African Americans' Satisfaction with the Neighborhood Fruit and Vegetable Environment in Detroit, MI: Correlates, Modifiers, and Implications for Reducing Disparities in Diet-Related Disease.

Abstract

African Americans are more likely to suffer from diet-related diseases than other racial and ethnic groups. Dietary intake behaviors that place many African Americans at increased risk for diet-related disease have been associated with characteristics of the neighborhood environments in which they reside. Effectively altering dietary intake behaviors with the goal of reducing disparities in diet-related disease requires understanding the factors that influence what people eat. African Americans are more likely than other racial and ethnic groups to live in urban, racially segregated neighborhoods that have lower access to healthy food and other health promoting resources. This research examines associations between observed characteristics of the neighborhood food environment (such as store type and location), the social and economic environment, self-reported satisfaction with the neighborhood fruit and vegetable environment (satisfaction), and fruit and vegetable intakes (FVI) among African Americans. Satisfaction is a perception based measure that is influenced by the observed food environment and components of the social environment. Research for this study was conducted with a sample of 522 African American adults across three neighborhoods in Detroit, Michigan. Data for this study were cross-sectional and were drawn from the Healthy Environments Partnership (HEP) wave 1 (2002) community survey. Data were analyzed using three-level hierarchical regression models (HLM 7). Results include: 1) satisfaction was associated with the observed food environment and with FVI; 2) SES was associated with satisfaction, controlling for the observed food environment; 3) SES modified associations between the observed food environment and FVI; and 4) social engagement modified associations between the observed food environment and FVI. These findings are consistent with the hypothesis that satisfaction with the food environment reflects both observed characteristics of the food environment and social factors, and that these are jointly associated with FVI. These results emphasize the importance of multilevel approaches to addressing racial inequities in diet-related conditions that consider associations between observed characteristics of the neighborhood food environment, socioeconomic factors (e.g., car access, education) and social factors (e.g., neighborhood participation) as these jointly influence satisfaction with the neighborhood fruit and vegetable environment and dietary intakes.