Abstract
Disparities in healthy food access are well documented in cross-sectional studies in communities across the United States. However, longitudinal studies examining changes in food environments within various neighborhood contexts are scarce. In a sample of 142 census tracts in four low-income, high-minority cities in New Jersey, United States, we examined the availability of different types of food stores by census tract characteristics over time (2009–2017). Outlets were classified as supermarkets, small grocery stores, convenience stores, and pharmacies using multiple sources of data and a rigorous protocol. Census tracts were categorized by median household income and race/ethnicity of the population each year. Significant declines were observed in convenience store prevalence in lower- and medium-income and majority black tracts (p for trend: 0.004, 0.031, and 0.006 respectively), while a slight increase was observed in the prevalence of supermarkets in medium-income tracts (p for trend: 0.059). The decline in prevalence of convenience stores in lower-income and minority neighborhoods is likely attributable to declining incomes in these already poor communities. Compared to non-Hispanic neighborhoods, Hispanic communities had a higher prevalence of small groceries and convenience stores. This higher prevalence of smaller stores, coupled with shopping practices of Hispanic consumers, suggests that efforts to upgrade smaller stores in Hispanic communities may be more sustainable.
Highlights
IntroductionHealthy food access is critical to improve population health [1] and to reduce social inequalities [2]
Healthy food access is critical to improve population health [1] and to reduce social inequalities [2].In longitudinal analyses, positive health outcomes, including lower risk of heart disease and diabetes, have been attributed to community level access to healthy food [3,4]
This study examined changes in the food environment over a nine-year period (2009–2017) in four low-income, high minority New Jersey cities in the United States
Summary
Healthy food access is critical to improve population health [1] and to reduce social inequalities [2]. Positive health outcomes, including lower risk of heart disease and diabetes, have been attributed to community level access to healthy food [3,4]. Greater exposure to unhealthy food outlets negatively impacts body mass index (BMI) [5]. In the United States, recommendations from the Centers for Disease Control and Prevention (CDC) and the National. Academy of Medicine advocate for improving access to and consumption of healthy, safe, and affordable food, and at the same time reducing access to and consumption of calorie-dense, nutrient-poor foods. Res. Public Health 2019, 16, 2354; doi:10.3390/ijerph16132354 www.mdpi.com/journal/ijerph
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