Comparing competing geospatial measures to capture the relationship between the neighborhood food environment and diet

Rummo, Pasquale E.; Algur, Yasemin; McAlexander, Tara; Judd, Suzanne E.; Lopez, Priscilla; Adhikari, Samrachana; Brown, Janene R; Meeker, Melissa; McClure, Leslie A.; Elbel, Brian

doi:10.1016/j.annepidem.2021.05.005

Cited by 11 publications

(17 citation statements)

References 29 publications

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“…Our choice to use relative availability as the primary food-environment measure for these analyses builds on prior research, including studies in which models with relative measures had better model fit than models with absolute measures ( 49 , 50 ). Indeed, in other analyses using these data, we also observed a high degree of collinearity between absolute measures of fast-food restaurant and supermarket availability ( 16 ).…”

Section: Discussionmentioning

confidence: 72%

“…The harmonized definitions and analyses undergirding these results minimized the potential for varying measurement approaches to influence findings across studies and provided an opportunity to compare, identify consistencies and anomalies, and synthesize findings efficiently. The widespread geographic coverage provided by the three studies and tailored analyses across a rural to urban spectrum using empirically derived geographic buffers reduced the possibility of differential item functioning by community type ( 16 ). To our knowledge, previous studies of the food environment have not accounted for differing buffer sizes by community type based on empirical studies of resident behavior.…”

Section: Discussionmentioning

confidence: 99%

“…Two aspects of prior studies that complicate the synthesis of findings on neighborhood attributes relative to T2D risk are the varying definitions of socioeconomic and food environments across studies and that attributes may function differently across regional and community contexts ( 16 ). Research has highlighted the importance of considering community type (e.g., urban versus rural) when measuring the effect of neighborhood environments on individual health outcomes ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

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Neighborhood Socioeconomic Environment and Risk of Type 2 Diabetes: Associations and Mediation Through Food Environment Pathways in Three Independent Study Samples

et al. 2022

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OBJECTIVE We examined whether relative availability of fast-food restaurants and supermarkets mediates the association between worse neighborhood socioeconomic conditions and risk of developing type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS As part of the Diabetes Location, Environmental Attributes, and Disparities Network, three academic institutions used harmonized environmental data sources and analytic methods in three distinct study samples: (1) the Veterans Administration Diabetes Risk (VADR) cohort, a national administrative cohort of 4.1 million diabetes-free veterans developed using electronic health records (EHRs); (2) Reasons for Geographic and Racial Differences in Stroke (REGARDS), a longitudinal, epidemiologic cohort with Stroke Belt region oversampling (N = 11,208); and (3) Geisinger/Johns Hopkins University (G/JHU), an EHR-based, nested case-control study of 15,888 patients with new-onset T2D and of matched control participants in Pennsylvania. A census tract–level measure of neighborhood socioeconomic environment (NSEE) was developed as a community type-specific z-score sum. Baseline food-environment mediators included percentages of (1) fast-food restaurants and (2) food retail establishments that are supermarkets. Natural direct and indirect mediating effects were modeled; results were stratified across four community types: higher-density urban, lower-density urban, suburban/small town, and rural. RESULTS Across studies, worse NSEE was associated with higher T2D risk. In VADR, relative availability of fast-food restaurants and supermarkets was positively and negatively associated with T2D, respectively, whereas associations in REGARDS and G/JHU geographies were mixed. Mediation results suggested that little to none of the NSEE–diabetes associations were mediated through food-environment pathways. CONCLUSIONS Worse neighborhood socioeconomic conditions were associated with higher T2D risk, yet associations are likely not mediated through food-environment pathways.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neighborhood Socioeconomic Environment and Risk of Type 2 Diabetes: Associations and Mediation Through Food Environment Pathways in Three Independent Study Samples

et al. 2022

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“… 36 , 37 , 38 The characteristics of the built environment in neighborhoods also influence dietary patterns. 39 Food environment factors, such as fast‐food restaurant density 40 and proximity to supermarkets, could affect eating behaviors and CVD risk factors through various pathways. 41 …”

Section: Discussionmentioning

confidence: 99%

Social Determinants of Cardiovascular Health: A Longitudinal Analysis of Cardiovascular Disease Mortality in US Counties From 2009 to 2018

Son

Zhang

Shen

et al. 2023

JAHA

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Background Disparities in cardiovascular disease (CVD) outcomes persist across the United States. Social determinants of health play an important role in driving these disparities. The current study aims to identify the most important social determinants associated with CVD mortality over time in US counties. Methods and Results The authors used the Agency for Healthcare Research and Quality's database on social determinants of health and linked it with CVD mortality data at the county level from 2009 to 2018. The age‐standardized CVD mortality rate was measured as the number of deaths per 100 000 people. Penalized generalized estimating equations were used to select social determinants associated with county‐level CVD mortality. The analytic sample included 3142 counties. The penalized generalized estimating equation identified 17 key social determinants of health including rural–urban status, county's racial composition, income, food, and housing status. Over the 10‐year period, CVD mortality declined at an annual rate of 1.08 (95% CI, 0.74–1.42) deaths per 100 000 people. Rural counties and counties with a higher percentage of Black residents had a consistently higher CVD mortality rate than urban counties and counties with a lower percentage of Black residents. The rural–urban CVD mortality gap did not change significantly over the past decade, whereas the association between the percentage of Black residents and CVD mortality showed a significant diminishing trend over time. Conclusions County‐level CVD mortality declined from 2009 through 2018. However, rural counties and counties with a higher percentage of Black residents continued to experience higher CVD mortality. Median income, food, and housing status consistently predicted higher CVD mortality.

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“…Longitudinal Analysis of Neighborhood Food Environment and Diabetes Risk in the VADR Cohort buffer for LDU communities, 6-mile driving buffer for suburban communities, and 10-mile driving buffer for rural communities. 22 Assigning food environment variables to addresses using each community type's information with different buffers helped standardize these variables and made it feasible to compare findings between different community types.…”

Section: Jama Network Open | Public Healthmentioning

confidence: 99%

Longitudinal Analysis of Neighborhood Food Environment and Diabetes Risk in the Veterans Administration Diabetes Risk Cohort

et al. 2021

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IMPORTANCE Diabetes causes substantial morbidity and mortality among adults in the US, yet its incidence varies across the country, suggesting that neighborhood factors are associated with geographical disparities in diabetes.OBJECTIVE To examine the association between neighborhood food environment and risk of incident type 2 diabetes across different community types (high-density urban, low-density urban, suburban, and rural). DESIGN, SETTING, AND PARTICIPANTSThis is a national cohort study of 4 100 650 US veterans without type 2 diabetes. Participants entered the cohort between 2008 and 2016 and were followed up through 2018. The median (IQR) duration of follow-up was 5.5 (2.6-9.8) person-years. Data were obtained from Veterans Affairs electronic health records. Incident type 2 diabetes was defined as 2 encounters with type 2 diabetes International Classification of Diseases, Ninth Revision or Tenth Revision codes, a prescription for diabetes medication other than metformin or acarbose alone, or 1 encounter with type 2 diabetes International Classification of Diseases Ninth Revision or Tenth Revision codes and 2 instances of elevated hemoglobin A 1c (Ն6.5%). Data analysis was performed from October 2020 to March 2021.EXPOSURES Five-year mean counts of fast-food restaurants and supermarkets relative to other food outlets at baseline were used to generate neighborhood food environment measures. The association between food environment and time to incident diabetes was examined using piecewise exponential models with 2-year interval of person-time and county-level random effects stratifying by community types. RESULTSThe mean (SD) age of cohort participants was 59.4 (17.2) years. Most of the participants were non-Hispanic White (2 783 756 participants [76.3%]) and male (3 779 555 participants [92.2%]). The relative density of fast-food restaurants was positively associated with a modestly increased risk of type 2 diabetes in all community types. The adjusted hazard ratio (aHR) was 1.01 (95% CI, 1.00-1.02) in high-density urban communities, 1.01 (95% CI, 1.01-1.01) in low-density urban communities, 1.02 (95% CI, 1.01-1.03) in suburban communities, and 1.01 (95% CI, 1.01-1.02) in rural communities. The relative density of supermarkets was associated with lower type 2 diabetes risk only in suburban (aHR, 0.97; 95% CI, 0.96-0.99) and rural (aHR, 0.99; 95% CI, 0.98-0.99) communities. CONCLUSIONS AND RELEVANCEThese findings suggest that neighborhood food environment measures are associated with type 2 diabetes among US veterans in multiple community types and that food environments are potential avenues for action to address the burden of diabetes. Tailored interventions targeting the availability of supermarkets may be associated with reduced diabetes (continued) Key Points Question Is there an association between the presence of fast-food restaurants and availability of supermarkets in neighborhoods and the risk of developing type 2 diabetes? Findings In this longitudinal cohort study of 4 100 650 veterans, the relat...

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Comparing competing geospatial measures to capture the relationship between the neighborhood food environment and diet

Cited by 11 publications

References 29 publications

Neighborhood Socioeconomic Environment and Risk of Type 2 Diabetes: Associations and Mediation Through Food Environment Pathways in Three Independent Study Samples

Neighborhood Socioeconomic Environment and Risk of Type 2 Diabetes: Associations and Mediation Through Food Environment Pathways in Three Independent Study Samples

Social Determinants of Cardiovascular Health: A Longitudinal Analysis of Cardiovascular Disease Mortality in US Counties From 2009 to 2018

Longitudinal Analysis of Neighborhood Food Environment and Diabetes Risk in the Veterans Administration Diabetes Risk Cohort

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