Franco, Manuel and Diez Roux, Ana V. and Glass, Thomas A. and Caballero, Benjamín and Brancati, Frederick L.
BACKGROUND: Differential access to healthy foods may contribute to racial and economic health disparities. The availability of healthy foods has rarely been directly measured in a systematic fashion. This study examines the associations among the availability of healthy foods and racial and income neighborhood composition. METHODS: A cross-sectional study was conducted in 2006 to determine differences in the availability of healthy foods across 159 contiguous neighborhoods (census tracts) in Baltimore City and Baltimore County and in the 226 food stores within them. A healthy food availability index (HFAI) was determined for each store, using a validated instrument ranging from 0 points to 27 points. Neighborhood healthy food availability was summarized by the mean HFAI for the stores within the neighborhood. Descriptive analyses and multilevel models were used to examine associations of store type and neighborhood characteristics with healthy food availability. RESULTS: Forty-three percent of predominantly black neighborhoods and 46% of lower-income neighborhoods were in the lowest tertile of healthy food availability versus 4% and 13%, respectively, in predominantly white and higher-income neighborhoods (p<0.001). Mean differences in HFAI comparing predominantly black neighborhoods to white ones, and lower-income neighborhoods to higher-income neighborhoods, were -7.6 and -8.1, respectively. Supermarkets in predominantly black and lower-income neighborhoods had lower HFAI scores than supermarkets in predominantly white and higher-income neighborhoods (mean differences -3.7 and -4.9, respectively). Regression analyses showed that both store type and neighborhood characteristics were independently associated with the HFAI score. CONCLUSIONS: Predominantly black and lower-income neighborhoods have a lower availability of healthy foods than white and higher-income neighborhoods due to the differential placement of types of stores as well as differential offerings of healthy foods within similar stores. These differences may contribute to racial and economic health disparities.
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|Uncontrolled Keywords:||racial and economic health disparities, access to healthy foods, racial and income neighborhood composition|
|Subjects:||Health > Health Equity > Access To Healthy Foods|
Health > Disparities
Research > studies
|Depositing User:||Users 141 not found.|
|Date Deposited:||16 Jun 2011 14:31|
|Last Modified:||16 Jun 2011 14:31|
|Link to this item (URI):||http://health-equity.pitt.edu/id/eprint/2590|
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