Store Density Research Articles

Contextual correlates of energy-dense snack food and sweetened beverage intake across the day in African American women: An application of ecological momentary assessment

This study examined relationships between contextual factors and within-person variations in snack food and sweetened beverage intake in African American women (n = 79), aged 25–65 years living in metropolitan Chicago. For seven days, participants wore a global positioning system (GPS) logger and were signaled five times per day to complete an ecological momentary assessment (EMA) survey assessing behaviors and environmental, social, and other contextual factors via smartphones. Within-person associations between snack food and beverage intake and contextual factors were analyzed using three-level logistic regressions. Participants reported consuming a snack food at 38.4% of signals and a sweetened beverage at 17.9% of signals. Fast food restaurant and convenience store density within the daily activity space was not associated with either snack food or sweetened beverage intake. However, perceptions of close proximity to fast food restaurants and convenience stores making it easier to eat/drink, while accounting for one's usual proximity, were associated with increased odds of snack intake (O.R. 2.1; 95% C.I. 1.4, 3.0) but not sweetened beverage. We also found engaging in activities such as watching television (O.R. 1.8; 95% C.I. 1.2, 2.7) and talking (O.R. 1.7; 95% C.I. 1.1, 2.6) while eating were associated with higher snack intake. These factors were not related to sweetened beverage intake. Public health interventions addressing fast food restaurant and convenience store accessibility and food offerings and marketing within these outlets may help reduce snack food intake. Additionally, to reduce concurrent activities while eating, real-time interventions using smart technology could be used to enhance attentive eating in this population.

The Cause and Evolution of Urban Street Vitality under the Time Dimension: Nine Cases of Streets in Nanjing City, China

Street vitality is associated with a comfortable human-based public environment and urban sustainability. In most current studies, street vitality is assessed considering single or multi factors; however, the impact of time dimension is ignored. This study selects nine different year-built streets in old, main, and new urban areas, in Nanjing, China, proposes a framework to assess street vitality considering the different time dimensions and selects the following factors: street form, including building density, continuity, and height-width; street business type, including store density, function density, and permeation rate; and street accessibility, including location, the number of entrances/exits, transportation, and walkability. After calculating the values of the subfactors, a ranking method was applied to assign the ranking of impact of all factors for a comprehensive analysis. The results showed that Pipa Street, Wufu Street in a main urban area, and Hongmiao Street had the highest street vitality and the highest rankings of almost all the factors. Street vitality in different periods demonstrated that street vitality in new urban areas is lower compared with old and main urban areas.

Inferring the Economics of Store Density from Closures: The Starbucks Case

This paper proposes a method that makes use of firms’ mass store closures to measure the store network effects of cannibalization and density economies. I calculate each store’s contribution to chain-level profits via one-store perturbations on the set of retained stores, and map these onto the firm’s closure choices. To separate the demand- and supply-side store network effects, I exploit the fact that the business-stealing effect intensifies with local network density, whereas the supply-side disadvantage prevails at sparse regions of the network. I apply the method to study the Starbucks chain. The average rate of cannibalization imposed by a neighbor outlet is 1.2% within one mile and 0.4% within one to three miles. For remote outlets, operation costs increase by 0.3% of revenues for each mile of distance from the network. Counterfactual analyses suggest that income level is a more important determinant of demand than population count at low levels of store penetration, whereas high-population regions can sustain denser store networks because of the softening of the cannibalization effect. Data are available at https://doi.org/10.1287/mksc.2017.1078 .

Understanding the relationship between alcohol outlet density and life expectancy in Baltimore City: The role of community violence and community disadvantage.

This research investigated the relationship between alcohol outlet density (AOD) and life expectancy, as mediated by community violence and community disadvantage. We used linear regression models to assess bivariate and multivariate relationships. There was a negative bivariate association between liquor store density and average life expectancy (β=-7.3370, p<0.001). This relationship was partially attenuated when controlling for community disadvantage and fully attenuated when controlling for community violence. Bars/taverns (i.e., on-premise) were not associated with average life expectancy (β=-0.589, p=0.220). Liquor store density is associated with higher levels of community disadvantage and higher rates of violence, both of which are associated with lower life expectancies. Future research, potential intervention, and current related policies are discussed.

Associations between proposed local government liquor store size classifications and alcohol consumption in young adults

The prevalence of warehouse-style liquor stores has prompted alarm from local communities and public health advocates. To increase local government control over liquor stores, one proposed planning response is to distinguish between ‘small’ (i.e., ≤ 300 m2) and ‘large’ (i.e., > 300 m2) liquor stores. We mapped the size and location of liquor stores in Perth, Western Australia, and tested associations between liquor store exposure and alcohol consumption (grams ethanol/day) in young adults (n = 990). The count of liquor stores of any size within 1600 m and 1601–5000 m of home were significantly associated with increased alcohol intake, whereas larger stores (i.e., > 300 m2 and > 600 m2) were not associated with alcohol intake. Young adults’ alcohol consumption appears to be impacted by liquor store density and convenience, rather than outlet size. However, the presence of multiple stores close to home increases market competition, driving alcohol prices down, and plausibly results in alcohol prices similar to those at liquor superstores.

Breast cancer screening and outcomes: an ecological study of county-level female Veteran population density and social vulnerability

Introduction: Previous studies have shown that breast cancer incidence rates are higher among female Veterans than the general population due to factors such as increased lifetime exposure to breast cancer risk factors or more accurate detection and surveillance. The present study explored relationships between nationally representative county-level breast cancer outcomes, mammography screening rates, female Veteran population density, and social vulnerability. Methods: Data for the present ecological study were obtained at the county level from the United States Census Bureau, the University of South Carolina's Hazards and Vulnerability Research Institute (HVRI), and the National Cancer Institute. We conducted ordinary least squares (OLS) multiple regression analyses to determine the relative influence of female Veteran population density, social vulnerability, and mammography screening rates on breast cancer incidence and mortality rates between 2010 and 2014. County-level covariates such as liquor store density, cigarette smoking prevalence, air pollution, and access to healthy foods, were entered into each model to determine the unique influence of each of the main study variables on breast cancer outcomes. Results: County-level breast cancer incidence rates were higher in counties with greater female Veteran population density, lower social vulnerability, and higher mammography screening rates ( n=2,698, F=33.669, p&lt;0.001). County-level breast cancer mortality rates were higher in counties with lower female Veteran population density, higher social vulnerability, and lower mammography screening rates ( n=1,803, F=18.180, p&lt;0.001). Discussion: The results of the present exploratory study were preliminary, and thus further research on relationships examined in this study are needed. However, because female Veterans were shown to live in counties with relatively high mammography screening rates and lower social vulnerability, their risk for mortality from breast cancer may be lower than for the general population – in particular due to early detection and treatment.

Abstract 017: Friends Make Children Less Sedentary but Neighborhoods Make Them More Active

Background and Purpose: Sedentary behavior (SB) and physical inactivity are distinct constructs for which separate research and intervention paradigms may be warranted. To this end, we compared individual- and neighborhood-level risk factors of each among youth at risk of obesity. Methods: Data are from QUALITY, a cohort study of the natural history of obesity in Quebec, Canada. Baseline data were obtained in 2005-2008 when children were aged 8-10y (n=512 families). Activity level was measured using accelerometers at age 8-10y and again 2 years later at age 10-12y. At each time point, children were categorized as inactive if they did &lt;60 min/day of moderate to vigorous physical activity (PA) and as excessively sedentary if they recorded &lt;100 counts/min for &gt; 50% of the day. Children were required to have worn the device for at least 4 days and for at least 10 hours/day. Child-level factors included sex, sleep duration, and weekly frequency seeing friends; neighborhood-level factors included density of fast food outlets, convenience stores, and parks; school proximity, street connectivity, land use mix, disorder, social and material deprivation, and parental perceived safety. Separate logistic regression models were estimated for each of inactivity and excessive SB. We tested models using the identical set of baseline risk factors at both time points. Analyses were restricted to 413 children with complete data at age 8-10y, and to 283 children with complete data at age 10-12y. Models controlled for child’s obesity status, father and mother’s obesity status, and parental education. Results: At both time points, girls were 75% to 85% more likely to be inactive than boys, but were equally likely to be excessively sedentary as were boys. Also at both time points, each additional weekly outing with friends reduced the likelihood of being sedentary by 20%, but did not reduce the likelihood of being inactive. Only area-level disorder was associated with being excessively sedentary, and only in 10-12y olds; in contrast, several factors increased the likelihood of being inactive, including area deprivation at age 8-10y (OR: 1.7; 1.0-3.0) and perceived lack of safety at age 10-12y (OR: 2.8: 1.1-6.3). Moreover, the likelihood of being inactive decreased by 24% for each quintile increase in land use mix. Although obesity status in children was strongly associated with outcomes in all models, other determinants were unaffected by its inclusion in the models. Conclusions: Our findings suggest that physical inactivity and sedentary behavior are driven by largely distinct paradigms. Each of these may be impacted through increases in light PA. Although interventions need to target all spheres of influence, reducing physical inactivity may be more effectively mediated by features of the built environment, while leveraging social and peer groups may be more effective to reduce sedentary behaviors.

Peer-to-Peer Crowdshipping as an Omnichannel Retail Strategy

Crowdshipping is an emerging operations model proposed to tackle the last-mile delivery problem for online and omnichannel retailers in urban markets. Major retailers such as Amazon and Walmart, as well as start-ups such as Instacart and Deliv, have adopted or experimented with variants of crowdshipping models. Peer-to-peer crowdshipping, i.e., using in-store customers as a resource to deliver online orders), carries important implications on the marketing-operations interface for omnichannel retailers: on the one hand, it offers the opportunity to improve last-mile delivery efficiency (the efficiency effect); on the other hand, it provides an additional tool for the retailer to price discriminate between the online and in-store channels (the pricing effect). We model an omnichannel retail network's pricing decision for its online and in-store channels, and consumers' decisions on purchase, channel choice and participation in crowdshipping. Contrasting two reimbursement modes for crowdshipping, i.e., reimbursing shopper-deliverers their incurred delivery costs or providing an additional premium as a (cross-channel) subsidy, against a store-operated delivery model, our analysis reveals that the potential benefits of crowdshipping to the retailer and consumers depend upon the interactions between the aforementioned efficiency and pricing effects. In particular, whether the efficiency effect benefits the firm depends on the availability of shoppers with low value of time; whereas the pricing effect benefits firms selling high-end products. The impact on consumer surplus of the two effects, however, depend on spatial store density. All in all, peer-to-peer crowdshipping can lead to significant win-win outcomes in dense urban markets for high-end items.

Community environment and its relationship with tobacco use in selected North Indian communities

Background: Community environmental factors can influence tobacco use and their modification could be one of the ways for reduction of tobacco use. This study measured community environmental determinants of tobacco use in urban and rural Haryana and relates them to tobacco use. Materials and Methods: Community audit was done in ten rural and urban communities of Ballabgarh, Haryana, to characterize the community, map establishments selling tobacco, and tobacco advertisements. Individual establishments were assessed for their compliance to national law. Fifteen men and 15 women were sampled from each community and interviewed for tobacco use, exposure to tobacco promotion, knowledge of tobacco laws, and attitude toward tobacco. Multilevel mixed-effects logistic regression was conducted to measure community-level determinants' contribution to tobacco use. Results: Overall, 218 establishments and 552 participants were assessed in these 20 communities. The median density of tobacco-selling stores expressed in terms of per square kilometer area of the community was 82.9 (75.5- 110.8) for rural area and lower in urban area 34.6 (9.0- 91.0). Nearly 18.5% of participants were currently using tobacco. Multilevel modeling shows that 35% of the differences in the tobacco use in the community were explained by community-level differences. Conclusion: The higher dependency of tobacco consumption on the community environment needs to be further explored.

Is there a link between availability of food and beverage establishments and BMI in Mexican adults?

To study the association between density of stores (food and beverage stores, stores selling only fruits and vegetables, and supermarkets) and the BMI of adults aged ≥20 years in Mexico. A cross-sectional study was performed. Individual data came from the 2012 National Health and Nutrition Survey, while information on stores was taken from the National Institute of Geography and Statistics' National Statistics Directory of Economic Units. A weighted least-squares model was estimated to test the association between density of stores and BMI of adults adjusting for sex, age, education, presence of hypertension, diabetes or both, household assets index and marginality index at the municipality level. Mexico. An additional 1 sd in the density of fruit and vegetable stores was associated with a reduction of 0·24 (95 % CI -0·37, -0·12) kg/m2 in BMI when the densities of the other stores were at their mean values. For food and beverage store density, a difference of 1 sd was associated with an increase of 0·50 (95 % CI 0·33, 0·67) kg/m2 in BMI, while for supermarkets the corresponding association was a reduction of 0·48 (95 % CI -1·52, 0·56) kg/m2 in BMI. In places with a higher density of stores that offer unhealthy foods, the BMI of adults tends to be higher.

Short- and Long-Term Impacts of Neighborhood Built Environment on Self-Rated Health of Older Adults.

Proximity to health care, healthy foods, and recreation is linked to improved health in older adults while deterioration of the built environment is a risk factor for poor health. Yet, it remains unclear whether individuals prone to good health self-select into favorable built environments and how long-term exposure to deteriorated environments impacts health. This study uses a longitudinal framework to address these questions. The study analyzes 3,240 Americans aged 45 or older from the Panel Study of Income Dynamics with good self-reported health at baseline, and follows them from 1999 to 2013. At each biennial survey wave, individual data are combined with data on services in the neighborhood of residence (defined as the zip code) from the Economic Census. The analysis overcomes the problem of residential self-selection by employing marginal structural models and inverse probability of treatment weights. Logistic regression estimates indicate that long-term exposure to neighborhood built environments that lack health-supportive services (e.g., physicians, pharmacies, grocery stores, senior centers, and recreational facilities) and are commercially declined (i.e., have a high density of liquor stores, pawn shops, and fast food outlets) increases the risk of fair/poor self-rated health compared to more average neighborhoods. Short-term exposure to the same environments as compared to average neighborhoods has no bearing on self-rated health after adjusting for self-selection. Results highlight the importance of expanding individuals' access to health-supportive services prior to their reaching old age, and expanding access for people unlikely to attain residence in service-dense neighborhoods.

Food environments in Malta: Associations with store size and area-level deprivation

Food environments are potential targets for interventions to reduce obesity prevalence, particularly in island settings that are typically dependent on food imports. This observational study aimed to characterise the availability, quality and price of foods and beverages in a nationally representative sample of grocery stores in Malta using the Nutrition Environment Measures Survey for Stores (NEMS-S) instrument, and to examine the association between area-level density of different types of food stores and the likelihood of children living in these areas being overweight or obese. Fieldwork was carried out between March and May 2014. There was a strong positive correlation between store size and NEMS-S score (p=<0.001), suggesting that smaller grocery stores generally offered a smaller range of products and fewer healthy food/beverage options than larger supermarkets. Across all stores, median prices of certain ‘healthier’ versions of foods were more expensive than their less healthy alternatives. A significant association between risk of childhood overweight, and density of confectionery stores in children’s locality of residence, was found (OR 1.19; 95% CI: 1.04, 1.37). These baseline findings highlight opportunities to improve the food environment in Malta to support more healthful eating, and may be of particular interest to public health practitioners in island settings.

Association of built environment characteristics with adiposity and glycaemic measures.

SummaryObjectiveThis study examined the cross‐sectional and longitudinal relationships of built environment characteristics with adiposity and glycaemic measures.MethodLongitudinal study sample consisted of 4,010 Framingham Heart Study Offspring (baseline: 1998–2001; follow‐up: 2005–2008) and Generation Three (baseline: 2002–2005; follow‐up: 2008–2011) participants (54.8% women, baseline mean age 48.6 years). Built environment characteristics (intersection density, greenspace, recreation land and food stores) at baseline were collected. Adiposity and glycaemic measures (body mass index [BMI], waist circumference, abdominal subcutaneous and visceral adipose tissue, and fasting plasma glucose) at baseline and changes during 6.4‐year follow‐up were measured.ResultsIn cross‐sectional models, higher intersection density and food store density (total food stores, fast food restaurants and supermarkets) were linearly associated with higher BMI (all p < 0.05). Higher greenspace was associated with lower BMI, waist circumference, fasting plasma glucose, prevalent obesity and prevalent diabetes (all p < 0.05). Longitudinally, higher intersection density and food store density, and lower greenspace were associated with smaller increases in abdominal visceral adipose tissue (all p < 0.05). Higher densities of intersections, fast food restaurants and supermarkets were associated with smaller increases in fasting plasma glucose (all p < 0.05).ConclusionsCollectively, built environment characteristics are associated with adiposity and glycaemic traits, suggesting the potential mechanisms by which built environment influences cardiometabolic health.

Local Market Characteristics and Online-to-Offline Commerce: An Empirical Analysis of Groupon

We investigate the factors that affect the growth of Groupon, the leading online daily deals platform. We concentrate on the online-to-offline (O2O) aspect of the business that differentiates it from other e-commerce platforms—its strong connection to local markets. We focus on travel cost and store density, the key local characteristics that affect consumer deal demand and merchant deal offering. Using a comprehensive longitudinal data set on deal offerings and sales across local markets, and combining it with local market characteristics, we estimate a simultaneous equation model of the weekly number of deal offerings and deal sales characterizing the two-sided nature of the platform. We find that the word-of-mouth effect on the consumer side and the observational learning effect on the merchant side contribute to and reinforce the expansion of a two-sided platform. However, a larger number of deals intensifies the competition, which then lowers per deal sales and limits the number of deal offerings. We find that local characteristics have significant impact on both the deal demand and the supply side. We further use model simulation to show how differences in growth patterns across markets may be driven by local characteristics, and we decompose their relative impact on the demand and supply sides. The paper provides managerial implications for firms specializing in O2O commerce. This paper was accepted by Matthew Shum, marketing.

School food environments associated with adiposity in Canadian children.

Targeting obesogenic features of children's environment that are amenable to change represents a promising strategy for health promotion. The school food environment, defined as the services and policies regarding nutrition and the availability of food in the school and surrounding neighborhood, is particularly important given that students travel through the school neighborhood almost daily and that they consume a substantial proportion of their calories at school. As part of the Quebec Adipose and Lifestyle Investigation in Youth (QUALITY) cohort study, we assessed features of school indoor dietary environment and the surrounding school neighborhoods, when children were aged 8-10 years (2005-2008). School principals reported on food practices and policies within the schools. The density of convenience stores and fast-food outlets surrounding the school was computed using a Geographical Information System. Indicators of school neighborhood deprivation were derived from census data. Adiposity outcomes were measured in a clinical setting 2 years later, when participants were aged 10-12 years (2008-2011). We conducted cluster analyses to identify school food environment types. Associations between school types and adiposity were estimated in linear regression models. Cluster analysis identified three school types with distinct food environments. Schools were characterized as: overall healthful (45%); a healthful food environment in the surrounding neighborhood, but an unhealthful indoor food environment (22%); or overall unhealthful (33%). Less healthful schools were located in more deprived neighborhoods and were associated with greater child adiposity. Despite regulatory efforts to improve school food environments, there is substantial inequity in dietary environments across schools. Ensuring healthful indoor and outdoor food environments across schools should be included in comprehensive efforts to reduce obesity-related health disparities.

How Does the Food Environment Affect Juvenile Obesity? A Study of Cleveland and Cuyahoga County, Ohio

It is well known that unhealthy food can contribute to obesity, diabetes, hypertension, and cardiovascular disease. It is also believed that the composition of the food environment (density and location of convenience stores, grocery stores, supermarkets, and restaurants in a neighborhood) can play a role in obesity and obesity-related diseases—further exacerbating or reducing health disparities that are already present in our society. To further our understanding of the role the food environment plays in health, this article will assess how the food environment may influence by utilizing geo-located individual electronic medical records (EMR) measured BMI percentile for juvenile patients in and around Cleveland, Ohio. The findings of this study demonstrate that in Cuyahoga County, Ohio (Cleveland) food deserts or availability of healthy food retailers nearby, have no statistically significant impact on juvenile obesity. The number of unhealthy food retailers, however, does have a statistically significant impact on juvenile BMI percentile—thus the more fast-food outlets or convenience stores present nearby will increase the likelihood of higher BMI percentile. However, the size of this effect is rather small, so policy makers should heed caution before seeking to dramatically reduce the number of unhealthy retailers in a community.

Grocery Store Density and Food Waste

We study the impact of grocery-store density on the food waste generated at stores and by households. Food waste is a major contributor to carbon emissions (as big as road transport). Identifying and influencing market conditions that can decrease food waste is thus important to combat global warming. We build and calibrate a stylized two-echelon perishable-inventory model to capture grocery purchases and expiration at competing stores and households in a market. We examine how the equilibrium waste in this model changes with store density. An increase in store density decreases consumer waste due to improved access to groceries, whereas increasing retail waste due to decentralization of inventory increased variability propagation in the supply chain (cycle truncation) and diminished demand by customers. Higher density also induces more competition which further increases (decreases) waste when stores compete on prices (service levels). Overall, consumer waste reductions compete with store waste increases and the effects of increased competition. Our analysis shows that higher density reduces food waste up to a threshold density; it leads to higher food waste beyond this threshold. Put differently, in so far as food waste is concerned, there exists an optimal store density. Calibration using grocery industry, economic, and demographic data reveals that actual store density in most American cities is well below this threshold/optimal level, and modest increases in store density substantially reduce waste; for example, in Chicago, just 3–4 more stores (per 10 sq km) can lead to a 6%–9% waste reduction, and a 1%–4% decrease in grocery expenses. These results arise from the principal role of consumer waste, suggesting that activists and policy makers’ focus on retail waste may be misguided. Store operators, urban planners, and decision makers should aim to increase store densities to make grocery shopping more affordable and sustainable.

Neighborhood social and physical environments and type 2 diabetes mellitus in African Americans: The Jackson Heart Study

Using data from Jackson Heart Study, we investigated the associations of neighborhood social and physical environments with prevalence and incidence of type 2 diabetes mellitus (T2DM) in African Americans (AA). Among non-diabetic participants at baseline (n=3670), 521 (14.2%) developed T2DM during a median follow-up of 7.3 years. Measures of neighborhood social environments, and food and physical activity resources were derived using survey-and GIS-based methods. Prevalence ratios (PR) and Hazard ratios (HR) were estimated using generalized estimating equations and Cox proportional hazards models. Higher neighborhood social cohesion was associated with a 22% lower incidence of T2DM while higher density of unfavorable food stores was associated with a 34% higher incidence of T2DM after adjusting for individual-level risk factors (HR=0.78 [95% CI:0.62, 0.99] and HR=1.34 [1.12, 1.60], respectively). In addition, neighborhood problems was also associated with prevalence of T2DM (PR=1.12 [1.03, 1.21]) independent of individual-level risk factors. Our findings suggest that efforts to strengthen community ties or to attract healthy food retail outlets might be important strategies to consider for prevention of T2DM in AA.

Beyond Supermarkets: Food Outlet Location Selection in Four U.S. Cities Over Time.

Understanding what influences where food outlets locate is important for mitigating disparities in access to healthy food outlets. However, few studies have examined how neighborhood characteristics influence the neighborhood food environment over time, and whether these relationships differ by neighborhood-level income. Neighborhood-level data from four U.S. cities (Birmingham, AL; Chicago, IL; Minneapolis, MN; Oakland, CA) from 1986, 1993, 1996, 2001, 2006, and 2011 were used with two-step econometric models to estimate longitudinal associations between neighborhood-level characteristics (z-scores) and the log-transformed count/km2 (density) of food outlets within real estate-derived neighborhoods. Associations were examined with lagged neighborhood-level sociodemographics and lagged density of food outlets, with interaction terms for neighborhood-level income. Data were analyzed in 2016. Neighborhood-level income at earlier years was negatively associated with the current density of convenience stores (β= -0.27, 95% CI= -0.16, -0.38, p<0.001). The percentage of neighborhood white population was negatively associated with fast food restaurant density in low-income neighborhoods (10th percentile of income: β= -0.17, 95% CI= -0.34, -0.002, p=0.05), and the density of smaller grocery stores across all income levels (β= -0.27, 95% CI= -0.45, -0.09, p=0.003). There was a lack of policy-relevant associations between the pre-existing food environment and the current density of food outlet types, including supermarkets. Socioeconomically disadvantaged and minority populations may attract "unhealthy" food outlets over time. To support equal access to healthy food outlets, the availability of "less healthy" food outlets types may be relatively more important than the potential lack of supermarkets or full-service restaurants.

Association Between Neighborhood Violence and Biological Stress in Children

ImportanceExposure to violence continues to be a growing epidemic, particularly among children. An enhanced understanding of the biological effect of exposure to violence is critical.ObjectiveTo examine the association between neighborhood violence and cellular and biological stress in children.Design, Setting, and ParticipantsA matched, cross-sectional study of 85 black children aged 5 to 16 years from 52 neighborhoods took place in the greater New Orleans, Louisiana, area between January 1, 2012, and July 31, 2013.ExposuresDensity of businesses where individuals can purchase alcohol as measured by rates per capita of liquor or convenience stores, and violence as measured by reports of violent crime and reports of domestic violence, operationalized as reports per capita of crime and domestic violence. Rates of exposure within a 500-, 1000-, and 2000-m radius from the child’s home were calculated.Main Outcomes and MeasuresPrimary biological outcomes were telomere length and cortisol functioning. ResultsAmong the 85 children in the study, (mean [SD] age, 9.8 [3.1] years; 50 girls and 35 boys) significant variation in telomere length and cortisol functioning was observed at the neighborhood level, with intraclass correlation coefficients of 6% for telomere length, 3.4% for waking cortisol levels, and 5.5% for peak cortisol levels following a stressor. Density of liquor or convenience stores within a 500-m radius of a child’s home was associated with a decrease in mean telomere length by 0.004 for each additional liquor store or convenience store (β [SE], –0.004 [0.002]; P = .02). The rate of domestic violence was significantly and inversely associated with a decrease in mean telomere length by 0.007 for each additional report of domestic violence in a 500-m radius of a child’s home (β [SE], –0.007 [0.001]; P < .001). The rate of violent crime was significantly associated with a decrease in mean telomere length by 0.006 for each additional report of violent crime in a 500-m radius of a child’s home (β [SE], –0.006 [0.002]; P < .001). Children exposed to more liquor and convenience stores within 500 m of their home were significantly less likely to reduce cortisol levels after a reactivity test (β, 0.029; P = .047), as were children exposed to high rates of domestic violence (β, 0.088; P = .12) and violent crime (β, 0.029; P = .006). Children exposed to more liquor and convenience stores within 500 m of their home had a steeper diurnal decline in cortisol levels during the day (β [SE], –0.002 [0.001]; P = .04), as did children exposed to more violent crime within 500 m of their home (β [SE] –0.032 [0.014]; P = .02).Conclusions and RelevanceNeighborhoods are important targets for interventions to reduce the effect of exposure to violence in the lives of children. These findings provide the first evidence that objective exposures to neighborhood-level violence influence both physiological and cellular markers of stress, even in children.