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. 2006 Jul;3(3):A76.
Epub 2006 Jun 15.

The role of race and poverty in access to foods that enable individuals to adhere to dietary guidelines

Elizabeth A Baker  1 , Mario Schootman, Ellen Barnidge, Cheryl Kelly
Affiliations

The role of race and poverty in access to foods that enable individuals to adhere to dietary guidelines

Elizabeth A Baker et al. Prev Chronic Dis. 2006 Jul.

Abstract

Introduction: The increase in obesity and disparities in obesity and related chronic diseases across racial and ethnic and income groups have led researchers to focus on the social and environmental factors that influence dietary intake. The question guiding the current study was whether all communities have equal access to foods that enable individuals to make healthy dietary choices.

Methods: We conducted audits of community supermarkets and fast food restaurants to assess location and availability of food choices that enable individuals to meet the dietary guidelines established by the U.S. Department of Agriculture (e.g., fruit and vegetable consumption, low-fat options). We used 2000 census data to assess the racial distribution and the percentage of individuals living below the federal poverty level in a defined area of St Louis, Mo. Spatial clustering of supermarkets and fast food restaurants was determined using a spatial scan statistic.

Results: The spatial distribution of fast food restaurants and supermarkets that provide options for meeting recommended dietary intake differed according to racial distribution and poverty rates. Mixed-race or white high-poverty areas and all African American areas (regardless of income) were less likely than predominantly white higher-income communities to have access to foods that enable individuals to make healthy choices.

Conclusion: Without access to healthy food choices, individuals cannot make positive changes to their diets. If certain eating behaviors are required to reduce chronic disease and promote health, then some communities will continue to have disparities in critical health outcomes unless we increase access to healthy food.

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Figures

Map of the St. Louis, Mo, study area.
Figure 1
Location of 81 supermarkets and 220 census tracts with underlying racial distribution and poverty rates in the St Louis, Mo, study area.
Map of the St. Louis, Mo, study area.
Figure 2
Unadjusted geographic clustering of supermarkets in the highest tertile, indicating greatest selection of healthy food markets in the St Louis, Mo, study area. The ratio of observed to expected number of supermarkets in Cluster 1 is 2.4 (P = .001); in Cluster 2, 0.0 (P = .003).
Map of the St. Louis, Mo, study area.
Figure 3
Location of 355 fast food restaurants and 220 census tracts with underlying racial distribution and poverty rate in the St Louis, Mo, study area.
Map of the St. Louis, Mo, study area.
Figure 4
Unadjusted geographic clustering of fast food restaurants in the St Louis, Mo, study area. The ratio of observed to expected number of restaurants in Cluster 1 is 0.4 (P = .001); Cluster 2, 3.4 (P = .001); Cluster 3, 3.2 (P = .02); Cluster 4, 12.0 (P = .03).
Map of the St. Louis, Mo, study area.
Figure 5
Geographic clustering of fast food restaurants adjusted for racial distribution and poverty rate by census tract in the St Louis, Mo, study area. The ratio of observed to expected number of restaurants in Cluster 1 is 0.07 (P = .004); Cluster 2, 3.1 (P = .001).
Map of the St. Louis, Mo, study area.
Figure 6
Unadjusted geographic clustering of fast food restaurants in highest tertile, indicating greatest selection of healthy food options in the St Louis, Mo, study area. The ratio of observed to expected number of restaurants in Cluster 1 is 0.3 (P = .001); Cluster 2, 3.0 (P = .01).
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References

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