Geospatial Analysis of Food Deserts and Their Impact on Health Outcomes in Children with Cystic Fibrosis.

Montserrat A Corbera-Hincapie,Traci M Kazmerski,Kristen S Kurland,Anthony Fabio,Mark R Hincapie,Daniel J Weiner,Sandra C Kim

doi:10.3390/nu13113996

Montserrat A Corbera-Hincapie, Traci M Kazmerski + Show 5 more

Open Access

https://doi.org/10.3390/nu13113996

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Journal: Nutrients	Publication Date: Nov 10, 2021
Citations: 3	License type: CC BY 4.0

Affiliation: University of Pittsburgh, Carnegie Mellon University

Abstract

Food insecurity (FI) is defined as “the limited or uncertain access to adequate food.” One root cause of FI is living in a food desert. FI rates among people with cystic fibrosis (CF) are higher than the general United States (US) population. There is limited data on the association between food deserts and CF health outcomes. We conducted a retrospective review of people with CF under 18 years of age at a single pediatric CF center from January to December 2019 using demographic information and CF health parameters. Using a Geographic Information System, we conducted a spatial overlay analysis at the census tract level using the 2015 Food Access Research Atlas to assess the association between food deserts and CF health outcomes. We used multivariate logistic regression analysis and adjusted for clinical covariates and demographic covariates, using the Child Opportunity Index (COI) to calculate odds ratios (OR) with confidence intervals (CI) for each health outcome. People with CF living in food deserts and the surrounding regions had lower body mass index/weight-for-length (OR 3.18, 95% CI: 1.01, 9.40, p ≤ 0.05 (food desert); OR 4.41, 95% CI: 1.60, 12.14, p ≤ 0.05 (600 ft buffer zone); OR 2.83, 95% CI: 1.18, 6.76, p ≤ 0.05 (1200 ft buffer zone)). Food deserts and their surrounding regions impact pediatric CF outcomes independent of COI. Providers should routinely screen for FI and proximity to food deserts. Interventions are essential to increase access to healthy and affordable food.

Highlights

This study investigated the effects of food deserts and their surrounding regions on health outcomes, including body mass index (BMI)/weight-for-length, percent predicted forced expiratory volume in 1 s and hospitalizations secondary to pulmonary exacerbations, in children and adolescents with cystic fibrosis (CF)
Children and adolescents with CF living in a food desert or within a 600 ft walkability distance from a food desert had four times the odds of having a non-ideal BMI as those not living in or 600 ft from a food desert
CF teams should routinely screen for Food insecurity (FI) and proximity to food deserts, and development of novel interventions are essential to increase access to healthy and affordable food

Summary

Introduction

The US Department of Agriculture (USDA) defines FI as a household in which there is “limited or uncertain access to adequate food” [1,2]. Some root causes of FI include poverty and food deserts, or low-income census tracts with a substantial number of residents with poor access to retail outlets selling healthy and affordable foods [3]. The USDA further defines low income and low access within a census tract as “a poverty rate of 20 percent or greater, or a median family income at or below 80 percent of the statewide or metropolitan area median family income,” and “at least 500 persons and/or at least 33 percent of the population lives more than 1 mile from a supermarket or large grocery store (10 miles, in the case of rural census tracts),”

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