Although the overall population in the United States has experienced a dramatic increase in obesity in the past 25 years, ethnic/racial minorities, and socioeconomically disadvantaged populations have a greater prevalence of obesity, as compared to white, and/or economically advantaged populations. Disparities in obesity are unlikely to be predominantly due to individual psychosocial or biological differences, and they may reflect differences in the built or social environment. The retail food environment is a critical aspect of the built environment that can contribute to observed disparities. This paper reviews the literature on retail food environments in the United States and proposes interrelated hypotheses that geographic, racial, ethnic, and socioeconomic disparities in obesity within the United States are the result of disparities in the retail food environment. The findings of this literature review suggest that poor-quality retail food environments in disadvantaged areas, in conjunction with limited individual economic resources, contribute to increased risk of obesity within racial and ethnic minorities and socioeconomically disadvantaged populations.

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Identifying disparities in park availability, features, and characteristics can aid policymakers and citizens in improving the contribution of parks to community health for all.

This study applied the Water Poverty Index (WPI) in border colonias of west Texas. The colonias are mostly unincorporated communities located primarily in New Mexico and Texas along the border with Mexico and are characterized by high poverty rates and sub-standard living conditions. In Texas, access to drinking water and sanitation services has been identified as one of the most significant determinants of health in over 350 colonias with about 50,000 residents. The WPI is a multidimensional measure that links household welfare with water availability which has been applied primarily in water poor countries. WPI components were identified and prioritized by a wide range of state stakeholders. This study demonstrated that the WPI can be an effective tool in integrating physical, social, economic and environmental information and in determining priorides associated with the water situation in wealthy countries with water poor communities such as colonias. These results highlight the need to classify the water necessities of colonias using a comprehensive but simple assessment tool that integrates several factors and is not based solely on infrastructure. They provide information that can be used by policy makers to provide assistance to Texas border communities with the greatest need.

High levels of neighborhood deprivation and lack of access to supermarkets have been associated with increased risk of obesity in women. This multilevel study used a statewide dataset (n = 21,166) of low-income women in the Special Supplemental Nutrition Program for Women, Infants, and Children to determine whether the association between neighborhood deprivation and BMI is mediated by the availability of retail food stores, and whether this relationship varied across the urban rural continuum. Residence in a high deprivation neighborhood was associated with a 0.94 unit increase in BMI among women in metropolitan areas. The relationship between tract deprivation and BMI was not linear among women in micropolitan areas, and no association was observed in rural areas. The presence of supermarkets or other retail food stores did not mediate the association between deprivation and BMI among women residing in any of the study areas. These results suggest that level of urbanity influences the effect of neighborhood condition on BMI among low-income women, and that the availability of supermarkets and other food stores does not directly influence BMI among low-income populations.

Socioecological theory and a growing body of research suggests that geographic, racial, ethnic, and socioeconomic disparities in the prevalence of obesity are linked to disparities in the availability of food retail outlets that provide healthy food options. We examined the availability of food stores for low‐income women in Kansas and tested whether food store availability was associated with obesity using cross‐sectional, geocoded data from women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (n = 21,166) in Kansas. The availability and density of food stores within a 1, 3, and 5 mile radius of residence was determined, and multivariate logistic regression was used to examine the association of food store availability with obesity. The availability of convenience, grocery stores, and supermarkets varied across the urban–rural continuum, but the majority of WIC recipients lived within a 1 mile radius of a small grocery store. WIC participants in micropolitan areas had the greatest availability of food stores within a 1 mile radius of residence. Availability and density of food stores was not associated with obesity in metropolitan and rural areas, but availability and density of any type of food store was associated with an increased risk of obesity among WIC recipients in micropolitan areas. These results suggest that limited spatial availability of grocery stores and supermarkets does not contribute to obesity risk among low‐income WIC recipients in Kansas, and that urban influence moderates the contribution of food environments to obesity.

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