Neighborhood Racial Segregation Predict the Spatial Distribution of Supermarkets and Grocery Stores Better than Socioeconomic Factors in Cleveland, Ohio: a Bayesian Spatial Approach

Abstract

Introduction The food environment influences the availability and affordability of food options for consumers in a given neighborhood. However, disparities in access to healthy food options exist, affecting Black and low-income communities disproportionately. This study investigated whether racial segregation predicted the spatial distribution of supermarkets and grocery stores better than socioeconomic factors or vice versa in Cleveland, Ohio. Method The outcome measure was the count of supermarket and grocery stores in each census tract in Cleveland. They were combined with US census bureau data as covariates. We fitted four Bayesian spatial models. The first model was a baseline model with no covariates. The second model accounted for racial segregation alone. The third model looked at only socioeconomic factors, and the final model combined both racial and socioeconomic factors. Results Overall model performance was better in the model that considered only racial segregation as a predictor of supermarkets and grocery stores (DIC = 476.29). There was 13% decrease in the number of stores for a census tract with a higher majority of Black people compared to areas with a lower number of Black people. Model 3 that considered only socioeconomic factors was less predictive of the retail outlets (DIC = 484.80). Conclusions These findings lead to the conclusion that structural racism evidenced in policies like residential segregation has a significant influence on the spatial distribution of food retail in the city of Cleveland.

Integrating Nutrition, Culinary Medicine, and Agriculture in a Longitudinal, Case-Based Medical Education Curriculum

“…Block 4 [17] focuses on Cardiovascular, Pulmonary, Renal, Cell Physiology, and Pharmacology subjects. Within the IQ case about myocardial infarction, we see an opportunity to consider nutrition recommendations for primary and secondary prevention, including exploration of the mechanisms of action and pathways by which lifestyle interventions reduce the risk of, or decrease the burden of atherosclerosis on heart disease [21]. Comparison of efficacy of these interventions with and without pharmacological treatment would enable students to speak confidently and knowledgeably to their medicine teams in the third year, and when counseling patients.…”