Measuring the Local Food Environment and its Associations with Diet Quality.

Abstract

Using data from multiple economic sources and the Multi-Ethnic Study of Atherosclerosis, this series of studies examined associations of various features of the local food environment with sociodemographic characteristics of neighborhoods (study 1), agreement between alternative assessments of the food environment (study 2), and the relation between the food environment (characterized in several different but complementary ways) and the diet of residents (study 3). Results from study 1 indicate that in addition to fewer supermarkets in minority and poor areas there were also fewer fruit and vegetable markets, bakeries, specialty stores, and natural food stores. One of the major challenges in studying the effect of the environment on diet is the measurement of the local food environment. Most studies have used the presence of supermarkets as a proxy for the availability of healthy foods in neighborhoods, but the quality of supermarkets can vary substantially and other stores may also offer healthier options. Study 2 investigated the interrelation of two alternative ways of characterizing the local food environment. Measures of the availability of healthy foods in neighborhoods based on the survey responses of residents were found to be positively associated but not synonymous with GIS derived densities of supermarkets. Alternative ways of representing the environment may help to create more representative pictures of what resources are available. Empirical evidence relating the local food environment to diet quality is limited. Study 3 found that having better spatial access to supermarkets was associated with meeting dietary fat recommendations and following the types of diets associated with better health outcomes. Similarly when assessing the food environment using the survey responses of the participants and the aggregated responses of those who live in the same area, those living in the worst ranked areas were significantly less likely to follow a healthy diet. The local food environment varies across neighborhoods and may contribute to disparities and social inequalities in health. Research is needed to evaluate additive and synergistic effects of individual-level and neighborhood-level interventions order to identify more effective approaches to stem the tide of obesity in the United States.