2015 APHA Annual Meeting & Expo

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Online Program

330934
A nationwide, longitudinal study of food store accessibility and adult BMI


Tuesday, November 3, 2015 : 8:30 a.m. - 8:50 a.m.

Shannon Zenk, PhD, MPH, FAAN, Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL
Elizabeth Tarlov, PhD, RN, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL
Lisa M. Powell, PhD, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
Coady Wing, PhD, School of Public and Environmental Affairs, Indiana University, Bloomington, IN
Stephen Matthews, PhD, Departments of Sociology, Anthropology & Demography, The Pennsylvania State University, University Park, PA, PA
Kelly Jones, BSN, College of Nursing, University of Illinois at Chicago, Chicago, IL
Ana Clara Duran, PhD, Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL
Brian Bartle, MS, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL
Introduction.Despite considerable research on the neighborhood food environment and obesity, few studies are longitudinal or nationwide and policy-relevant questions remain regarding the relative importance of different food store types. The Weight And Veteran Environments Study is a longitudinal, nationwide study of adults followed over 7 years that will determine environmental attributes that help individuals maintain a healthier BMI. In this analysis, we examined cross-sectional and one-year longitudinal associations between food store availability and BMI.

Methods. The sample is 1.4 million military veterans aged 20-64 who received VA healthcare. We linked data on number of food stores near participants’ homes in 2011 and 2012 to electronic health record data on BMI in 2012 and 2013. OLS regression estimated cross-sectional associations. Panel data models incorporating person fixed effects estimated the impact of changes in chain and non-chain supermarket, supercenter, and grocery-store availability, controlling for individual- and neighborhood-level time-varying demographic characteristics. These models also adjust for time-invariant unobserved factors that are potential confounders.

Results. In preliminary, cross-sectional multivariable analyses, each additional chain supermarket within 3-miles was associated with 0.04-unit lower BMI, while each additional non-chain supermarket was associated with a 0.01-unit lower BMI. Supercenter presence was associated with a 0.20-unit higher BMI. These patterns held for store availability within 1-mile. In panel data models, an increase in grocery-store availability was associated with a reduction in BMI, while an increase in supercenter availability was associated with an increase in BMI.

Conclusions. Different food store types may differentially contribute to BMI changes over time.

Learning Areas:

Environmental health sciences
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss the relative effects of different food store types to BMI cross-sectionally and over time. Identify policy implications of the findings.

Keyword(s): Built Environment, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Zenk is Co-Principal Investigator on the study and has expertise on neighborhood food environments and obesityr isk.
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.

Back to: 4029.0: Food and the Environment