Disparities in obesity prevalence due to variation in the retail food environment: three testable hypotheses

Abstract

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.

Biological, environmental, and social influences on childhood obesity

“…Socioeconomic disadvantage may exert its influence as early as the prenatal and postnatal period, through its association with maternal depression (106,118) and its consequences. Moreover, poverty may be associated with poorer individual diet (119), poorer retail food and recreational environment (34,120,121), suboptimal family food routines (118,122), and environmental stressors such as living in a higher crime neighborhood (121). The risks associated with socioeconomic disadvantage may accumulate and compound throughout childhood (123).…”

“…Food choices have been shown to be influenced by proximity to fast food outlets, supermarkets, and farmers markets (34)(35)(36)(37)(38). Physical activity levels are influenced by public recreation opportunities, transit availability, and neighborhood walkability (35,37,(39)(40)(41)(42).…”

Measuring the Food Environment: From Theory to Planning Practice

“…Several theoretical models of how the food environment may affect food choices have been developed in the last few years (Black & Macinko, 2008;Ford & Dzewaltowski, 2008;Glanz, Sallis, Saelens & Frank, 2005;Lytle, 2009;White, 2007). Glanz et al present an ecological conceptual model of food environments that distinguishes between community and consumer nutrition environments.…”

“…Black & Macinko suggest that neighborhoods either act as effect modifiers or direct mediators on individual behavior, with neighborhood characteristics supporting or thwarting residents' intentions to eat healthy foods. Ford and Dzewaltowski (2008) present a model in which socioeconomic status moderates the impact of poor quality food environments on eating behaviors. Specifically, individual SES is viewed as a cross-level confounder on the food environment variables of interest, where individuals who are more socioeconomically disadvantaged have less healthy eating behaviors all along the gradient of food environment quality.…”

“…Finally, Lytle's (2009) conceptual model broadens Ford and Dzewaltowski's (2008) contribution by considering the proportion of variance in eating behaviors explained by individual factors, environmental factors, and social factors. The model indicates that as individual and social factors become increasingly restricted, the environment explains a higher proportion of variance.…”