Just how contextual is it: The role of neighborhoods in explaining differences in eating behavior

Background. Obesity is a critical health problem underlying many chronic diseases in North America. While rising obesity prevalence cuts across industrialized populations, not all groups are affected equally. Socioeconomic status differences have been shown to be important in understanding obesity risk. One line of research continues to document disparities in health behaviors and health outcomes. Another line of research tries to understand how neighborhood context can independently explain health outcomes. However, what is missing from the literature is an empirical understanding of how context explains health disparities. Our analysis addresses the question of whether neighborhood environment mediates the relationship between SES and eating behavior.

Methods. Our data comes from a survey of household food preparers belonging to religious organizations from one county in Washington State. Our neighborhood data comes from both self-report and from the US Census. Our analysis implements GEE as a method of adjusting the standard errors.

Results. We anticipate that aspects of the neighborhood environment related to eating environment, particularly perceptions of access to food, will mediate the relationship between SES and eating behavior.

Conclusions. Our research will provide some empirical traction in understanding not just how much neighborhoods affect health, but how much they are implicated in health disparities. Understanding how neighborhood environment explains health disparities will help us to think more clearly about the role of neighborhood level policy in improving the public's health.