The childhood obesity epidemic is an increasing cause for national concern. Although a number of studies have demonstrated associations between availability of food stores and risk for obesity in adults,1,2 fewer studies have assessed impacts on children. Enhanced understanding of disparities in neighborhood food store availability may help in part explain racial/ethnic and socio-economic disparities in childhood obesity.
Low income, minority communities are particularly at risk for obesity, the very same communities that have limited access to grocery stores and supermarkets and increased access to fast food stores. Studies across the United States including Chicago,3 Detroit,4 and Los Angeles5 all demonstrate that lower socioeconomic and minority neighborhoods have fewer supermarkets. Meanwhile studies from New Orleans, Louisiana to Canada and Australia have demonstrated more fast food stores in low income neighborhoods compared to higher income neighborhoods.6-8
Low SES populations have less access to healthy foods to meet dietary guidelines. In a study comparing East Harlem, New York to the higher socioeconomic and predominantly white Upper East Side, only 18% of East Harlem stores carried foods recommended for diabetics, compared with 58% of the Upper East Side stores.9 In a separate study comparing two neighborhoods of Brooklyn, New York, predominantly black area stores carried canned and frozen fruits and vegetables whereas white neighborhood stores more typically offered fresh and organic produce.10 These studies highlight the community level barriers residents may face when trying to meet basic nutritional recommendations.
Why does this all matter? Food store availability, and supermarket availability in particular, has been shown to affect both dietary quality and body size as measured by body mass index (BMI). Residents without supermarkets close to their homes were 25-46% less likely to have a healthy diet than study participants who lived in areas of high supermarket density.11 Moreover, decreased neighborhood access to large, chain supermarkets was associated with higher BMI in adults.12
Less is known about the influence of the inner city food environment on a child's body size. Kipke et al. demonstrated that children living in low-income neighborhoods of East Los Angeles had proportionately more fast-food restaurants than grocery stores within walking distance of schools, which suggests that children have easy access to fast food and limited access to healthy food options.13 The greater the number of fast-food restaurants and convenience stores in proximity to the home, the lower the child's intake of fruits and vegetables14 and the higher the BMI.15 As seen in adults, decreased availability of supermarkets has demonstrated correlations with higher BMI in children aged 3 to 18
