Food environment and unfair treatment in a multiethnic urban sample

Background. Although most research has focused on implications of the food environment for diet, it may affect health and contribute to health disparities through additional pathways. This study examined whether the food environment (neighborhood store availability, store where shopped) was associated with reports of unfair treatment and depressive symptoms. Methods. We used the Detroit Healthy Environment Partnership's survey of 919 adults. Unfair treatment was measured as frequency of receiving “poorer service than other people at restaurants or stores” (dichotomized). Neighborhood food environment was measured as availability of five store types (large-grocery, small-grocery, convenience, liquor, specialty). Store where shopped was classified by type (supermarket, other) and location (Detroit, suburbs). CES-D measured depressive symptoms. Hierarchical regression estimated relationships, controlling for covariates (e.g., SES). Results. 27.7% of African-Americans reported unfair treatment compared to 17.4% and 14.7% of Latinos and Whites, respectively. Respondents with more liquor stores in their neighborhood were more likely to report unfair treatment, while those with a small grocer were less likely to report unfair treatment, though relationships were non-significant (p<0.10). Those shopping at a supermarket versus another store type were twice as likely to report unfair treatment (p<0.05). Store location was not related to unfair treatment. Associations did not differ by race/ethnicity. Unfair treatment was positively associated with depressive symptoms. Conclusions. African-Americans seeking healthy foods at supermarkets may encounter unfair treatment, with adverse consequences for mental health. Based on these results, planning and policy efforts that promote equity in physical and social access to food outlets will be discussed.