Food swamps and food deserts in Baltimore City, MD, USA: associations with dietary behaviours among urban adolescent girls

Abstract

Objective To determine whether living in a food swamp (≥4 corner stores within 0·40 km (0·25 miles) of home) or a food desert (generally, no supermarket or access to healthy foods) is associated with consumption of snacks/desserts or fruits/vegetables, and if neighbourhood-level socio-economic status (SES) confounds relationships. Design Cross-sectional. Assessments included diet (Youth/Adolescent FFQ, skewed dietary variables normalized) and measured height/weight (BMI-for-age percentiles/Z-scores calculated). A geographic information system geocoded home addresses and mapped food deserts/food swamps. Associations examined using multiple linear regression (MLR) models adjusting for age and BMI-for-age Z-score. Setting Baltimore City, MD, USA. Subjects Early adolescent girls (6th/7th grade, n 634; mean age 12·1 years; 90·7 % African American; 52·4 % overweight/obese), recruited from twenty-two urban, low-income schools. Results Girls’ consumption of fruit, vegetables and snacks/desserts: 1·2, 1·7 and 3·4 servings/d, respectively. Girls’ food environment: 10·4 % food desert only, 19·1 % food swamp only, 16·1 % both food desert/swamp and 54·4 % neither food desert/swamp. Average median neighbourhood-level household income: $US 35 298. In MLR models, girls living in both food deserts/swamps consumed additional servings of snacks/desserts v. girls living in neither (β = 0·13, P = 0·029; 3·8 v. 3·2 servings/d). Specifically, girls living in food swamps consumed more snacks/desserts than girls who did not (β = 0·16, P = 0·003; 3·7 v. 3·1 servings/d), with no confounding effect of neighbourhood-level SES. No associations were identified with food deserts or consumption of fruits/vegetables. Conclusions Early adolescent girls living in food swamps consumed more snacks/desserts than girls not living in food swamps. Dietary interventions should consider the built environment/food access when addressing adolescent dietary behaviours.

Neighbourhood food environments revisited: When food deserts meet food swamps

“…Rose et al () considered the food swamp to be an especially valuable concept to describe neighbourhood food environments since the excess amount of unhealthy food sources would “inundate” or “swamp out” the healthy food choices that residents have. Luan et al () and Hager et al () defined food swamps as areas where residents have access to large amounts of energy‐dense snack foods while having limited healthy food options in their study areas.…”

Food swamps by area socioeconomic deprivation in New Zealand: a national study

“…North American studies provide the most support for the existence of food swamps (Hager et al 2016). Less support for the existence of food swamps has been found in the United Kingdom (Cetateanu and Jones 2014;Fraser et al 2012).…”

A mixed methods assessment of the barriers and readiness for meeting the SNAP depth of stock requirements in Baltimore’s small food stores

“…Small independently owned food stores known as “corner stores” are ubiquitous in these residential areas and primarily sell sugar-sweetened beverages and packaged foods high in fat, sodium, and sugar (Borradaile et al 2009; D’Angelo et al 2011). Furthermore, the unhealthiest food environments in Baltimore with limited access to healthy foods and abundant unhealthy food outlets are located in areas with high proportions of low-income African-American residents (Hager et al 2016). These food environments are particularly concerning as they are associated with high rates of noncommunicable diseases (Drewnowski et al 2012; Morland, Roux, and Wing 2006).…”