Spatial Disparities: The Role of Nativity in Neighborhood Exposure to Alcohol and Tobacco Retailers

Abstract

Studies of retail environment, one of the social determinants of health, document racial/ethnic disparities in exposure to alcohol and tobacco (A and T) retailers, but have largely overlooked nativity. We examined associations between A and T retailer density and rates of foreign-born Latinx and foreign-born Asian residents in California census tracts (N = 7888), using spatial regressions and controlling for population and ecological confounders (e.g., population density, zoning, residential instability, urbanicity). Socio-demographic data came from the American Community Survey (2012-2016); census tract density of A and T retailers came from geocoded addresses from state license data for off-sale alcohol distributors and purchased data on tobacco retailers from a commercial provider. Models predicting A and T tract retailer density showed that the rate of foreign-born Latinx residents was associated with higher tobacco retailer density but lower alcohol retailer density, and demonstrate no significant associations between rate of foreign-born Asian residents tobacco and alcohol retail density. Retail environment could contribute to observed declines in immigrant health over time in the US and across generations.

A statewide study of disparities in local policies and tobacco, vape, and cannabis retail environments

“…We calculated the number of tobacco, vape, and cannabis stores within each jurisdiction, and standardized per 100 miles of roadway within the jurisdiction ( Bostean et al, 2022 , Gruenewald et al, 2006 ). Studies commonly standardize by population or roadway ( Holmes et al, 2014 , Lee et al, 2022 ); we use roadway because retailers generally cannot locate where there is no roadway.…”

“…We examined the percentages of non-Latinx Black, Latinx, and Asian populations to examine racial/ethnic disparities; we also included the percentage of foreign-born, given the moderating impact of nativity on ethnic disparities in exposure to alcohol and tobacco retailers in California ( Bostean et al, 2021 ). Percentage unemployed and median household income examined income-related disparities (education was not included because of high [r = 0.9] collinearity with Latinx).…”

“…A large literature documents greater densities of “unhealthy” retailers (e.g., tobacco, alcohol, fast food, cannabis) in socioeconomically disadvantaged and predominantly minority neighborhoods ( James et al, 2014 , Trangenstein et al, 2020 , Wheeler et al, 2020 , Yu et al, 2010 ). Some studies find tobacco retail environment disparities by nativity—a Chicago study found a positive correlation between retailer density and percentage foreign-born ( Novak et al, 2006 ), and a California study found a positive association with percentage foreign-born Latinx ( Bostean et al, 2021 ). A study of 80 tobacco control programs found that affluent localities were more likely to adopt tobacco retail environment policies ( Combs et al, 2019 )—notably, the first two US cities to ban tobacco sales within city limits, both in California ( Action on Smoking and Health, 2021 ), are among the top 2.5% most affluent in the state (U.S. Census Bureau, 2014 ).…”

Evaluation of Restrictions on Tobacco Sales to Youth Younger Than 21 Years in Cleveland, Ohio, Area

“…The decline in tobacco use in the US has been a notable public health achievement, 1 yet the prevalence of tobacco use among youth remains high, at 31.2% among high school students and 12.5% among middle school students. 2 There are substantial racial, ethnic, and sex disparities in how and what types of tobacco products are used by different adolescent populations, 3 , 4 , 5 which are likely compounded by disparities in tobacco retail density, 6 , 7 , 8 age restrictive sales adherence, 9 and targeted marketing by the tobacco industry. 10 , 11 , 12 Population-level interventions and policies are recommended to alter population and societal norms 13 , 14 ; however, care must be taken in implementing these strategies so as to not exacerbate existing inequities.…”

“…JAMA Network Open. 2022;5(7):e2222987. doi:10.1001/jamanetworkopen.2022.22987 (Reprinted) July 12, 2022 13/13 Downloaded From: https://jamanetwork.com/ on 07/18/2022…”