Elsevier

Preventive Medicine

Volume 58, January 2014, Pages 33-39
Preventive Medicine

The intersection of neighborhood racial segregation, poverty, and urbanicity and its impact on food store availability in the United States

https://doi.org/10.1016/j.ypmed.2013.10.010Get rights and content

Highlights

  • High poverty neighborhoods have fewer supermarkets regardless of race/ethnicity.

  • At equal poverty levels, Black neighborhoods have the fewest supermarkets.

  • Supermarket availability in urban areas is similar nationwide.

  • Rural supermarket availability is not associated with neighborhood poverty.

  • Rural supermarket availability is not associated with racial/ethnic composition.

Abstract

Background

Food store availability may determine the quality of food consumed by residents. Neighborhood racial residential segregation, poverty, and urbanicity independently affect food store availability, but the interactions among them have not been studied.

Purpose

To examine availability of supermarkets, grocery stores, and convenience stores in US census tracts according to neighborhood racial/ethnic composition, poverty, and urbanicity.

Methods

Data from 2000 US Census and 2001 InfoUSA food store data were combined and multivariate negative binomial regression models employed.

Results

As neighborhood poverty increased, supermarket availability decreased and grocery and convenience stores increased, regardless of race/ethnicity. At equal levels of poverty, Black census tracts had the fewest supermarkets, White tracts had the most, and integrated tracts were intermediate. Hispanic census tracts had the most grocery stores at all levels of poverty. In rural census tracts, neither racial composition nor level of poverty predicted supermarket availability.

Conclusions

Neighborhood racial composition and neighborhood poverty are independently associated with food store availability. Poor predominantly Black neighborhoods face a double jeopardy with the most limited access to quality food and should be prioritized for interventions. These associations are not seen in rural areas which suggest that interventions should not be universal but developed locally.

Introduction

Significant racial and ethnic disparities in obesity exist in the United States (US). Age-adjusted prevalence of obesity is 32.4% in non-Hispanic whites, 38.7% among Mexican Americans, and 44.1% in non-Hispanic blacks (Flegal et al., 2010). Reasons for these disparities are uncertain, but one potential factor may be food store availability. Evidence suggests neighborhood racial segregation and poverty affects food store availability, but a search of the literature found only one previous study that has examined this in a nationwide sample (Powell et al., 2007). Additionally, the impact of urbanicity has not been well studied, and there is little data regarding the interaction of these factors affecting neighborhood food store availability.

Studies find positive associations between healthy food availability in neighborhoods and the intake of those foods by residents (Cheadle et al., 1991, Laraia et al., 2004, Larson et al., 2009, Morland and Evenson, 2009). Large supermarkets have been shown to stock more healthy foods (Horowitz et al., 2004) at lower cost (Chung and Meyers, 1999, Cummins and MacIntyre, 2002). Grocery and convenience stores are found to stock more energy dense, processed, high-fat, sugary, and salty foods (Walker et al., 2010). Residents of neighborhoods with better access to supermarkets eat healthier diets (Larson et al., 2009), but low-income and minority neighborhoods lack adequate access to large supermarkets (Black and Macinko, 2008, Millstein et al., 2009), a possible result of racial residential segregation.

Racial residential segregation may act indirectly through neighborhood concentrated poverty (Acevedo-Garcia, 2000, Williams, 1996). Studies find neighborhoods with more residents of low socioeconomic status (SES) have fewer high quality food stores and more low quality food stores (Landrine and Corral, 2009, Moore and Diez Roux, 2006, Morland et al., 2002, Powell et al., 2007). However, since racially segregated minority neighborhoods are more likely to be economically disadvantaged (Massey, 2001), it is difficult to disentangle the impact of segregation versus poverty. Zenk et al. (2005b) found no relationship between supermarkets and racial composition in low poverty areas, but in high poverty areas, neighborhoods with the highest percent of Black residents were further from a supermarket. This interaction between neighborhood racial composition and neighborhood SES poses a challenge in health disparities research.

The relationship between neighborhood racial composition and food store availability has primarily been studied in urban areas and has consistently found neighborhoods with higher proportions of Black residents which have fewer supermarkets, longer distances to supermarkets, and more grocery stores (Baker et al., 2006, Bodor et al., 2010, Galvez et al., 2008, Landrine and Corral, 2009, Morland and Filomena, 2007, Zenk et al., 2005a, Zenk et al., 2005b). One study of this relationship in a rural setting found the opposite association; residents of low income and minority communities were closer to all types of food stores compared to high income and White communities (Sharkey et al., 2010).

Our study examines availability of supermarkets, grocery stores, and convenience stores in US census tracts according to neighborhood racial/ethnic composition, poverty, and urbanicity. It expands on an existing nationwide study (Powell et al., 2007) by examining these relationships within census tracts instead of zip codes, examining the interaction between neighborhood racial/ethnic composition and neighborhood income, and including analysis of rural census tracts.

Section snippets

Census bureau

Data were obtained from the 2000 US Census Population and Housing Summary Files 1 and 3. The nationwide sample includes 65,174 census tracts. The number of residents per census tract ranges from 1500 to 8000 and the spatial composition of census tracts varies widely depending on population density (US Census Bureau, 2012).

InfoUSA

Food store data from 2001 were obtained from InfoUSA, a nationwide commercial database of 12 million US businesses. Data are collected and updated monthly using telephone

Descriptive summary statistics

Table 1 presents characteristics of census tracts by neighborhood racial composition. Predominantly White tracts are most frequently low poverty, urban, and in the South. Predominantly Black tracts are most frequently high poverty, urban, and in the South. Hispanic tracts are most often high poverty, urban, and in the West. Integrated tracts are most commonly high poverty, urban, and in the West. While 50.1% of White census tracts are low poverty, less than 10% of Black or Hispanic tracts are

Discussion

Disparities in food store availability are each inversely associated with both neighborhood poverty and neighborhood racial segregation, and there is an interaction between them. Neighborhoods with greater poverty and large minority populations have less access to supermarkets. The combination of living in an impoverished and a segregated Black neighborhood presents a double disadvantage in access to high quality foods. The distribution of food stores and relationship to segregated Hispanic

Conclusions

Our findings suggest that interventions to promote access to supermarkets should not be applied nationwide. Urban, low-income, segregated communities lack access to supermarkets which likely limits their access to fresh fruit, vegetables, low-fat milk, and high-fiber foods. And, in order to decrease disparities in obesity, these communities should be targeted for innovative policies and interventions. However, interventions should be developed with local knowledge of the food environment so

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Acknowledgments

This research was funded by a grant from the National Heart, Blood, and Lung Institute (1R01-5R01HL092846-02). A poster presentation of these study findings was awarded the Student Abstract Award by the Epidemiology Section at the 2012 American Public Health Association Annual Conference. Thanks to Larry Wissow, MD, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health and Gayane Yenokyan, PhD, Department of Biostatistics, Johns Hopkins Bloomberg School of

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