University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA.
RAND Corporation, Behavior and Policy Sciences, Pittsburgh, PA.
Ethn Dis. 2021 Oct 21;31(4):537-546. doi: 10.18865/ed.31.4.537. eCollection 2021 Fall.
This study sought to: 1) understand how the perceived food environment (availability, accessibility, and affordability) is associated with cardiometabolic health outcomes in predominately low-income Black residents in urban neighborhoods with limited healthy food access; and 2) examine the association of shopping at specific store types with cardiometabolic health outcomes.
We report on cross-sectional data from 459 individuals participating in the Pittsburgh, PA Hill/Homewood Research on Neighborhoods and Health (PHRESH) study. Mean participant age was 60.7 (SD=13.9); 81.7% were female. We used logistic regression to examine associations between three factors (perceived fruit and vegetable availability, quality, and price; primary food shopping store characteristics; and frequency of shopping at stores with low or high access to healthy foods) and cardiometabolic and self-rated health.
Adjusting for sociodemographic characteristics, participants with higher perceived fruit and vegetable accessibility (AOR:.47, 95%CI: .28-.79, P=.004) and affordability (AOR:.59, 95%CI: .36-.96, P=.034) had lower odds of high blood pressure. Shopping often (vs rarely) at stores with low access to healthy foods was associated with higher odds of high total cholesterol (AOR:3.52, 95%CI: 1.09-11.40, P=.035). Finally, primary food shopping at a discount grocery (vs full-service supermarket) was associated with lower odds of overweight/obesity (AOR:.51, 95%CI: .26-.99, P=.049).
These results suggest that both perceived accessibility and affordability of healthy foods are associated with reduced cardiometabolic risk factors in this urban, low-income predominantly Black population. Additionally, discount grocery stores may be particularly valuable by providing access and affordability of healthy foods in this population.
本研究旨在:1)了解在食物获取途径有限的城市贫困黑人社区中,感知的食物环境(可得性、可及性和可负担性)如何与心血管代谢健康结果相关;2)研究在特定商店类型购物与心血管代谢健康结果的关联。
我们报告了来自匹兹堡宾夕法尼亚州山/霍姆伍德邻里与健康研究(PHRESH)的 459 名参与者的横断面数据。参与者的平均年龄为 60.7(标准差=13.9)岁,81.7%为女性。我们使用逻辑回归来检验感知的水果和蔬菜可得性、质量和价格、主要食品购物商店特征以及在低或高健康食品获取途径商店购物的频率等三个因素与心血管代谢和自我评估健康之间的关联。
在调整社会人口统计学特征后,感知水果和蔬菜可及性较高(优势比:0.47,95%置信区间:0.28-0.79,P=.004)和可负担性较高(优势比:0.59,95%置信区间:0.36-0.96,P=.034)的参与者患高血压的可能性较低。经常(而非很少)在健康食品获取途径较低的商店购物与高总胆固醇的可能性较高相关(优势比:3.52,95%置信区间:1.09-11.40,P=.035)。最后,在折扣杂货店(而非全服务超市)进行主要食品购物与超重/肥胖的可能性较低相关(优势比:0.51,95%置信区间:0.26-0.99,P=.049)。
这些结果表明,在这个城市低收入的主要是黑人人群中,健康食品的感知可及性和可负担性都与心血管代谢风险因素的降低有关。此外,折扣杂货店可能通过为该人群提供健康食品的获取途径和可负担性而具有特别的价值。