TY - JOUR
T1 - Food swamps and food deserts in Baltimore City, MD, USA
T2 - Associations with dietary behaviours among urban adolescent girls
AU - Hager, Erin R.
AU - Cockerham, Alexandra
AU - O'Reilly, Nicole
AU - Harrington, Donna
AU - Harding, James
AU - Hurley, Kristen M.
AU - Black, Maureen M.
N1 - Funding Information:
The authors would like to acknowledge the Challenge! in Schools data collection team, especially Robyn Foreman, PhD (currently: Battelle Memorial Institute), Laura Latta (currently: Family League of Baltimore), Samantha Wilkes (currently: Family League of Baltimore) and Raquel Arbaiza. They are also grateful to the participants for their time. Financial support: This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)-University of Maryland's Organized Research Effort in Women's Health BIRCWH K12 Scholar Program (grant number K12HD4489-8); the National Institutes of Health, NICHD (grant number R01HD054727); the Robert Wood Johnson Foundation, Active Living Research/New Connections (grant number 65631); and a State of Maryland MPower Initiative Grant awarded to the University of Maryland College Park Department of Geographical Sciences. The funders had no role in the design, analysis or writing of this article. Conflict of interest: None. Authorship: E.R.H. conceived of this study. E.R.H., A.C. and D.H. conducted analyses for hypothesis testing. A.C., N.O. and J.H. gathered the spatial data and conducted the geocoding/spatial analyses. M.M.B., E.R.H., K.M.H. and N.O. gathered participant data. All authors participated in interpretation of findings and drafting and critically revising the manuscript for intellectual content. Ethics of human subject participation: This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the University of Maryland School of Medicine and public school system Institutional Review Boards. Written informed assent was obtained from all enrolled children and written informed consent was obtained from all parents/primary caregivers.
Publisher Copyright:
Copyright © The Authors 2016.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Objective: To determine whether living in a food swamp (≥4 corner stores within 0·40 km (0·25 miles) of home) or a food desert (generally, no supermarket or access to healthy foods) is associated with consumption of snacks/desserts or fruits/vegetables, and if neighbourhood-level socio-economic status (SES) confounds relationships. Design: Cross-sectional. Assessments included diet (Youth/Adolescent FFQ, skewed dietary variables normalized) and measured height/weight (BMI-for-age percentiles/Z-scores calculated). A geographic information system geocoded home addresses and mapped food deserts/food swamps. Associations examined using multiple linear regression (MLR) models adjusting for age and BMI-for-age Z-score. Setting: Baltimore City, MD, USA. Subjects: Early adolescent girls (6th/7th grade, n 634; mean age 12·1 years; 90·7 % African American; 52·4 % overweight/obese), recruited from twenty-two urban, low-income schools. Results: Girls' consumption of fruit, vegetables and snacks/desserts: 1·2, 1·7 and 3·4 servings/d, respectively. Girls' food environment: 10·4 % food desert only, 19·1 % food swamp only, 16·1 % both food desert/swamp and 54·4 % neither food desert/swamp. Average median neighbourhood-level household income: $US 35 298. In MLR models, girls living in both food deserts/swamps consumed additional servings of snacks/desserts v. girls living in neither (β=0·13, P=0·029; 3·8 v. 3·2 servings/d). Specifically, girls living in food swamps consumed more snacks/desserts than girls who did not (β=0·16, P=0·003; 3·7 v. 3·1 servings/d), with no confounding effect of neighbourhood-level SES. No associations were identified with food deserts or consumption of fruits/vegetables. Conclusions: Early adolescent girls living in food swamps consumed more snacks/desserts than girls not living in food swamps. Dietary interventions should consider the built environment/food access when addressing adolescent dietary behaviours.
AB - Objective: To determine whether living in a food swamp (≥4 corner stores within 0·40 km (0·25 miles) of home) or a food desert (generally, no supermarket or access to healthy foods) is associated with consumption of snacks/desserts or fruits/vegetables, and if neighbourhood-level socio-economic status (SES) confounds relationships. Design: Cross-sectional. Assessments included diet (Youth/Adolescent FFQ, skewed dietary variables normalized) and measured height/weight (BMI-for-age percentiles/Z-scores calculated). A geographic information system geocoded home addresses and mapped food deserts/food swamps. Associations examined using multiple linear regression (MLR) models adjusting for age and BMI-for-age Z-score. Setting: Baltimore City, MD, USA. Subjects: Early adolescent girls (6th/7th grade, n 634; mean age 12·1 years; 90·7 % African American; 52·4 % overweight/obese), recruited from twenty-two urban, low-income schools. Results: Girls' consumption of fruit, vegetables and snacks/desserts: 1·2, 1·7 and 3·4 servings/d, respectively. Girls' food environment: 10·4 % food desert only, 19·1 % food swamp only, 16·1 % both food desert/swamp and 54·4 % neither food desert/swamp. Average median neighbourhood-level household income: $US 35 298. In MLR models, girls living in both food deserts/swamps consumed additional servings of snacks/desserts v. girls living in neither (β=0·13, P=0·029; 3·8 v. 3·2 servings/d). Specifically, girls living in food swamps consumed more snacks/desserts than girls who did not (β=0·16, P=0·003; 3·7 v. 3·1 servings/d), with no confounding effect of neighbourhood-level SES. No associations were identified with food deserts or consumption of fruits/vegetables. Conclusions: Early adolescent girls living in food swamps consumed more snacks/desserts than girls not living in food swamps. Dietary interventions should consider the built environment/food access when addressing adolescent dietary behaviours.
KW - Adolescents
KW - African American
KW - Food desert/food swamp
KW - Geographic information system
KW - Snacks and desserts
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U2 - 10.1017/S1368980016002123
DO - 10.1017/S1368980016002123
M3 - Article
C2 - 27652511
AN - SCOPUS:84988646151
SN - 1368-9800
VL - 20
SP - 2598
EP - 2607
JO - Public health nutrition
JF - Public health nutrition
IS - 14
ER -