Racial residential segregation disproportionately places African Americans in more-impoverished neighborhoods in Detroit and consequently reduces access to supermarkets. However, supermarkets have opened or remained open close to middle-income neighborhoods that have transitioned from White to African American. Development of economically disadvantaged African American neighborhoods is critical to effectively prevent diet-related diseases among this population.

This study examined relationships among individual demographics, environmental features (e.g., fast food outlet density, park land use) of residential neighborhoods and activity spaces, and obesity-related behaviors (diet, physical activity). Participants’ movement was tracked for seven days using global positioning systems (GPS). Two activity space measures (one standard deviation ellipse, daily path area) were derived from the GPS data. Activity spaces were generally larger than residential neighborhoods; environmental features of residential neighborhoods and activity spaces were weakly associated; and some activity space environmental features were related to dietary behaviors. Activity spaces may provide new insights into environmental influences on obesity-related behaviors.

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Placing full-service supermarkets in food deserts (areas with limited access to healthy foods) has been proposed as an important policy strategy to confront inequalities in healthy food access. Capitalizing on a natural experiment, we enrolled n=1,372 randomly selected households from two comparable neighborhoods, one of which received a full-service supermarket in 2013. We looked at the impact on residents’ diet, perceived access to healthy foods and satisfaction with one’s neighborhood as a place to live. Baseline data was collected in 2011, and follow-up in 2014. Relative to the comparison neighborhood, we found a net positive change in the intervention neighborhood in overall dietary quality, total kilocalories, added sugars, and solid fats, alcohol and added sugars (SoFAAS). However, we did not observe differential improvement in fruit and vegetable intake, whole grain consumption or body mass index (BMI). Regular users of the new supermarket had significantly improved perceived access to healthy foods compared to others, but use of the new supermarket was not related to dietary changes or to improvements with neighborhood satisfaction. Our study is the first to our knowledge to have found significant improvements in multiple dietary outcomes and neighborhood satisfaction among residents of a food desert, following the opening of a supermarket. Our study supports the Healthy Food Financing Initiative and other policies that incentivize food retail venues to locate in food deserts, but we recommend further efforts proceed with caution until research has clarified the mechanisms through which diet is improved and associations with weight status/obesity have been observed.

Purpose To examine relationships between the neighborhood food environment and fruit and vegetable intake in a multiethnic urban population. Design Analysis of cross-sectional survey and observational data. Setting 146 neighborhoods within three large geographic communities of Detroit, Michigan. Subjects Probability sample of 919 African-American, Latino, and White adults. Measures The dependent variable was mean daily fruit and vegetable servings measured using a modified Block 98 food frequency questionnaire. Independent variables included the neighborhood food environment: store availability (large grocery, specialty, convenience, liquor, small grocery), supermarket proximity (street-network distance to nearest chain grocer), and perceived and observed neighborhood fresh fruit and vegetable supply (availability, variety, quality, affordability). Analysis Weighted multilevel regression. Results Presence of a large grocery store in the neighborhood was associated with, on average, 0.69 more daily fruit and vegetable servings in the full sample. Relationships between the food environment and fruit and vegetable intake did not differ between Whites and African-Americans. However, Latinos compared with African-Americans with a large grocery store in their neighborhood consumed 2.20 more daily servings of fruits and vegetables. Presence of a convenience store in the neighborhood was associated with 1.84 fewer daily fruit and vegetable servings among Latinos than African-Americans. Conclusion The neighborhood food environment influences fruit and vegetable intake, and the size of this relationship may vary for different racial/ethnic subpopulations.

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Background Lack of access to healthy foods may explain why residents of low-income neighborhoods and African Americans in the U.S. have high rates of obesity. The findings on where people shop and how that may influence health are mixed. However, multiple policy initiatives are underway to increase access in communities that currently lack healthy options. Few studies have simultaneously measured obesity, distance, and prices of the store used for primary food shopping. Purpose To examine the relationship among distance to store, food prices, and obesity. Methods The Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health study conducted baseline interviews with 1,372 households between May and December 2011 in two low-income, majority African American neighborhoods without a supermarket. Audits of 16 stores where participants reported doing their major food shopping were conducted. Data were analyzed between February 2012 and February 2013. Results Distance to store and prices were positively associated with obesity (p<0.05). When distance to store and food prices were jointly modeled, only prices remained significant (p<0.01), with higher prices predicting a lower likelihood of obesity. Although low- and high-price stores did not differ in availability, they significantly differed in their display and marketing of junk foods relative to healthy foods. Conclusions Placing supermarkets in food deserts to improve access may not be as important as simultaneously offering better prices for healthy foods relative to junk foods, actively marketing healthy foods, and enabling consumers to resist the influence of junk food marketing.

Objectives To (a) examine the relationships among objective and perceived indicators of neighborhood environment, racial discrimination, psychological distress, and gestational age at birth; (b) determine if neighborhood environment and racial discrimination predicted psychological distress; (c) determine if neighborhood environment, racial discrimination, and psychological distress predicted preterm birth; and (d) determine if psychological distress mediated the effects of neighborhood environment and racial discrimination on preterm birth. Design Descriptive correlational comparative. Setting Postpartum unit of a medical center in Chicago. Participants African American women (n1 = 33 with preterm birth; n2 = 39 with full-term birth). Methods Women completed the instruments 24 to 72 hours after birth. Objective measures of the neighborhood were derived using geographic information systems (GIS). Results Women who reported higher levels of perceived social and physical disorder and perceived crime also reported higher levels of psychological distress. Women who reported more experiences of racial discrimination also had higher levels of psychological distress. Objective social disorder and perceived crime predicted psychological distress. Objective physical disorder and psychological distress predicted preterm birth. Psychological distress mediated the effect of objective social disorder and perceived crime on preterm birth. Conclusion Women’s neighborhood environments and racial discrimination were related to psychological distress, and these factors may increase the risk for preterm birth.