Sciensano, Department of Epidemiology and Public Health, Brussels, Belgium.
Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
Int J Health Geogr. 2024 May 9;23(1):10. doi: 10.1186/s12942-024-00369-4.
Obesity, a significant public health concern, disproportionately affects people with lower socioeconomic status (SES). Food environments have been identified as part of the causal chain of this disparity. This study investigated variations in the food environment across groups with different SES profiles residing in peri-urban municipal settings. In addition, it examined the association of the perceived and objective food environments with eating behaviour and assessed if these associations were moderated by SES. Utilizing GIS and survey data (n = 497, aged 25-65), results showed differences in the objective and perceived food environments based on SES. Respondents with higher SES perceived their food environments as better but resided farther from all food outlets compared to respondents with lower SES. However, there was no difference in outlet density or mRFEI between SES groups. SES moderated associations between the objective and perceived food environments and most eating behavior outcomes except fast food consumption frequency. For fruits and vegetables, SES moderated the association between neighborhood availability and consumption frequency (β0.23,CI0.03;0.49). Stratified analysis revealed a positive association for both lower (β0.15, CI0.03;0.27) and higher (β0.37, CI 0.12;0.63) SES groups. For snack foods, SES moderated the association between healthy outlet density and consumption frequency (β-0.60, CI-0.94; -0.23), showing statistical significance only for respondents with higher SES (β0.36,CI 0.18;0.55). Similarly, for sugar-sweetened beverages, a statistically significant interaction was observed between unhealthy outlet density in the 1000m buffer and consumption frequency (β 0.06, CI 0.02; 0.11). However, this association was only statistically significant for respondents with higher SES (β-0.02,CI -0.05;-0.0002). These results emphasize the significance of SES as a crucial element in comprehending the connection between the food environment and eating behaviour. Indicating the need for policymakers to take SES into account when implementing food environment interventions, particularly when focusing on the neighborhood food environment without considering residents' SES and their perceptions.
肥胖是一个严重的公共卫生问题，不成比例地影响社会经济地位较低的人群。食品环境已被确定为造成这种差异的原因之一。本研究调查了居住在城市周边环境中不同社会经济地位群体的食品环境差异。此外，它还研究了感知和客观食品环境与饮食行为的关系，并评估了这些关系是否受到社会经济地位的调节。利用 GIS 和调查数据（n=497，年龄 25-65 岁），结果显示社会经济地位不同，客观和感知食品环境也不同。社会经济地位较高的受访者认为他们的食品环境更好，但与社会经济地位较低的受访者相比，他们居住的地方离所有食品店都更远。然而，社会经济地位较高和较低的受访者之间的食品店密度或 mRFEI 没有差异。社会经济地位调节了客观和感知食品环境与大多数饮食行为结果之间的关系，除了快餐消费频率外。对于水果和蔬菜，社会经济地位调节了邻里供应与消费频率之间的关系（β0.23，CI0.03；0.49）。分层分析显示，较低（β0.15，CI0.03；0.27）和较高（β0.37，CI0.12；0.63）社会经济地位群体都存在正相关。对于零食，社会经济地位调节了健康食品店密度与消费频率之间的关系（β-0.60，CI-0.94；-0.23），仅对社会经济地位较高的受访者有统计学意义（β0.36，CI 0.18；0.55）。同样，对于含糖饮料，在 1000 米缓冲区中观察到不健康食品店密度与消费频率之间存在统计学显著的相互作用（β0.06，CI0.02；0.11）。然而，这种关联仅对社会经济地位较高的受访者有统计学意义（β-0.02，CI-0.05；-0.0002）。这些结果强调了社会经济地位作为理解食品环境与饮食行为之间关系的关键因素的重要性。这表明政策制定者在实施食品环境干预措施时，特别是在不考虑居民的社会经济地位及其感知而关注邻里食品环境时，需要考虑社会经济地位。
