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Salah Z, Canning M, Rickless D, Devine C, Buckman R, Payne DC, Marshall KE. Comparing Individual and Community-level Characteristics of People with Ground Beef-associated Salmonellosis and Other Ground Beef Eaters: A Case-control Analysis. J Food Prot 2024; 87:100303. [PMID: 38796114 PMCID: PMC11213658 DOI: 10.1016/j.jfp.2024.100303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/03/2024] [Accepted: 05/15/2024] [Indexed: 05/28/2024]
Abstract
Salmonella is estimated to be the leading bacterial cause of U.S. domestically acquired foodborne illness. Large outbreaks of Salmonella attributed to ground beef have been reported in recent years. The demographic and sociodemographic characteristics of infected individuals linked to these outbreaks are poorly understood. We employed a retrospective case-control design; case-patients were people with laboratory-confirmed Salmonella infections linked to ground beef-associated outbreaks between 2012 and 2019, and controls were respondents to the 2018-2019 FoodNet Population Survey who reported eating ground beef and denied recent gastrointestinal illness. We used county-level CDC/ATSDR Social Vulnerability Index (SVI) to compare case-patient and controls. Case-patient status was regressed on county-level social vulnerability and individual-level demographic characteristics. We identified 376 case-patients and 1,321 controls in the FoodNet sites. Being a case-patient was associated with increased overall county-level social vulnerability (OR: 1.21 [95% CI: 1.07-1.36]) and socioeconomic vulnerability (OR: 1.24 [1.05-1.47]) when adjusted for individual-level demographics. Case-patient status was not strongly associated with the other SVI themes of household composition and disability, minority status and language, and housing type and transportation. Data on individual-level factors such as income, poverty, unemployment, and education could facilitate further analyses to understand this relationship.
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Affiliation(s)
- Zainab Salah
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
| | - Michelle Canning
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - David Rickless
- Geospatial Research, Analysis, and Services Program, Office of Innovation and Analytics, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; Booz Allen Hamilton, Atlanta, Georgia, USA
| | - Carey Devine
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ryan Buckman
- California Emerging Infections Program, Oakland, California, USA
| | - Daniel C Payne
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katherine E Marshall
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Houghtaling B, Zhang N, Yaroch A, Milburn Atkinson C, Byker Shanks C. How does eligibility for GusNIP produce prescriptions relate to fruit and vegetable purchases and what factors shape the relationship? A protocol for a secondary analysis of nationally representative data in the USA. BMJ Open 2024; 14:e085322. [PMID: 38697763 PMCID: PMC11085977 DOI: 10.1136/bmjopen-2024-085322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION US Department of Agriculture (USDA) Gus Schumacher Nutrition Incentive Programme (GusNIP) produce prescription programme (PPR) 'prescriptions' provide eligible participants with low income, risk for diet-related chronic disease and food insecurity a healthcare issued incentive to purchase lower to no cost fruits and vegetables (FVs). However, GusNIP requirements specify that PPR prescriptions can only be redeemed for fresh (not frozen, canned or dried) FVs. This requirement may prevent participants from fully engaging in or benefiting from GusNIP PPR, given communities with lower healthy food access may have reduced fresh FV accessibility. METHODS AND ANALYSIS We will use the nationally representative 2012-2013 National Household Food Acquisition and Purchase Survey (FoodAPS) and complementary FoodAPS Geography Component data in a secondary data analysis to examine how household GusNIP PPR eligibility relates to the quantity and variety of fresh, frozen, canned and dried FV purchases and to what extent individual, household and food environment factors shape the relationship. FoodAPS data include household food purchasing and acquisition information across a 7 day period from 14 317 individuals among 4826 households and was collected between April 2012 and January 2013. The FoodAPS Geography Component provides information about the local community/environment relative to FoodAPS households. This study will examine the correlation or association of selected variables between different quantities and varieties of fresh, frozen, canned and dried FVs, as well as correlations among multilevel predictors. ETHICS AND DISSEMINATION We are following data integrity standards as outlined by agreements with the USDA Economic Research Service. All results of analyses will undergo a thorough disclosure review to ensure no identifiable data are shared. Results will be disseminated to research, practice and policy communities using an Open Access peer-reviewed manuscript(s), scientific and practice presentations, and a public facing report and infographic.
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Affiliation(s)
- Bailey Houghtaling
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Nanhua Zhang
- Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Amy Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
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Dominianni C, Prasad D, Sharkey A, Solomon E, Seligson AL, Jasek JP. Sodium Intake and Sodium to Potassium Ratio among New York City Adults in the 2018 Heart Follow-Up Study. Curr Dev Nutr 2024; 8:102143. [PMID: 38638556 PMCID: PMC11024494 DOI: 10.1016/j.cdnut.2024.102143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Background High sodium and low potassium intake are positively associated with blood pressure, a significant risk factor for cardiovascular disease. The mean intake of sodium among United States adults exceeds the chronic disease risk reduction level of 2300 mg/d, whereas potassium intake remains lower than the recommended levels. From 2008 through 2019, there were several local and national initiatives to reduce sodium in New York City (NYC). Objectives We aimed to update and compare estimates of sodium intake among NYC adults overall and by covariates from the 2010 Heart Follow-Up Study (HFUS) with the 2018 HFUS. We also estimated the 2018 sodium-to-potassium ratio to understand overall diet quality among demographic groups. Methods This cross-sectional study used sodium and potassium measurements from 24-h urine collection and self-reported data from 2509 and 1656 participants in the 2018 and 2010 HFUS, respectively. The weighted mean daily intake of sodium and the sodium-to-potassium ratio were estimated. T-tests and multivariable linear regression models with tests for interactions were used to compare changes in sodium intake. Results The mean sodium intake of adult New Yorkers in 2018 was 3292 mg/d. Sodium intake did not change from 2010 (3234 mg/d, P = 0.45) to 2018 in the overall population, although there was a decrease in sodium intake among adults 18-24 y old (3445 mg/d to 2957 mg/d, P = 0.05). The daily mean sodium-to-potassium ratio was 1.7 mg/mg. The highest sodium-to-potassium ratios were among Black females 18-44 y old (2.0) and 45-64 y old (2.2) and Black (2.1) and Latino (2.1) males between 18 and 44 y old. Conclusions The lack of population-level changes in sodium intake and the high sodium-to-potassium ratios among Black females and younger Black and Latino males suggest that further efforts to reduce sodium in the food supply and address persistent inequities are needed.
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Affiliation(s)
- Christine Dominianni
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Long Island City, NY, United States
| | - Divya Prasad
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Long Island City, NY, United States
| | - Andrea Sharkey
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Long Island City, NY, United States
| | - Elizabeth Solomon
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Long Island City, NY, United States
| | - Amber Levanon Seligson
- Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, Long Island City, NY, United States
| | - John P Jasek
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Long Island City, NY, United States
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Giurini L, Lipworth L, Murff HJ, Zheng W, Warren Andersen S. Race- and Gender-Specific Associations between Neighborhood-Level Socioeconomic Status and Body Mass Index: Evidence from the Southern Community Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7122. [PMID: 38063552 PMCID: PMC10706233 DOI: 10.3390/ijerph20237122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023]
Abstract
Obesity and a low socioeconomic status (SES), measured at the neighborhood level, are more common among Americans of Black race and with a low individual-level SES. We examined the association between the neighborhood SES and body mass index (BMI) using data from 80,970 participants in the Southern Community Cohort Study, a cohort that oversamples Black and low-SES participants. BMI (kg/m2) was examined both continuously and categorically using cut points defined by the CDC. Neighborhood SES was measured using a neighborhood deprivation index composed of census-tract variables in the domains of education, employment, occupation, housing, and poverty. Generally, the participants in lower-SES neighborhoods were more likely to have a higher BMI and to be considered obese. We found effect modification by race and sex, where the neighborhood-BMI association was most apparent in White female participants in all the quintiles of the neighborhood SES (ORQ2 = 1.55, 95%CI = 1.34, 1.78; ORQ3 = 1.71, 95%CI = 1.48, 1.98; ORQ4 = 1.76, 95%CI = 1.52, 2.03; ORQ5 = 1.64, 95%SE = 1.39, 1.93). Conversely, the neighborhood-BMI association was mostly null in Black male participants (ORQ2 = 0.91, 95%CI = 0.72, 1.15; ORQ3 = 1.05, 95%CI = 0.84, 1.31; βQ4 = 1.00, 95%CI = 0.81, 1.23; ORQ5 = 0.76, 95%CI = 0.63, 0.93). Within all the subgroups, the associations were attenuated or null in participants residing in the lowest-SES neighborhoods. These findings suggest that the associations between the neighborhood SES and BMI vary, and that other factors aside from the neighborhood SES may better predict the BMI in Black and low-SES groups.
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Affiliation(s)
- Lauren Giurini
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA;
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Loren Lipworth
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; (L.L.); (W.Z.)
| | - Harvey J. Murff
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; (L.L.); (W.Z.)
| | - Shaneda Warren Andersen
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA;
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; (L.L.); (W.Z.)
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Marinello S, Powell LM, Falbe J. Neighborhood sociodemographic characteristics and healthfulness of store checkouts in Northern California. Prev Med Rep 2023; 35:102379. [PMID: 37680856 PMCID: PMC10481349 DOI: 10.1016/j.pmedr.2023.102379] [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: 03/17/2023] [Revised: 08/04/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023] Open
Abstract
Placement of products at food store checkouts has been shown to trigger impulse purchases and child purchasing requests. Therefore, food companies pay substantial amounts of money to ensure their products are placed at checkout, and these products are mostly unhealthy (e.g., sugar-sweetened beverages [SSBs], candy, chips). To improve the healthfulness of store environments, Berkeley, CA, U.S. became the first jurisdiction globally to implement a healthy checkout policy. This study examined associations between store neighborhood characteristics and healthfulness of foods and beverages offered at checkout to understand the potential for healthy checkout policies, such as Berkeley's healthy checkout ordinance (HCO), to promote equitable food environments. Data on a near census of food and beverage facings (n = 26,758) at sampled checkouts were collected from 102 food stores (supermarkets, grocery stores, drugstores, dollar stores, specialty food stores, and mass merchandisers) across four Northern California cities (Berkeley, Oakland, Davis, and Sacramento) in February 2021. Bivariate regression analyses revealed that neighborhoods with lower socioeconomic status (SES) and higher Black and Hispanic residential composition had a higher prevalence of foods and beverages that did not meet HCO standards, including associations with a higher prevalence of sweets, higher prevalence of SSBs, and/or lower prevalence of healthy foods at checkout. Findings suggest that the checkout environment may be one of many contributors to diet-related health disparities. Additionally, healthy checkout policies may have the potential to increase nutrition equity by improving food environments across neighborhoods and especially in areas with lower SES and higher Black and Hispanic composition.
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Affiliation(s)
- Samantha Marinello
- Division of Health Policy and Administration, School of Public Health, University of Illinois Chicago, 1603 W. Taylor Street, M/C 923, Chicago, IL 60612-4394, USA
| | - Lisa M. Powell
- Division of Health Policy and Administration, School of Public Health, University of Illinois Chicago, 1603 W. Taylor Street, M/C 923, Chicago, IL 60612-4394, USA
| | - Jennifer Falbe
- Human Development and Family Studies Program, Department of Human Ecology, University of California, Davis, 1 Shields Ave, CA 95616, USA
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Algur Y, Rummo PE, McAlexander TP, De Silva SSA, Lovasi GS, Judd SE, Ryan V, Malla G, Koyama AK, Lee DC, Thorpe LE, McClure LA. Assessing the association between food environment and dietary inflammation by community type: a cross-sectional REGARDS study. Int J Health Geogr 2023; 22:24. [PMID: 37730612 PMCID: PMC10510199 DOI: 10.1186/s12942-023-00345-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Communities in the United States (US) exist on a continuum of urbanicity, which may inform how individuals interact with their food environment, and thus modify the relationship between food access and dietary behaviors. OBJECTIVE This cross-sectional study aims to examine the modifying effect of community type in the association between the relative availability of food outlets and dietary inflammation across the US. METHODS Using baseline data from the REasons for Geographic and Racial Differences in Stroke study (2003-2007), we calculated participants' dietary inflammation score (DIS). Higher DIS indicates greater pro-inflammatory exposure. We defined our exposures as the relative availability of supermarkets and fast-food restaurants (percentage of food outlet type out of all food stores or restaurants, respectively) using street-network buffers around the population-weighted centroid of each participant's census tract. We used 1-, 2-, 6-, and 10-mile (~ 2-, 3-, 10-, and 16 km) buffer sizes for higher density urban, lower density urban, suburban/small town, and rural community types, respectively. Using generalized estimating equations, we estimated the association between relative food outlet availability and DIS, controlling for individual and neighborhood socio-demographics and total food outlets. The percentage of supermarkets and fast-food restaurants were modeled together. RESULTS Participants (n = 20,322) were distributed across all community types: higher density urban (16.7%), lower density urban (39.8%), suburban/small town (19.3%), and rural (24.2%). Across all community types, mean DIS was - 0.004 (SD = 2.5; min = - 14.2, max = 9.9). DIS was associated with relative availability of fast-food restaurants, but not supermarkets. Association between fast-food restaurants and DIS varied by community type (P for interaction = 0.02). Increases in the relative availability of fast-food restaurants were associated with higher DIS in suburban/small towns and lower density urban areas (p-values < 0.01); no significant associations were present in higher density urban or rural areas. CONCLUSIONS The relative availability of fast-food restaurants was associated with higher DIS among participants residing in suburban/small town and lower density urban community types, suggesting that these communities might benefit most from interventions and policies that either promote restaurant diversity or expand healthier food options.
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Affiliation(s)
- Yasemin Algur
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA.
| | - Pasquale E Rummo
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Tara P McAlexander
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - S Shanika A De Silva
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Gina S Lovasi
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Suzanne E Judd
- Department of Biostatistics, The University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Victoria Ryan
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Gargya Malla
- Department of Epidemiology, The University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Alain K Koyama
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David C Lee
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- Department of Emergency Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Lorna E Thorpe
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
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Falbe J, Marinello S, Wolf EC, Solar SE, Schermbeck RM, Pipito AA, Powell LM. Food and Beverage Environments at Store Checkouts in California: Mostly Unhealthy Products. Curr Dev Nutr 2023; 7:100075. [PMID: 37250387 PMCID: PMC10213198 DOI: 10.1016/j.cdnut.2023.100075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 05/31/2023] Open
Abstract
Background As the only place in a store where customers must pass through, checkouts may be especially influential over purchases. Research is needed to understand the healthfulness of checkout environments. Objectives The objective of this study was to classify checkout product facings in California food stores. Methods In a cross-sectional study, 102 stores, including chains (dollar stores, drugstores, specialty food stores, supermarkets, and mass merchandisers) and independent supermarkets and grocery stores were sampled from 4 northern California cities. Observational assessments of each checkout product facing were conducted in February 2021 using the Store CheckOUt Tool. Facings were classified by category and healthfulness, defined by meeting Berkeley's Healthy Checkout Ordinance's healthy checkout standards: unsweetened beverages and specific foods containing ≤5 g added sugar and ≤200 mg sodium per serving. Log binomial regressions compared healthfulness by store and checkout characteristics. Results Of 26,758 food and beverage checkout facings, the most common categories were candy (31%), gum (18%), sugar-sweetened beverages (SSBs; 11%), salty snacks (9%), mints (7%), and sweets (6%). Water represented only 3% and fruits and vegetables 1% of these facings. Only 30% of food and beverage facings met Berkeley's healthy checkout standards, with 70% not meeting the standards. The percentage of food and beverage facings not meeting the standards was even higher (89%) among snack-sized packages (≤2 servings/package). Compared with chain supermarkets, mass merchandisers, and specialty food stores (34%-36%), dollar and independent grocery stores had a lower percentage of food and beverage facings that met the healthy checkout standards (18%-20%; P < 0.05). Compared with lane and register areas (35%), endcaps and snaking sections within checkouts had fewer food and beverage facings that met the standards (21%-23%; P < 0.001). Conclusions Most foods and beverages at checkout consisted of candy, SSBs, salty snacks, and sweets and failed to meet the healthy checkout standards.Curr Dev Nutr 2023;xx:xx.
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Affiliation(s)
- Jennifer Falbe
- Human Development and Family Studies Program, Department of Human Ecology, University of California, Davis, CA, United States
| | - Samantha Marinello
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, IL, United States
| | - Ethan C. Wolf
- Human Development and Family Studies Program, Department of Human Ecology, University of California, Davis, CA, United States
- Public Health Nutrition Program, Community Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, United States
| | - Sarah E. Solar
- Human Development and Family Studies Program, Department of Human Ecology, University of California, Davis, CA, United States
| | - Rebecca M. Schermbeck
- Institute for Health Research and Policy, School of Public Health, University of Illinois Chicago, Chicago, IL, United States
| | - Andrea A. Pipito
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, IL, United States
| | - Lisa M. Powell
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, IL, United States
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Lovasi GS, Boise S, Jogi S, Hurvitz PM, Rundle AG, Diez J, Hirsch JA, Fitzpatrick A, Biggs ML, Siscovick DS. Time-Varying Food Retail and Incident Disease in the Cardiovascular Health Study. Am J Prev Med 2023; 64:877-887. [PMID: 36882344 PMCID: PMC10200742 DOI: 10.1016/j.amepre.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 03/08/2023]
Abstract
INTRODUCTION Natural experiments can strengthen evidence linking neighborhood food retail presence to dietary intake patterns and cardiometabolic health outcomes, yet sample size and follow-up duration are typically not extensive. To complement natural experiment evidence, longitudinal data were used to estimate the impacts of neighborhood food retail presence on incident disease. METHODS The Cardiovascular Health Study recruited adults aged 65+ years in 1989-1993. Analyses conducted in 2021-2022 included those in good baseline health, with addresses updated annually through the year of death (restricted to 91% who died during >2 decades of cohort follow-up). Baseline and annually updated presence of 2 combined food retail categories (supermarkets/produce markets and convenience/snack focused) was characterized using establishment-level data for 1-km and 5-km Euclidean buffers. Cox proportional hazards models estimated associations with time to each incident outcome (cardiovascular disease, diabetes), adjusting for individual and area-based confounders. RESULTS Among 2,939 participants, 36% with baseline supermarket/produce market presence within 1 km had excess incident cardiovascular disease (hazard ratio=1.12; 95% CI=1.01, 1.24); the association was attenuated and no longer statistically significant after adjustment for sociodemographic characteristics. Adjusted associations were robustly null for time-varying supermarket/produce market or convenience/fast food retail presence across analyses with outcomes of cardiovascular disease or diabetes incidence. CONCLUSIONS Food environment changes continue to be studied to provide an evidence base for policy decisions, and null findings in this longitudinal analysis add literature that casts doubt on the sufficiency of strategies targeting food retail presence alone of an elderly cohort for curtailing incident events of clinical importance.
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Affiliation(s)
- Gina S Lovasi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
| | - Sarah Boise
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Siddharth Jogi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Philip M Hurvitz
- Center for Studies in Demography & Ecology, University of Washington, Seattle, Washington; Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle, Washington
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Julia Diez
- Department of Surgery, Medical and Social Sciences, Universidad de Alcalá, Madrid, Spain
| | - Jana A Hirsch
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Annette Fitzpatrick
- Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington; Department of Global Health, School of Medicine, University of Washington, Seattle, Washington; Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Mary L Biggs
- Department of Biostatistics, School Public Health, University of Washington, Seattle, Washington
| | - David S Siscovick
- Research, evaluation and policy, New York Academy of Medicine, New York, New York
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Wolf PG, Kim S, Tussing-Humphreys L. Socioenvironmental Stressors, Gut Microbes, and Colorectal Cancer Inequities: A Chicago Perspective. Am J Gastroenterol 2023; 118:765-768. [PMID: 36689734 PMCID: PMC10159872 DOI: 10.14309/ajg.0000000000002131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/21/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Patricia G Wolf
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Sage Kim
- Division of Health Policy and Administration, School of Public Health, University of Illinois Cancer Center, University of Illinois Chicago, Chicago, Illinois, USA
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, University of Illinois Cancer Center, University of Illinois Chicago, Chicago, Illinois, USA
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Winkler MR, Lenk K, Erickson DJ, Laska MN. Retailer Marketing Strategies and Customer Purchasing of Sweetened Beverages in Convenience Stores. J Acad Nutr Diet 2022; 122:2050-2059. [PMID: 35240342 PMCID: PMC9420172 DOI: 10.1016/j.jand.2022.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/10/2022] [Accepted: 02/25/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Marketing strategies for sweetened beverages (SBs) are pervasive across food retail. Yet few studies have examined how these strategies associate with planned and unplanned SB purchasing. OBJECTIVE This study aimed to examine whether customers with greater exposure to SB retail marketing (eg, advertisements and product placement) were more likely to purchase an SB and whether this varied by customer characteristics. DESIGN This was an observational, cross-sectional study using objective customer purchasing and store assessment data from convenience and other small food stores. PARTICIPANTS/SETTING Participants were 1,604 food and beverage customers at 144 randomly sampled convenience and other small food stores in Minneapolis-St Paul, MN. EXPOSURE Marketing strategies, including SB advertisements, placement, and shelf space were included. MAIN OUTCOME MEASURES We determined the probability of customers purchasing ≥4 fluid ounces of a ready-to-drink sugar and/or artificially sweetened beverage. STATISTICAL ANALYSES PERFORMED Associations between marketing strategies and purchasing were estimated using mixed regression models, controlling for customer characteristics and accounting for customers nested within stores. RESULTS Fifty-six percent of customers purchased an SB; 14% also specified that it was an unplanned purchase. Customers were more likely to purchase an SB when exterior advertisements (P < .001) and advertisements hanging from the ceiling (P < .001) that promoted SBs were present. Customers with moderate and high cumulative exposure to SB marketing were significantly more likely to purchase SBs (51.2% and 54.9%, respectively) than those with lower exposure (34%); this effect was particularly salient for men. There were no significant associations between retail marketing strategies and unplanned purchases. CONCLUSIONS Findings demonstrate that feasible and sustainable approaches are required from policy makers, retailers, and public health professionals to shift store environments away from cues that promote unhealthy beverage selections. Given that numerous retail actors are invested in the availability, promotion, and sales of SBs, changing the predominance of SB marketing in convenience stores will likely be challenging and require cross-sector collaboration.
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Affiliation(s)
- Megan R Winkler
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Kathleen Lenk
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Darin J Erickson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Melissa N Laska
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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11
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Acciai F, DeWeese RS, Yedidia MJ, Lloyd K, Tulloch D, DeLia D, Ohri-Vachaspati P. Differential Associations Between Changes in Food Environment and Changes in BMI Among Adults Living in Urban, Low-Income Communities. J Nutr 2022; 152:2582-2590. [PMID: 36774124 PMCID: PMC9644168 DOI: 10.1093/jn/nxac186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/12/2022] [Accepted: 08/16/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Food environments can contribute to excess weight gain among adults, but the evidence is mixed. OBJECTIVES This longitudinal study investigated the associations between changes in the food environment and changes in BMI in adults and whether changes in the food environment differentially impact various subgroups. METHODS At 2 time points, BMI was calculated using self-reported height and weight data from 517 adults (mean age, 41 years) living in 4 New Jersey cities. The counts of different types of food outlets within 0.4, 0.8, and 1.6 km of respondents' residences were collected at baseline and tracked until follow-up. A binary measure of social standing (social-advantage group, n = 219; social-disadvantage group, n = 298) was created through a latent class analysis using social, economic, and demographic variables. Multivariable linear regression modeled the associations between changes in BMI with measures of the food environment; additionally, interaction terms between the measures of food environment and social standing were examined. RESULTS Overall, over 18 months, an increase in the number of small grocery stores within 0.4 km of a respondent's residence was associated with a decrease in BMI (β = -1.0; 95% CI: -1.9, -0.1; P = 0.024), while an increase in the number of fast-food restaurants within 1.6 km was associated with an increase in BMI (β = 0.1; 95% CI: 0.01, 0.2; P = 0.027). These overall findings, however, masked some group-specific associations. Interaction analyses suggested that associations between changes in the food environment and changes in BMI varied by social standing. For instance, the association between changes in fast-food restaurants and changes in BMI was only observed in the social-disadvantage group (β = 0.1; 95% CI: 0.02, 0.2; P = 0.021). CONCLUSIONS In a sample of adults living in New Jersey, changes in the food environment had differential effects on individuals' BMIs, based on their social standing.
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Affiliation(s)
- Francesco Acciai
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
| | - Robin S DeWeese
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Michael J Yedidia
- Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - Kristen Lloyd
- Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - David Tulloch
- Department of Landscape Architecture, Rutgers University, New Brunswick, NJ, USA
| | - Derek DeLia
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, USA
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12
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Houghtaling B, Greene M, Parab KV, Singleton CR. Improving Fruit and Vegetable Accessibility, Purchasing, and Consumption to Advance Nutrition Security and Health Equity in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11220. [PMID: 36141494 PMCID: PMC9517087 DOI: 10.3390/ijerph191811220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
In recent years, national and local efforts to improve diet and health in the United States have stressed the importance of nutrition security, which emphasizes consistent access to foods and beverages that promote health and prevent disease among all individuals. At the core of this endeavor is fruit and vegetable (FV) consumption, a dietary practice that is integral to attaining and sustaining a healthy diet. Unfortunately, significant inequities in FV accessibility, purchasing, and consumption exist, particularly among populations that are socially and economically disadvantaged. To achieve nutrition and health equity in the United States, the field must center the goal of nutrition security and initiatives that aim to increase FV consumption, specifically, in future work. The International Journal of Environmental Research and Public Health (IJERPH) Special Issue titled "Nutrition and Health Equity: Revisiting the Importance of Fruit and Vegetable Availability, Purchasing, and Consumption" features several scholarly publications from experts conducting timely research on these topics. In this commentary, we (1) summarize the U.S.-based literature on inequities in FV accessibility, purchasing, and consumption, (2) describe how the contributions to this IJERPH special issue can advance nutrition security and health equity, and (3) outline future research questions from our perspective.
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Affiliation(s)
- Bailey Houghtaling
- Gretchen Swanson Center for Nutrition, Omaha, NE 68514, USA
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, LA 70803, USA
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA
| | - Matthew Greene
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, LA 70803, USA
| | - Kaustubh V. Parab
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Chelsea R. Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
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13
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Is altering the availability of healthier vs. less-healthy options effective across socioeconomic groups? A mega-analysis. Int J Behav Nutr Phys Act 2022; 19:88. [PMID: 35854353 PMCID: PMC9297538 DOI: 10.1186/s12966-022-01315-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 06/13/2022] [Indexed: 12/03/2022] Open
Abstract
Background Availability interventions have been hypothesised to make limited demands on conscious processes and, as a result, to be less likely to generate health inequalities than cognitively-oriented interventions. Here we synthesise existing evidence to examine whether the impact of altering the availability of healthier vs. less-healthy options differs by socioeconomic position. Methods Individual-level data (21,360 observations from 7,375 participants) from six studies (conducted online (n = 4) and in laboratories (n = 2)) were pooled for mega-analysis. Multilevel logistic regressions analysed the impact of altering the availability of healthier options on selection of a healthier (rather than a less-healthy) option by socioeconomic position, assessed by (a) education and (b) income. Results Participants had over threefold higher odds of selecting a healthier option when the available range was predominantly healthier compared to selections when the range offered was predominantly less-healthy (odds ratio (OR): 3.8; 95%CIs: 3.5, 4.1). Less educated participants were less likely to select healthier options in each availability condition (ORs: 0.75–0.85; all p < 0.005), but there was no evidence of differences in healthier option selection by income. Compared to selections when the range offered was predominantly less-healthy, when predominantly healthier options were available there was a 31% increase in selecting healthier options for the most educated group vs 27% for the least educated. This modest degree of increased responsiveness in the most educated group appeared only to occur when healthier options were predominant. There was no evidence of any differential response to the intervention by income. Conclusion Increasing the proportion of healthier options available increases the selection of healthier options across socioeconomic positions. Availability interventions may have a slightly larger beneficial effect on those with the highest levels of education in settings when healthier options predominate.
Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01315-y.
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14
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Taylor DE, Lusuegro A, Loong V, Cambridge A, Nichols C, Goode M, McCoy E, Daupan SM, Bartlett M, Noel E, Pollvogt B. Racial, Gender, and Age Dynamics in Michigan's Urban and Rural Farmers Markets: Reducing Food Insecurity, and the Impacts of a Pandemic. THE AMERICAN BEHAVIORAL SCIENTIST 2022; 66:894-936. [PMID: 35645401 PMCID: PMC8107495 DOI: 10.1177/00027642211013387] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In recent decades, the number of farmers markets has increased dramatically across the country. Though farmers markets have been described as White spaces, they can play important roles in reducing food insecurity. It is particularly true in Michigan, where farmers markets were crucial collaborators in pioneering programs such as Double-Up Food Bucks that help low-income residents and people of color gain access to fresh, healthy, locally grown food. This article examines the questions: (1) What are the demographic characteristics of farmers market managers, vendors, and customers? (2) How do these influence market activities? (3) To what extent do farmers markets participate in programs to reduce food insecurity? (4) To what extent do farmers markets serve low-income residents and people of color? And (5) How has the Coronavirus Pandemic (COVID-19) affected farmers' markets? This article discusses the findings of a 2020 study that examined the extent to which Michigan's farmers markets served low-income customers and people of color, and participated in food assistance programs. The study examined 79 farmers markets and found that 87.3% of the farmers market managers are White. On average, roughly 79% of the markets' vendors are White, and almost 18% are people of color. Most of the vendors in the markets participate in nutrition assistance programs. Market managers estimate that about 76% of their customers are White, and about 23% are people of color. Farmers markets operated by people of color attract more customers and vendors of color than those administered by White market managers. Almost half of the farmers markets started operations later than usual in 2020 because of the pandemic. More than a third of the markets reported that their funding declined during the pandemic. Moreover, the number of vendors fell at two-thirds of the markets; customers dipped by more than 40%. On the other hand, the number of people requesting food assistance during the pandemic increased in more than half of the markets.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Erin Noel
- University of Massachusetts-Boston, Boston, MA, USA
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15
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Thorndike AN, Gardner CD, Kendrick KB, Seligman HK, Yaroch AL, Gomes AV, Ivy KN, Scarmo S, Cotwright CJ, Schwartz MB. Strengthening US Food Policies and Programs to Promote Equity in Nutrition Security: A Policy Statement From the American Heart Association. Circulation 2022; 145:e1077-e1093. [PMID: 35535604 DOI: 10.1161/cir.0000000000001072] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nutritionally inadequate dietary intake is a leading contributor to chronic cardiometabolic diseases. Differences in dietary quality contribute to socioeconomic and racial and ethnic health disparities. Food insecurity, a household-level social or economic condition of limited access to sufficient food, is a common cause of inadequate dietary intake. Although US food assistance policies and programs are designed to improve food security, there is growing consensus that they should have a broader focus on nutrition security. In this policy statement, we define nutrition security as an individual or household condition of having equitable and stable availability, access, affordability, and utilization of foods and beverages that promote well-being and prevent and treat disease. Despite existing policies and programs, significant gaps remain for achieving equity in nutrition security across the life span. We provide recommendations for expanding and improving current food assistance policies and programs to achieve nutrition security. These recommendations are guided by several overarching principles: emphasizing nutritional quality, improving reach, ensuring optimal utilization, improving coordination across programs, ensuring stability of access to programs across the life course, and ensuring equity and dignity for access and utilization. We suggest a critical next step will be to develop and implement national measures of nutrition security that can be added to the current US food security measures. Achieving equity in nutrition security will require coordinated and sustained efforts at the federal, state, and local levels. Future advocacy, innovation, and research will be needed to expand existing food assistance policies and programs and to develop and implement new policies and programs that will improve cardiovascular health and reduce disparities in chronic disease.
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16
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Singleton CR, Winata F, Roehll AM, Adamu I, McLoughlin GM. Community-Level Factors Associated With Geographic Access to Food Retailers Offering Nutrition Incentives in Chicago, Illinois. Prev Chronic Dis 2022; 19:E07. [PMID: 35143387 PMCID: PMC8880105 DOI: 10.5888/pcd19.210211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Nutrition incentive programs provide low-income populations with a monetary resource to make healthy foods affordable and accessible. This study aimed to use geospatial analysis to evaluate availability of the Link Match nutrition incentive program in Chicago, Illinois, to determine whether underresourced communities have access. Methods We obtained 2018 spatial data on census tract–level sociodemographic characteristics in Chicago. Fifty-seven retailers (eg, farmers markets, food cooperatives) offered Link Match across the city’s 801 census tracts. We examined ordinary least squares and spatial lag regression models to identify census tract–level variables associated with distance (in miles) from the nearest Link Match retailer. Variables of interest included percentage of non-Hispanic Black residents, percentage of Hispanic residents, median household income, violent crime rate, per capita grocery store availability, and walkability. Results Most Link Match retailers were located on Chicago’s South and West sides. Ordinary least squares regression models indicated that low-income census tracts were on average closer to a Link Match retailer than higher-income tracts were (P < .001). Tracts in the highest quartile of violent crime were also significantly closer to a Link Match retailer than tracts in the lowest quartile (P < .001). After accounting for spatial dependency of census tracts, only violent crime rate was significantly associated with distance to nearest Link Match retailer. Conclusion Link Match retailers in Chicago appear to be in underresourced communities. However, these areas have high violent crime rates, which may negatively influence program use. Additional research is needed on how social and environmental factors influence availability and use of nutrition incentive programs.
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Affiliation(s)
- Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health and Tropical Medicine, Ste 2200-40, Tidewater Bldg, 1440 Canal St, New Orleans, LA 70112.
| | - Fikriyah Winata
- Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Alexandra M Roehll
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Isa Adamu
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Gabriella M McLoughlin
- Department of Kinesiology, Temple University College of Public Health, Philadelphia, Pennsylvania.,Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
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Bile Acids, Gut Microbes, and the Neighborhood Food Environment-a Potential Driver of Colorectal Cancer Health Disparities. mSystems 2022; 7:e0117421. [PMID: 35103491 PMCID: PMC8805634 DOI: 10.1128/msystems.01174-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Bile acids (BAs) facilitate nutrient digestion and absorption and act as signaling molecules in a number of metabolic and inflammatory pathways. Expansion of the BA pool and increased exposure to microbial BA metabolites has been associated with increased colorectal cancer (CRC) risk. It is well established that diet influences systemic BA concentrations and microbial BA metabolism. Therefore, consumption of nutrients that reduce colonic exposure to BAs and microbial BA metabolites may be an effective method for reducing CRC risk, particularly in populations disproportionately burdened by CRC. Individuals who identify as Black/African American (AA/B) have the highest CRC incidence and death in the United States and are more likely to live in a food environment with an inequitable access to BA mitigating nutrients. Thus, this review discusses the current evidence supporting diet as a contributor to CRC disparities through BA-mediated mechanisms and relationships between these mechanisms and barriers to maintaining a low-risk diet.
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18
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Singleton CR, Adeyemi OS, Parab KV, Roehll AM, Flores E, Adams AM, Quintiliani LM, Bell BM, Dulin-Keita A. Society of Behavioral Medicine (SBM) position statement: provide funding for incentive programs to expand healthy food offerings in SNAP-authorized small food stores. Transl Behav Med 2021; 11:1283-1285. [PMID: 33200771 DOI: 10.1093/tbm/ibaa111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Individuals and families with limited access to healthy foods often experience increased risk for poor diet and chronic disease. Low-income communities are more likely to have a large number of small food stores (e.g., corner stores and dollar stores) compared to higher-income communities. Since many of these small food stores participate in the Supplemental Nutrition Assistance Program (SNAP), increasing healthy food offerings in these stores may expand healthy food retail in low-income communities. We recommend the provision of funding for incentive programs that encourage SNAP-authorized small food stores in low-income communities to expand their healthy food offerings. This programming should (a) provide seed grants to store owners to develop or reconfigure store infrastructure, (b) offer store owners technical assistance and educational materials on marketing strategies for promoting healthy food items to customers, and (c) give a tax break to SNAP-authorized small food stores in low-income communities that maintain a predetermined minimum stock of U.S. Department of Agriculture-recognized staple foods.
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Affiliation(s)
- Chelsea R Singleton
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Oluwafikayo S Adeyemi
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Kaustubh V Parab
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Alexandra M Roehll
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Edson Flores
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Ashley M Adams
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Lisa M Quintiliani
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Brooke M Bell
- Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles, CA, USA
| | - Akilah Dulin-Keita
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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19
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Examining changes to food and beverage availability and marketing in a low-income community after the opening of a new supermarket. Public Health Nutr 2021; 24:5837-5846. [PMID: 34342260 DOI: 10.1017/s1368980021003165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE In 2016, a Whole Foods Market© opened in the Englewood community of Chicago, IL - a predominately low-income African American community. This study aimed to examine changes to food and beverage availability and marketing in Englewood's existing food stores after the opening of this supermarket. DESIGN Quasi-experimental study. SETTING Two low-income African American communities in Chicago, IL. PARTICIPANTS Fieldworkers audited all small grocery and limited service stores (e.g. convenience stores, liquor stores and dollar/discount stores) located within one-square mile of the new supermarket and a one-square mile area of a demographically comparable community that also lacked a supermarket. Stores were audited before (2016) and after (2017 and 2018) the supermarket opened. RESULTS Of the 78 stores audited at baseline, 71·8 % were limited service stores and 85·9 % accepted Supplemental Nutrition Assistance Program (SNAP) benefits. Overall, the availability of healthy food and beverage options in nearby small stores was low at baseline and both follow-up periods. Difference-in-difference regression models revealed a significant increase in: (1) the percentage of stores in the intervention community (i.e. Englewood) offering regular cheese and promoting salty snacks at check-out from 2016 to 2017; and (2) the percentage of stores in the comparison community with interior store promotions for other sweetened beverages from 2016 to 2018. CONCLUSIONS Minimal changes in food and beverage availability and marketing occurred 1 and 2 years after the opening of a new supermarket. However, the wide range of staple food items offered by the supermarket expanded healthy food retail in Chicago's Englewood community.
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20
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Lovasi GS, Johnson NJ, Altekruse SF, Hirsch JA, Moore KA, Brown JR, Rundle AG, Quinn JW, Neckerman K, Siscovick DS. Healthy food retail availability and cardiovascular mortality in the United States: a cohort study. BMJ Open 2021; 11:e048390. [PMID: 34244272 PMCID: PMC8273445 DOI: 10.1136/bmjopen-2020-048390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/26/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We investigated the association of healthy food retail presence and cardiovascular mortality, controlling for sociodemographic characteristics. This association could inform efforts to preserve or increase local supermarkets or produce market availability. DESIGN Cohort study, combining Mortality Disparities in American Communities (individual-level data from 2008 American Community Survey linked to National Death Index records from 2008 to 2015) and retail establishment data. SETTING Across the continental US area-based sociodemographic and retail characteristics were linked to residential location by ZIP code tabulation area (ZCTA). Sensitivity analyses used census tracts instead, restricted to urbanicity or county-based strata, or accounted for non-independence using frailty models. PARTICIPANTS 2 753 000 individuals age 25+ living in households with full kitchen facilities, excluding group quarters. PRIMARY AND SECONDARY OUTCOME MEASURES Cardiovascular mortality (primary) and all-cause mortality (secondary). RESULTS 82% had healthy food retail (supermarket, produce market) within their ZCTA. Density of such retail was correlated with density of unhealthy food sources (eg, fast food, convenience store). Healthy food retail presence was not associated with reduced cardiovascular (HR: 1.03; 95% CI 1.00 to 1.07) or all-cause mortality (HR: 1.05; 95% CI 1.04 to 1.06) in fully adjusted models (with adjustment for gender, age, marital status, nativity, Black race, Hispanic ethnicity, educational attainment, income, median household income, population density, walkable destination density). The null finding for cardiovascular mortality was consistent across adjustment strategies including minimally adjusted models (individual demographics only), sensitivity analyses related to setting, and across gender or household type strata. However, unhealthy food retail presence was associated with elevated all-cause mortality (HR: 1.15; 95% CI 1.11 to 1.20). CONCLUSIONS In this study using food establishment locations within administrative areas across the USA, the hypothesised association of healthy food retail availability with reduced cardiovascular mortality was not supported; an association of unhealthy food retail presence with higher mortality was not specific to cardiovascular causes.
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Affiliation(s)
- Gina S Lovasi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Norman J Johnson
- Center for Administrative Records and Research Applications, Census Bureau, Washington, District of Columbia, USA
| | - Sean F Altekruse
- National Heart Lung and Blood institute, Division of Cardiovascular Sciences, National Institutes of Health, Bethesda, Maryland, USA
| | - Jana A Hirsch
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kari A Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Janene R Brown
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Andrew G Rundle
- Built Environment and Health Research Group, Columbia University, New York, New York, USA
| | - James W Quinn
- Built Environment and Health Research Group, Columbia University, New York, New York, USA
| | - Kathryn Neckerman
- Built Environment and Health Research Group, Columbia University, New York, New York, USA
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A relational approach to evaluate food environments finds that the proximate food environment matters for those who use it. Health Place 2021; 69:102564. [PMID: 33894655 DOI: 10.1016/j.healthplace.2021.102564] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/18/2021] [Accepted: 03/14/2021] [Indexed: 11/22/2022]
Abstract
Using a relational approach, this study investigates whether shopping close to home moderates the relationship between the proximate food environment and diet. To address this question, we develop the proximate food retail quality (PFRQ) score, an inverse-distance weighted measure of all food retailers within a resident's neighborhood that incorporates audit data of each food retailer. This study relies on data collected through 24-h dietary recalls and psychosocial surveys administered to 449 adults in two socioeconomically matched neighborhoods. Food retailer audits collected data on the availability, price, and quality of healthful foods. Seventy-one percent of study participants report conducting at least 50% of their food shopping within approximately one mile of their home. Household income and education are associated with likelihood to shop close to home, while access to a personal vehicle is not. Finally, results suggest that, for residents who shop primarily close to home, a one unit increase in proximate food retail environment score is associated with a 17.2-point increase in HEI-2010 score, a measure of overall diet quality that ranges from zero to 100. This study suggests that the food environment matters for those who use it and that a low-quality proximate food environment can amplify individual disadvantage.
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22
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A Model Depicting the Retail Food Environment and Customer Interactions: Components, Outcomes, and Future Directions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207591. [PMID: 33086537 PMCID: PMC7589434 DOI: 10.3390/ijerph17207591] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/06/2020] [Accepted: 10/16/2020] [Indexed: 12/26/2022]
Abstract
The retail food environment (RFE) has important implications for dietary intake and health, and dramatic changes in RFEs have been observed over the past few decades and years. Prior conceptual models of the RFE and its relationships with health and behavior have played an important role in guiding research; yet, the convergence of RFE changes and scientific advances in the field suggest the time is ripe to revisit this conceptualization. In this paper, we propose the Retail Food Environment and Customer Interaction Model to convey the evolving variety of factors and relationships that convene to influence food choice at the point of purchase. The model details specific components of the RFE, including business approaches, actors, sources, and the customer retail experience; describes individual, interpersonal, and household characteristics that affect customer purchasing; highlights the macro-level contexts (e.g., communities and nations) in which the RFE and customers behave; and addresses the wide-ranging outcomes produced by RFEs and customers, including: population health, food security, food justice, environmental sustainability, and business sustainability. We believe the proposed conceptualization helps to (1) provide broad implications for future research and (2) further highlight the need for transdisciplinary collaborations to ultimately improve a range of critical population outcomes.
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Powell LM, Singleton CR, Li Y, Anderson Steeves E, Castro IA, Grigsby-Toussaint D, Haynes-Maslow L, Houghtaling B, Laska MN, Leone LA, Seguin R, Uslan D. Changes to SNAP-authorized retailer stocking requirements and the supply of foods and beverages in low-income communities in seven U.S. states. Transl Behav Med 2020; 9:857-864. [PMID: 31570924 DOI: 10.1093/tbm/ibz093] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Low-income communities often lack access to supermarkets and healthy foods. Enhanced stocking requirements for staple foods for Supplemental Nutrition Assistance Program (SNAP)-authorized retailers may increase availability of healthy foods in smaller stores which are prevalent in low-income areas. This study aimed to evaluate the extent that small food stores located in low-income areas met the U.S. Department of Agriculture's 2016 final rule on SNAP-authorized retailer stocking requirements, which increased the minimum number of required staple food varieties from three to seven for each staple food category, required a depth of stock of three units of each variety, and increased the required number of categories with perishables from two to three. A multisite research project was conducted in 2017. Nine research teams located in seven U.S. states audited the availability of perishable and nonperishable staple foods and beverages in 351 small food stores in low-income areas. Analyses determined the extent to which stores met all or part of the stocking requirements and tested differences by store type. 30.2% of stores met all of the 2016 final rule requirements; 86.3% met the requirements for fruits and vegetables, whereas only 30.5% met requirements for dairy. 53.1% of non-chain small grocery stores met all requirements compared to 17.1% of convenience stores (p < .0001). Less than one half of the food stores audited met the U.S. Department of Agriculture's 2016 final rule that would expand SNAP-authorized retailer stocking requirements suggesting that, if implemented, the rule may generate increased offerings of staple foods in small stores in low-income areas.
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Affiliation(s)
- Lisa M Powell
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Chelsea R Singleton
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Yu Li
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Iana A Castro
- Department of Marketing, San Diego State University, San Diego, CA, USA
| | - Diana Grigsby-Toussaint
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Lindsey Haynes-Maslow
- Department of Agricultural and Human Sciences, North Carolina State University, Raleigh, NC, USA
| | - Bailey Houghtaling
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Lucia A Leone
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
| | - Rebecca Seguin
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Daniella Uslan
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Beckelman T, Sinclair-White BM, McGurk MD, Donohoe-Mather C, Vu U, Ching LK, Pirkle CM, Sentell TL, Keliikoa LB. Encouraging Adults to Choose Healthy Now: A Hawai'i Convenience Store Intervention. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:330-334. [PMID: 31902691 DOI: 10.1016/j.jneb.2019.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/25/2019] [Accepted: 11/29/2019] [Indexed: 06/10/2023]
Affiliation(s)
| | | | - Meghan D McGurk
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
| | | | - Uyen Vu
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
| | | | | | - Tetine L Sentell
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
| | - L Brooke Keliikoa
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI.
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Singleton CR, Kessee N, Chatman C, Spreen C. Racial/Ethnic Differences in the Shopping Behaviors and Fruit and Vegetable Consumption of Farmers' Market Incentive Program Users in Illinois. Ethn Dis 2020; 30:109-118. [PMID: 31969790 DOI: 10.18865/ed.30.1.109] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction Farmers' market incentive programs, such as Link Match, provide monetary incentives to Supplemental Nutrition Assistance Program (SNAP) participants to promote their use of local farmers' markets. Information on racial/ethnic differences in the shopping behaviors and fruit and vegetable (FV) consumption of farmers' market incentive program users is scarce. This research aimed to address this need by examining users of the Link Match incentive program in Illinois. Methods A cross-sectional survey of 328 Link Match users (39.6% non-Hispanic White; 45.4% non-Hispanic Black; and 15.0% other) was conducted in 2016 and 2017. Information on each participant's demographics, farmers' market shopping behaviors, and monthly frequency of FV consumption was collected from Link Match users. Chi-square and ANOVA tests were used to assess differences in farmers' market shopping measures by race/ethnicity. Logistic regression models were used to examine the association between race/ethnicity and frequency of FV consumption. Results A significantly higher percentage of non-Hispanic Black participants reported being an infrequent farmers' market user (ie, shopping ≤ once a month) compared with non-Hispanic White and other participants (P=.01). After adjusting for covariates, non-Hispanic Black participants had lower odds of consuming fruit daily (OR: .44; 95% CI:.22-.86) compared with non-Hispanic White participants. Other participants had lower odds of consuming both fruit and vegetables compared with non-Hispanic White participants (OR: .30; 95% CI:.12-.71). Conclusions Differences in shopping behaviors and FV consumption were observed by race/ethnicity among Link Match users. Future research should examine the nutritional implications of these differences.
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Affiliation(s)
- Chelsea R Singleton
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Nicollette Kessee
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
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Daga S, Mhatre S, Kasbe A, Dsouza E. Double burden of malnutrition among Indian schoolchildren and its measurement: a cross-sectional study in a single school. BMJ Paediatr Open 2020; 4:e000505. [PMID: 32099905 PMCID: PMC7015044 DOI: 10.1136/bmjpo-2019-000505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 12/02/2019] [Accepted: 12/10/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This cross-sectional study set in a single school on the outskirts of a large city aimed to document the extent of double burden of malnutrition (coexistence of overnutrition and undernutrition) among Indian schoolchildren from lower socioeconomic groups, and to determine if mid-upper arm circumference (MUAC) can be used as a proxy for body mass index (BMI). SUBJECTS The total number of participants was 1444, comprising 424 girls and 1020 boys belonging to playgroups and grades 1 to 7. MEASUREMENTS Anthropometric measurements, such as participants' MUAC, height and weight were measured using standard techniques. Descriptive statistics for BMI and MUAC were obtained based on gender; z-scores were computed using age-specific and sex-specific WHO reference data. The distribution of variables was calculated for three groups: girls, boys and all participants. Homogeneous subsets for BMI and MUAC were identified in the three groups. Age-wise comparisons of BMI and MUAC were conducted for each gender. MAIN OUTCOME MEASURES (1) To know if MUAC and BMI are correlated among boys and girls. (2) To study BMI and MUAC z-score distribution among the participants. RESULTS MUAC was positively correlated with BMI in both boys and girls. The following BMI z-score distribution was observed: severe acute malnutrition (SAM), 5 (0.3%); moderate acute malnutrition (MAM), 146 (10.1%) and undernourished, at risk of MAM/SAM, 141 (9.8%); obese, 21 (1.5%); overweight, 36 (2.5%) and pre-obese, 136 (9.4%). The distribution of categories of children based on MUAC z-scores was: SAM, 7 (0.5%); MAM, 181 (12.5%) and undernourished, at risk of MAM/SAM, 181 (12.5%); obese, 19 (1.3%); overweight, 178 (12.3%) and pre-obese, 135 (9.3%). CONCLUSIONS SAM/MAM/undernourished states and obesity/overweight/pre-obese states, indicating undernutrition more than overweight, coexist among Indian schoolchildren from lower middle/lower socioeconomic categories. BMI and MUAC were significantly correlated. MUAC identifies both undernutrition and overnutrition by early detection of aberrant growth.
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Affiliation(s)
| | - Sameer Mhatre
- Paediatrics, Smt Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India
| | - Abhiram Kasbe
- Community Health, Topiwala National Medical College, Mumbai, Maharashtra, India
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Peres LC, Hebert JR, Qin B, Guertin KA, Bandera EV, Shivappa N, Camacho TF, Chyn D, Alberg AJ, Barnholtz-Sloan JS, Bondy ML, Cote ML, Funkhouser E, Moorman PG, Peters ES, Schwartz AG, Terry PD, Schildkraut JM. Prediagnostic Proinflammatory Dietary Potential Is Associated with All-Cause Mortality among African-American Women with High-Grade Serous Ovarian Carcinoma. J Nutr 2019; 149:1606-1616. [PMID: 31152675 PMCID: PMC6735701 DOI: 10.1093/jn/nxz098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/21/2019] [Accepted: 04/15/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Chronic inflammation is associated with ovarian carcinogenesis; yet, the impact of inflammatory-related exposures on outcomes has been understudied. OBJECTIVE Given the poor survival of women diagnosed with ovarian cancer, especially African-Americans, we examined whether diet-associated inflammation, a modifiable source of chronic systemic inflammation measured by the dietary inflammatory index (DII), was associated with all-cause mortality among African-American women with ovarian carcinoma. METHODS Data were available from 490 ovarian carcinoma patients enrolled in a population-based case-control study of African-American women with ovarian cancer, the African-American Cancer Epidemiology Study. Energy-adjusted DII (E-DII) scores were calculated based on prediagnostic dietary intake of foods alone or foods and supplements, which was self-reported using the 2005 Block Food Frequency Questionnaire. Cox proportional hazards regression was used to estimate risk of mortality overall and for the most common histotype, high-grade serous carcinoma. Additionally, we assessed interaction by age at diagnosis and smoking status. RESULTS Women included in this study had a median age of 57 y, and the majority of women were obese (58%), had late-stage disease (Stage III or IV, 66%), and had high-grade serous carcinoma (64%). Greater E-DII scores including supplements (indicating greater inflammatory potential) were associated with an increased risk of mortality among women with high-grade serous carcinoma (HR1-unit change: 1.08; 95% CI: 1.01, 1.17). Similar associations were observed for the E-DII excluding supplements, although not statistically significant (HR1-unit change: 1.07; 95% CI: 0.97, 1.17). There was an interaction by smoking status, where the positive association with mortality was present only among ever smokers (HRQuartile 4/Quartile 1: 2.36; 95% CI: 1.21, 4.60) but not among never smokers. CONCLUSIONS Greater inflammatory potential of prediagnostic diet may adversely impact prognosis among African-American women with high-grade serous carcinoma, and specifically among ever smokers.
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Affiliation(s)
- Lauren C Peres
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL,Department of Public Health Sciences, University of Virginia, Charlottesville, VA,Address correspondence to LCP (E-mail: )
| | - James R Hebert
- Cancer Prevention and Control Program,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC,Connecting Health Innovations LLC, Columbia, SC
| | - Bo Qin
- Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Kristin A Guertin
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA
| | - Elisa V Bandera
- Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Nitin Shivappa
- Cancer Prevention and Control Program,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC,Connecting Health Innovations LLC, Columbia, SC
| | - Tareq F Camacho
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA
| | - Deanna Chyn
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA
| | - Anthony J Alberg
- Cancer Prevention and Control Program,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Melissa L Bondy
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX
| | - Michele L Cote
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI
| | - Ellen Funkhouser
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Patricia G Moorman
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC
| | - Edward S Peters
- Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA
| | - Ann G Schwartz
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI
| | - Paul D Terry
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN
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Mui Y, Ballard E, Lopatin E, Thornton RLJ, Pollack Porter KM, Gittelsohn J. A community-based system dynamics approach suggests solutions for improving healthy food access in a low-income urban environment. PLoS One 2019; 14:e0216985. [PMID: 31086409 PMCID: PMC6516673 DOI: 10.1371/journal.pone.0216985] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/02/2019] [Indexed: 11/19/2022] Open
Abstract
Little is known about the mechanisms through which neighborhood-level factors (e.g., social support, economic opportunity) relate to suboptimal availability of healthy foods in low-income urban communities. We engaged a diverse group of chain and local food outlet owners, residents, neighborhood organizations, and city agencies based in Baltimore, MD. Eighteen participants completed a series of exercises based on a set of pre-defined scripts through an interactive, iterative group model building process over a two-day community-based workshop. This process culminated in the development of causal loop diagrams, based on participants' perspectives, illustrating the dynamic factors in an urban neighborhood food system. Synthesis of diagrams yielded 21 factors and their embedded feedback loops. Crime played a prominent role in several feedback loops within the neighborhood food system: contributing to healthy food being "risky food," supporting unhealthy food stores, and severing social ties important for learning about healthy food. Findings shed light on a new framework for thinking about barriers related to healthy food access and pointed to potential new avenues for intervention, such as reducing neighborhood crime.
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Affiliation(s)
- Yeeli Mui
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Ellis Ballard
- Social System Design Lab, Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, United States of America
| | - Eli Lopatin
- Reservoir Hill Improvement Council; Baltimore, MD, United States of America
| | - Rachel L. J. Thornton
- Center for Child and Community Health Research, Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Keshia M. Pollack Porter
- Department of Health Policy and Management, Institute for Health and Social Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Baltimore, MD, United States of America
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Coping with Food Insecurity Among African American in Public-Sector Mental Health Services: A Qualitative Study. Community Ment Health J 2019; 55:440-447. [PMID: 30825072 DOI: 10.1007/s10597-019-00376-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
While there are high rates of food insecurity among individuals with serious mental illnesses, and among African Americans, there is very little research on the ways African Americans in public-sector mental health services cope with food insecurity. This research paper presents qualitative data from a mixed methods study on the prevalence and management of food insecurity among African Americans using public sector mental health services. We interviewed 21 people about their everyday experiences of food insecurity and strategies they used to cope. While participants reported experiencing high levels of food insecurity, they also described the use of communal strategies to help them cope, including sharing food and cooking meals jointly, which seemed to reduce the negative effects of living with high levels of food insecurity as well as a serious mental illness. Policy innovations like communal gardens and kitchens provided through public mental health services may be particularly helpful.
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Variation in the food environment of small and non-traditional stores across racial segregation and corporate status. Public Health Nutr 2019; 22:1624-1634. [PMID: 30846012 DOI: 10.1017/s1368980019000132] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We examined differences in consumer-level characteristics and structural resources and capabilities of small and non-traditional food retailers (i.e. corner stores, gas-marts, pharmacies, dollar stores) by racial segregation of store neighbourhood and corporate status (corporate/franchise- v. independently owned). DESIGN Observational store assessments and manager surveys were used to examine availability-, affordability- and marketing-related characteristics experienced by consumers as well as store resources (e.g. access to distributors) and perceived capabilities for healthful changes (e.g. reduce pricing on healthy foods). Cross-sectional regression analyses of store and manager data based on neighbourhood segregation and store corporate status were conducted. SETTING Small and non-traditional food stores in Minneapolis and St. Paul, MN, USA.ParticipantsOne hundred and thirty-nine stores; seventy-eight managers. RESULTS Several consumer- and structural-level differences occurred by corporate status, independent of residential segregation. Compared with independently owned stores, corporate/franchise-owned stores were more likely to: not offer fresh produce; when offered, receive produce via direct delivery and charge higher prices; promote unhealthier consumer purchases; and have managers that perceived greater difficulty in making healthful changes (P≤0·05). Only two significant differences were identified by residential racial segregation. Stores in predominantly people of colour communities (<30 % non-Hispanic White) had less availability of fresh fruit and less promotion of unhealthy impulse buys relative to stores in predominantly White communities (P≤0·05). CONCLUSIONS Corporate status appears to be a relevant determinant of the consumer-level food environment of small and non-traditional stores. Policies and interventions aimed at making these settings healthier may need to consider multiple social determinants to enable successful implementation.
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Côté-Lussier C, Kakinami L, Danieles PK. Ego-centered relative neighborhood deprivation and reported dietary habits among youth. Appetite 2019; 132:267-274. [PMID: 30473022 DOI: 10.1016/j.appet.2018.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 09/05/2018] [Accepted: 10/09/2018] [Indexed: 11/17/2022]
Abstract
Dietary habits are important precursors of childhood obesity. Youths' dietary habits may be constrained by the experience of deprivation due to social (e.g., family purchasing power) and physical (e.g., availability of fast food outlets in low-income neighborhoods) factors limiting dietary choices. This study considers whether a Yitzhaki-based index of ego-centered relative neighborhood deprivation explains dietary outcomes (i.e., reported healthful and unhealthful food consumption), adjusting for absolute deprivation. The Yitzhaki index takes into account the total incomes to which a youth is deprived in relation to a meaningful reference group, and the youth's position in the cumulative income distribution of this meaningful reference group. The study also considers whether the impact of deprivation on dietary outcomes is moderated by the experience of symptoms of depression. There was some indication that reported healthful food consumption was highest for youth who experienced low absolute deprivation (p ≤ 0.01) and low symptoms of depression (p ≤ 0.01), but high relative deprivation (p ≤ 0.001). These youth therefore appear to benefit from being both "better-off", and living among "better-off" individuals. The results for reported unhealthful food consumption were less robust. The results may therefore suggest that youth who are not detrimentally impacted by their relative deprivation, and who have the financial means to access healthful foods, have improved dietary outcomes. The findings suggest that while absolute deprivation plays a key role in explaining healthful food consumption, additional insights can be gleaned from considering youths' relative deprivation and indicators of their well-being.
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Affiliation(s)
- Carolyn Côté-Lussier
- Department of Criminology and Centre for Research on Educational and Community Services (CRECS), University of Ottawa, 120 University, Ottawa, Ontario, K1N 6N5, Canada.
| | - Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University PERFORM Centre, Concordia University, Canada
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Exploring absolute and relative measures of exposure to food environments in relation to dietary patterns among European adults. Public Health Nutr 2018; 22:1037-1047. [PMID: 30523774 PMCID: PMC6536821 DOI: 10.1017/s1368980018003063] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Objective To explore the associations of absolute and relative measures of exposure to food retailers with dietary patterns, using simpler and more complex measures. Design Cross-sectional survey. Setting Urban regions in Belgium, France, Hungary, the Netherlands and the UK. Participants European adults (n 4942). Supermarkets and local food shops were classified as ‘food retailers providing healthier options’; fast-food/takeaway restaurants, cafés/bars and convenience/liquor stores as ‘food retailers providing less healthy options’. Simpler exposure measures used were density of healthy and density of less healthy food retailers. More complex exposure measures used were: spatial access (combination of density and proximity) to healthy and less healthy food retailers; density of healthier food retailers relative to all food retailers; and a ratio of spatial access scores to healthier and less healthy food retailers. Outcome measures were a healthy or less healthy dietary pattern derived from a principal component analysis (based on consumption of fruits, vegetables, fish, fast foods, sweets and sweetened beverages). Results Only the highest density of less healthy food retailers was significantly associated with the less healthy dietary pattern (β = −129·6; 95 % CI −224·3, −34·8). None of the other absolute density measures nor any of the relative measures of exposures were associated with dietary patterns. Conclusions More complex measures of exposure to food retailers did not produce stronger associations with dietary patterns. We had some indication that absolute and relative measures of exposure assess different aspects of the food environment. However, given the lack of significant findings, this needs to be further explored.
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The Role of Religious Behavior in Health Self-Management: A Community-Based Participatory Research Study. RELIGIONS 2018. [DOI: 10.3390/rel9110357] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Prevalence of chronic disease, mental health problems, and risk behaviors in San Bernardino (SB) County reflect some of the worst health outcomes in the State of California and the United States. Using the Integrated Theory of Health Behavior Change (ITHBC) as the theoretical framework, this community-based participatory research (CBPR) study aimed to determine how religious self-regulation skills and ability, and religious behaviors, jointly affect health promotion behaviors among socio-economically challenged residents of southwest SB County, California. A convenience sample of adult residents (N = 261) completed a series of inventories to measure the relationship between modified ITHBC constructs of religious self-regulation skills, religious self-management behaviors, and health outcomes. Structural Equation Modeling (SEM) analysis was conducted to validate the strong positive effect of religious self-regulation skills and ability on how frequently individuals engage in both organized and non-organized religious activities. Results also indicated a significant positive impact of religious behaviors towards healthy eating behaviors. However, without the engagement in religious activities, high religious self-regulation skills and ability inhibited the likelihood of healthy food intake. This faith-related theoretical model provides an avenue for faith-based organizations’ capacity for contributing to community health promotion.
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Multilevel Structural Equation Modeling of Students' Dietary Intentions/Behaviors, BMI, and the Healthfulness of Convenience Stores. Nutrients 2018; 10:nu10111569. [PMID: 30360538 PMCID: PMC6266756 DOI: 10.3390/nu10111569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/17/2018] [Accepted: 10/20/2018] [Indexed: 11/16/2022] Open
Abstract
Background: When dietary behaviors are habitual, intentions are low, and environmental cues, such as the consumer food environment, might guide behavior. How might intentions to eat healthily and ultimately actual dietary behaviors, be influenced by the consumer food environment (including the availability and affordability of healthy foods) in convenience stores? This study will determine pathways between the healthfulness of convenience stores and college students’ dietary intentions/behaviors, and body mass index (BMI). Methods: Through multilevel structural equation modeling, a comparison was made of students’ healthful meal intentions (HMI); intake (fruits/vegetables, %kcal/fat, sugar-sweetened beverages (SSBs) and whole-grains); and measured BMI; as well as the healthfulness of convenience stores (fruits/vegetables availability/quality, healthy food availability/affordability). Data was collected on 1401 students and 41 convenience stores across 13 US college campuses. Results: Controlling for gender, HMI was negatively associated with SSBs (β = −0.859) and %kcal/fat (β = −1.057) and positively with whole-grains (β = 0.186) and fruits/vegetables intake (β = 0.267); %Kcal/fat was positively (β = 0.098) and fruits/vegetables intake (β = −0.055) negatively associated with BMI. Campus level, fruits/vegetables availability were positively associated to HMI (β = 0.214, β = 0.129) and directly/negatively to BMI (β = −2.657, β = −1.124). Conclusions: HMI modifies dietary behaviors, with energy from fat and fruit/vegetable intake the most predictive of weight. Availability of fruit/vegetables in convenience stores make it easier for young adults to eat well.
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Singleton CR, Li Y, Odoms-Young A, Zenk SN, Powell LM. Change in Food and Beverage Availability and Marketing Following the Introduction of a Healthy Food Financing Initiative–Supported Supermarket. Am J Health Promot 2018; 33:525-533. [DOI: 10.1177/0890117118801744] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: The Healthy Food Financing Initiative (HFFI) aims to expand access to healthy foods in low-resourced communities across the United States. This study examined changes in food and beverage availability and marketing in nearby small food stores after the opening of an HFFI-supported supermarket in a predominately low-income and African American community. Design: Natural experiment. Setting: Rockford, Illinois. Participants: A full audit was conducted of the small grocery and limited service stores located in a 1-mile radius around the new supermarket (N = 22) and a 1-square mile area within a nearby demographically matched comparison community (N = 18). Stores were audited in 2015 (1 month preopening) and 2016 (1 year afterward). Measures: Store characteristics, item availability, and interior and exterior promotions/advertisements were examined. Analysis: Difference-in-difference (DID) regression models assessed pre- and postintervention changes in availability and marketing between small food stores in the intervention and comparison communities. Results: The DID regression models indicated no difference between intervention and comparison communities with respect to changes in availability and marketing of all food items with the exception of frozen vegetables which had higher availability postintervention in the comparison community versus intervention (β for interaction term = .67; standard error: 0.33; P = .04). Conclusion: After the opening of the HFFI-supported supermarket, food and beverage availability and marketing in nearby small food stores did not change significantly. However, the wide range of staple foods offered by the supermarket contributed to the expansion of healthy food retail in the intervention community.
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Affiliation(s)
- Chelsea R. Singleton
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Yu Li
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Angela Odoms-Young
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Shannon N. Zenk
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Lisa M. Powell
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
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Zenk SN, Tarlov E, Wing C, Matthews SA, Jones K, Tong H, Powell LM. Geographic Accessibility Of Food Outlets Not Associated With Body Mass Index Change Among Veterans, 2009-14. Health Aff (Millwood) 2018; 36:1433-1442. [PMID: 28784736 DOI: 10.1377/hlthaff.2017.0122] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In recent years, various levels of government in the United States have adopted or discussed subsidies, tax breaks, zoning laws, and other public policies that promote geographic access to healthy food. However, there is little evidence from large-scale longitudinal or quasi-experimental research to suggest that the local mix of food outlets actually affects body mass index (BMI). We used a longitudinal design to examine whether the proximity of food outlets, by type, was associated with BMI changes between 2009 and 2014 among 1.7 million veterans in 382 metropolitan areas. We found no evidence that either absolute or relative geographic accessibility of supermarkets, fast-food restaurants, or mass merchandisers was associated with changes in an individual's BMI over time. While policies that alter only geographic access to food outlets may promote equitable access to healthy food and improve nutrition, our findings suggest they will do little to combat obesity in adults.
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Affiliation(s)
- Shannon N Zenk
- Shannon N. Zenk is a professor in the Department of Health Systems Science, University of Illinois at Chicago
| | - Elizabeth Tarlov
- Elizabeth Tarlov is a research health scientist at the Edward Hines Jr. Veterans Affairs Hospital, in Hines, Illinois and an assistant professor in the Department of Health Systems Science, University of Illinois at Chicago
| | - Coady Wing
- Coady Wing is an assistant professor in the School of Public and Environmental Affairs, Indiana University, in Bloomington
| | - Stephen A Matthews
- Stephen A. Matthews is a professor in the Department of Sociology, Anthropology, and Demography at Pennsylvania State University, in State College
| | - Kelly Jones
- Kelly Jones is a PhD student in the Department of Health Systems Science, University of Illinois at Chicago
| | - Hao Tong
- Hao Tong is a data manager/analyst at the Edward Hines Jr. VA Hospital
| | - Lisa M Powell
- Lisa M. Powell is a professor in the Health Policy and Administration Division, University of Illinois at Chicago
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Jalbert-Arsenault É, Robitaille É, Paquette MC. Development, reliability and use of a food environment assessment tool in supermarkets of four neighbourhoods in Montréal, Canada. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 37:293-302. [PMID: 28902478 DOI: 10.24095/hpcdp.37.9.04] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The food environment is a promising arena in which to influence people's dietary habits. This study aimed to develop a comprehensive food environment assessment tool for businesses and characterize the food environment of a low-tomedium income area of Montréal, Canada. METHODS We developed a tool, Mesure de l'environnement alimentaire du consommateur dans les supermarchés (MEAC-S), and tested it for reliability. We used the MEAC-S to assess the consumer food environment of 17 supermarkets in four neighbourhoods of Montréal. We measured the shelf length, variety, price, display counts and in-store positions of fruits and vegetables (FV) and ultra-processed food products (UPFPs). We also assessed fresh FV for quality. Store size was estimated using the total measured shelf length for all food categories. We conducted Spearman correlations between these indicators of the food environment. RESULTS Reliability analyses revealed satisfactory results for most indicators. Characterization of the food environment revealed high variability in shelf length, variety and price of FV between supermarkets and suggested a disproportionate promotion of UPFPs. Display counts of UPFPs outside their normal display location ranged from 7 to 26, and they occupied 8 to 33 strategic in-store positions, whereas the number of display counts of fresh FV outside their normal display location exceeded 1 in only 2 of the 17 stores surveyed, and they occupied a maximum of 2 strategic in-store positions per supermarket. Price of UPFPs was inversely associated with their prominence (p < .005) and promotion (p < .003). Store size was associated with display counts and strategic in-store positioning of UPFPs (p < .001), but not FV, and was inversely associated with the price of soft drinks (p < .003). CONCLUSION This study illustrates the variability of the food environment between supermarkets and underscores the importance of measuring in-store characteristics to adequately picture the consumer food environment.
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Affiliation(s)
| | - Éric Robitaille
- Université de Montréal, Montréal, Quebec, Canada.,Institut national de santé publique du Québec, Montréal, Quebec, Canada
| | - Marie-Claude Paquette
- Université de Montréal, Montréal, Quebec, Canada.,Institut national de santé publique du Québec, Montréal, Quebec, Canada
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Saelens BE, Arteaga SS, Berrigan D, Ballard RM, Gorin AA, Powell-Wiley TM, Pratt C, Reedy J, Zenk SN. Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Environmental Domain. Obesity (Silver Spring) 2018; 26 Suppl 2:S35-S44. [PMID: 29575779 PMCID: PMC5875459 DOI: 10.1002/oby.22159] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/31/2018] [Accepted: 02/12/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is growing interest in how environment is related to adults' weight and activity and eating behaviors. However, little is known about whether environmental factors are related to the individual variability seen in adults' intentional weight loss or maintenance outcomes. OBJECTIVES The environmental domain subgroup of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project sought to identify a parsimonious set of objective and perceived neighborhood and social environment constructs and corresponding measures to include in the assessment of response to adult weight-loss treatment. SIGNIFICANCE Starting with the home address, the environmental domain subgroup recommended for inclusion in future weight-loss or maintenance studies constructs and measures related to walkability, perceived land use mix, food outlet accessibility (perceived and objective), perceived food availability, socioeconomics, and crime-related safety (perceived and objective) to characterize the home neighborhood environment. The subgroup also recommended constructs and measures related to social norms (perceived and objective) and perceived support to characterize an individual's social environment. The 12 neighborhood and social environment constructs and corresponding measures provide a succinct and comprehensive set to allow for more systematic examination of the impact of environment on adults' weight loss and maintenance.
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Affiliation(s)
- Brian E Saelens
- Department of Pediatrics, University of Washington, Seattle Washington, USA
- Seattle Children's Research Institute, Seattle, Washington, USA
| | - S Sonia Arteaga
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - David Berrigan
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Rachel M Ballard
- Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Amy A Gorin
- Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Tiffany M Powell-Wiley
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Charlotte Pratt
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jill Reedy
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Shannon N Zenk
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
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Wippold GM, Tucker CM, Smith TM, Rodriguez VA, Hayes LF, Folger AC. Motivators of and Barriers to Health-Promoting Behaviors Among Culturally Diverse Middle and High School Students. AMERICAN JOURNAL OF HEALTH EDUCATION 2018. [DOI: 10.1080/19325037.2017.1414644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zenk SN, Tarlov E, Powell LM, Wing C, Matthews SA, Slater S, Gordon HS, Berbaum M, Fitzgibbon ML. Weight and Veterans' Environments Study (WAVES) I and II: Rationale, Methods, and Cohort Characteristics. Am J Health Promot 2018; 32:779-794. [PMID: 29214851 PMCID: PMC5876028 DOI: 10.1177/0890117117694448] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To present the rationale, methods, and cohort characteristics for 2 complementary "big data" studies of residential environment contributions to body weight, metabolic risk, and weight management program participation and effectiveness. DESIGN Retrospective cohort. SETTING Continental United States. PARTICIPANTS A total of 3 261 115 veterans who received Department of Veterans Affairs (VA) health care in 2009 to 2014, including 169 910 weight management program participants and a propensity score-derived comparison group. INTERVENTION The VA MOVE! weight management program, an evidence-based lifestyle intervention. MEASURES Body mass index, metabolic risk measures, and MOVE! participation; residential environmental attributes (eg, food outlet availability and walkability); and MOVE! program characteristics. ANALYSIS Descriptive statistics presented on cohort characteristics and environments where they live. RESULTS Forty-four percent of men and 42.8% of women were obese, whereas 4.9% of men and 9.9% of women engaged in MOVE!. About half of the cohort had at least 1 supermarket within 1 mile of their home, whereas they averaged close to 4 convenience stores (3.6 for men, 3.9 for women) and 8 fast-food restaurants (7.9 for men, 8.2 for women). Forty-one percent of men and 38.6% of women did not have a park, and 35.5% of men and 31.3% of women did not have a commercial fitness facility within 1 mile. CONCLUSION Drawing on a large nationwide cohort residing in diverse environments, these studies are poised to significantly inform policy and weight management program design.
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Affiliation(s)
- Shannon N Zenk
- 1 Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
| | - Elizabeth Tarlov
- 1 Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
- 2 Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines VA Hospital, Hines, IL, USA
| | - Lisa M Powell
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Coady Wing
- 5 Indiana University-Bloomington School of Public and Environmental Affairs, Bloomington, IN, USA
| | - Stephen A Matthews
- 6 Department of Sociology, Anthropology, and Demography, Pennsylvania State University, University Park, PA, USA
| | - Sandy Slater
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Howard S Gordon
- 7 Jesse Brown VA Medical Center, Chicago, IL, USA
- 8 Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael Berbaum
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Marian L Fitzgibbon
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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Zenk SN, Tarlov E, Wing CM, Matthews SA, Tong H, Jones KK, Powell L. Long-Term Weight Loss Effects of a Behavioral Weight Management Program: Does the Community Food Environment Matter? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E211. [PMID: 29373556 PMCID: PMC5858280 DOI: 10.3390/ijerph15020211] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/27/2017] [Accepted: 10/29/2017] [Indexed: 12/18/2022]
Abstract
This study examined whether community food environments altered the longer-term effects of a nationwide behavioral weight management program on body mass index (BMI). The sample was comprised of 98,871 male weight management program participants and 15,385 female participants, as well as 461,302 and 37,192 inverse propensity-score weighted matched male and female controls. We measured the community food environment by counting the number of supermarkets, convenience stores, and fast food restaurants within a 1-mile radius around each person's home address. We used difference-in-difference regression models with person and calendar time fixed effects to estimate MOVE! effects over time in sub-populations defined by community food environment attributes. Among men, after an initial decrease in BMI at 6 months, the effect of the program decreased over time, with BMI increasing incrementally at 12 months (0.098 kg/m², p < 0.001), 18 months (0.069 kg/m², p < 0.001), and 24 months (0.067 kg/m², p < 0.001). Among women, the initial effects of the program decreased over time as well. Women had an incremental BMI change of 0.099 kg/m² at 12 months (p < 0.05) with non-significant incremental changes at 18 months and 24 months. We found little evidence that these longer-term effects of the weight management program differed depending on the community food environment. Physiological adaptations may overwhelm environmental influences on adherence to behavioral regimens in affecting longer-term weight loss outcomes.
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Affiliation(s)
- Shannon N Zenk
- College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA.
| | - Elizabeth Tarlov
- College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA.
- Edward Hines Jr. Veterans Affairs Hospital, Hines, IL 60141, USA.
| | - Coady M Wing
- School of Public and Environmental Affairs, Indiana University, Bloomington, IN 47405, USA.
| | - Stephen A Matthews
- Department of Sociology & Criminology and Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA.
- Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA.
| | - Hao Tong
- Edward Hines Jr. Veterans Affairs Hospital, Hines, IL 60141, USA.
| | - Kelly K Jones
- College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA.
| | - Lisa Powell
- School of Public Health, University of Illinois at Chicago, IL 60612, USA.
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Precin P, Koenig VE, Chiariello E, Masotti GK, Diamond BN, Lashinsky DB, Tierno O. SPOTS: A Model for the Creation of Sustainable, Population-Based, Occupational Therapy Fieldwork Sites. Occup Ther Health Care 2018; 32:44-58. [PMID: 29265904 DOI: 10.1080/07380577.2017.1402228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This paper describes a model for the creation of sustainable, population-based, occupational therapy fieldwork sites (SPOTS). An example of a population-based fieldwork site was created with Appalachian Mountain People in Kentucky and its outcomes are presented. Outcomes were gathered using a wide variety of evaluation feedback forms. The results indicate that all staff, student, and college feedback were extremely favorable as detailed and suggest that others may use the SPOTS Model to develop population-based occupational therapy services that address public health issues for people with disabilities identified in Healthy People 2020 and create scholarly opportunities for students and faculty.
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Affiliation(s)
- Pat Precin
- a Department of Occupational Therapy , Touro College and University System , New York , United States
| | - Virginia E Koenig
- a Department of Occupational Therapy , Touro College and University System , New York , United States
| | - Elizabeth Chiariello
- a Department of Occupational Therapy , Touro College and University System , New York , United States
| | - Gabriela K Masotti
- a Department of Occupational Therapy , Touro College and University System , New York , United States
| | - Bari N Diamond
- a Department of Occupational Therapy , Touro College and University System , New York , United States
| | - Diana B Lashinsky
- a Department of Occupational Therapy , Touro College and University System , New York , United States
| | - Olivia Tierno
- a Department of Occupational Therapy , Touro College and University System , New York , United States
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Singleton CR, Li Y, Duran AC, Zenk SN, Odoms-Young A, Powell LM. Food and Beverage Availability in Small Food Stores Located in Healthy Food Financing Initiative Eligible Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101242. [PMID: 29057794 PMCID: PMC5664743 DOI: 10.3390/ijerph14101242] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/03/2017] [Accepted: 10/12/2017] [Indexed: 12/17/2022]
Abstract
Food deserts are a major public health concern. This study aimed to assess food and beverage availability in four underserved communities eligible to receive funding from the Healthy Food Financing Initiative (HFFI). Data analyzed are part of a quasi-experimental study evaluating the impact of the HFFI on the retail food environment in selected Illinois communities. In 2015, 127 small grocery and limited service stores located in the four selected communities were audited. All communities had a large percentage of low-income and African-American residents. Differences in food and beverage item availability (e.g., produce, milk, bread, snack foods) were examined by store type and community location. Food stores had, on average, 1.8 fresh fruit and 2.9 fresh vegetable options. About 12% of stores sold low-fat milk while 86% sold whole milk. Only 12% of stores offered 100% whole wheat bread compared to 84% of stores offering white bread. Almost all (97%) stores offered soda and/or fruit juice. In summary, we found limited availability of healthier food and beverage items in the communities identified for HFFI support. Follow up findings will address how the introduction of new HFFI-supported supermarkets will affect food and beverage availability in these communities over time.
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Affiliation(s)
- Chelsea R Singleton
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
| | - Yu Li
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
| | - Ana Clara Duran
- Center for Food Studies, University of Campinas, Av. Albert Einstein, 291, Cidade Universitária, SP 13083-852, Brazil.
| | - Shannon N Zenk
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Avenue, Office 960, Chicago, IL 60608, USA.
| | - Angela Odoms-Young
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 West Taylor Street, Office 709, Chicago, IL 60608, USA.
| | - Lisa M Powell
- Division of Health Policy and Administration, University of Illinois at Chicago, 1747 West Roosevelt Road, Office 448, Chicago, IL 60608, USA.
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Singleton CR, Opoku-Agyeman W, Affuso E, Baskin ML, Levitan EB, Sen B, Affuso O. WIC Cash Value Voucher Redemption Behavior in Jefferson County, Alabama, and Its Association With Fruit and Vegetable Consumption. Am J Health Promot 2017; 32:325-333. [PMID: 28950724 DOI: 10.1177/0890117117730807] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To examine cash value voucher (CVV) redemption behavior and its association with fruit and vegetable (FV) consumption among women who participate in the Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN Cross-sectional. SETTING Jefferson County, Alabama. PARTICIPANTS Between October 2014 and January 2015, 300 women (mean age: 27.6 years; 66.8% non-Hispanic black; 45.1% obese) who participated in the Birmingham WIC program were surveyed. MEASURES Self-reported information on demographics, produce shopping behaviors, and residential access to fresh produce retailers (eg, supermarkets and farmers markets) was examined. Fruit and vegetable intake was collected via the Block Fruit-Vegetable-Fiber screener. Participants who self-reported redeeming the WIC CVV in each of the 3 prior months were classified as regular redeemers. ANALYSIS Multivariable-adjusted regression models were used to examine associations between variables of interest and regular WIC CVV redemption. RESULTS There were 189 (63.0%) study participants classified as regular WIC CVV redeemers. Regular redeemers and other participants (ie, irregular redeemers and nonredeemers) were similar with respect to demographics. Regular redeemers were more likely to use grocery stores to purchase FVs ( P = .003) and consumed significantly more servings of FVs per day (β = .67; standard error = 0.24; P = .007). CONCLUSION Regular WIC CVV redemption was associated with some produce shopping behaviors and increased FV consumption and among WIC participants in Jefferson County, Alabama.
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Affiliation(s)
- Chelsea R Singleton
- 1 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - William Opoku-Agyeman
- 2 Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ermanno Affuso
- 3 Department of Economics and Finance, University of South Alabama, Mobile, AL, USA
| | - Monica L Baskin
- 4 Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,5 Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily B Levitan
- 5 Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA.,6 Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Bisakha Sen
- 5 Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA.,7 Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Olivia Affuso
- 5 Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA.,6 Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Developing multidimensional measures of healthy food access among low-income adults in Cleveland, Ohio, USA. Public Health Nutr 2017; 20:2859-2868. [PMID: 28847323 DOI: 10.1017/s1368980017002002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Access to nutritious foods is key to achieving health promotion goals. While there is evidence that nutritious food access is complex, measures assessing multiple domains of access, including spatial-temporal, economic, social, service delivery and personal, are lacking. The current study evaluates psychometric properties of scales designed to measure perceptions of multiple domains of nutritious food access among low-income populations. DESIGN A cross-sectional survey was conducted in 2015. Eighty-one items were selected or developed to represent five domains of nutritious food access for food shopping overall and specific to shopping at farmers' markets. Evaluation of the items included exploratory factor analysis within each domain and internal consistency reliability for each of the sub-scales. SETTING Data were collected in seventeen urban neighbourhoods in Greater Cleveland, Ohio, USA that have high levels of poverty. All participants had access to at least one farmers' market within 1·6 km (1 mile) of their home to standardize spatial access to nutritious foods. SUBJECTS Adults (n 304) receiving Supplemental Nutrition Assistance Program benefits. RESULTS Each domain included multiple sub-domains: spatial-temporal (four), service delivery (two), economic (two), social (three) and personal (three), for a total of fourteen subdomains. The internal consistency reliability for one of the sub-domains was outstanding (>0·90), seven were excellent (0·80-0·89), five were very good (0·70-0·79) and one scale had poor reliability (0·58). CONCLUSIONS Multiple sub-domains of nutritious food access can be assessed using short measures that have been tested for internal consistency. These measures are suitable for assessing the complex phenomena of nutritious food access among low-income populations.
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The impact of financial incentives on participants' food purchasing patterns in a supermarket-based randomized controlled trial. Int J Behav Nutr Phys Act 2017; 14:115. [PMID: 28841892 PMCID: PMC5574131 DOI: 10.1186/s12966-017-0573-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 08/17/2017] [Indexed: 11/20/2022] Open
Abstract
Background The impacts of supermarket-based nutrition promotion interventions might be overestimated if participants shift their proportionate food purchasing away from their usual stores. This study quantified whether participants who received price discounts on fruits and vegetables (FV) in the Supermarket Healthy Eating for Life (SHELf) randomized controlled trial (RCT) shifted their FV purchasing into study supermarkets during the intervention period. Methods Participants were 642 females randomly assigned to a 1) skill-building (n = 160), 2) price reduction (n = 161), 3) combined skill-building and price reduction (n = 160), or 4) control (n = 161) group. Participants self-reported the proportion of FV purchased in study supermarkets at baseline, 3- and 6-months post-intervention. Fisher’s exact and χ2 tests assessed differences among groups in the proportion of FV purchased in study supermarkets at each time point. Multinomial logistic regression assessed differences among groups in the change in proportionate FV purchasing over time. Results Post-intervention, 49% of participants purchased ≥50% of their FV in study supermarkets. Compared to all other groups, the price reduction group was approximately twice as likely (RRR: 1.8-2.2) to have increased proportionate purchasing of FV in study supermarkets from baseline to post-intervention (p< 0.05). Conclusions Participants who received price reductions on FV were approximately twice as likely to shift their FV purchasing from other stores into study supermarkets during the intervention period. Unless food purchasing data are available for all sources, differential changes in purchasing patterns can make it difficult to discern the true impacts of nutrition interventions. Trial registration The SHELf trial is registered with Current Controlled Trials Registration ISRCTN39432901, Registered 30 June 2010, Retrospectively registered (http://www.isrctn.com/ISRCTN39432901).
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Ghosh-Dastidar M, Hunter G, Collins RL, Zenk SN, Cummins S, Beckman R, Nugroho AK, Sloan JC, Wagner L, Dubowitz T. Does opening a supermarket in a food desert change the food environment? Health Place 2017. [PMID: 28648926 DOI: 10.1016/j.healthplace.2017.06.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Improving access to healthy foods in low-income neighborhoods is a national priority. Our study evaluated the impact of opening a supermarket in a 'food desert' on healthy food access, availability and prices in the local food environment. We conducted 30 comprehensive in-store audits collecting information on healthy and unhealthy food availability, food prices and store environment, as well as 746 household surveys in two low-income neighborhoods before and after one of the two neighborhoods received a new supermarket. We found positive and negative changes in food availability, and an even greater influence on food prices in neighborhood stores. The supermarket opening in a 'food desert' caused little improvement in net availability of healthy foods, challenging the underpinnings of policies such as the Healthy Food Financing Initiative.
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Affiliation(s)
| | - Gerald Hunter
- RAND Corporation Pittsburgh, 4570 Fifth Ave #600, Pittsburgh, PA 15213, United States.
| | - Rebecca L Collins
- RAND Corporation Santa Monica, 1776 Main St, Santa Monica, CA 90401, United States.
| | - Shannon N Zenk
- Department of Health Systems Science, University of Illinois at Chicago, College of Nursing, 845S. Damen Ave., Rm 907, Chicago, IL 60612, United States.
| | - Steven Cummins
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom.
| | - Robin Beckman
- RAND Corporation Santa Monica, 1776 Main St, Santa Monica, CA 90401, United States.
| | - Alvin K Nugroho
- RAND Corporation Pittsburgh, 4570 Fifth Ave #600, Pittsburgh, PA 15213, United States.
| | - Jennifer C Sloan
- RAND Corporation Pittsburgh, 4570 Fifth Ave #600, Pittsburgh, PA 15213, United States.
| | - La'Vette Wagner
- RAND Corporation Pittsburgh, 4570 Fifth Ave #600, Pittsburgh, PA 15213, United States.
| | - Tamara Dubowitz
- RAND Corporation Santa Monica, 1776 Main St, Santa Monica, CA 90401, United States; RAND Corporation Pittsburgh, 4570 Fifth Ave #600, Pittsburgh, PA 15213, United States; Department of Health Systems Science, University of Illinois at Chicago, College of Nursing, 845S. Damen Ave., Rm 907, Chicago, IL 60612, United States; Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom.
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48
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Caspi CE, Lenk K, Pelletier JE, Barnes TL, Harnack L, Erickson DJ, Laska MN. Association between store food environment and customer purchases in small grocery stores, gas-marts, pharmacies and dollar stores. Int J Behav Nutr Phys Act 2017; 14:76. [PMID: 28583131 PMCID: PMC5460502 DOI: 10.1186/s12966-017-0531-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 05/26/2017] [Indexed: 12/19/2022] Open
Abstract
Background Purchases at small/non-traditional food stores tend to have poor nutritional quality, and have been associated with poor health outcomes, including increased obesity risk The purpose of this study was to examine whether customers who shop at small/non-traditional food stores with more health promoting features make healthier purchases. Methods In a cross-sectional design, data collectors assessed store features in a sample of 99 small and non-traditional food stores not participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Minneapolis/St. Paul, MN in 2014. Customer intercept interviews (n = 594) collected purchase data from a bag check and demographics from a survey. Store measures included fruit/vegetable and whole grain availability, an overall Healthy Food Supply Score (HFSS), healthy food advertisements and in-store placement, and shelf space of key items. Customer nutritional measures were analyzed using Nutrient Databases System for Research (NDSR), and included the purchase of ≥1 serving of fruits/vegetables; ≥1 serving of whole grains; and overall Healthy Eating Index-2010 (HEI-2010) score for foods/beverages purchased. Associations between store and customer measures were estimated in multilevel linear and logistic regression models, controlling for customer characteristics and store type. Results Few customers purchased fruits and vegetables (8%) or whole grains (8%). In fully adjusted models, purchase HEI-2010 scores were associated with fruit/vegetable shelf space (p = 0.002) and the ratio of shelf space devoted to healthy vs. less healthy items (p = 0.0002). Offering ≥14 varieties of fruit/vegetables was associated with produce purchases (OR 3.9, 95% CI 1.2–12.3), as was having produce visible from the store entrance (OR 2.3 95% CI 1.0 to 5.8), but whole grain availability measures were not associated with whole grain purchases. Conclusions Strategies addressing both customer demand and the availability of healthy food may be necessary to improve customer purchases. Trial registration ClinialTrials.gov: NCT02774330. Registered May 4, 2016 (retrospectively registered). Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0531-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Caitlin E Caspi
- Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA.
| | - Kathleen Lenk
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, 55454, USA
| | - Jennifer E Pelletier
- Statewide Health Improvement Program, Minnesota Department of Health, Saint Paul, MN, 55164, USA
| | - Timothy L Barnes
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, 55454, USA
| | - Lisa Harnack
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, 55454, USA
| | - Darin J Erickson
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, 55454, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, 55454, USA
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49
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Zenk SN, Mentz G, Schulz AJ, Johnson-Lawrence V, Gaines CR. Longitudinal Associations Between Observed and Perceived Neighborhood Food Availability and Body Mass Index in a Multiethnic Urban Sample. HEALTH EDUCATION & BEHAVIOR 2017; 44:41-51. [PMID: 27230271 PMCID: PMC5777147 DOI: 10.1177/1090198116644150] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Blacks, Hispanics, and women of lower socioeconomic status tend to have a higher risk of obesity. Numerous studies over the past decade examined the role of the neighborhood food environment in body weight. However, few were longitudinal. PURPOSE This longitudinal study examined whether multiple measures of neighborhood food availability were associated with body mass index (BMI) in a predominately Black and Hispanic adult sample living in low- to moderate-income urban neighborhoods. METHOD This longitudinal study used two waves of data (2002, 2008), including interviewer-measured height and weight, from a community survey of adults ( n = 219). In both 2002 and 2008, multiple measures characterized neighborhood food availability: GIS-derived availability of retail food outlets (large grocery store, small grocery store, convenience store, liquor stores), observed fruit and vegetable availability (count of stores selling 10 or more fresh fruit or vegetable varieties), and perceived fruit and vegetable access. Random intercept models estimated multivariable associations, controlling for individual-level demographics and neighborhood median household income. RESULTS Small grocery store availability was associated with 1.22-unit increase in BMI ( p = .047), while each unit increase in perceived fruit and vegetable access was associated with a 0.69-unit decrease in BMI ( p = .055). BMI was not associated with large grocery store, convenience store, or liquor store availability, or with observed fruit and vegetable availability. CONCLUSIONS Findings suggest that improving the neighborhood food environment, particularly at small grocery stores, may help urban residents living in low- to moderate-income neighborhoods achieve healthier body weights over time.
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50
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Bound J, Geronimus AT, Rodriguez JM, Waidmann TA. Measuring Recent Apparent Declines In Longevity: The Role Of Increasing Educational Attainment. Health Aff (Millwood) 2017; 34:2167-73. [PMID: 26643639 DOI: 10.1377/hlthaff.2015.0481] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Independent researchers have reported an alarming decline in life expectancy after 1990 among US non-Hispanic whites with less than a high school education. However, US educational attainment rose dramatically during the twentieth century; thus, focusing on changes in mortality rates of those not completing high school means looking at a different, shrinking, and increasingly vulnerable segment of the population in each year. We analyzed US data to examine the robustness of earlier findings categorizing education in terms of relative rank in the overall distribution of each birth cohort, instead of by credentials such as high school graduation. Estimating trends in mortality for the bottom quartile, we found little evidence that survival probabilities declined dramatically. We conclude that widely publicized estimates of worsening mortality rates among non-Hispanic whites with low socioeconomic position are highly sensitive to how educational attainment is classified. However, non-Hispanic whites with low socioeconomic position, especially women, are not sharing in improving life expectancy, and disparities between US blacks and whites are entrenched. Findings underscore the urgency of an agenda to equitably disseminate new medical technologies and to deepen knowledge of social determinants of health and how that knowledge can be applied, to promote the objective of achieving population health equity.
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Affiliation(s)
- John Bound
- John Bound is a professor in the Department of Economics at the University of Michigan, in Ann Arbor
| | - Arline T Geronimus
- Arline T. Geronimus is a professor in the School of Public Health at the University of Michigan
| | - Javier M Rodriguez
- Javier M. Rodriguez is a health researcher at Mathematica Policy Research in Ann Arbor
| | - Timothy A Waidmann
- Timothy A. Waidmann is a senior fellow in the Health Policy Center at the Urban Institute, in Washington, D.C
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