Abstract
In the U.S., preterm birth disproportionately impacts certain racial/ethnic groups, with Black women experiencing preterm birth at a rate 50% higher than other groups. Among the numerous factors that likely contribute to these increased rates are neighborhood characteristics, such as food environment. In this mixed-methods case study, we evaluated how pregnant women living in a predominately minority, lower income community with high preterm birth rates navigate and perceive their food environment. Qualitative interviews were performed to assess perceptions of food environment (n = 7) along with geographic and observational assessments of their food environment. Participants traveled an average of 2.10 miles (SD = 1.16) and shopped at an average of 3 stores. They emphasized the importance of pricing and convenience when considering where to shop and asserted that they sought out healthier foods they thought would enhance their pregnancy health. Observational assessments of stores’ nutrition environment showed that stores with lower nutritional scores were in neighborhoods with greater poverty and a higher percent Black population. Future policies and programmatic efforts should focus on improving nutrition during pregnancy for women living in communities with high rates of poor birth outcomes. Availability, affordability, and accessibility are key aspects of the food environment to consider when attempting to achieve birth equity.
Highlights
Understanding the experience of food shopping for women living in communities with high rates of preterm birth holds potential to offer insights into intervention strategies that would improve healthy food access during pregnancy
While the results provided details on how pregnant women in this community navigate their food environment, the study design does not allow for direct correlations to be drawn between the food availability, healthfulness of diets, and the pregnancy outcome of preterm birth
These findings support further inquiry into the impact of neighborhood food environments on improving pregnancy outcomes. They highlight the importance of considering the food environment when attempting to reduce preterm birth at the population level
Summary
Black women are at risk for delivering early, experiencing a preterm birth at rate 50% higher than all other racial/ethnic groups in the U.S [4]. Among factors found to play a role in preterm birth are neighborhood racial composition and the level of neighborhood deprivation. Greater proportions of residents from predominantly Black or more deprived neighborhoods (i.e., neighborhoods that have median household incomes below the national level) were associated with low birthweight and preterm birth [5,6,7]. The mechanisms for increased preterm birth among Black women and/or women living in deprived neighborhoods is not clearly established, but a likely contributor is access to nutritious foods [8,9]
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