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Nam SJ, Suk J. Influence of health food literacy on willingness to pay for healthier foods: focus on food insecurity. Int J Equity Health 2024; 23:80. [PMID: 38649971 PMCID: PMC11036708 DOI: 10.1186/s12939-024-02135-1] [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] [Received: 08/29/2023] [Accepted: 02/23/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The repercussions of food insecurity are widely recognized to negatively impact overall health and are influenced by a complex interplay of physiological, psychological, social, and environmental factors. METHODS This study examined the disparities in food consumption and literacy between among food security households and food insecurity households using data from the Korea Rural Economic Institute's 2022 Consumer Behavior Survey for Food, which involved 3,321 respondents. RESULTS Food security households had a greater understanding of and better attitude toward healthier food choices than food insecurity households. Economic ability was identified as having the most significant association with food purchasing behavior, with food security households spending more on average than food insecurity households. Structural equation modeling demonstrated the association of knowledge and attitude with dietary implementation and underscored the significance of consumer literacy as a factor related to willingness to pay for healthier foods. CONCLUSIONS This study underscores the intertwined relationships among financial capacity, knowledge, and health-conscious dietary choices. It also suggests the need for targeted interventions addressing economic and educational gaps to foster healthier food consumption patterns across different socioeconomic contexts.
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Affiliation(s)
- Su-Jung Nam
- Department of Consumer Sciences, Convergence Program for Social Innovation, College of Social Sciences, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jaehye Suk
- Convergence Program for Social Innovation, College of Social Sciences, Sungkyunkwan University, Seoul, Republic of Korea.
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2
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Bernhart JA, Turner-McGrievy GM, DuBois KE, Sentman C, Rudisill C, Okpara N, Wilcox S, Clemons BD. Community Health Worker Implementation and Cost Analysis of a Plant-Based Nutrition Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:256-264. [PMID: 38310498 PMCID: PMC10999348 DOI: 10.1016/j.jneb.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 12/22/2023] [Accepted: 12/22/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVE This study describes program implementation through a research-restaurant partnership and assesses participant satisfaction, program costs, and percent body weight changes. METHODS Participants (n = 60) in a virtual synchronous (n = 43) or virtual asynchronous (n = 17) 12-week plant-based nutrition program received restaurant vouchers. Class satisfaction data were collected weekly. Assessments were completed at baseline, 3 months, and 9 months, along with interviews (n = 13) between 3 and 9 months. The costing approach estimated costs per participant. Interviews were coded using a content analysis and constant comparative method. RESULTS Participants rated the intervention favorably. Program costs were $198.63/participant, and participants' willingness to pay postintervention was $101.50 ± $63.90. Participants shared satisfaction with course content, the restaurant partnership, and suggestions for future delivery. No changes in participants' percent body weight were observed between 3 and 9 months (P = 0.98), indicating maintenance of 3-month weight loss. CONCLUSIONS AND IMPLICATIONS A research-restaurant partnership successfully implemented a nutrition program and generated positive feedback. With the lifting of coronavirus disease 2019 pandemic restrictions, future research can now test alternative implementation methods (in person vs online) in other restaurants.
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Affiliation(s)
- John A Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC.
| | - Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Kelli E DuBois
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Claudia Sentman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Caroline Rudisill
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Nkechi Okpara
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
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Dupuis R, Block JP, Barrett JL, Long MW, Petimar J, Ward ZJ, Kenney EL, Musicus AA, Cannuscio CC, Williams DR, Bleich SN, Gortmaker SL. Cost Effectiveness of Calorie Labeling at Large Fast-Food Chains Across the U.S. Am J Prev Med 2024; 66:128-137. [PMID: 37586572 PMCID: PMC10840662 DOI: 10.1016/j.amepre.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Calorie labeling of standard menu items has been implemented at large restaurant chains across the U.S. since 2018. The objective of this study was to evaluate the cost effectiveness of calorie labeling at large U.S. fast-food chains. METHODS This study evaluated the national implementation of calorie labeling at large fast-food chains from a modified societal perspective and projected its cost effectiveness over a 10-year period (2018-2027) using the Childhood Obesity Intervention Cost-Effectiveness Study microsimulation model. Using evidence from over 67 million fast-food restaurant transactions between 2015 and 2019, the impact of calorie labeling on calorie consumption and obesity incidence was projected. Benefits were estimated across all racial, ethnic, and income groups. Analyses were performed in 2022. RESULTS Calorie labeling is estimated to be cost saving; prevent 550,000 cases of obesity in 2027 alone (95% uncertainty interval=518,000; 586,000), including 41,500 (95% uncertainty interval=33,700; 50,800) cases of childhood obesity; and save $22.60 in healthcare costs for every $1 spent by society in implementation costs. Calorie labeling is also projected to prevent cases of obesity across all racial and ethnic groups (range between 126 and 185 cases per 100,000 people) and all income groups (range between 152 and 186 cases per 100,000 people). CONCLUSIONS Calorie labeling at large fast-food chains is estimated to be a cost-saving intervention to improve long-term population health. Calorie labeling is a low-cost intervention that is already implemented across the U.S. in large chain restaurants.
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Affiliation(s)
- Roxanne Dupuis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Jason P Block
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia
| | - Jessica L Barrett
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Michael W Long
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia
| | - Joshua Petimar
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Zachary J Ward
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Erica L Kenney
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Aviva A Musicus
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Carolyn C Cannuscio
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sara N Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Steven L Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Alba C, An R. Using Mobile Phone Data to Assess Socio-Economic Disparities in Unhealthy Food Reliance during the COVID-19 Pandemic. HEALTH DATA SCIENCE 2023; 3:0101. [PMID: 38487207 PMCID: PMC10904071 DOI: 10.34133/hds.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/20/2023] [Indexed: 03/17/2024]
Abstract
Background: Although COVID-19 has disproportionately affected socio-economically vulnerable populations, research on its impact on socio-economic disparities in unhealthy food reliance remains scarce. Methods: This study uses mobile phone data to evaluate the impact of COVID-19 on socio-economic disparities in reliance on convenience stores and fast food. Reliance is defined in terms of the proportion of visits to convenience stores out of the total visits to both convenience and grocery stores, and the proportion of visits to fast food restaurants out of the total visits to both fast food and full-service restaurants. Visits to each type of food outlet at the county level were traced and aggregated using mobile phone data before being analyzed with socio-economic demographics and COVID-19 incidence data. Results: Our findings suggest that a new COVID-19 case per 1,000 population decreased a county's odds of relying on convenience stores by 3.41% and increased its odds of fast food reliance by 0.72%. As a county's COVID-19 incidence rate rises by an additional case per 1,000 population, the odds of relying on convenience stores increased by 0.01%, 0.02%, and 0.06% for each additional percentage of Hispanics, college-educated residents, and every additional year in median age, respectively. For fast food reliance, as a county's COVID-19 incidence rate increases by one case per 1,000 population, the odds decreased by 0.003% for every additional percentage of Hispanics but increased by 0.02% for every additional year in the county's median age. Conclusion: These results complement existing literature to promote equitable food environments.
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Affiliation(s)
- Charles Alba
- Division of Computational & Data Sciences,
Washington University in St Louis, St Louis, MO, USA
| | - Ruopeng An
- Division of Computational & Data Sciences,
Washington University in St Louis, St Louis, MO, USA
- Brown School,
Washington University in St Louis, St Louis, MO, USA
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Bostean G, Ponicki WR, Padon AA, McCarthy WJ, Unger JB. A statewide study of disparities in local policies and tobacco, vape, and cannabis retail environments. Prev Med Rep 2023; 35:102373. [PMID: 37691887 PMCID: PMC10483047 DOI: 10.1016/j.pmedr.2023.102373] [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: 03/27/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/12/2023] Open
Abstract
The current study: (1) assesses sociodemographic disparities in local policies related to tobacco and cannabis retail, and (2) examines the cross-sectional association between policy strength and retailer densities of tobacco, e-cigarette (vape), and cannabis retailers within California cities and county unincorporated areas (N = 539). We combined (a) American Community Survey data (2019 5-year estimates), (b) 2018 tobacco, vape, and cannabis retailer locations from a commercial data provider, (c) 2017 tobacco and vape retail environment policy data from American Lung Association, and (d) 2018 cannabis policy data from California Cannabis Local Laws Database. Conditional autoregressive models examined policy strength associations with sociodemographic composition and retailer density in California jurisdictions. Jurisdictions with larger percentages of Black and foreign-born residents had stronger tobacco and vape policies. For cannabis policy, only income had a small, significant positive association with policy strength. Contrary to hypothesis, tobacco/vape policies were not significantly associated with retailer density, but cannabis policy strength was associated with lower cannabis retailer density (relative rate = 0.58, 95% Uncertainty Interval 0.47-0.70)-this effect was completely driven by storefront bans. Thus, storefront cannabis bans were the only policy studied that was associated with lower cannabis retailer density. Further research is needed to understand policies and disparities in retail environments for tobacco, vape, and cannabis, including data on the prospective association between policy implementation and subsequent retailer density, and the role of enforcement.
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Affiliation(s)
- Georgiana Bostean
- Sociology Department, Environmental Science & Policy Program, Chapman University, One University Drive, Orange, CA 92866, USA
| | - William R. Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | | | - William J. McCarthy
- Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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Graybeal AJ, Brandner CF, Aultman R, Ojo DE, Braun-Trocchio R. Differences in Perceptual and Attitudinal Body Image Between White and African-American Adults Matched for Sex, Age, and Body Composition. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01799-9. [PMID: 37749440 DOI: 10.1007/s40615-023-01799-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the differences in perceptual and attitudinal body image between White and African-American males and females matched for sex, age, BMI, and other body composition components using a combination of 3-dimensional mobile digital imaging analysis (DIA) and the Multidimensional Body-Self Relations Questionnaire-Appearance Scale (MBSRQ-AS). METHODS One-hundred non-Hispanic White (n=50) and non-Hispanic African-American (n=50) adults (M=34, F=66) matched for sex, age, BMI, and body composition components completed this cross-sectional study. Participants underwent several anthropometric assessments, completed the MBSRQ-AS, and rated their perceived appearance, ideal appearance, and the appearance they believed a partner would find societally attractive using a state of the art mobile 3-dimensional DIA produced using broad developmental populations. Body image distortion was measured as the perceived minus actual appearance, and body image dissatisfaction was defined as the ideal appearance and appearance a partner would find attractive minus the perceived appearance. RESULTS Using the DIA, only African-American females demonstrated significant body image distortion (p<0.001); reporting perceived appearances significantly lower their than their actual. Further, AA females demonstrated significantly larger differences between their ideal and perceived appearance (p=0.009), perceived larger bodies as more attractive to a potential partner (p=0.009), and reported higher ratings of appearance evaluation (p=0.001) and body area satisfaction (p=0.011) compared to White females. CONCLUSIONS After accounting for all anthropometric determinants of body image, perceptual and attitudinal body image differs between White and African-American adults with differences supporting larger body size acceptance for African-American individuals, particularly African-American females.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA.
| | - Caleb F Brandner
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Ryan Aultman
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Desiree E Ojo
- University of Incarnate Word School of Osteopathic Medicine, San Antonio, TX, 78235, USA
| | - Robyn Braun-Trocchio
- Department of Kinesiology, Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX, 76129, USA
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Yankey O, Lee J, Gardenhire R, Borawski E. Neighborhood Racial Segregation Predict the Spatial Distribution of Supermarkets and Grocery Stores Better than Socioeconomic Factors in Cleveland, Ohio: a Bayesian Spatial Approach. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01669-4. [PMID: 37368191 DOI: 10.1007/s40615-023-01669-4] [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: 01/03/2023] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION The food environment influences the availability and affordability of food options for consumers in a given neighborhood. However, disparities in access to healthy food options exist, affecting Black and low-income communities disproportionately. This study investigated whether racial segregation predicted the spatial distribution of supermarkets and grocery stores better than socioeconomic factors or vice versa in Cleveland, Ohio. METHOD The outcome measure was the count of supermarket and grocery stores in each census tract in Cleveland. They were combined with US census bureau data as covariates. We fitted four Bayesian spatial models. The first model was a baseline model with no covariates. The second model accounted for racial segregation alone. The third model looked at only socioeconomic factors, and the final model combined both racial and socioeconomic factors. RESULTS Overall model performance was better in the model that considered only racial segregation as a predictor of supermarkets and grocery stores (DIC = 476.29). There was 13% decrease in the number of stores for a census tract with a higher majority of Black people compared to areas with a lower number of Black people. Model 3 that considered only socioeconomic factors was less predictive of the retail outlets (DIC = 484.80). CONCLUSIONS These findings lead to the conclusion that structural racism evidenced in policies like residential segregation has a significant influence on the spatial distribution of food retail in the city of Cleveland.
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Affiliation(s)
- Ortis Yankey
- WorldPop Research Group, School of Geography and Environmental Science, University Road, University of Southampton, Southampton, SO17 1BJ, UK.
| | - Jay Lee
- Department of Geography, Kent State University, 413 McGilvrey Hall, 325 S. Lincoln Street, Kent, OH, 44240, USA
| | - Rachel Gardenhire
- Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, 11000 Cedar Ave, Cleveland, OH, 44106, USA
| | - Elaine Borawski
- Department of Population & Quantitative Health Sciences and Nutrition, Case Western Reserve University, 2103 Cornell Road, Cleveland, OH, 44106, USA
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Olarte DA, Petimar J, James P, Cooksey-Stowers K, Cash SB, Rimm EB, Economos CD, Rohmann M, Blossom JC, Chen Y, Deo R, Cohen JFW. Trends in Quick-Service Restaurants near Public Schools in the United States: Differences by Community, School, and Student Characteristics. J Acad Nutr Diet 2023; 123:923-932.e1. [PMID: 36740187 PMCID: PMC10200734 DOI: 10.1016/j.jand.2023.01.016] [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: 07/11/2022] [Revised: 01/12/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND More than one-third of children and adolescents consume foods from quick-service restaurants (QSRs) daily, which is associated with an increased risk of diet-related adverse health conditions. OBJECTIVE To examine trends in the proximity of top-selling QSR chains to all public schools across the United States between 2006 and 2018 by community-, school-, and student-level characteristics. DESIGN This longitudinal study examined changes in the number QSRs between the 2006-2007 and 2017-2018 school years using data from National Center for Education Statistics, Infogroup US Historical Business Data, and the US Department of Agriculture's Economic Research Service. STATISTICAL ANALYSIS A mixed-model analysis of variance using census tract as a random effect and accounting for repeated measures by school was used to examine the proximity of QSRs near schools. Models adjusted for demographic characteristics and census tract population density. Data were analyzed in 2021. RESULTS During 2006, 9% of schools had QSRs within 400 m, and 25% of schools in the most populated areas had at least one QSR within 400 m. There were more QSRs near schools with a high percentage of poverty (12%), and near schools with high school students with the highest population of Black or African American (16%) and Hispanic or Latino (18%) students. By 2018, the percent of all public schools within 400 m of QSRs increased to 12%. The increase over time was greater near schools with a high percentage of poverty (16%) and near schools with high school students with the highest population of Black or African American students (22%) and Hispanic or Latino (23%) students. CONCLUSIONS This is the first nationwide study to examine trends in QSR proximity to all public schools. QSRs were most likely to be located near schools with high school students, near schools with a high percentage of poverty, and near schools with a higher proportion of racial and ethnic minority students. Over time, there were greater increases in QSRs near these schools which may have important implications for children's health and diet-related disparities.
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Affiliation(s)
- Deborah A Olarte
- Center for Health Inclusion, Research and Practice, Department of Nutrition and Public Health, School of Health Sciences, Merrimack College, North Andover, Massachusetts.
| | - Joshua Petimar
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, East Boston, Massachusetts
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, East Boston, Massachusetts; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kristen Cooksey-Stowers
- Allied Health Sciences, Rudd Center for Food Policy and Health, University of Connecticut, Hartford, Connecticut
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Marlaina Rohmann
- Center for Health Inclusion, Research and Practice, Department of Nutrition and Public Health, School of Health Sciences, Merrimack College, North Andover, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jeffrey C Blossom
- Center for Geographic Analysis, Harvard University, Cambridge, Massachusetts
| | - Yuting Chen
- Center for Geographic Analysis, Harvard University, Cambridge, Massachusetts
| | - Rinki Deo
- Center for Geographic Analysis, Harvard University, Cambridge, Massachusetts
| | - Juliana F W Cohen
- Center for Health Inclusion, Research and Practice, Department of Nutrition and Public Health, School of Health Sciences, Merrimack College, North Andover, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Consistent and changing consumption of fast-food and full-service meals and 3-year weight change in a large population cohort study. Am J Clin Nutr 2023; 117:392-401. [PMID: 36811570 DOI: 10.1016/j.ajcnut.2022.12.006] [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: 09/23/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND An average American consumes 3 meals weekly from fast-food or full-service restaurants, which contain more calories, fat, sodium, and cholesterol than meals prepared at home. OBJECTIVES This study examined whether consistent and changing fast-food or full-service consumption was associated with weight change over a 3-y period. METHODS Among 98,589 US adults from the American Cancer Society's Cancer Prevention Study-3, self-reported weight and fast-food and full-service consumption from 2015 and 2018 were examined using a multivariable-adjusted linear regression analysis to assess the association of consistent and changing consumption on 3-y weight change. RESULTS Individuals who made no changes to their fast-food or full-service intake over the study period gained weight regardless of consumption frequency, although low consumers gained less weight than high consumers (low fast-food: β = -1.08; 95% CI: -1.22, -0.93; low full-service: β = -0.35; 95% CI: -0.50, -0.21; P < 0.001). Decreased fast-food intake during the study period (e.g., from high [>1 meal/wk] to low [≤0.5 meal/wk], high to medium [>0.5 to ≤1 meal/wk], or medium to low) and decreased full-service intake from high (≥1 meal/wk) to low (<1 meal/mo) were significantly associated with weight loss (high-low: β = -2.77; 95% CI: -3.23, -2.31; high-medium: β = -1.53; 95% CI: -1.72, -1.33; medium-low: β = -0.85; 95% CI: -1.06, -0.63; high-low full-service: β = -0.92; 95% CI: -1.36, -0.49; P < 0.001). Decreased consumption of both fast-food and full-service restaurant meals was associated with greater weight loss than decreasing fast-food alone (both: β = -1.65; 95% CI: -1.82, -1.37; fast-food only: β = -0.95; 95% CI: -1.12, -0.79; P < 0.001). CONCLUSIONS Decreased consumption of fast-food and full-service meals over 3 y, particularly among high consumers at baseline, was associated with weight loss and may be an effective approach to weight loss. Moreover, decreasing both fast-food and full-service meal consumption was associated with a greater weight loss than decreasing only fast-food meal consumption.
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Banerjee T, Nayak A, Zhao H. A county-level study of the effects of state-mandated COVID-19 lockdowns on urban and rural restaurant visits using consumers' cell phone geo-location data. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023; 31:249-258. [PMID: 33469476 PMCID: PMC7809091 DOI: 10.1007/s10389-020-01473-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/28/2020] [Indexed: 01/19/2023]
Abstract
Aim US federal, state, and local governments implemented numerous COVID-19 shelter-in-place orders (lockdowns) starting in March 2020 to ensure social distancing regulations and help stop the spread of COVID-19. It is important to know how these lockdowns affected businesses, such as restaurants, in regions that vary in terms of poverty status and geography. In this paper, we analyze the differential changes in rural and urban restaurant visits by the restaurants' NAICS codes following the COVID-19 lockdowns. Our analysis contributes to the public policy literature and helps operational planning for food distribution during a pandemic. Methods Since urban and rural consumer behavior and food resources are significantly different, it is crucial to conduct a comparative analysis. Our study applies a difference-in-differences model to capture the differential effects lockdowns have on urban and rural restaurants. Results We find that restaurant visits declined significantly in both rural and urban counties after shelter-at-home orders. The decrease in total restaurant visits was almost twice as high in urban counties as in rural counties. We also find that visits to fast-food restaurants increased in rural counties during shelter-at-home orders. Conclusions These results contribute to previous studies on the dearth of healthy food in rural and poorer regions, and inform important public policy response in the wake of the COVID-19 pandemic.
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Affiliation(s)
- Tannista Banerjee
- Department of Economics, Auburn University, 140 Miller Hall, Auburn, AL 36849 USA
| | - Arnab Nayak
- Department of Economics, Mercer University, Atlanta, Georgia
| | - HaiYue Zhao
- Department of Economics, Auburn University, 140 Miller Hall, Auburn, AL 36849 USA
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Hirsch JA, Michael YL, Moore KA, Melly S, Hughes TM, Hayden K, Luchsinger JA, Jimenez MP, James P, Besser LM, Sánchez B, Diez Roux AV. Longitudinal neighbourhood determinants with cognitive health and dementia disparities: protocol of the Multi-Ethnic Study of Atherosclerosis Neighborhoods and Aging prospective cohort study. BMJ Open 2022; 12:e066971. [PMID: 36368762 PMCID: PMC9660618 DOI: 10.1136/bmjopen-2022-066971] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The burden of Alzheimer's disease (AD) and AD-related dementias (ADRD) is increasing nationally and globally, with disproportionate impacts on lower-income, lower education and systematically marginalised older adults. Presence of inequalities in neighbourhood factors (eg, social context, physical and built environments) may affect risk of cognitive decline and be key for intervening on AD/ADRD disparities at the population level. However, existing studies are limited by a dearth of longitudinal, detailed neighbourhood measures linked to rich, prospective cohort data. Our main objective is to identify patterns of neighbourhood change related to prevalence of-and disparities in-cognitive decline and dementia. METHODS AND ANALYSES We describe the process of collecting, processing and linking extensive neighbourhood data to the Multi-Ethnic Study of Atherosclerosis (MESA), creating a 25+ years dataset. Within the MESA parent study, the MESA Neighborhoods and Aging cohort study will characterise dynamic, longitudinal neighbourhood social and built environment variables relevant to cognition for residential addresses of MESA participants. This includes administering new surveys, expanding residential address histories, calculating new measures derived from spatial data and implementing novel deep learning algorithms on street-level imagery. Applying novel statistical techniques, we will examine associations of neighbourhood environmental characteristics with cognition and clinically relevant AD/ADRD outcomes. We will investigate determinants of disparities in outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighbourhood environments to these disparities. This project will provide new evidence about pathways between neighbourhood environments and cognitive outcomes, with implications for policies to support healthy ageing. ETHICS AND DISSEMINATION This project was approved by the University of Washington and Drexel University Institutional Review Boards (protocols #00009029 and #00014523, and #180900605). Data will be distributed through the MESA Coordinating Center. Findings will be disseminated in peer-reviewed scientific journals, briefs, presentations and on the participant website.
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Affiliation(s)
- Jana A Hirsch
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kari A Moore
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
| | - Steven Melly
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Medical Center Boulevard, Winston-Salem, Carolina, USA
| | - Kathleen Hayden
- Department of Social Sciences and Health Policy, Bowman Gray Center for Medical Education, Winston-Salem, Carolina, USA
| | - Jose A Luchsinger
- Department of Medicine, Columbia University, New York, New York, USA
| | - Marcia P Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Lilah M Besser
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Brisa Sánchez
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
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12
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McCullough ML, Chantaprasopsuk S, Islami F, Rees-Punia E, Um CY, Wang Y, Leach CR, Sullivan KR, Patel AV. Association of Socioeconomic and Geographic Factors With Diet Quality in US Adults. JAMA Netw Open 2022; 5:e2216406. [PMID: 35679041 PMCID: PMC9185183 DOI: 10.1001/jamanetworkopen.2022.16406] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IMPORTANCE Poor diet quality is a key factor associated with obesity and chronic disease. Understanding associations of socioeconomic and geographic factors with diet quality can inform public health and policy efforts for advancing health equity. OBJECTIVE To identify socioeconomic and geographic factors associated with diet quality in a large US cohort study. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included adult men and women who enrolled in the Cancer Prevention Study-3 at American Cancer Society community events in 35 US states, the District of Columbia, and Puerto Rico between 2006 and 2013. Participants completed a validated food frequency questionnaire between 2015 and 2017. Data were analyzed from February to November 2021. EXPOSURES The main exposures included self-reported race and ethnicity, education, and household income. Geocoded addresses were used to classify urbanization level using Rural-Urban Commuting Area codes; US Department of Agriculture's Food Access Research Atlas database classified residence in food desert. MAIN OUTCOMES AND MEASURES Poor diet quality was defined as lowest quartile of dietary concordance with the 2020 American Cancer Society recommendations for cancer prevention score, based on sex-specific intake categories of vegetables and legumes, whole fruits, whole grains, red and processed meat, highly processed foods and refined grains, and sugar-sweetened beverages. RESULTS Among 155 331 adults, 123 115 were women (79.3%), and the mean (SD) age was 52 (9.7) years), and there were 1408 American Indian or Alaskan Native individuals (0.9%); 2721 Asian, Native Hawaiian, or Pacific Islander individuals (1.8%); 3829 Black individuals (2.5%); 7967 Hispanic individuals (5.1%); and 138 166 White individuals (88.9%). All key exposures assessed were statistically significantly and independently associated with poor diet quality. Compared with White participants, Black participants had a 16% (95% CI, 8%-25%) higher risk of poor diet quality, while Hispanic/Latino had 16% (95% CI, 12%-21%) lower risk and Asian, Native Hawaiian, and Pacific Islander participants had 33% (95% CI, 26%-40%) lower risk of poor diet quality. After controlling for other characteristics, rural residence was associated with a 61% (95% CI, 48%-75%) higher risk of poor diet quality, and living in a food desert was associated with a 17% (95% CI, 12%-22%) higher risk. Associations of income with diet quality and education with diet quality varied by race and ethnicity (income: P for interaction = .01; education: P for interaction < .001). All diet score components were associated with disparities observed. CONCLUSIONS AND RELEVANCE This cross-sectional study found that multiple individual-level socioeconomic and geographic variables were independently associated with poor diet quality among a large, racially and ethnically and geographically diverse US cohort. These findings could help to identify groups at highest risk of outcomes associated with poor diet to inform future approaches for advancing health equity.
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Affiliation(s)
| | | | - Farhad Islami
- Department of Surveillance and Health Equity Science, American Cancer Society, Kennesaw, Georgia
| | - Erika Rees-Punia
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Caroline Y. Um
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Ying Wang
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Corinne R. Leach
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Kristen R. Sullivan
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Alpa V. Patel
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
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13
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Cohen JFW, Posluszny H, Falbe J, Mueller MP, Gearhardt AN, Leung CW, Wolfson JA. Restaurant dining during the COVID-19 pandemic among adults with low-income in the United States. Appetite 2022; 173:105976. [PMID: 35245643 PMCID: PMC8885442 DOI: 10.1016/j.appet.2022.105976] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic caused widespread non-essential business closures in the U.S., which may have disproportionately impacted food consumption in lower-income communities, in part due to reduced access to healthy and affordable foods, as well as occupations that may have required working outside the home. The aims of this study were to examine restaurant dining behaviors (including drive-through, takeout, and delivery) at fast-food and non-fast-food (i.e., fast casual and full-service ['other']) restaurants and the impact on diet quality among racially/ethnically diverse low-income adults during the early months of the pandemic. Participants completed an online survey using CloudResearch regarding restaurant dining behaviors in the past week (during June 2020) and during a typical week prior to the pandemic. Diet quality was measured using the Prime Diet Quality Score (PDQS). Surveys from 1,756 low-income adults (incomes <250% of the Federal Poverty Level) were analyzed using chi-squared tests to examine differences in demographic characteristics among those dining at restaurants during the pandemic, as well as to examine differences in dining frequency compared with prior to COVID-19. Negative binomial regressions were used to examine the mean frequency of eating food from fast-food and other restaurants, adjusted for socio-demographic characteristics. This study found reductions in fast-food and other restaurant dining compared with prior to COVID-19, although overall restaurant consumption remained high with over half of participants reporting fast-food consumption in the week prior (average consumption of twice per week). Greater fast-food consumption was associated with poorer diet quality. In conclusion, while fast-food consumption was slightly lower during the pandemic, the overall high levels observed among socioeconomically disadvantaged adults remains concerning, highlighting the continued need for initiatives and policies to encourage greater access to and consumption of affordable and healthier foods.
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Affiliation(s)
- Juliana F W Cohen
- Department of Nutrition and Public Health, Merrimack College, 315 Turnpike Street, North Andover, MA, 01845, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Hannah Posluszny
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
| | - Jennifer Falbe
- Department of Human Ecology, University of California Davis, 1 Shields Ave, Davis, CA, 95616, USA.
| | - Megan P Mueller
- Department of Food Science and Human Nutrition, Colorado State University, 1571 Campus Dr, Fort Collins, CO, 80523, USA.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA.
| | - Cindy W Leung
- Department of Nutritional Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Julia A Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
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14
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Mackey ER, Burton ET, Cadieux A, Getzoff E, Santos M, Ward W, Beck AR. Addressing Structural Racism Is Critical for Ameliorating the Childhood Obesity Epidemic in Black Youth. Child Obes 2022; 18:75-83. [PMID: 34491828 DOI: 10.1089/chi.2021.0153] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Racism and childhood obesity are both pervasive factors adversely affecting the health and wellbeing of children and adolescents in the United States. The association between racism and obesity has been touched upon in the literature; yet most work has focused on a few dimensions of intersectionality of these two domains at one time. The renewed focus on structural racism as the primary contributor to distress of Black individuals in the United States has highlighted the urgency of identifying the contributions of racism to the childhood obesity epidemic. The current article is not a complete review of the literature, rather, it is meant to take a broad narrative review of the myriad ways in which racism contributes to the obesity epidemic in Black youth to serve as a call to action for more research, prevention, and intervention. The current article illustrates how a number of mechanisms for the etiology and maintenance of obesity are heavily influenced by racism and how addressing racism is critical for ameliorating the childhood obesity epidemic.
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Affiliation(s)
- Eleanor R Mackey
- Children's National Hospital, Center for Translational Research, Washington, DC, USA.,The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - E Thomaseo Burton
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Adelle Cadieux
- Department of Behavioral Health, Helen DeVos Children's Hospital, Grand Rapids, MI, USA.,Department of Pediatrics and Human Development, Michigan State University, Lansing MI, USA
| | - Elizabeth Getzoff
- Department of Psychology and Neuropsychology, Mt. Washington Pediatric Hospital, Baltimore, MD, USA
| | - Melissa Santos
- Division of Pediatric Psychology, Connecticut Children's, Hartford, CT, USA
| | - Wendy Ward
- Department of Pediatrics, College of Medicine, University of Arkansas Medical Center, Little Rock, AR, USA
| | - Amy R Beck
- Center for Children's Healthy Lifestyles and Nutrition and Division of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, MO, USA.,Department of Pediatrics, University of Missouri, Kansas City School of Medicine, Kansas City, MO, USA
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15
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Factors Associated with Home Food Environment in Low-Income Overweight or Obese Pregnant Women. Nutrients 2022; 14:nu14040869. [PMID: 35215519 PMCID: PMC8875725 DOI: 10.3390/nu14040869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/29/2022] Open
Abstract
Limited research has examined factors associated with home food availability. This study investigated the associations among demographics, body mass index category, stress, and home food availability among low-income overweight or obese pregnant women. This cross-sectional study enrolled 332 participants who were non-Hispanic black or white. We performed logistic regression modeling for unprocessed food, processed food, overall ultra-processed food, and three subcategories of ultra-processed food (salty snacks, sweet snacks and candies, and soda). Black women were less likely than white women to have large amounts of processed foods (OR = 0.56), salty snacks (OR = 0.61), and soda (OR = 0.49) available at home. Women with at least some college education or at least a college education were more likely to have large amounts of unprocessed food (OR = 2.58, OR = 4.38 respectively) but less likely to have large amounts of soda (OR = 0.44; OR = 0.22 respectively) available at home than their counterparts. Women with higher stress were less likely to have large amounts of unprocessed food available at home (OR = 0.58) than those with lower stress. Home food availability varied by race, education, and levels of stress in low-income overweight or obese pregnant women.
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16
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Chang MW, Lin CJ, Lee RE, Wegener DT, Hu J, Williams KP. Factors Associated with Beverage Intake in Low-Income, Overweight, or Obese Pregnant Women. Nutrients 2022; 14:nu14040840. [PMID: 35215490 PMCID: PMC8877862 DOI: 10.3390/nu14040840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/06/2022] [Accepted: 02/15/2022] [Indexed: 02/05/2023] Open
Abstract
This study examined consumption proportions and factors associated with sugar-sweetened beverages (SSBs), artificially sweetened beverages (ASBs), and 100% fruit juice (FJ) consumption. We recruited Non-Hispanic Black (n = 136) and White (n = 192) low-income overweight or obese pregnant women aged 18 to 46 years (mean = 25.7 years) from the Special Supplemental Nutrition Program for Women, Infants, and Children clinics in Michigan, USA. Independent variables included weight status, trimester, smoking, stress, education, employment, race, and age. Dependent variables were high (consuming ≥ 1 serving/day) versus low consumptions of SSB, ASB, and 100% FJ. Multivariate logistic regression modeling was performed to examine factors associated with beverage consumption. Out of the sample, 48.2%, 6.7%, and 31.3% reported high SSB, ASB, and 100% FJ consumption, respectively. SSB consumption was associated with smoking (OR: 3.77, p < 0.001), education (OR: 0.57, p = 0.03), and race (OR: 1.69, p = 0.03). Artificially sweetened beverage consumption was not associated with any factors examined. One hundred percent FJ consumption was associated with stress (OR: 0.90, p = 0.03) and race (OR: 4.48, p < 0.001). Clinicians may advocate for reductions in SSB and 100% FJ consumption tailored to client consumption characteristics.
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Affiliation(s)
- Mei-Wei Chang
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, USA; (C.J.L.); (J.H.); (K.P.W.)
- Correspondence: ; Tel.: +86-614-247-7211; Fax: +1-614-292-4948
| | - Chyongchiou J. Lin
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, USA; (C.J.L.); (J.H.); (K.P.W.)
| | - Rebecca E. Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA;
| | - Duane T. Wegener
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH 43210, USA;
| | - Jie Hu
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, USA; (C.J.L.); (J.H.); (K.P.W.)
| | - Karen Patricia Williams
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, USA; (C.J.L.); (J.H.); (K.P.W.)
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17
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Rhubart D, Sun Y, Pendergrast C, Monnat S. Sociospatial Disparities in "Third Place" Availability in the United States. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2022; 8:10.1177/23780231221090301. [PMID: 37946734 PMCID: PMC10634631 DOI: 10.1177/23780231221090301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Tertiary to home and work, "third places" serve as opportunity structures that transmit information and facilitate social capital and upward mobility. However, third places may be inequitably distributed, thereby exacerbating disparities in social capital and mobility. The authors use tract-level data from the National Neighborhood Data Archive to examine the distribution of third places across the United States. There were significant disparities in the availability of third places. Higher poverty rates were associated with fewer third places. Tracts with the smallest shares of Black and Hispanic populations had comparatively more third places. However, this racial disadvantage was not linear, suggesting potential buffering effects in places with the largest shares of Black and Hispanic populations. There was also a rural disadvantage, except in the most isolated rural tracts. This study demonstrates the value of conceptualizing and measuring third places to understand sociospatial disparities in the availability of these understudied opportunity structures.
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Affiliation(s)
| | - Yue Sun
- Syracuse University, Syracuse, NY, USA
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18
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Wijayaratna S, Lee A, Park HY, Jo E, Wu F, Bagg W, Cundy T. Socioeconomic status and risk factors for complications in young people with type 1 or type 2 diabetes: a cross-sectional study. BMJ Open Diabetes Res Care 2021; 9:9/2/e002485. [PMID: 34969690 PMCID: PMC8719138 DOI: 10.1136/bmjdrc-2021-002485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/26/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Young people with type 2 diabetes (T2D) develop complications earlier than those with type 1 diabetes (T1D) of comparable duration, but it is unclear why. This apparent difference in phenotype could relate to relative inequality. RESEARCH DESIGN AND METHODS Cross-sectional study of young people referred to secondary diabetes services in Auckland, Aotearoa-New Zealand (NZ): 731 with T1D and 1350 with T2D currently aged <40 years, and diagnosed between 15 and 30 years. Outcome measures were risk factors for complications (glycemic control, urine albumin/creatinine ratio (ACR), cardiovascular disease (CVD) risk) in relation to a validated national index of deprivation (New Zealand Deprivation Index (NZDep)). RESULTS Young people with T2D were an average 3 years older than those with T1D but had a similar duration of diabetes. 71% of those with T2D were of Māori or Pasifika descent, compared with 24% with T1D (p<0.001). T1D cases were distributed evenly across NZDep categories. 78% of T2D cases were living in the lowest four NZDep categories (p<0.001). In both diabetes types, body mass index (BMI) increased progressively across the NZDep spectrum (p<0.002), as did mean glycated hemoglobin (HbA1c) (p<0.001), the prevalence of macroalbuminuria (p≤0.01), and CVD risk (p<0.001). Adjusting for BMI, diabetes type, and duration and age, multiple logistic regression revealed deprivation was the strongest risk factor for poorly controlled diabetes (defined as HbA1c >64 mmol/mol, >8%); OR 1.17, 95% CI 1.13 to 1.22, p<0.0001. Ordinal logistic regression showed each decile increase in NZDep increased the odds of a higher ACR by 11% (OR 1.11, 95% CI 1.06 to 1.16, p<0.001) following adjustment for BMI, blood pressure, diabetes type and duration, HbA1c, and smoking status. Multiple linear regression indicated a 4% increase in CVD risk for every decile increase in NZDep, regardless of diabetes type. CONCLUSIONS The apparent more aggressive phenotype of young-onset T2D is at least in part explicable by relative deprivation.
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Affiliation(s)
- Sasini Wijayaratna
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, Aotearoa-New Zealand
- Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
| | - Arier Lee
- Department of Population Health, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
| | - Hyun Young Park
- Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
| | - Emmanuel Jo
- Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
- Health Workforce Directorate, New Zealand Ministry of Health, Wellington, Aotearoa-New Zealand
| | - Fiona Wu
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, Aotearoa-New Zealand
| | - Warwick Bagg
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, Aotearoa-New Zealand
- Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
| | - Tim Cundy
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, Aotearoa-New Zealand
- Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
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19
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Cummings JR, Hoover LV, Turner MI, Glozier K, Zhao J, Gearhardt AN. Extending Expectancy Theory to Food Intake: Effect of a Simulated Fast-Food Restaurant on Highly and Minimally Processed Food Expectancies. Clin Psychol Sci 2021; 9:1115-1127. [PMID: 35003906 DOI: 10.1177/21677026211004582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Unhealthy diets are widespread and linked to a number of detrimental clinical outcomes. The current preregistered experiment extended Expectancy Theory into the study of food intake; specifically, we tested whether a fast-food restaurant affects food expectancies, or the emotions one expects to feel while eating highly (e.g., pizza) and minimally (e.g., carrots) processed foods. Participants (N = 200, M age = 18.79) entered a simulated fast-food restaurant or a neutral space, completed questionnaires, and engaged in a 'bogus' taste test. The simulated fast-food restaurant increased positive highly-processed food expectancies (d = 0.29). Palatable eating coping motives scores did not moderate the effect; however, this clinically-relevant pattern of eating behavior was associated with greater positive highly-processed food expectancies. In addition, there was an indirect effect of the fast-food restaurant on ad libitum food intake through positive highly-processed food expectancies. Reducing positive highly-processed food expectancies may improve diet, which may broadly impact health.
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Affiliation(s)
| | | | | | - Kalei Glozier
- Department of Psychology, University of Michigan, Ann Arbor
| | - Jessica Zhao
- Department of Psychology, University of Michigan, Ann Arbor
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20
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Marketing to Children Inside Quick Service Restaurants: Differences by Community Demographics. Am J Prev Med 2021; 61:96-104. [PMID: 33994053 PMCID: PMC8277431 DOI: 10.1016/j.amepre.2021.01.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/04/2020] [Accepted: 01/12/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION In the U.S., children regularly consume foods from quick-service restaurants, but little is known about the marketing strategies currently used inside quick-service restaurants. This study aims to validate a child-focused Environmental Assessment Tool for quick-service restaurants, evaluate marketing strategies inside and on the exterior of quick-service restaurants, and examine differences by community race/ethnicity or income. METHODS The inter-rater and test-retest reliability of the Environmental Assessment Tool were assessed across the top 5 national quick-service restaurant chains. Marketing techniques in 165 quick-service restaurants (33 per national chain) in socioeconomically and racially/ethnically diverse communities throughout New England were examined in 2018-2019. Mixed methods ANOVA examined the differences in marketing techniques in 2020. RESULTS The inter-rater and test-retest reliability of the Environmental Assessment Tool were high (Cohen's κ>0.80). Approximately 95% of quick-service restaurants marketed less healthy foods, whereas only 6.5% marketed healthy options. When examining the differences by community demographics, there were significantly more price promotion advertisements inside and on the exterior of quick-service restaurants in lower-income communities. In addition, there was a greater number of child-directed advertisements with cartoon or TV/movie characters as well as fewer healthy entrée options and more sugar-sweetened beverage and dessert options on the children's menu inside quick-service restaurants in communities with higher minority populations. CONCLUSIONS Environmental Assessment Tool is a valid tool to evaluate marketing inside quick-service restaurants. Results suggest that there is a substantial amount of unhealthy food and beverage marketing inside quick-service restaurants, with differences in the number and types of techniques used in lower-income and minority communities. Policies that limit quick-service restaurant marketing to children should be considered.
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21
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E-shopping changes and the state of E-grocery shopping in the US - Evidence from national travel and time use surveys. RESEARCH IN TRANSPORTATION ECONOMICS 2021; 87. [PMCID: PMC7214339 DOI: 10.1016/j.retrec.2020.100864] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
In spite of the popularity of e-shopping, only 16% of US adults have ordered groceries online, and 7 out of 10 of those who currently buy groceries online do so at most twice a month. Understanding the determinants of e-grocery shopping is important for grocers, supply chain managers, and urban planners. In this context, we first explore how deliveries from online shopping have been changing over time. From our analysis of the 2009 and 2017 National Household Travel Surveys, we found that online shopping has been embraced by increasingly diverse households, although income, education, and some racial/ethnic differences persist. Our analysis of the 2017 American Time Use Survey shows that Americans are 24 times more likely to shop for groceries in stores than online. Moreover, in-store grocery shoppers are more likely to be female and unemployed, but less likely to belong to younger generations, to have less than a college degree, or to be African American. The gender imbalance in grocery shopping is larger online than in stores, but e-grocery shoppers do not otherwise differ from the general population. Future travel and e-shopping surveys (especially for e-grocery) should combine time use and travel questions with retrospective questions about online purchases.
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22
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Peng K, Rodriguez DA, Hirsch JA, Gordon-Larsen P. A method for estimating neighborhood characterization in studies of the association with availability of sit-down restaurants and supermarkets. Int J Health Geogr 2021; 20:15. [PMID: 33766045 PMCID: PMC7995746 DOI: 10.1186/s12942-020-00257-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 12/21/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Although neighborhood-level access to food differs by sociodemographic factors, a majority of research on neighborhoods and food access has used a single construct of neighborhood context, such as income or race. Therefore, the many interrelated built environment and sociodemographic characteristics of neighborhoods obscure relationships between neighborhood factors and food access. METHODS The objective of this study was to account for the many interrelated characteristics of food-related neighborhood environments and examine the association between neighborhood type and relative availability of sit-down restaurants and supermarkets. Using cluster analyses with multiple measures of neighborhood characteristics (e.g., population density, mix of land use, and sociodemographic factors) we identified six neighborhood types in 1993 in the Twin Cities Region, Minnesota. We then used mixed effects regression models to estimate differences in the relative availability of sit-down restaurants and supermarkets in 1993, 2001, and 2011 across the six neighborhood types. RESULTS We defined six types of neighborhoods that existed in 1993, namely, urban core, inner city, urban, aging suburb, high-income suburb, and suburban edge. Between 1993 and 2011, inner city neighborhoods experienced a greater increase in the percent of sit-down restaurants compared with urban core, urban, and aging suburbs. Differences in the percent of sit-down restaurants between inner city and aging suburbs, high-income suburbs and suburban edge neighborhoods increased between 1993 and 2011. Similarly, aging suburb neighborhoods had a greater percent of supermarkets compared with urban and high-income suburb neighborhoods in 2001 and 2011, but not in 1993, suggesting a more varied distribution of food stores across neighborhoods over time. Thus, the classification of neighborhood type based on sociodemographic and built environment characteristics resulted in a complex and increasingly varied distribution of restaurants and food stores. CONCLUSIONS The temporal increase in the relative availability of sit-down restaurants in inner cities after accounting for all restaurants might be partly related to a higher proportion of residents who eat-away-from-home, which is associated with higher calorie and fat intake.
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Affiliation(s)
- Ke Peng
- Department of Urban Planning, School of Architecture, Hunan University, Changsha, Hunan, China.
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Daniel A Rodriguez
- Department of City and Regional Planning and Institute of Transportation Studies, University of California, Berkeley, Berkeley, CA, USA
| | - Jana A Hirsch
- Urban Health Collaborative, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Li M. Adolescent college expectation and nutritional health in adulthood: The hidden power of social position. Soc Sci Med 2020; 265:113482. [PMID: 33162199 DOI: 10.1016/j.socscimed.2020.113482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/30/2020] [Accepted: 10/27/2020] [Indexed: 11/16/2022]
Abstract
Few studies investigated whether expected college attendance in adolescence may generate comparable health benefits in early adulthood for the disadvantaged and the privileged. Using data from the National Longitudinal Study of Adolescent to Adult Health, this study examined the contingent associations of college attendance expectation with weekly fast food consumption (FFC), sugar-sweetened beverage consumption (SBC), physical activity (PA), and obesity in early adulthood based on four social position indicators: family poverty, neighborhood poverty, parental education, and race. Results suggested that family poverty, neighborhood poverty, and low parental education significantly compromised college expectation's associations with all outcomes except for PA. Further, college expectation's negative associations with FFC and SBC were lower for Blacks than for Whites; and college expectation's negative association with SBC and positive association with PA were lower for Hispanics than for Whites. These findings imply that the "ambition inflation" among American youth, often celebrated by the American culture for its acclaimed life changing power, may be not equally benefiting the disadvantaged and the privileged. Future behavioral interventions focusing on fostering a positive outlook in youth should consider possible effect heterogeneity based on social background.
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Affiliation(s)
- Miao Li
- Department of Sociology, Anthropology, and Criminal Justice, Clemson University, 135A Brackett Hall, Clemson, SC, 29634, USA.
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Racial Differences in Perceived Food Swamp and Food Desert Exposure and Disparities in Self-Reported Dietary Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197143. [PMID: 33003573 PMCID: PMC7579470 DOI: 10.3390/ijerph17197143] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 01/24/2023]
Abstract
Both food swamps and food deserts have been associated with racial, ethnic, and socioeconomic disparities in obesity rates. Little is known about how the distribution of food deserts and food swamps relate to disparities in self-reported dietary habits, and health status, particularly for historically marginalized groups. In a national U.S. sample of 4305 online survey participants (age 18+), multinomial logistic regression analyses were used to assess by race and ethnicity the likelihood of living in a food swamp or food desert area. Predicted probabilities of self-reported dietary habits, health status, and weight status were calculated using the fitted values from ordinal or multinomial logistic regression models adjusted for relevant covariates. Results showed that non-Hispanic, Black participants (N = 954) were most likely to report living in a food swamp. In the full and White subsamples (N = 2912), the perception of residing in a food swamp/desert was associated with less-healthful self-reported dietary habits overall. For non-Hispanic Blacks, regression results also showed that residents of perceived food swamp areas (OR = 0.66, p < 0.01, 95% CI (0.51, 0.86)) had a lower diet quality than those not living in a food swamp/food desert area. Black communities in particular may be at risk for environment-linked diet-related health inequities. These findings suggest that an individual's perceptions of food swamp and food desert exposure may be related to diet habits among adults.
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Calloway EE, Parks CA, Bowen DJ, Yaroch AL. Environmental, social, and economic factors related to the intersection of food security, dietary quality, and obesity: an introduction to a special issue of the Translational Behavioral Medicine journal. Transl Behav Med 2020; 9:823-826. [PMID: 31682731 DOI: 10.1093/tbm/ibz097] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This special issue of Translational Behavioral Medicine solicited papers focusing on the intersection of food security, dietary quality, and obesity. Specifically, the special issue seeks to highlight research that provides actionable takeaways related to policy, systems, and environmental (PSE) approaches for practitioners and policymakers. The purpose of this introduction was to summarize relevant background literature and then briefly introduce topics covered by the articles included in the special issue. There are economic, environmental, and social factors that create systemic barriers that drive persistent poverty in communities and underlay the intersection of food security, dietary quality, and obesity. Although equitable healthful food access is needed, the issue is exceedingly complicated. Understanding and operationalizing effective and efficient PSE approaches is in its infancy. More research is needed to better understand how to appropriately measure determinants of health (and how they relate to the conditions that ultimately promote obesity through food insecurity and compromises to dietary quality), implement deliberate interventions that address the underlying factors, and disseminate that information to policymakers and practitioners in the field. This special issue of Translational Behavioral Medicine includes articles that relay practical findings, measurement methods, and lessons learned related to PSE approaches such as federal food assistance programs (e.g., National School Lunch Program), systems-based interventions (e.g., clinic-community connections), and environmental modifications(e.g., food retail marketing). Although much more practical and action-oriented research is needed in this area, these articles will contribute to the evidence base supporting better future assessment and PSE interventions that address food security, dietary quality, and obesity.
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Affiliation(s)
| | | | - Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington, Seattle, WA, USA
| | - Amy L Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA
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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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Min J, Jahns L, Xue H, Kandiah J, Wang Y. Americans' Perceptions about Fast Food and How They Associate with Its Consumption and Obesity Risk. Adv Nutr 2018; 9:590-601. [PMID: 30084879 PMCID: PMC6140449 DOI: 10.1093/advances/nmy032] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/12/2018] [Indexed: 12/21/2022] Open
Abstract
We aimed to systematically examine Americans' perceptions of fast food (FF) and how these perceptions might affect fast food consumption (FFC) and obesity risk. We searched PubMed and Google for studies published in English until February 17, 2017 that reported on Americans' perceptions (defined as their beliefs, attitudes, and knowledge) regarding FF as well as those on their associations with FFC and obesity risk. Thirteen articles met inclusion criteria. Limited research has been conducted on these topics, and most studies were based on convenience samples. A 2013 nationally representative phone survey of about 2000 subjects showed that one-fifth of Americans thought FF was good for health, whereas two-thirds considered FF not good. Even over two-thirds of weekly FF consumers (47% of the total population) thought FF not good. Americans seem to have limited knowledge of calories in FF. Negative and positive FF perceptions were associated with FFC. Those who consumed less FF seemed more likely to view FF negatively. When Americans valued the convenience and taste of FF and preferred FF restaurants with kid's menus and play areas, they were likely to purchase more FF. Available research indicates neither perceived availability of FF nor Geographical Information System (GIS)-based FF presence in the neighborhood has significant associations with weekly FFC. No studies examined potential links between FF perceptions and obesity risk. Americans' perceptions of FF and how they might associate with FFC and obesity risk are understudied. Considerable variation was observed in Americans' perceptions and FFC.
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Affiliation(s)
- Jungwon Min
- Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN
| | - Lisa Jahns
- Grand Forks Human Nutrition Research Center, US Department of Agriculture-Agricultural Research Service, Grand Forks, ND
| | - Hong Xue
- Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN,Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Jayanthi Kandiah
- Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN
| | - Youfa Wang
- Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN,Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN,Address correspondence to YW (e-mail: )
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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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Wade JM. "Doing Difference" and Fast Food Consumption: Patterns Among a Sample of White and African American Emerging Adults. J Racial Ethn Health Disparities 2017. [PMID: 28643269 DOI: 10.1007/s40615-017-0383-8] [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: 11/27/2022]
Abstract
Previous research has demonstrated that frequent consumption of fast food is linked to obesity and that trends in both are disparate across race and sex categories. Contextualizing race- and sex-related factors that structure fast food consumption in emerging adulthood is a much-needed contribution to social research. Specifically, this study uses the "doing difference" framework, to examine the frequency of fast food consumption in a sample of White and African American (18-25 years old). According to the framework, social inequalities are reproduced through dramaturgical performances of race, class, and gender. Results of this suggest that feminine gender orientation and education serve as protective factors, while African American race and male sex serve as risk factors. African American women emerged as especially high risk given their higher prevalence of traditionally masculine traits.
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Affiliation(s)
- Jeannette M Wade
- Department of Child and Family Development, University of Akron, College of Arts and Sciences, Akron, OH, USA.
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30
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Lytle LA, Sokol RL. Measures of the food environment: A systematic review of the field, 2007-2015. Health Place 2017; 44:18-34. [PMID: 28135633 DOI: 10.1016/j.healthplace.2016.12.007] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/21/2016] [Accepted: 12/02/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Many studies have examined the relationship between the food environment and health-related outcomes, but fewer consider the integrity of measures used to assess the food environment. The present review builds on and makes comparisons with a previous review examining food environment measures and expands the previous review to include a more in depth examination of reliability and validity of measures and study designs employed. METHODS We conducted a systematic review of studies measuring the food environment published between 2007 and 2015. We identified these articles through: PubMed, Embase, Web of Science, PsycINFO, and Global Health databases; tables of contents of relevant journals; and the National Cancer Institute's Measures of the Food Environment website. This search yielded 11,928 citations. We retained and abstracted data from 432 studies. RESULTS The most common methodology used to study the food environment was geographic analysis (65% of articles) and the domination of this methodology has persisted since the last review. Only 25.9% of studies in this review reported the reliability of measures and 28.2% reported validity, but this was an improvement as compared to the earlier review. Very few of the studies reported construct validity. Studies reporting measures of the school or worksite environment have decreased since the previous review. Only 13.9% of the studies used a longitudinal design. CONCLUSIONS To strengthen research examining the relationship between the food environment and population health, there is a need for robust and psychometrically-sound measures and more sophisticated study designs.
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Affiliation(s)
- Leslie A Lytle
- Department of Health Behavior, Campus Box 7440, UNC Gillings School of Global Public Health, Chapel Hill, NC 27599-7440, United States.
| | - Rebeccah L Sokol
- Department of Health Behavior, Campus Box 7440, UNC Gillings School of Global Public Health, Chapel Hill, NC 27599-7440, United States
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Tucker-Seeley RD, Bezold CP, James P, Miller M, Wallington SF. Retail Pharmacy Policy to End the Sale of Tobacco Products: What Is the Impact on Disparity in Neighborhood Density of Tobacco Outlets? Cancer Epidemiol Biomarkers Prev 2016; 25:1305-10. [PMID: 27302724 PMCID: PMC5010482 DOI: 10.1158/1055-9965.epi-15-1234] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 01/22/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Population-level research on the implications of retail pharmacy policies to end the sale of tobacco products is scant, and the impact of such policies on racial/ethnic and socioeconomic disparities across neighborhoods in access to tobacco products remains unexplored. METHODS We investigated the association between neighborhood sociodemographic characteristics and tobacco retail density in Rhode Island (RI; N = 240 census tracts). We also investigated whether the CVS Health (N = 60) policy to end the sale of tobacco products reduces the disparity in the density of tobacco retail across neighborhoods, and we conducted a prospective policy analysis to determine whether a similar policy change in all pharmacies in RI (N = 135) would reduce the disparity in tobacco retail density. RESULTS The results revealed statistically significant associations between neighborhood sociodemographic characteristics and tobacco retail outlet density across RI neighborhoods. The results when excluding the CVS Health locations, as well as all pharmacies as tobacco retailers, revealed no change in the pattern for this association. CONCLUSIONS The results of this study suggest that while a commendable tobacco control policy, the CVS Health policy appears to have no impact on the neighborhood racial/ethnic and socioeconomic disparities in the density of tobacco retailers in RI. Prospective policy analyses showed no impact on this disparity even if all other pharmacies in the state adopted a similar policy. IMPACT Policy efforts aimed at reducing the disparity in access to tobacco products should focus on reducing the density of tobacco outlets in poor and racial/ethnic neighborhoods. Cancer Epidemiol Biomarkers Prev; 25(9); 1305-10. ©2016 AACR.
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Affiliation(s)
- Reginald D Tucker-Seeley
- Center for Community Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Carla P Bezold
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Peter James
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Melecia Miller
- Center for Community Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Sherrie F Wallington
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
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Mortality outcomes associated with intake of fast-food items and sugar-sweetened drinks among older adults in the Vitamins and Lifestyle (VITAL) study. Public Health Nutr 2016; 19:3319-3326. [DOI: 10.1017/s1368980016001518] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo evaluate associations of fast-food items (FFI) and sugar-sweetened drinks (SSD) with mortality outcomes including deaths due to any cause, CVD and total cancers among a large sample of adults.DesignUsing a prospective design, risk of death was compared across baseline dietary exposures. Intakes of FFI and SSD were quantified using a semi-quantitative FFQ (baseline data collected 2000–2002). Deaths (n4187) were obtained via the Washington State death file through 2008, excluding deaths in the first year of follow-up. Causes of death were categorized as due to CVD (I00–I99) or cancer (C00–D48). Cox models were used to estimated hazard ratios (HR) and 95 % CI.SettingThe Vitamins and Lifestyle (VITAL) study among adults living in Western Washington State.SubjectsMen and women (n69 582) between 50 and 76 years of age at baseline.ResultsIntakes of FFI and SSD were higher among individuals who were younger, female, African-American, American Indian or Alaska Native, Asian-American or Pacific Islander, of lower educational attainment, and of lower income (P<0·0001 for all). Higher risk of total mortality was associated with greater intake of FFI (HR=1·16; 95 % CI 1·04, 1·29;P=0·004; comparing highestv. lowest quartile) and SSD (HR=1·19; 95 % CI 1·08, 1·30;P<0·0001; comparing highestv. lowest quartile). Higher intake of FFI was associated with greater cancer-specific mortality while an association with CVD-specific mortality was suggested. Associations between intake of SSD and cause-specific mortality were less clear.ConclusionsIntake of FFI and SSD has a detrimental effect on future mortality risk. These findings may be salient to socially patterned disparities in mortality.
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Caspi CE, Lopez AM, Nanney MS. Geographic access to food shelves among racial/ethnic minorities and foreign-born residents in the Twin Cities. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016; 11:29-44. [PMID: 27066158 DOI: 10.1080/19320248.2015.1066735] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Place-based disparities in access to affordable food sources (e.g., supermarkets) have been well documented, but geographic access to emergency food sources (e.g., food panties, also known as food shelves) is unknown. This study examined the geography of emergency food in the Twin Cities, MN. U.S. Census and American Community Survey data were used to estimate the average distance to the closest food shelf according to area racial/ethnic composition and foreign-born group composition. In adjusted models, areas with the highest proportion of minority groups had shorter distances to the nearest food shelf (0.13-1.03 log-transformed miles, p <0.05), as did census tracts with more residents born in East Africa and Latin America (0.29-0.31 log-transformed miles, p< 0.001). Areas with more racial/ethnic minorities and foreign-born groups may have access to emergency food, but efforts are needed to evaluate the healthfulness and culturally relevance of these offerings.
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Affiliation(s)
- Caitlin Eicher Caspi
- University of Minnesota, Department of Family Medicine and Community Health, 717 Delaware Ave SE, Minneapolis, MN 55414; Minnesota Population Center, University of Minnesota, 50 Willey Hall, 225 - 19th Avenue South, Minneapolis, MN 55455
| | - Amy Maheswaran Lopez
- Greater Twin Cities United Way, 404 South Eighth Street, Minneapolis, MN 55404-1084
| | - Marilyn S Nanney
- University of Minnesota, Department of Family Medicine and Community Health, 717 Delaware Ave SE, Minneapolis, MN 55414; Minnesota Population Center, University of Minnesota, 50 Willey Hall, 225 - 19th Avenue South, Minneapolis, MN 55455
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Reitzel LR, Okamoto H, Hernandez DC, Regan SD, McNeill LH, Obasi EM. The Built Food Environment and Dietary Intake among African-American Adults. Am J Health Behav 2016; 40:3-11. [PMID: 26685808 DOI: 10.5993/ajhb.40.1.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The built food environment surrounding people's homes may influence their dietary intake. This exploratory study examined how the density of different sources of food in the residential environment was associated with dietary consumption among 77 African-American adults in Houston, Texas. METHODS The number of fast-food-type restaurants, large grocery stores, and convenience-type stores within 2- and 5-mile residential buffers were divided by the respective areas to obtain food environment density variables. Intake of fruit and vegetables [FV], fiber [FI], and percent energy from fat [PEF] was assessed using National Health Interview Survey items. Covariate-adjusted regressions were used to assess relations of interest. RESULTS Greater density of fast-food-type restaurants within 2 miles was associated with greater FV, FI, and PEF (ps ≤ .012); and for FV and FI within 5 miles (ps ≤ .004). Density of large grocery stores was unrelated to intake. Greater density of convenience-type stores within 2 miles was negatively associated with FV and FI (ps ≤ .03); results became marginal at 5 miles for FV (p = .10) but not FI (p = .03). CONCLUSION Maximizing healthy offerings in venue-rich metropolitan areas might provide direction for policies to reduce obesity.
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Affiliation(s)
- Lorraine R Reitzel
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, USA
| | - Hiroe Okamoto
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, USA
| | - Daphne C Hernandez
- The University of Houston, Department of Health and Human Performance, Houston, TX, USA
| | | | - Lorna H McNeill
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX, USA
| | - Ezemenari M Obasi
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, USA
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Block JP, Subramanian SV. Moving Beyond "Food Deserts": Reorienting United States Policies to Reduce Disparities in Diet Quality. PLoS Med 2015; 12:e1001914. [PMID: 26645285 PMCID: PMC4672916 DOI: 10.1371/journal.pmed.1001914] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Jason Block and S. V. Subramanian explore avenues for improving the health of Americans through reducing dietary inequalities and look at whether concern over "food deserts" has been taken too far.
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Affiliation(s)
- Jason P Block
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
- Harvard Center for Population and Development Studies, Harvard T H Chain School of Public Health, Cambridge, Massachusetts, United States of America
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Harvard T H Chain School of Public Health, Cambridge, Massachusetts, United States of America
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health Boston, Massachusetts, United States of America
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Zenk SN, Powell LM, Isgor Z, Rimkus L, Barker DC, Chaloupka FJ. Prepared Food Availability in U.S. Food Stores: A National Study. Am J Prev Med 2015; 49:553-62. [PMID: 25913149 DOI: 10.1016/j.amepre.2015.02.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/18/2015] [Accepted: 02/18/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Prepared, ready-to-eat foods comprise a significant part of Americans' diets and are increasingly obtained from food stores. Yet, little is known about the availability and healthfulness of prepared, ready-to-eat food offerings at stores. This study examines associations among community characteristics (racial/ethnic composition, poverty level, urbanicity) and availability of both healthier and less-healthy prepared foods in U.S. supermarkets, grocery stores, and convenience stores. METHODS Observational data were collected from 4,361 stores in 317 communities spanning 42 states in 2011 and 2012. Prepared food availability was assessed via one healthier food (salads or salad bar), three less-healthy items (pizza, hot dog/hamburger, taco/burrito/taquito), and one cold sandwich item. In 2014, multivariable generalized linear models were used to test associations with community characteristics. RESULTS Overall, 63.6% of stores sold prepared foods, with 20.0% offering prepared salads and 36.4% offering at least one less-healthy item. Rural stores were 26% less likely to carry prepared salads (prevalence ratio [PR]=0.74, 95% CI=0.62, 0.88) and 14% more likely to carry at least one less-healthy prepared food item (PR=1.14, 95% CI=1.00, 1.30). Convenience stores in high-poverty communities were less likely to carry prepared salads than those in low-poverty communities (PR=0.64, 95% CI=0.47, 0.87). Among supermarkets, prepared salads were more likely to be carried in majority-white, low-poverty communities than in non-white, high-poverty communities. CONCLUSIONS Increasing the healthfulness of prepared foods within stores may offer an important opportunity to improve the food environment.
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Affiliation(s)
- Shannon N Zenk
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois.
| | - Lisa M Powell
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Zeynep Isgor
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Leah Rimkus
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Dianne C Barker
- Barker Bi-Coastal Health Consultants Inc., Calabasas, California
| | - Frank J Chaloupka
- Department of Economics, University of Illinois at Chicago, Chicago, Illinois
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