Abstract
BackgroundIt is well documented in the literature that low socioeconomic status (SES) is associated with lower consumption of healthy foods and that these differences in consumption patterns are influenced by neighborhood food environments. Less understood is the role that SES differences in physical and social aspects of the home food environment play in consumption patterns.MethodsUsing data on 4th grade children from the 2009–2011 Texas School Physical Activity and Nutrition (SPAN) study, we used mixed-effects regression models to test the magnitude of differences in the SPAN Health Eating Index (SHEI) by parental education as an indicator of SES, and the extent to which adjusting for measures of the home food environment, and measures of the neighborhood environment accounted for these SES differences.ResultsSmall but significant differences in children’s SHEI by SES strata exist (-1.33 between highest and lowest SES categories, p<0.01). However, incorporating home food environment and neighborhood environment measures in this model eliminates these differences (-0.7, p=0.145). Home food environment explains a greater portion of the difference. Both social (mealtime structure) and physical aspects (food availability) of the home food environment are strongly associated with consumption of healthy and unhealthy foods.ConclusionsOur findings suggest that modifiable parent behaviors at home can improve children’s eating habits and that the neighborhood may impact diet in ways other than through access to healthy food.
Highlights
It is well documented in the literature that low socioeconomic status (SES) is associated with lower consumption of healthy foods and that these differences in consumption patterns are influenced by neighborhood food environments
We showed that (a) there exist small but significant differences in children’s diet quality across parents’ education levels, and (b) after accounting for the home food environment, these differences are reduced to insignificance, differences pertaining to consumption of unhealthy foods
Both social and physical aspects of the home food environment were strongly associated with consumption of healthy and unhealthy foods, and each of these measures continued to have a strong independent association with diet, even in adjusted models that considered multiple measures of socioeconomic status, neighborhood environment, and other home food environment measures
Summary
It is well documented in the literature that low socioeconomic status (SES) is associated with lower consumption of healthy foods and that these differences in consumption patterns are influenced by neighborhood food environments. Several recent reviews confirm a consistent positive association between multiple indicators of socioeconomic status (SES) and micronutrient intake as well as multiple dietary constituents [9,10,11] While most of these studies were focused on adults, low SES was found to be associated with poor dietary practices in an extensive review focused on health behaviors among adolescents [12]. This association appears to hold across multiple indicators of socioeconomic status, including education, income and occupational class [13]. Like neighborhoods, are often subject to differentiated environmental characteristics by socioeconomic status [30,31]; for instance, the percentage of low-income students in schools is a reliable predictor of the number of fast-food outlets and convenience stores located close to the schools [32]
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