The Neighborhood Food Resource Environment and the Health of Residents with Chronic Conditions
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Residence in disadvantaged neighborhoods is associated with poorer access to healthy foods.
To understand associations between the neighborhood food resource environment and residents’ health status and body mass index (BMI) for adults with and without chronic conditions.
Cross-sectional multilevel analysis.
2,536 adults from the 2000–2001 Los Angeles Family and Neighborhood Survey.
The food resource environment was defined as the number of chain supermarkets, independent supermarkets, small markets, or convenience stores per roadway miles in the census tract. The main dependent variables were self-rated health, dichotomized as excellent or fair/poor, and body mass index (BMI). Multilevel regression models examined the association between the food resource environment and both BMI and the odds of reporting excellent health after adjustment for neighborhood SES and individual characteristics.
More chain supermarkets per roadway mile in a census tract was associated with higher adjusted rates of reporting excellent health (33%, 38%, and 43% for those in the lowest, middle, and highest tertiles of chain supermarkets) and lower adjusted mean BMI (27, 26, and 25 kg/m2) for residents without a chronic condition, but not those with a chronic condition. In contrast, having more convenience stores per roadway mile was associated with lower health ratings only among adults with a chronic condition (39%, 32%, and 27% for the lowest to highest tertile of convenience stores).
Health status and BMI are associated with the local food environment, but the associations differ by type of market and presence of a chronic condition.
KEY WORDSchronic diseases community health health status
Dr. Brown received support from the Beeson Career Development Award (#K23 AG26748) and the UCLA Resource Center in Minority Aging Research (#AG02004). Drs. Brown and Vargas received support from the National Center on Minority Health and Health Disparities (#P20MD00148). The Los Angeles Family and Neighborhood Survey was funded by the National Institute of Child Health and Human Development (grant R01 HD35944); the Office of the Assistant Secretary for Planning and Evaluation (OASPE), US Department of Health and Human Services; the Office of Behavioral and Social Sciences Research, National Institutes of Health; the Los Angeles County Urban Research Group; and the Russell Sage Foundation.
The authors would like to thank Ms. Hope Watkins for her assistance with the preparation of the manuscript. An earlier version of this work was presented at the 2004 Annual Meeting of the Society of General Internal Medicine in Chicago, IL.
Human Participant Protection: The UCLA Institutional Review Board approved these analyses.
Conflicts of Interest
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