Association of community food environment and obesity among US adults: a geographical information system analysis

Abstract

BackgroundEmerging studies have investigated the contribution of food environment to obesity in the USA. However, the findings were inconsistent. Methodological explanations for the inconsistent findings included: (1) using individual store/restaurant exposure as food environment indicator, and (2) not accounting for non-stationarity assumption. This study aimed to describe the spatial distribution of obesity and examine the association between community food environment and obesity, and the variation of magnitude and direction of this association across the USA.MethodsData from 20 897 adults who participated in the REasons for Geographic and Racial Differences in Stroke study and completed baseline assessment between January 2003 and October 2007 were eligible in analysis. Hot Spot analysis was used to assess the spatial distribution of obesity. The association between community food environment and obesity and the variation of this association across the USA were examined using global ordinary least squares regression and local geographically weighted regression.ResultsHigher body mass index (BMI) clusters were more likely to locate in socioeconomically disadvantaged, rural, minority neighbourhoods with a smaller population size, while lower BMI clusters were more likely to appear in more affluent, urban neighbourhoods with a higher percentage of non-Hispanic white residences. There was an overall significant, inverse association between community food environment and obesity (β=−0.0210; p<0.0001). Moreover, the magnitude and direction of this association varied significantly across the US regions.ConclusionsThe findings underscored the need for geographically tailored public health interventions and policies to address unique local food environment issues to achieve maximum effects on obesity prevention.

Supplemental Nutrition Assistance Program (SNAP)-Authorized Grocery, Convenience, Dollar, and Restaurant or Delivery Service Settings Are Associated With Increased Obesity Prevalence in Virginia

“…Prior research has established a strong relationship between store access and consumer obesity in socioeconomically disadvantaged areas, 9 which is why it is particularly important to understand such access for SNAP consumers. This study adds to existing literature by characterizing the relationship between obesity prevalence and a wider range of SNAP-authorized stores.…”

“…7,8 This relationship may vary among communities, and additionally, obesity prevalence related to traditional and nontraditional (eg, dollar, drug, and convenience) SNAP-authorized store access is underinvestigated. 7 -9 Exploring a wide range of store associations with community obesity prevalence can inform future food environment research and guide SNAP-Education (SNAP-Ed) healthy food retail programming. 10 This was the purpose of the presented research, using Virginia as a case study due to authors’ practice site location.…”

Spatial Clusters of Diabetes and Physical Inactivity: Do Neighborhood Characteristics in High and Low Clusters Differ?

“…Studies identifying spatial clusters or hotspots of physical activity, sedentary behavior, obesity, and diabetes have been carried out mainly in the United States, while few are reported from low-and middle-income countries. [8][9][10][11][12][13] Despite the high burden of NCDs in India, research incorporating spatial clustering techniques is lacking.…”

Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications

“…This negative relationship has been shown in numerous countries outside of the US (e.g., Netherlands, Turkey, Morocco, South Asia) [103]. Hot-spot analysis in the US shows that higher BMI clusters are more likely in socioeconomically disadvantaged minority neighborhoods [104]. Meanwhile, large datasets (n = 43,864) have shown that obesity risk is decreased when positive contextual factors (maternal mental health, school safety, and child resilience) are present [105].…”