGerald C
        • Hurst S.
        Implicit bias in healthcare professionals: a systematic review.
        BMC Med Ethics. 2017; 18: 19
        • Maina IW
        • Belton TD
        • Ginzberg S
        • Singh A
        • Johnson TJ.
        A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test.
        Soc Sci Med. 2018; 199: 219-229
        • Hagiwara N
        • Kron FW
        • Scerbo MW
        • Watson GS.
        A call for grounding implicit bias training in clinical and translational frameworks.
        Lancet. 2020; 395: 1457-1460
        • Jarrín OF
        • Nyandege AN
        • Grafova IB
        • Dong X
        • Lin H.
        Validity of race and ethnicity codes in Medicare administrative data compared with gold-standard self-reported race collected during routine home health care visits.
        Med Care. 2020; 58: e1-e8
        • Hasnain-Wynia R
        • Baker DW.
        Obtaining data on patient race, ethnicity, and primary language in health care organizations: current challenges and proposed solutions.
        Health Serv Res. 2006; 41: 1501-1518
        • Weaver CM
        • Fukagawa NK
        • Liska DA
        • et al.
        Perspective: US documentation and regulation of human nutrition randomized controlled trials.
        Adv Nutr. 2021; 12: 21-45
        • Finlay L.
        “Outing” the researcher: the provenance, process, and practice of reflexivity.
        Qual Health Res. 2002; 12: 531-545
        • Berger R.
        Now I see it, now I don't: researcher's position and reflexivity in qualitative research.
        Qual Res. 2015; 15: 219-234
        • Tong A
        • Sainsbury P
        • Craig J.
        Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.
        Int J Qual Health Care. 2007; 19: 349-357
        • Tufford L
        • Newman P.
        Bracketing in qualitative research.
        Qual Soc Work. 2012; 11: 80-96
        • Ahern KJ.
        Ten tips for reflexive bracketing.
        Qual Health Res. 1999; 9: 407-411
        • Isik U
        • Wouters A
        • Croiset G
        • Kusurkar RA.
        “What kind of support do I need to be successful as an ethnic minority medical student?” A qualitative study.
        BMC Med Educ. 2021; 21: 6
        • Graham LJ
        • Connelly DM.
        “Any movement at all is exercise”: a focused ethnography of rural community-dwelling older adults’ perceptions and experiences of exercise as self-care.
        Physiother Can. 2013; 65: 333-341
        • McArthur C
        • Bai Y
        • Hewston P
        • Giangregorio L
        • Straus S
        • Papaioannou A.
        Barriers and facilitators to implementing evidence-based guidelines in long-term care: a qualitative evidence synthesis.
        Implement Sci. 2021; 16: 70
        • Connor EO
        • Dolan E
        • Horgan F
        • Robinson K
        • Galvin R.
        A protocol for a qualitative synthesis exploring people with stroke, family members, caregivers and healthcare professionals experiences of early supported discharge (ESD) after stroke.
        HRB Open Res. 2020; 3: 79
        • Korstjens I
        • Moser A.
        Series: practical guidance to qualitative research. Part 4: Trustworthiness and publishing.
        Eur J Gen Pract. 2018; 24: 120-124
        • Douglass S
        • Mirpuri S
        • English D
        • Yip T.
        “They were just making jokes”: ethnic/racial teasing and discrimination among adolescents.
        Cultur Divers Ethn Minor Psychol. 2016; 22: 69-82
        • Held MBE.
        Decolonizing research paradigms in the context of settler colonialism: an unsettling, mutual, and collaborative effort.
        Int J Qual Methods. 2019; 181609406918821574
        • Alexander SA
        • Jones CM
        • Tremblay MC
        • Beaudet N
        • Rod MH
        • Wright MT.
        Reflexivity in health promotion: a typology for training.
        Health Promot Pract. 2020; 21: 499-509
        • Ermakov IV
        • Gellermann W.
        Optical detection methods for carotenoids in human skin.
        Arch Biochem Biophys. 2015; 572: 101-111
        • Jilcott Pitts SB
        • Moran NE
        • Wu Q
        • et al.
        Pressure-mediated reflection spectroscopy criterion validity as a biomarker of fruit and vegetable intake: a 2-site cross-sectional study of 4 racial or ethnic groups.
        J Nutr. 2022; 152: 107-116
        • Siega-Riz AM
        • Pace ND
        • Butera NM
        • et al.
        How well do US Hispanics adhere to the Dietary Guidelines for Americans? Results from the Hispanic Community Health Study/Study of Latinos.
        Health Equity. 2019; 3: 319-327
        • Stephenson BJK
        • Sotres-Alvarez D
        • Siega-Riz AM
        • et al.
        Empirically derived dietary patterns using robust profile clustering in the Hispanic Community Health Study/Study of Latinos.
        J Nutr. 2020; 150: 2825-2834
        • Laster Pirtle WN
        • Valdez Z
        • Daniels KP
        • Duenas MD
        • Castro D.
        Conceptualizing ethnicity: how dimensions of ethnicity affect disparities in health outcomes among Latinxs in the United States.
        Ethn Dis. 2020; 30: 489-500
        • Moubarac JC.
        Persisting problems related to race and ethnicity in public health and epidemiology research.
        Rev Saude Publica. 2013; 47: 104-115
        • Larson N
        • Alexander T
        • Slaughter-Acey JC
        • Berge J
        • Widome R
        • Neumark-Sztainer D.
        Barriers to accessing healthy food and food assistance during the COVID-19 pandemic and racial justice uprisings: a mixed-methods investigation of emerging adults’ experiences.
        J Acad Nutr Diet. 2021; 121: 1679-1694
        • Phojanakong P
        • Brown Weida E
        • Grimaldi G
        • Lê-Scherban F
        • Chilton M.
        Experiences of racial and ethnic discrimination are associated with food insecurity and poor health.
        Int J Environ Res Public Health. 2019; 16: 4369
        • Hardeman RR
        • Murphy KA
        • Karbeah J
        • Kozhimannil KB.
        Naming institutionalized racism in the public health literature: a systematic literature review.
        Public Health Rep. 2018; 133: 240-249
        • Castle B
        • Wendel M
        • Kerr J
        • Brooms D
        • Rollins A.
        Public health's approach to systemic racism: a systematic literature review.
        J Racial Ethn Health Disparities. 2019; 6: 27-36
        • O'Brien R
        • Neman T
        • Seltzer N
        • Evans L
        • Venkataramani A.
        Structural racism, economic opportunity and racial health disparities: evidence from US counties.
        SSM Popul Health. 2020; 11100564
        • Duggan CP
        • Kurpad A
        • Stanford FC
        • Sunguya B
        • Wells JC.
        Race, ethnicity, and racism in the nutrition literature: an update for 2020.
        Am J Clin Nutr. 2020; 112: 1409-1414
        • Foster MW
        • Sharp RR.
        Race, ethnicity, and genomics: social classifications as proxies of biological heterogeneity.
        Genome Res. 2002; 12: 844-850
        • Kaplan JB
        • Bennett T.
        Use of race and ethnicity in biomedical publication.
        J Am Med Assoc. 2003; 289: 2709-2716
        • Bray SRM
        • McLemore MR.
        Demolishing the myth of the default human that is killing Black mothers.
        Front Public Health. 2021; 9675788
        • Ford CL
        • Harawa NT.
        A new conceptualization of ethnicity for social epidemiologic and health equity research.
        Soc Sci Med. 2010; 71: 251-258
        • Boyd RW
        • Lindo EB
        • Weeks LD
        • McLemore MR.
        On racism: a new standard for publishing on racial health inequities.
        Health Affairs Blog. 2020; (Accessed January 15, 2022)
        • Coughlin SS
        • Smith SA.
        Community-based participatory research to promote healthy diet and nutrition and prevent and control obesity among African-Americans: a literature review.
        J Racial Ethn Health Disparities. 2017; 4: 259-268
        • Sadeghi B
        • Kaiser LL
        • Schaefer S
        • et al.
        Multifaceted community-based intervention reduces rate of BMI growth in obese Mexican-origin boys.
        Pediatr Obes. 2017; 12: 247-256
        • DeBruyn L
        • Fullerton L
        • Satterfield D
        • Frank M.
        Integrating culture and history to promote health and help prevent type 2 diabetes in American Indian/Alaska native communities: traditional foods have become a way to talk about health.
        Prev Chronic Dis. 2020; 17: E12
        • Kumanyika SK
        • Whitt-Glover MC
        • Gary TL
        • et al.
        Expanding the obesity research paradigm to reach African American communities.
        Prev Chronic Dis. 2007; 4: A112