An objective and subjective assessment of the nutrition environment in relation to county health outcomes
Methods. We used the Nutrition Environment Measurement Survey (NEMS) for both food stores and restaurants to generate a census-block NEI as part of the Assessment of the Nutrition Environment in Wisconsin Communities. Individual perceptions of the nutrition environment were obtained from the Survey of the Health of Wisconsin. County-level data were obtained from the County Health Rankings. We used multiple linear regression models to estimate the relationship between socio-demographic factors and county-level NEIs. Estimated census-block nutrition environment values were aggregated to create NEIs for each Wisconsin county. Correlations between county-level NEIs and premature death/obesity rates were calculated.
Results. Mean NEIs were higher for restaurants (mean = 36% of possible points) than stores (28%). Within stores, the quality (55%) and availability (28%) indices were generally better, compared to the price index (12.5%), with substantial within county variation. Correlations between county-level NEIs and obesity/premature death were statistically significant (range: 0.26-0.49).
Conclusions. Wisconsin's nutrition environment has significant room for improvement with regard to the price of and access to healthy foods. Further, variation in county NEIs underscores significant disparities in obesity determinants and related outcomes. Since our findings support the association of the nutrition environment with health outcomes, interventions aimed at providing healthier options and reducing access to unhealthy foods should be pursued.
Learning Areas:Chronic disease management and prevention
Other professions or practice related to public health
Public health or related public policy
Public health or related research
Social and behavioral sciences
Discuss the association of the Nutrition Environment, measured using NEMS restaurant and store scores, and health outcomes at the county level in Wisconsin. Describe which aspects of the Nutrition Environment strongly correlate with the health outcomes of obesity and premature death at the county level.
Keyword(s): Food and Nutrition, Obesity
Qualified on the content I am responsible for because: I am a Doctoral candidate at the University of Wisconsin School of Medicine and Public Health. I completed my MS work using data from the Assessment of the Nutrition Environment in Wisconsin Communities and the County Health Rankings. Specific tasks under my current research positions include assistance with original data compilation and analysis, literature reviews, and manuscript formation. I have co-authored several abstracts for professional conferences and manuscripts that have been published in peer-reviewed journals.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.