A food desert in Detroit: associations with food shopping and eating behaviours, dietary intakes and obesity

Abstract

Objective: Currently 67 % of the US population is overweight or obese and obesity is associated with several chronic medical conditions. Geographic areas where individuals lack access to healthy foods have been termed 'food deserts'. The study aim was to examine if area of residence within Metro Detroit was associated with dietary intake, food and shopping behaviours, and BMI. Design: Cross-sectional study. Settings: Participants were recruited in the waiting area of four primary-care clinics. Subjects: Individuals (n 1004) completed a questionnaire comprising four sections: demographics; personal health status including self-reported height and weight; a modified diet, transportation and shopping survey; and a subscale from the Diet and Health Knowledge Survey. Results: Seventy-four per cent of participants were female and the mean age was 46?7 (SD 15?0) years. In univariate analyses, living in Detroit was associated with being African American, unemployment, less education, no regular exercise, worse health self-rating and obesity (P , 0?0005 for all). Participants living in Detroit had a 3?06 (95 % CI 1?91, 4?21) kg/m 2 larger BMI compared with people living outside the city (P , 0?0005) in univariate analyses, but the effect was attenuated when adjusted for demographics, disease status, shopping and eating behaviours, dietary intakes and diet knowledge (b 5 20?46 kg/m 2 , 95% CI 22?23, 1?30 kg/m 2 , P 5 0?60). Conclusions: Overweight and obesity are highly prevalent both inside (82?9 %) and outside (72?8 %) the city of Detroit, presenting a major public health problem. However, living in this food desert was not significantly associated with BMI after potential covariates were considered.

The Association between Food Security and Store-Specific and Overall Food Shopping Behaviors

“…In addition to in-store food purchasing behaviors, store utilization behaviors are of interest as well. Review of previous studies focusing specifically on food shopping behaviors suggests that low-income populations may grocery shop less frequently because of the timing of food assistance benefits, which would affect perishable items such as fresh fruits and vegetables 4–6,11–17 ; they may have insufficient spatial access (living further away from a grocery store) to supermarkets and grocery stores selling healthful foods 4,5,16,18–21 ; and they may lack transportation to facilitate food shopping 4,22 .…”

Health‐equity issues related to childhood obesity: a scoping review

“…The only elements that were not found to be consistently associated with obesity were food insecurity and food deserts from the food environment. The lack of association indicates a resilient response of the population, despite the limitations associated with their low income.…”

Towards comprehensive global monitoring of food environments and policies to reduce diet-related non-communicable diseases

“…Studies in the current issue reflect this heterogeneity. In a study conducted in Melbourne, Australia, for example, women who lived further from the nearest supermarket were less likely to consume low amounts of fast food (12) , but living in a food desert in Detroit, USA, was not significantly associated with residents' BMI (13) . Food cost is another important aspect of the food environment, and in this issue Holm et al (14) found a moderate reduction in the incidence of cardiovascular diseases and some cancers in Denmark when the rate of value-added tax on fruit and vegetables was halved and the tax on fats was increased.…”