Minority Health and Health Equity Archive

Permanent URI for this collectionhttp://hdl.handle.net/1903/21769

Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.

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    Baltimore’s can-do approach to food justice
    (2011) BARRINGTON, VANESSA
    Cities all over the country are addressing the lack of access to fresh and healthy food on the part of their residents, but few are in as much of a bind as Baltimore. Like Detroit, and other cities known for their class and race disparity, Baltimore has been losing population and gaining vacant land at a fast pace in recent decades. The result is vast swaths of neighborhoods located far from grocery stores. Baltimore gave itself a D on its own 2010 Health Disparities Report Card, which found that 43 percent of the residents in the city's predominantly black neighborhoods …
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    Fast Food Restaurants and Food Stores: Longitudinal Associations With Diet in Young to Middle-aged Adults: The CARDIA Study
    (2011) Boone-Heinonen, J.; Gordon-Larsen, P.; Kiefe, C. I.; Shikany, J. M.; Lewis, C. E.; Popkin, B. M.
    BACKGROUND: A growing body of cross-sectional, small-sample research has led to policy strategies to reduce food deserts -neighborhoods with little or no access to healthy foods-by limiting fast food restaurants and small food stores and increasing access to supermarkets in low-income neighborhoods. METHODS: We used 15 years of longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of US young adults (aged 18-30 years at baseline) (n = 5115), with linked time-varying geographic information system-derived food resource measures. Using repeated measures from 4 examination periods (n = 15 854 person-examination observations) and conditional regression (conditioned on the individual), we modeled fast food consumption, diet quality, and adherence to fruit and vegetable recommendations as a function of fast food chain, supermarket, or grocery store availability (counts per population) within less than 1.00 km, 1.00 to 2.99 km, 3.00 to 4.99 km, and 5.00 to 8.05 km of respondents' homes. Models were sex stratified, controlled for individual sociodemographic characteristics and neighborhood poverty, and tested for interaction by individual-level income. RESULTS: Fast food consumption was related to fast food availability among low-income respondents, particularly within 1.00 to 2.99 km of home among men (coefficient, 0.34; 95% confidence interval, 0.16-0.51). Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake, and relationships between grocery store availability and diet outcomes were mixed. CONCLUSION: Our findings provide some evidence for zoning restrictions on fast food restaurants within 3 km of low-income residents but suggest that increased access to food stores may require complementary or alternative strategies to promote dietary behavior change.
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    Neighborhood Characteristics and Availability of Healthy Foods in Baltimore
    (2008) Franco, Manuel; Diez Roux, Ana V.; Glass, Thomas A.; Caballero, Benjamín; Brancati, Frederick L.
    BACKGROUND: Differential access to healthy foods may contribute to racial and economic health disparities. The availability of healthy foods has rarely been directly measured in a systematic fashion. This study examines the associations among the availability of healthy foods and racial and income neighborhood composition. METHODS: A cross-sectional study was conducted in 2006 to determine differences in the availability of healthy foods across 159 contiguous neighborhoods (census tracts) in Baltimore City and Baltimore County and in the 226 food stores within them. A healthy food availability index (HFAI) was determined for each store, using a validated instrument ranging from 0 points to 27 points. Neighborhood healthy food availability was summarized by the mean HFAI for the stores within the neighborhood. Descriptive analyses and multilevel models were used to examine associations of store type and neighborhood characteristics with healthy food availability. RESULTS: Forty-three percent of predominantly black neighborhoods and 46% of lower-income neighborhoods were in the lowest tertile of healthy food availability versus 4% and 13%, respectively, in predominantly white and higher-income neighborhoods (p<0.001). Mean differences in HFAI comparing predominantly black neighborhoods to white ones, and lower-income neighborhoods to higher-income neighborhoods, were -7.6 and -8.1, respectively. Supermarkets in predominantly black and lower-income neighborhoods had lower HFAI scores than supermarkets in predominantly white and higher-income neighborhoods (mean differences -3.7 and -4.9, respectively). Regression analyses showed that both store type and neighborhood characteristics were independently associated with the HFAI score. CONCLUSIONS: Predominantly black and lower-income neighborhoods have a lower availability of healthy foods than white and higher-income neighborhoods due to the differential placement of types of stores as well as differential offerings of healthy foods within similar stores. These differences may contribute to racial and economic health disparities.