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Li D, Ruan Y, Kang Q, Rong C. Gender differences in association of urbanization with psychological stress in Chinese adults: A population-based study. Front Public Health 2022; 10:1022689. [PMID: 36452958 PMCID: PMC9703068 DOI: 10.3389/fpubh.2022.1022689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022] Open
Abstract
Objective To investigate the gender-specific associations between exposure to urbanization and psychological stress in China experiencing rapid urbanization. Methods Data were obtained from the 2015 China Health and Nutrition Survey. A total of 4,388 men and 5,098 women aged at least 18 years were obtained from 288 communities across 12 provinces and municipalities. Tertiles of the urbanization index, summarizing 12 urbanization dimensions at the community level, were used to define low, medium, and high levels of urbanization. The psychological stress was measured based on the 10-item Perceived Stress Scale. The gender-stratified multilevel analysis (Level-1: Individuals, Level-2: Communities, and Level-3: provinces/municipalities) was used to estimate the association between exposure to urbanization and psychological stress. Results After controlling for age, education status, marital status, work status, household income per capita, current smoking, alcohol drinking, sleep duration, BMI, and chronic conditions, the urbanization index was negatively associated with psychological stress in women (P trend = 0.017) but not men (P trend = 0.476). More specifically, a one-standard deviation increase in the score of community population density (β = -0.329, P = 0.329), modern markets (β = -0.247, P = 0.044), education (β = -0.448, P = 0.002), and housing (β = -0.380, P = 0.005) was negatively associated with psychological stress only in women, separately. Conclusion Our data revealed that living in the most urbanized communities is associated with lower levels of psychological stress for women but not men. Thus, this study can help empower decision-makers to accurately target vulnerable communities and plan effective strategies to address psychological outcomes.
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Affiliation(s)
- Dianjiang Li
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China,Research Center for Social Risk Governance for Major Public Health Events, Nanjing Medical University, Nanjing, China,*Correspondence: Dianjiang Li
| | - Yuhui Ruan
- School of Politics and Public Administration, Soochow University, Suzhou, China,Institute of Public Health, Soochow University, Suzhou, China
| | - Qi Kang
- Department of Health Policy Research, Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China
| | - Chao Rong
- Department of Health Service and Management, School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
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Lambdin-Pattavina C, Pyatak E. Occupational Therapy's Role in Chronic Conditions. Am J Occup Ther 2022; 76:24002. [PMID: 36706303 DOI: 10.5014/ajot.2022.76s3003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
It is the position of the American Occupational Therapy Association (AOTA) that occupational therapy practitioners are distinctly qualified to address the impact of chronic conditions on occupational performance and participation across the life span. The purpose of this position statement is twofold. First, it defines chronic conditions and describes the multiple factors associated with the development of one or more chronic conditions. Second, it provides an overview of how the field of occupational therapy has a distinct impact on improving the health and wellness of persons, groups, and populations with or at risk for chronic conditions through health promotion, disease prevention, and intervention.
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Wilkins E, Morris M, Radley D, Griffiths C. Methods of measuring associations between the Retail Food Environment and weight status: Importance of classifications and metrics. SSM Popul Health 2019; 8:100404. [PMID: 31245526 PMCID: PMC6582068 DOI: 10.1016/j.ssmph.2019.100404] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/26/2019] [Accepted: 04/24/2019] [Indexed: 12/29/2022] Open
Abstract
Despite considerable research, evidence supporting associations between the 'Retail Food Environment' (RFE) and obesity remains mixed. Differences in the methods used to measure the RFE may explain this heterogeneity. Using data on a large (n = 10,111) sample of adults from the Yorkshire Health Study (UK), we modelled cross-sectional associations between the RFE and weight status using (i) multiple definitions of 'Fast Food', 'Convenience' and 'Supermarkets' and (ii) multiple RFE metrics, identified in a prior systematic review to be common in the literature. Both the choice of outlet definition and the choice of RFE metric substantively impacted observed associations with weight status. Findings differed in relation to statistical significance, effect sizes, and directions of association. This study provides novel evidence that the diversity of RFE measurement methods is contributing to heterogeneous study findings and conflicting policy messages. Greater attention is needed when selecting and communicating RFE measures in research.
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Affiliation(s)
- Emma Wilkins
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Michelle Morris
- Leeds Institute for Data Analytics, School of Medicine, University of Leeds, Leeds, UK
| | - Duncan Radley
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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A Time-Based Objective Measure of Exposure to the Food Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071180. [PMID: 30986919 PMCID: PMC6480343 DOI: 10.3390/ijerph16071180] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/13/2019] [Accepted: 03/29/2019] [Indexed: 12/03/2022]
Abstract
Exposure to food environments has mainly been limited to counting food outlets near participants’ homes. This study considers food environment exposures in time and space using global positioning systems (GPS) records and fast food restaurants (FFRs) as the environment of interest. Data came from 412 participants (median participant age of 45) in the Seattle Obesity Study II who completed a survey, wore GPS receivers, and filled out travel logs for seven days. FFR locations were obtained from Public Health Seattle King County and geocoded. Exposure was conceptualized as contact between stressors (FFRs) and receptors (participants’ mobility records from GPS data) using four proximities: 21 m, 100 m, 500 m, and ½ mile. Measures included count of proximal FFRs, time duration in proximity to ≥1 FFR, and time duration in proximity to FFRs weighted by FFR counts. Self-reported exposures (FFR visits) were excluded from these measures. Logistic regressions tested associations between one or more reported FFR visits and the three exposure measures at the four proximities. Time spent in proximity to an FFR was associated with significantly higher odds of FFR visits at all proximities. Weighted duration also showed positive associations with FFR visits at 21-m and 100-m proximities. FFR counts were not associated with FFR visits. Duration of exposure helps measure the relationship between the food environment, mobility patterns, and health behaviors. The stronger associations between exposure and outcome found at closer proximities (<100 m) need further research.
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Kranjac AW, Denney JT, Kimbro RT, Moffett BS, Lopez KN. Neighborhood and Social Environmental Influences on Child Chronic Disease Prevalence. POPULATION AND ENVIRONMENT 2018; 40:93-114. [PMID: 31485093 PMCID: PMC6726389 DOI: 10.1007/s11111-018-0303-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We investigate how distinct residential environments uniquely influence chronic child disease. Aggregating over 200,000 pediatric geocoded medical records to the census tract of residence and linking them to neighborhood-level measures, we use multiple data analysis techniques to assess how heterogeneous exposures of social and environmental neighborhood conditions influence an index of child chronic disease (CCD) prevalence for the neighborhood. We find there is a graded relationship between degree of overall neighborhood disadvantage and children's chronic disease such that the highest neighborhood CCD scores reside in communities with the highest concentrated disadvantage. Finally, results show that higher levels of neighborhood concentrated disadvantage and air pollution exposure associate with higher risks of having at least one chronic condition for children after also considering their individual- and family-level characteristics. Overall, our analysis serves as a comprehensive start for future researchers interested in assessing which neighborhood factors matter most for child chronic health conditions.
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Affiliation(s)
| | - Justin T. Denney
- Washington State University, Department of Sociology, Washington, United States
| | - Rachel T. Kimbro
- Rice University, Department of Sociology, Kinder Institute Urban Health Program, Houston, United States
| | - Brady S. Moffett
- Baylor College of Medicine, Pain Medicine, Houston, United States
| | - Keila N. Lopez
- Baylor College of Medicine, Texas Children’s Hospital, Heart Center, Cardiology, Houston, United States
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Social media indicators of the food environment and state health outcomes. Public Health 2017; 148:120-128. [PMID: 28478354 DOI: 10.1016/j.puhe.2017.03.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/24/2017] [Accepted: 03/28/2017] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Contextual factors can influence health through exposures to health-promoting and risk-inducing factors. The aim of this study was to (1) build, from geotagged Twitter and Yelp data, a national food environment database and (2) to test associations between state food environment indicators and health outcomes. STUDY DESIGN This is a cross-sectional study based upon secondary analyses of publicly available data. METHODS Using Twitter's Streaming Application Programming Interface (API), we collected and processed 4,041,521 food-related, geotagged tweets between April 2015 and March 2016. Using Yelp's Search API, we collected data on 505,554 unique food-related businesses. In linear regression models, we examined associations between food environment characteristics and state-level health outcomes, controlling for state-level differences in age, percent non-Hispanic white, and median household income. RESULTS A one standard deviation increase in caloric density of food tweets was related to higher all-cause mortality (+46.50 per 100,000), diabetes (+0.75%), obesity (+1.78%), high cholesterol (+1.40%), and fair/poor self-rated health (2.01%). More burger Yelp listings were related to higher prevalence of diabetes (+0.55%), obesity (1.35%), and fair/poor self-rated health (1.12%). More alcohol tweets and Yelp bars and pub listings were related to higher state-level binge drinking and heavy drinking, but lower mortality and lower percent reporting fair/poor self-rated health. Supplemental analyses with county-level social media indicators and county health outcomes resulted in finding similar but slightly attenuated associations compared to those found at the state level. CONCLUSIONS Social media can be utilized to create indicators of the food environment that are associated with area-level mortality, health behaviors, and chronic conditions.
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GPS or travel diary: Comparing spatial and temporal characteristics of visits to fast food restaurants and supermarkets. PLoS One 2017; 12:e0174859. [PMID: 28388619 PMCID: PMC5384745 DOI: 10.1371/journal.pone.0174859] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 03/16/2017] [Indexed: 01/19/2023] Open
Abstract
To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health Seattle King County, addresses from food permit data were matched to King County tax assessor parcels in a GIS. A three-step process was used to verify travel-diary reported visits using GPS records: (1) GPS records were temporally matched if their timestamps were within the time window created by the arrival and departure times reported in the travel diary; (2) the temporally matched GPS records were then spatially matched if they were located in a food establishment parcel of the same type reported in the diary; (3) the travel diary visit was then GPS-sensed if the name of food establishment in the parcel matched the one reported in the travel diary. To account for errors in reporting arrival and departure times, GPS records were temporally matched to three time windows: the exact time, +/- 10 minutes, and +/- 30 minutes. One third of the participants reported 273 visits to fast food restaurants; 88% reported 1,102 visits to supermarkets. Of these, 77.3 percent of the fast food and 78.6 percent supermarket visits were GPS-sensed using the +/-10-minute time window. At this time window, the mean travel-diary reported fast food visit duration was 14.5 minutes (SD 20.2), 1.7 minutes longer than the GPS-sensed visit. For supermarkets, the reported visit duration was 23.7 minutes (SD 18.9), 3.4 minutes longer than the GPS-sensed visit. Travel diaries provide reasonably accurate information on the locations and brand names of fast food restaurants and supermarkets participants report visiting.
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Lytle LA, Sokol RL. Measures of the food environment: A systematic review of the field, 2007-2015. Health Place 2017; 44:18-34. [PMID: 28135633 DOI: 10.1016/j.healthplace.2016.12.007] [Citation(s) in RCA: 158] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/21/2016] [Accepted: 12/02/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Many studies have examined the relationship between the food environment and health-related outcomes, but fewer consider the integrity of measures used to assess the food environment. The present review builds on and makes comparisons with a previous review examining food environment measures and expands the previous review to include a more in depth examination of reliability and validity of measures and study designs employed. METHODS We conducted a systematic review of studies measuring the food environment published between 2007 and 2015. We identified these articles through: PubMed, Embase, Web of Science, PsycINFO, and Global Health databases; tables of contents of relevant journals; and the National Cancer Institute's Measures of the Food Environment website. This search yielded 11,928 citations. We retained and abstracted data from 432 studies. RESULTS The most common methodology used to study the food environment was geographic analysis (65% of articles) and the domination of this methodology has persisted since the last review. Only 25.9% of studies in this review reported the reliability of measures and 28.2% reported validity, but this was an improvement as compared to the earlier review. Very few of the studies reported construct validity. Studies reporting measures of the school or worksite environment have decreased since the previous review. Only 13.9% of the studies used a longitudinal design. CONCLUSIONS To strengthen research examining the relationship between the food environment and population health, there is a need for robust and psychometrically-sound measures and more sophisticated study designs.
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Affiliation(s)
- Leslie A Lytle
- Department of Health Behavior, Campus Box 7440, UNC Gillings School of Global Public Health, Chapel Hill, NC 27599-7440, United States.
| | - Rebeccah L Sokol
- Department of Health Behavior, Campus Box 7440, UNC Gillings School of Global Public Health, Chapel Hill, NC 27599-7440, United States
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Hosler AS, Michaels IH, Buckenmeyer EM. Food Shopping Venues, Neighborhood Food Environment, and Body Mass Index Among Guyanese, Black, and White Adults in an Urban Community in the US. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:361-368.e1. [PMID: 27085256 DOI: 10.1016/j.jneb.2016.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/25/2016] [Accepted: 03/06/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate relationships among food shopping venues, food environment, and body mass index (BMI). DESIGN Cross-sectional survey data and directly assessed food environment data were linked at the neighborhood level. SETTING Schenectady, NY. PARTICIPANTS A sample of Guyanese, black, and white adults (n = 226, 485, and 908, respectively). MAIN OUTCOME MEASURES BMI. ANALYSIS Linear regression models were constructed with 10 food shopping venues and neighborhood food environment as explanatory variables, controlling for sociodemographics, dietary behavior, physical activity, and perception of healthy food access. RESULTS On average, respondents used 3.5 different food shopping venues. Supermarkets and ethnic markets were associated with a lower BMI in Guyanese adults. Among black adults, farmers' markets were associated with a lower BMI, whereas supermarkets, wholesale clubs, and food pantries were associated with a higher BMI. Among white adults, food coops and supermarkets were associated with a lower BMI and wholesale clubs were associated with a higher BMI. Neighborhoods with less a favorable food environment (longer travel distance to a supermarket) were associated with a lower BMI in Guyanese adults. CONCLUSIONS AND IMPLICATIONS Both primary (ie, supermarkets) and secondary food shopping venues could be independent determinants of BMI. The observed variations by race and ethnicity provided insights into a culturally tailored approach to address obesity.
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Affiliation(s)
- Akiko S Hosler
- Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY.
| | - Isaac H Michaels
- Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY
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Khojasteh M, Raja S. Agents of Change: How Immigrant-Run Ethnic Food Retailers Improve Food Environments. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016. [DOI: 10.1080/19320248.2015.1112759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Maryam Khojasteh
- University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Samina Raja
- University at Buffalo, The State University of New York, Buffalo, New York, USA
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11
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Gamba RJ, Schuchter J, Rutt C, Seto EYW. Measuring the food environment and its effects on obesity in the United States: a systematic review of methods and results. J Community Health 2016; 40:464-75. [PMID: 25326425 DOI: 10.1007/s10900-014-9958-z] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We identified fifty-one peer-reviewed studies that geospatially analyzed the relationship between the community nutrition environment (CNE) and obesity. Eighty percent of studies found at least one significant association between the CNE and obesity. However we calculated the proportion of studies that found at least one significant association between the CNE and obesity in the expected direction for each food store type and measurement technique, and the proportion across the different store types and measurement techniques was just 32%. Different methods for classifying, locating, and analyzing food stores produced mixed results and challenged direct study level comparison.
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Affiliation(s)
- Ryan J Gamba
- Department of Epidemiology, Berkeley School of Public Health, University of California, 50 University Hall, Berkeley, CA, 94720-7360, USA,
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Cobb LK, Appel LJ, Franco M, Jones-Smith JC, Nur A, Anderson CAM. The relationship of the local food environment with obesity: A systematic review of methods, study quality, and results. Obesity (Silver Spring) 2015; 23:1331-44. [PMID: 26096983 PMCID: PMC4482774 DOI: 10.1002/oby.21118] [Citation(s) in RCA: 327] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 03/13/2015] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To examine the relationship between local food environments and obesity and assess the quality of studies reviewed. METHODS Systematic keyword searches identified studies from US and Canada that assessed the relationship of obesity to local food environments. We applied a quality metric based on design, exposure and outcome measurement, and analysis. RESULTS We identified 71 studies representing 65 cohorts. Overall, study quality was low; 60 studies were cross-sectional. Associations between food outlet availability and obesity were predominantly null. Among non-null associations, we saw a trend toward inverse associations between supermarket availability and obesity (22 negative, 4 positive, 67 null) and direct associations between fast food and obesity (29 positive, 6 negative, 71 null) in adults. We saw direct associations between fast food availability and obesity in lower income children (12 positive, 7 null). Indices including multiple food outlets were most consistently associated with obesity in adults (18 expected, 1 not expected, 17 null). Limiting to higher quality studies did not affect results. CONCLUSIONS Despite the large number of studies, we found limited evidence for associations between local food environments and obesity. The predominantly null associations should be interpreted cautiously due to the low quality of available studies.
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Affiliation(s)
- Laura K Cobb
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Epidemiology, Prevention and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lawrence J Appel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Epidemiology, Prevention and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Manuel Franco
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Surgery, Medicine and Social Sciences, Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Madrid, Spain
| | - Jessica C Jones-Smith
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alana Nur
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cheryl A M Anderson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Family and Preventive Medicine, University of California San Diego School of Medicine, California, USA
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Yan R, Bastian ND, Griffin PM. Association of food environment and food retailers with obesity in US adults. Health Place 2015; 33:19-24. [DOI: 10.1016/j.healthplace.2015.02.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 02/04/2015] [Accepted: 02/06/2015] [Indexed: 11/30/2022]
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Lear SA, Gasevic D, Schuurman N. Association of supermarket characteristics with the body mass index of their shoppers. Nutr J 2013; 12:117. [PMID: 23941309 PMCID: PMC3751149 DOI: 10.1186/1475-2891-12-117] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 08/12/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research on the built food environment and weight status has mostly focused on the presence/absence of food outlets while ignoring their internal features or where residents actually shop. We explored associations of distance travelled to supermarkets and supermarket characteristics with shoppers' body mass index (BMI). METHODS Shoppers (n=555) of five supermarkets situated in different income areas in the city were surveyed for food shopping habits, demographics, home postal code, height and weight. Associations of minimum distance to a supermarket (along road network, objectively measured using ArcGIS), its size, food variety and food basket price with shoppers' BMI were investigated. The 'food basket' was defined as the mixture of several food items commonly consumed by residents and available in all supermarkets. RESULTS Supermarkets ranged in total floor space (7500-135,000 square feet) and had similar varieties of fruits, vegetables and cereals. The majority of participants shopped at the surveyed supermarket more than once per week (mean range 1.2 ± 0.8 to 2.3 ± 2.1 times per week across the five supermarkets, p < 0.001), and identified it as their primary store for food (52% overall). Mean participant BMI of the five supermarkets ranged from 23.7 ± 4.3 kg/m² to 27.1 ± 4.3 kg/m² (p < 0.001). Median minimum distance from the shoppers' residence to the supermarket they shopped at ranged from 0.96 (0.57, 2.31) km to 4.30 (2.83, 5.75) km (p < 0.001). A negative association was found between food basket price and BMI. There were no associations between BMI and minimum distance to the supermarket, or other supermarket characteristics. After adjusting for age, sex, dissemination area median individual income and car ownership, BMI of individuals who shopped at Store 1 and Store 2, the supermarkets with lowest price of the 'food basket', was 3.66 kg/m² and 3.73 kg/m² higher compared to their counterparts who shopped at the supermarket where the 'food basket' price was highest (p < 0.001). CONCLUSIONS The food basket price in supermarkets was inversely associated with BMI of their shoppers. Our results suggest that careful manipulation of food prices may be used as an intervention for decreasing BMI.
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Affiliation(s)
- Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6 British Columbia, Canada
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Robinson PL, Dominguez F, Teklehaimanot S, Lee M, Brown A, Goodchild M. Does distance decay modelling of supermarket accessibility predict fruit and vegetable intake by individuals in a large metropolitan area? J Health Care Poor Underserved 2013; 24:172-85. [PMID: 23395954 DOI: 10.1353/hpu.2013.0049] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED Obesity, a risk factor for hypertension, diabetes, and other chronic diseases is influenced by geographic accessibility to supermarkets, which has been shown to affect nutritional behaviors. PURPOSE To determine how individual fruit and vegetable (FV) consumption was independently influenced by accessibility to supermarkets, and to quantify that relationship. METHODS A distance decay based model was specified for a random sample (n=7,514) of urban residents. Associations between FV consumption and accessibility to supermarkets were explored, controlling for factors known to influence eating behaviors. RESULTS There was as independent effect of accessibility to supermarkets, even after the inclusion of the significant controlling factors of age, gender, race/ethnicity, education, marital status, and knowledge of nutritional guidelines. CONCLUSION Our model of accessibility was an effective predictor of FV consumption in an urban population, setting the stage for inclusion of supply and demand parameters, and estimation of local factors that contribute to differential obesity rates.
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Affiliation(s)
- Paul L Robinson
- Charles Drew University and David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
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Abstract
OBJECTIVE To assess a county population’s exposure to different types of food sources reported to affect both diet quality and obesity rates. DESIGN Food permit records obtained from the local health department served to establish the full census of food stores and restaurants. Employing prior categorization schemes which classified the relative healthfulness of food sources based on establishment type (i.e. supermarkets v. convenience stores, or full-service v. fast-food restaurants), food establishments were assigned to the healthy, unhealthy or undetermined groups. SETTING King County, WA, USA. SUBJECTS Full census of food sources. RESULTS According to all categorization schemes, most food establishments in King County fell into the unhealthy and undetermined groups. Use of the food permit data showed that large stores, which included supermarkets as healthy food establishments, contained a sizeable number of bakery/delis, fish/meat, ethnic and standard quick-service restaurants and coffee shops, all food sources that, when housed in a separate venue or owned by a different business establishment, were classified as either unhealthy or of undetermined value to health. CONCLUSIONS To fully assess the potential health effects of exposure to the extant food environment, future research would need to establish the health value of foods in many such common establishments as individually owned grocery stores and ethnic food stores and restaurants. Within-venue exposure to foods should also be investigated.
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LeDoux TF, Vojnovic I. Going outside the neighborhood: The shopping patterns and adaptations of disadvantaged consumers living in the lower eastside neighborhoods of Detroit, Michigan. Health Place 2013; 19:1-14. [DOI: 10.1016/j.healthplace.2012.09.010] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 09/06/2012] [Accepted: 09/10/2012] [Indexed: 01/15/2023]
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Drewnowski A, Aggarwal A, Hurvitz PM, Monsivais P, Moudon AV. Obesity and supermarket access: proximity or price? Am J Public Health 2012; 102:e74-80. [PMID: 22698052 PMCID: PMC3464835 DOI: 10.2105/ajph.2012.300660] [Citation(s) in RCA: 176] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2011] [Indexed: 01/22/2023]
Abstract
OBJECTIVES We examined whether physical proximity to supermarkets or supermarket price was more strongly associated with obesity risk. METHODS The Seattle Obesity Study (SOS) collected and geocoded data on home addresses and food shopping destinations for a representative sample of adult residents of King County, Washington. Supermarkets were stratified into 3 price levels based on average cost of the market basket. Sociodemographic and health data were obtained from a telephone survey. Modified Poisson regression was used to test the associations between obesity and supermarket variables. RESULTS Only 1 in 7 respondents reported shopping at the nearest supermarket. The risk of obesity was not associated with street network distances between home and the nearest supermarket or the supermarket that SOS participants reported as their primary food source. The type of supermarket, by price, was found to be inversely and significantly associated with obesity rates, even after adjusting for individual-level sociodemographic and lifestyle variables, and proximity measures (adjusted relative risk=0.34; 95% confidence interval=0.19, 0.63) CONCLUSIONS Improving physical access to supermarkets may be one strategy to deal with the obesity epidemic; improving economic access to healthy foods is another.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, WA 9819, USA.
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Peek ME, Wilson SC, Bussey-Jones J, Lypson M, Cordasco K, Jacobs EA, Bright C, Brown AF. A study of national physician organizations' efforts to reduce racial and ethnic health disparities in the United States. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:694-700. [PMID: 22534593 PMCID: PMC3785372 DOI: 10.1097/acm.0b013e318253b074] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To characterize national physician organizations' efforts to reduce health disparities and identify organizational characteristics associated with such efforts. METHOD This cross-sectional study was conducted between September 2009 and June 2010. The authors used two-sample t tests and chi-square tests to compare the proportion of organizations with disparity-reducing activities between different organizational types (e.g., primary care versus subspecialty organizations, small [<1,000 members] versus large [>5,000 members]). Inclusion criteria required physician organizations to be (1) focused on physicians, (2) national in scope, and (3) membership based. RESULTS The number of activities per organization ranged from 0 to 22. Approximately half (53%) of organizations had 0 or 1 disparity-reducing activities. Organizational characteristics associated with having at least 1 disparity-reducing effort included membership size (88% of large groups versus 58% of small groups had at least 1 activity; P = .004) and the presence of a health disparities committee (95% versus 59%; P < .001). Primary care (versus subspecialty) organizations and racial/ethnic minority physician organizations were more likely to have disparity-reducing efforts, although findings were not statistically significant. Common themes addressed by activities were health care access, health care disparities, workforce diversity, and language barriers. Common strategies included education of physicians/trainees and patients/general public, position statements, and advocacy. CONCLUSIONS Despite the national priority to eliminate health disparities, more than half of national physician organizations are doing little to address this problem. Primary care and minority physician organizations, and those with disparities committees, may provide leadership to extend the scope of disparity-reduction efforts.
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Affiliation(s)
- Monica E Peek
- University of Chicago, Section of General Internal Medicine, 5841 S. Maryland, MC 2007, Chicago, IL 60637, USA.
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Macdonald L, Ellaway A, Ball K, Macintyre S. Is proximity to a food retail store associated with diet and BMI in Glasgow, Scotland? BMC Public Health 2011; 11:464. [PMID: 21663674 PMCID: PMC3128028 DOI: 10.1186/1471-2458-11-464] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 06/10/2011] [Indexed: 11/10/2022] Open
Abstract
Background Access to healthy food is often seen as a potentially important contributor to diet. Policy documents in many countries suggest that variations in access contribute to inequalities in diet and in health. Some studies, mostly in the USA, have found that proximity to food stores is associated with dietary patterns, body weight and socio-economic differences in diet and obesity, whilst others have found no such relationships. We aim to investigate whether proximity to food retail stores is associated with dietary patterns or Body Mass Index in Glasgow, a large city in the UK. Methods We mapped data from a 'Health and Well-Being Survey' (n = 991), and a list of food stores (n = 741) in Glasgow City, using ArcGIS, and undertook network analysis to find the distance from respondents' home addresses to the nearest fruit and vegetable store, small general store, and supermarket. Results We found few statistically significant associations between proximity to food retail outlets and diet or obesity, for unadjusted or adjusted models, or when stratifying by gender, car ownership or employment. Conclusions The findings suggest that in urban settings in the UK the distribution of retail food stores may not be a major influence on diet and weight, possibly because most urban residents have reasonable access to food stores.
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Affiliation(s)
- Laura Macdonald
- MRC/CSO Social & Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow, G12 8RZ, Scotland, UK.
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Vega WA, Ang A, Rodriguez MA, Finch BK. Neighborhood protective effects on depression in Latinos. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2011; 47:114-126. [PMID: 21052825 DOI: 10.1007/s10464-010-9370-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Neighborhood social ecologies may have protective effects on depression in Latinos, after adjusting for demographic risk factors, such as nativity and length of stay in the US. This study examines the effects of neighborhood collective efficacy and linguistic isolation on depression in a heterogeneous urban Latino population from 1,468 adult respondents in Los Angeles County. We used multilevel models to analyze how major depression is associated with socioeconomic background, length of stay in the U.S., neighborhood collective efficacy and linguistic isolation among Latinos. A significant cross-level interaction effect was found between collective efficacy and foreign-born Latinos who resided in the US ≥ 15 years. We report cross-level interaction effects between linguistic isolation and nativity for U.S.-born and nativity and duration of residence for foreign-born Latinos who had lived in the U.S. at least 15 years. The moderating effects reported in this study suggest that the benefits of neighborhood collective efficacy and linguistic isolation vary by Latino subgroup and are conceptually discrete forms of social capital and offer insights for community based interventions.
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Affiliation(s)
- William A Vega
- University of Southern California, Los Angeles, CA 90089-0411, USA.
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Sharkey JR, Johnson CM, Dean WR, Horel SA. Focusing on fast food restaurants alone underestimates the relationship between neighborhood deprivation and exposure to fast food in a large rural area. Nutr J 2011; 10:10. [PMID: 21266055 PMCID: PMC3036605 DOI: 10.1186/1475-2891-10-10] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Accepted: 01/25/2011] [Indexed: 11/14/2022] Open
Abstract
Background Individuals and families are relying more on food prepared outside the home as a source for at-home and away-from-home consumption. Restricting the estimation of fast-food access to fast-food restaurants alone may underestimate potential spatial access to fast food. Methods The study used data from the 2006 Brazos Valley Food Environment Project (BVFEP) and the 2000 U.S. Census Summary File 3 for six rural counties in the Texas Brazos Valley region. BVFEP ground-truthed data included identification and geocoding of all fast-food restaurants, convenience stores, supermarkets, and grocery stores in study area and on-site assessment of the availability and variety of fast-food lunch/dinner entrées and side dishes. Network distance was calculated from the population-weighted centroid of each census block group to all retail locations that marketed fast food (n = 205 fast-food opportunities). Results Spatial access to fast-food opportunities (FFO) was significantly better than to traditional fast-food restaurants (FFR). The median distance to the nearest FFO was 2.7 miles, compared with 4.5 miles to the nearest FFR. Residents of high deprivation neighborhoods had better spatial access to a variety of healthier fast-food entrée and side dish options than residents of low deprivation neighborhoods. Conclusions Our analyses revealed that identifying fast-food restaurants as the sole source of fast-food entrées and side dishes underestimated neighborhood exposure to fast food, in terms of both neighborhood proximity and coverage. Potential interventions must consider all retail opportunities for fast food, and not just traditional FFR.
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Affiliation(s)
- Joseph R Sharkey
- Program for Research in Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX, USA.
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Nagata JM, Valeggia CR, Barg FK, Bream KDW. Body mass index, socio-economic status and socio-behavioral practices among Tz'utujil Maya women. ECONOMICS AND HUMAN BIOLOGY 2009; 7:96-106. [PMID: 19299213 DOI: 10.1016/j.ehb.2009.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Revised: 02/12/2009] [Accepted: 02/12/2009] [Indexed: 05/27/2023]
Abstract
This study investigates the associations between body mass index (BMI), socio-economic status (SES) and related socio-behavioral practices including marriage and market visits in a population of adult Tz'utujil Maya women in Santiago Atitlán, Guatemala, aged 18-82. Mixed qualitative and quantitative methods include cross-sectional anthropometric measurements and semi-structured interviews gathered in 2007, as well as participant observation and purposive interviews conducted in 2007-2008. The regional quota sample of 53 semi-structured interviews was designed to be representative of the cantones (municipal divisions) of Santiago Atitlán. BMI was positively associated with years of schooling, income and literacy, all measures of SES. A statistical analysis of our data indicates that increased income, increased market visits and being married are significantly positively associated with BMI. Qualitative analysis based on the grounded theory method reveals relevant themes including a preoccupation with hunger and undernutrition rather than obesity, a preference for food quantity over dietary diversity, the economic and social influence of a husband, the effects of market distance and the increasing consumption of food from tiendas. These themes help to explain how SES, socio-behavioral practices and BMI are positively associated and can inform future public health interventions related to obesity and undernutrition.
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Affiliation(s)
- Jason M Nagata
- Health and Societies Program, Department of History and Sociology of Science, 249 South 36th Street, University of Pennsylvania, Philadelphia, PA 19104, United States.
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Galvez MP, Hong L, Choi E, Liao L, Godbold J, Brenner B. Childhood obesity and neighborhood food-store availability in an inner-city community. Acad Pediatr 2009; 9:339-43. [PMID: 19560992 PMCID: PMC2770899 DOI: 10.1016/j.acap.2009.05.003] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2008] [Revised: 05/04/2009] [Accepted: 05/12/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Prior studies have shown an association between fast-food restaurants and adolescent body size. Less is known about the influence of neighborhood food stores on a child's body size. We hypothesized that in the inner-city, minority community of East Harlem, New York, the presence of convenience stores and fast-food restaurants near a child's home is associated with increased risk for childhood obesity as measured by body mass index (BMI). DESIGN Baseline data of 6- to 8-year-old East Harlem boys and girls (N=323) were used. Anthropometry (height and weight) was conducted with a standardized protocol. Food-store data were collected via a walking survey. Stores located within the same census block as the child's home address were identified by using ArcGIS 8.3. We computed age- and sex-specific BMI percentiles by using national norms of the Centers for Disease Control and Prevention. Using odds ratios, we estimated risk of a child's BMI percentile being in the top tertile based on number and types of food stores on their census blocks. RESULTS Convenience stores were present in 55% of the surveyed blocks in which a study particpant lived and fast-food restaurants were present in 41%. Children (n=177) living on a block with 1 or more convenience stores (range, 1-6) were more likely to have a BMI percentile in the top tertile (odds ratio 1.90, 95% confidence interval, 1.15-3.15) compared with children having no convenience stores (n=146). CONCLUSIONS The presence of convenience stores near a child's residence was associated with a higher BMI percentile. This has potential implications for both child- and neighborhood-level childhood obesity interventions.
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Affiliation(s)
- Maida P. Galvez
- Department of Community and Preventive Medicine, Mount Sinai School of Medicine,Department of Pediatrics, Mount Sinai School of Medicine
| | - Lu Hong
- Department of Community and Preventive Medicine, Mount Sinai School of Medicine
| | | | - Laura Liao
- Department of Community and Preventive Medicine, Mount Sinai School of Medicine
| | - James Godbold
- Department of Community and Preventive Medicine, Mount Sinai School of Medicine
| | - Barbara Brenner
- Department of Community and Preventive Medicine, Mount Sinai School of Medicine
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Pomeranz JL, Gostin LO. Improving laws and legal authorities for obesity prevention and control. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2009; 37 Suppl 1:62-75. [PMID: 19493093 DOI: 10.1111/j.1748-720x.2009.00393.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This paper is one of four interrelated action papers resulting from the 2008 National Summit on Legal Preparedness for Obesity Prevention and Control. Summit participants engaged in discussions on the current state of the law with respect to obesity, nutrition and food policy, physical activity, and physical education. Participants also identified gaps in the law at all jurisdictional levels and relevant to numerous sectors and disciplines that have a stake in obesity prevention and control.The companion paper, “Assessment of Laws and Legal Authorities for Obesity Prevention and Control,”identified numerous laws and policies enacted to target the three domains of healthy lifestyles, healthy places, and healthy societies. That paper identified several gaps in the law that require attention and action. This paper addresses those gaps and presents applicable laws and legal authorities that public health professionals and lawyers can consider to implement to close the gaps.
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