Outside of western countries, the study of the local food environment and evidence for its association with dietary behavior is limited. The aim of this paper was to examine the association between the local retail food environment and consumption of fruit and vegetables (FV) among adults in Hong Kong. Local retail food environment was measured by density of different types of retail food outlets (grocery stores, convenience stores, and fast food restaurants) within a 1000 m Euclidean buffer around individual’s homes using a geographic information system (GIS). The Retail Food Environment Index (RFEI) was calculated based on the relative density of fast-food restaurants and convenience stores to grocery stores. Logistic regressions were performed to examine associations using cross-sectional data of 1977 adults (18 years or older). Overall, people living in an area with the highest RFEI (Q4, >5.76) had significantly greater odds of infrequent FV consumption (<7 days/week) after covariates adjustment (infrequent fruit consumption: OR = 1.36, 95% CI 1.04–1.78; infrequent vegetable consumption: OR = 1.72, 95% CI 1.11–2.68) in comparison to the lowest RFEI (Q1, <2.25). Highest density of fast food restaurants (Q4, >53) was also significantly associated with greater odds of infrequent fruit consumption (<7 days/week) (unadjusted model: OR = 1.34, 95% CI 1.04–1.73), relative to lowest density of fast food restaurants (Q1, <13). No significant association of density of grocery stores or convenience stores was observed with infrequent FV consumption regardless of the covariates included in the model. Our results suggest that the ratio of fast-food restaurants and convenience stores to grocery stores near people’s home is an important environmental factor in meeting fruit and vegetable consumption guidelines. “Food swamps” (areas with an abundance of unhealthy foods) rather than “food deserts” (areas where there is limited access to healthy foods) seems to be more of a problem in Hong Kong’s urban areas. We advanced international literature by providing evidence in a non-western setting.

With decades of urbanization, housing and community problems (e.g., poor ventilation and lack of open public spaces) have become important social determinants of health that require increasing attention worldwide. Knowledge regarding the link between health and these problems can provide crucial evidence for building healthy communities. However, this link has heretofore not been identified in Hong Kong, and few studies have compared the health impact of housing and community conditions across different income groups. To overcome this gap, we hypothesize that the health impact of housing and community problems may vary across income groups and across health dimensions. We tested these hypotheses using cross-sectional survey data from Hong Kong. Several health outcomes, e.g., chronic diseases and the SF-12 v. 2 mental component summary scores, were correlated with a few types of housing and community problems, while other outcomes, such as the DASS-21–Stress scores, were sensitive to a broader range of problems. The middle- and low-income group was more severely affected by poor built environments. These results can be used to identify significant problems in the local built environment, especially amongst the middle- and low-income group.

Public rental housing (PRH) for low-income families has been shown in several studies to be associated with poor health status and obesity. However, the causes of this health disparity are controversial, and the associations and pathways between PRH and obesogenic behaviors remain unknown. Using cross-sectional survey data of 1977 adults living in Hong Kong (aged or over 18) together with multi-source GIS-based environmental data, we examined the associations between PRH and obesogenic behaviors and the extent to which those associations can be explained by neighborhood food and physical environment. The unhealthy food environment, which relates with infrequent fruit and vegetables consumption, was calculated based on the relative density of fast food restaurants and convenience stores to grocery stores. The physical activity environment, which relates to physical inactivity and prolonged sitting, was assessed in terms of density of sports facilities and street greenery, separately. Regressions and mediation analyses show that PRH was negatively associated with physical inactivity directly and also indirectly via higher sports facilities density; however, PRH was positively associated with unhealthy diet largely directly and positively associated with prolonged sitting indirectly via less street greenery. We advanced the international literature of PRH health impact assessment and its environmental health pathways by providing evidence from the least housing-affordable city in the world. The findings provide planning implications in formulating a healthier PRH community for these low-income PRH households and mitigating health disparities induced by housing type.