Grocery store location in an urban multiethnic community: Mapping the relations to food access, obesity and diabetes in an underserved community

Introduction: Social determinants of health include consumers' ready access to affordable, nutritious food, including full-service groceries, but minority and high-poverty communities are less likely to have accessible national chain groceries. Indianapolis in 2008-09 was ranked among the top 25 foodhardship MSAs [19.9% families/past year]. Methods: Marion County, IN 2005 RDD survey of 4,787 respondents queried fruit and vegetable consumption, self-reported BMI and diabetes status of adults. These data, grocery inspection, and GIS census data allowed mapping analysis of the relations between high density poverty/minority areas and locations of full-service groceries per 1,000 population [with daily available wide variety of fresh produce, dairy and meat/poultry/fish items], convenience marts and licensed soup kitchens/food pantries. National chain stores were rare in high-poverty areas and most full service stores in poorer communities were locally and minority owned. The latter allowed over 94% of county adults to report access to fresh produce. However obesity and diabetes prevalence rates were greatest in areas served primarily by convenience stores and social-service/faith-based food pantries. These findings provide data for local nutrition-equity advocates, such as fiscal incentives for grocery placement; transportation strategies, local food co-ops and other mechanisms to increase community access to available grocery supplies. Implications: Social costs of low grocery availability in high-poverty census tracts are borne not only in affected communities' prevalence of obesity and diabetes, but also increases the likelihood of food insecurity in the broader population.