Abstract
BackgroundNeighborhood-level characteristics such as economic hardship and the retail food environment are assumed to be correlated and to influence consumers’ dietary behavior and health status, but few studies have investigated these different relationships comprehensively in a single study. This work aims to investigate the association between neighborhood-level economic hardship, the retail food environment, fast food consumption, and obesity prevalence.MethodsLinking data from the population-based Survey of the Health of Wisconsin (SHOW, n = 1,570, 2008–10) and a commercially available business database, the Wisconsin Retail Food Environment Index (WRFEI) was defined as the mean distance from each participating household to the three closest supermarkets divided by the mean distance to the three closest convenience stores or fast food restaurants. Based on US census data, neighborhood-level economic hardship was defined by the Economic Hardship Index (EHI). Relationships were analyzed using multivariate linear and logistic regression models.ResultsSHOW residents living in neighborhoods with the highest economic hardship faced a less favorable retail food environment (WRFEI = 2.53) than residents from neighborhoods with the lowest economic hardship (WRFEI = 1.77; p-trend < 0.01). We found no consistent or significant associations between the WRFEI and obesity and only a weak borderline-significant association between access to fast food restaurants and self-reported fast food consumption (≥2 times/week, OR = 0.59-0.62, p = 0.05-0.09) in urban residents. Participants reporting higher frequency of fast food consumption (≥2 times vs. <2 times per week) were more likely to be obese (OR = 1.35, p = 0.06).ConclusionThis study indicates that neighborhood-level economic hardship is associated with an unfavorable retail food environment. However inconsistent or non-significant relationships between the retail food environment, fast food consumption, and obesity were observed. More research is needed to enhance methodological approaches to assess the retail food environment and to understand the complex relationship between neighborhood characteristics, health behaviors, and health outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1576-x) contains supplementary material, which is available to authorized users.
Highlights
Neighborhood-level characteristics such as economic hardship and the retail food environment are assumed to be correlated and to influence consumers’ dietary behavior and health status, but few studies have investigated these different relationships comprehensively in a single study
This study aims to fill these gaps by linking data from the statewide, representative Survey of the Health of Wisconsin (SHOW), a commercial business database inventorying food retailers, and socioeconomic data from the US National Census, in order to address the following questions: 1) whether neighborhood-level economic hardship is associated with the quality of the retail food environment; and 2) whether the characteristics of the retail food environment are associated with self-reported frequency of fast food consumption and obesity prevalence in a statewide representative sample
This study shows that neighborhood economic hardship is associated with an unfavorable retail food environment
Summary
Neighborhood-level characteristics such as economic hardship and the retail food environment are assumed to be correlated and to influence consumers’ dietary behavior and health status, but few studies have investigated these different relationships comprehensively in a single study. This work aims to investigate the association between neighborhood-level economic hardship, the retail food environment, fast food consumption, and obesity prevalence. In response to the increasing rates of obesity in all subgroups of the population, among socially and economically deprived subpopulations, researchers have begun to analyze how people’s social and physical environment might influence eating behavior, activity level, and weight status [3,4]. Previous studies have found that a high density of fast food restaurants in neighborhoods was associated with regular consumption of fast food and a higher prevalence of obesity [6,13,14,15,18]. It can be hypothesized that the imbalanced distribution of food outlets might be a contributor to the inequality of obesity among ethnic minorities and different socioeconomic groups
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