Abstract 18025: Greater Consumer Nutrition Environment Disparities Are Associated With Lower Levels of Neighborhood Wellness

Abstract

Introduction: Poor AHA Healthy Diet Scores are a major obstacle to the improvement of cardiovascular (CV) health in the U.S. population. Food accessibility and availability have been widely recognized to influence eating behaviors that lead to obesity and adversely influence CV health status. The purpose of this investigation is to examine associations between the consumer nutrition environment and level of community wellness in a Southwestern metropolitan area of the United States (U.S.). Methods: The Nutrition Environment Measures Survey in Stores (NEMS-S) was used to assess the availability, quality, and price of healthy food options in supermarkets located in Oklahoma County, Oklahoma. NEMS-S is a validated measure that assesses a variety of food products commonly purchased in the U.S., including low-fat milk, fruits, vegetables, lean meats, processed foods, whole grain breads, lower-calorie/-fat food options, and sugar-sweetened beverages. The Oklahoma County Wellness Score was calculated for all regional ZIP codes according to major health and socioeconomic indicators. NEMS-S scores were compared between ZIP codes with highest (n=11) and lowest (n=11) quartiles of Wellness Score. Results: High Wellness score ZIP codes exhibited significantly higher overall NEMS-S scores compared to those with low Wellness Scores (38.0 vs. 30.6, p=0.003). Although NEMS-S food quality and price scores were similar across ZIP code Wellness Scores, food availability score was significantly higher in high Wellness Score ZIP codes compared to ZIP codes with low Wellness Score (27.9 vs. 2.6, p<0.001). ZIP codes with lower NEMS-S scores also had a higher percentage of households lacking access to a personal vehicle (6.1 vs. 16.0, p=0.001), higher proportion of minority population (50.9% vs. 20.7%, p=0.015), and lower median household income ($27,954 vs. $61,370, p<0.0001) compared to high NEMS-S Score ZIP codes. Conclusions: Consumer nutrition environment disparities that limit access to healthy food options are negatively associated with regional indicators of health and socioeconomic status. Promoting healthy food availability in neighborhoods with low health status may be a successful strategy for improving the CV health of the U.S. population.