Neighborhood disadvantage and the sales of unhealthy products: alcohol, tobacco and unhealthy snack food

Abstract

Background Individuals may use unhealthy coping mechanisms such as alcohol, tobacco, and unhealthy snack consumption. The purpose of this study was to assess how neighborhood disadvantage is associated with sales of alcohol, tobacco, and unhealthy snacks at stores of a discount variety store chain. Methods Alcohol, tobacco, and unhealthy snack sales were measured monthly for 20 months, 2017–2018, in 16 discount variety stores in the United States. Mixed effects linear regressions adjusted for population size, with store-specific random effects, to examine the relationship of weekly unit sales with three outcome variables and neighborhood disadvantage, measured using the Area Deprivation Index (ADI). Results The discount variety stores were located in neighborhoods where the median ADI percentile was 87 [interquartile range 83,89], compared to the median ADI percentile of 50 for all US communities, indicating that the stores were located in substantially disadvantaged neighborhoods. For every 1% increase in ADI, weekly unit sales of unhealthy snack food increased by 43 [95% confidence interval, CI 28–57], and weekly unit sales of tobacco products increased by 11.5 [95% CI 5–18] per store. No significant relationship between neighborhood disadvantage and the weekly unit sales of alcohol products was identified. Conclusions The positive relationship between neighborhood disadvantage and the sale of tobacco and snack foods may help explain the pathway between neighborhood disadvantage and poor health outcomes. It would be useful for future research to examine how neighborhood disadvantage influences resident health-related behaviors.

Health disparities in chronic liver disease

“…In fact, binge drinking prevalence increased with household income and was highest among those with a household income > $75,000 a year (20.2%) 25,26. Neighborhood‐level deprivation has been shown to be inversely associated with or to have no association with alcohol consumption in two US‐based studies 27,28. Importantly, lower socioeconomic status has been associated with negative alcohol‐related consequences, including alcohol‐related mortality 26…”

“…25 , 26 Neighborhood‐level deprivation has been shown to be inversely associated with or to have no association with alcohol consumption in two US‐based studies. 27 , 28 Importantly, lower socioeconomic status has been associated with negative alcohol‐related consequences, including alcohol‐related mortality. 26…”

Area Deprivation Index and Gut-Brain Axis in Cirrhosis

“…It is possible that the progression to cirrhosis rather the postcirrhosis course that was included in this study may be more dependent on microbiota-ADI interactions. For instance, patients with lower SES may be more likely to be obese, have lower access to healthier foods such as yogurt and high-fiber diets, and have lesser access to services that reduce alcohol and drug dependence (4,19,20,32,40). These may in turn affect the microbiota, brain function, and increase progression of patients with lower ADI toward cirrhosis (41)(42)(43)(44).…”

“…Cirrhosis is an established cause of altered gut microbial structure and function (11)(12)(13)(14). The most common causes of cirrhosis include obesity, viral hepatitis, and alcohol misuse, which disproportionately affect people with socioeconomic disadvantage (4,(15)(16)(17)(18)(19)(20). Furthermore, an altered gut-brain axis (21) is inherent in the causation of MHE that affects daily function, progression to the overt stage, and survival (22,23).…”

Association of Socioeconomic Status With Relapse After Ponseti Method Treatment of Idiopathic Clubfeet

“…It includes factors for the domains of income, education, employment, and housing quality. It has been used extensively across medicine; a few such examples are in chronic medical diseases, 17 , 19 , 42 , 48 trauma, 16 , 45 joint arthroplasty, 14 , 28 and pediatrics/pediatric orthopaedics. 3 , 4 , 21 , 23 …”