Introduction
Racial disparities in obesity exist at the individual and community levels. Retail
food environment has been hypothesized to be associated with racial disparities in
obesity prevalence. This study aimed to quantify how much food environment measures
explain racial disparities in obesity at the county level.
Methods
Data from 2009 to 2010 on 3,135 U.S. counties were extracted from the U.S. Department
of Agriculture Food Environment Atlas and the Behavioral Risk Factor Surveillance
System and analyzed in 2013. Oaxaca–Blinder decomposition was used to quantify the
portion of the gap in adult obesity prevalence observed between counties with a high
and low proportion of African-American residents is explained by food environment
measures (e.g., proximity to grocery stores, per capita fast-food restaurants). Counties
were considered to have a high African-American population if the percentage of African-American
residents was >13.1%, which represents the 2010 U.S. Census national estimate of percentage
African-American citizens.
Results
There were 665 counties (21%) classified as a high African-American county. The total
gap in mean adult obesity prevalence between high and low African-American counties
was found to be 3.35 percentage points (32.98% vs 29.63%). Retail food environment
measures explained 13.81% of the gap in mean age-adjusted adult obesity prevalence.
Conclusions
Retail food environment explains a proportion of the gap in adult obesity prevalence
observed between counties with a high proportion of African-American residents and
counties with a low proportion of African-American residents.
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References
Fryar CD, Carroll MD, Ogden CL. Prevalence of overweight, obesity, and extreme obesity among adults: United States, trends 1960-1962 through 2009−2010. Published 2012. www.cdc.gov/nchs/data/hestat/obesity_adult_09_10/obesity_adult_09_10.pdf. Accessed on August 15, 2014
- Residency and racial/ethnic differences in weight status and lifestyle behaviors among U.S. youth.J Rural Health. 2014; 30: 89-100https://doi.org/10.1111/jrh.12034
- Black-white disparities in overweight and obesity trends by educational attainment in the United States, 1997-2008.J Obes. 2013; 2013: 140743https://doi.org/10.1155/2013/140743
- Racial, ethnic and socioeconomic disparities in the clustering of cardiovascular disease risk factors.Ethn Disp. 2004; 14: 43-48
- The obesity epidemic in the United States—gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis.Epidemiol Rev. 2007; 29: 6-28https://doi.org/10.1093/epirev/mxm007
- Prevalence of obesity and trends in the distribution of body mass index among U.S. adults, 1999−2010.JAMA. 2012; 307: 491-497https://doi.org/10.1001/jama.2012.39
- Regional disparities in obesity prevalence in the United States: a spatial regime analysis.Obesity (Silver Spring). 2015; 23: 481-487https://doi.org/10.1002/oby.20963
- A multilevel analysis of state and regional disparities in childhood and adolescent obesity in the United States.J Community Health. 2008; 33: 90-102https://doi.org/10.1007/s10900-007-9071-7
- Environmental influences on childhood obesity: ethnic and cultural influences in context.Physiol Behav. 2008; 94: 61-70https://doi.org/10.1016/j.physbeh.2007.11.019
- Running to the store? The relationship between neighborhood environments and the risk of obesity.Soc Sci Med. 2009; 69: 1493-1500https://doi.org/10.1016/j.socscimed.2009.08.032
- Neighborhood Environments: Disparities in Access to Healthy Foods in the U.S.Am J Prev Med. 2009; 36: 74-81https://doi.org/10.1016/j.amepre.2008.09.025
- Disparities in obesity prevalence due to variation in the retail food environment: three testable hypotheses.Nutr Rev. 2008; 66: 216-228https://doi.org/10.1111/j.1753-4887.2008.00026.x
- Neighborhood characteristics and availability of healthy foods in Baltimore.Am J Prev Med. 2008; 35: 561-567https://doi.org/10.1016/j.amepre.2008.07.003
- The role of race and poverty in access to food that enable individuals to adhere to dietary guidelines.Prev Chronic Dis. 2006; 3: A76
- Fast food, race/ethnicity, and income.Am J Prev Med. 2004; 27: 211-217https://doi.org/10.1016/j.amepre.2004.06.007
- Race and food store availability in an inner-city neighborhood.Public Health Nutr. 2007; 11: 624-631
- Disparities in the food environments of New York City Public Schools.Am J Prev Med. 2010; 39: 195-202https://doi.org/10.1016/j.amepre.2010.05.004
- The availability of fast-food and full-service restaurants in the United States: associations with neighborhood characteristics.Am J Prev Med. 2007; 33: S240-S245https://doi.org/10.1016/j.amepre.2007.07.005
- Food store availability and neighborhood characteristics in the United States.Prev Med. 2006; 44: 189-195https://doi.org/10.1016/j.ypmed.2006.08.008
- Neighborhood socioeconomic deprivation and minority composition are associated with better potential spatial access to the ground-truthed food environment in a large rural area.J Nutr. 2008; 138: 620-627
- Are neighbourhood food resources distributed inequitably by income and race in the USA? Epidemiological findings across the urban spectrum.BMJ Open. 2012; 2: e000698https://doi.org/10.1136/bmjopen-2011-000698
- Disparities in the availability of fruits and vegetables between racially segregated urban neighborhoods.Public Health Nutr. 2007; 10: 1481-1489https://doi.org/10.1017/S1368980007000079
- Neighborhood characteristics associated with the location of food stores and food service places.Am J Prev Med. 2002; 22: 23-29https://doi.org/10.1016/S0749-3797(01)00403-2
- Disparities in food access: does aggregate availability of key foods from other stores offset the relative lack of supermarkets in African-American neighborhoods?.Prev Med. 2010; 51: 63-67https://doi.org/10.1016/j.ypmed.2010.04.009
- Obesity and supermarket access: proximity or price?.Am J Public Health. 2012; 102: e74-e80https://doi.org/10.2105/AJPH.2012.300660
- Associations of supermarket accessibility with obesity and fruit and vegetable consumption in the conterminous United States.Int J Health Geogr. 2010; 9: 49https://doi.org/10.1186/1476-072X-9-49
- Examining associations among obesity and per capita farmers’ markets, grocery stores/supermarkets, and supercenters in U.S. counties.J Am Diet Assoc. 2011; 111: 567-572https://doi.org/10.1016/j.jada.2011.01.010
- A national study of the association between food environments and county-level health outcomes.J Rural Health. 2011; 27: 367-379https://doi.org/10.1111/j.1748-0361.2011.00378.x
- Commute times, food retail gaps, and body mass index in North Carolina counties.Prev Chronic Dis. 2010; 7: A107
- Area-based variations in obesity are more than a function of the food and physical activity environment: area-based variations in obesity.J Urban Health. 2013; 90: 442-463https://doi.org/10.1007/s11524-012-9715-5
- Using the Oaxaca-Blinder decomposition as an empirical tool to analyze racial disparities in obesity.Obesity. 2014; 22: 1750-1755https://doi.org/10.1002/oby.20755
- Ethnic disparities in adolescent body mass index in the United States: the role of parental socioeconomic status and economic contextual factors.Soc Sci Med. 2012; 75: 467-476https://doi.org/10.1016/j.socscimed.2012.03.019
- An economic analysis of adult obesity: results from the Behavioral Risk Factor Surveillance System.J Health Econ. 2004; 23: 565-587https://doi.org/10.1016/j.jhealeco.2003.10.003
U.S. Department of Agriculture Economic Research Service. Food Environment Atlas. USDA 2013. www.ers.usda.gov/data-products/food-environment-atlas.aspx. Accessed March 6, 2013.
- Increasing fruit and vegetable intake by changing environments, policy and pricing: restaurant-based research, strategies, and recommendations.Prev Med. 2004; 2: S88-S93https://doi.org/10.1016/j.ypmed.2004.03.002
- Creating healthy food and eating environments: policy and environmental approaches.Annu Rev Public Health. 2008; 29: 253-272https://doi.org/10.1146/annurev.publhealth.29.020907.090926
- The relationship between diet and perceived and objected access to supermarkets among low-income housing residents.Soc Sci Med. 2012; 75: 125-1262https://doi.org/10.1016/j.socscimed.2012.05.014
- Socio-economic status, neighborhood food environments and consumption of fruits and vegetables in New York City.Public Health Nutr. 2013; 16: 1197-1205https://doi.org/10.1017/S1368980012005642
- Obesity and the food environment: income and ethnicity differences among people with diabetes.Diabetes Care. 2013; 36: 2697-2705https://doi.org/10.2337/dc12-2190
Article Info
Publication History
Published online: October 21, 2015
Identification
Copyright
© 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
