ABSTRACT

Studies aimed as measuring how local food environments (LFEs) might influence disease progression and management are described in Chapters 4 and 5. This research has shown geographic disparities in the availability of healthy foods across the United States as well as provided empirical evidence of the relationship between these disparities and dietary intake among some U.S. populations. Results of these and other seminal studies on disease rates associated with area socioeconomic and racial/ethnic characteristics continue to challenge investigators to measure geographic disparities of disease patterns. Regarding the local food environment literature, investigators have heavily relied on obesity as a disease outcome. Part of the rationale for measuring the associations between local food environments and obesity is that like disparities in local food environments, racial/ethnic minorities, individuals of low socioeconomic status (SES), and rural residents are disproportionately affected by obesity. For example, in 2009-2010, the age-adjusted prevalence of obesity was 58.5% in African-American women compared to 32.2% in white women and 38.8% in African-American men (Flegal et al. 2012). Obesity rates are higher among rural

residents of every race/ethnicity compared with urban whites (Patterson et al. 2004). Black et al. (2010) present geographic differences in obesity prevalence by neighborhood across the five boroughs of New York City, with some of the highest prevalence found in neighborhoods such as Bedford Stuyvesant in Brooklyn, Harlem in Manhattan, and the South Bronx, where people of color are concentrated (Figure 6.1).