The proposed pre-doctoral training fellowship serves two overarching goals: 1) To enhance my quantitative and qualitative research methods skills toward applying for and obtaining a mixed methods R01grant; and 2) To apply and refine my public health training by conducting a dissertation research project to understand the effect of the changing food environment on obesity in a historically low-socioeconomic status (SES) community of color undergoing gentrification. Background: Since the late 1990s, the neighborhood of Central Harlem in New York City has been undergoing dramatic transformation as characterized by gentrification, a mixture of divestment and redevelopment. These changes influence the food environment (i.e. grocery outlets, restaurants, street vendors, and farmers' markets) and, with it, residents' food-related practices and health. Given the high rates of nutrition-related conditions such as obesity, diabetes, and cardiovascular disease in Harlem, any transformation in its food environment raises the need for investigation. The overarching question of my dissertation is: How does the changing food environment in Harlem, a neighborhood undergoing gentrification, affect residents' risk for obesity mediated by food-related dispositions and practices? Aims:
The specific aims are to: 1) Examine changes in Central Harlem's food environment during 1990-2010 by analyzing the NETS database; 2) Examine whether longitudinal changes in the food practices of mothers and children are associated with changes in weight measurements and risk for obesity using the Columbia Center of Children's Environmental Health (CCCEH) cohort data; 2a) Compare changes in the weights of mothers and children who have remained in Central Harlem and those who have moved from the neighborhood; 3) Use ethnographic methods (including participant observation, and in-depth interviews with a sub-set of CCCEH participants) and key informant interviews to explore ongoing changes in Harlem's food environment, and how these changes affect food practices and dispositions, thus corroborating and expanding upon the quantitative findings under Aims 1 and 2; and 4) Integrate the quantitative and qualitative findings and thus develop a provisional conceptual framework to understand the effects of gentrification on obesity as mediated by food practices and dispositions. Methods: Consistent with my training objectives, the study will apply an ethnographic and sociological framework of habitus to examine the relationship between gentrification, habitus and obesity prevalence among residents of a historically resource poor neighborhood. Specifically, I will conduct a mixed methods explanatory sequential design including three phases: 1) secondary longitudinal data analyses of the National Establishments Time-Series database and CCCEH mother-child pairs; 2) qualitative data collection and analysis by employing an ethnography of Harlem's food environment and interview with 15- 20 key informants and 45 CCCEH participants; and 3) integration of findings to develop a provisional conceptual framework that illustrates the effect o gentrification on obesity as mediated by food habitus.
A neighborhood undergoing gentrification, characterized by a mixture of divestment and redevelopment, also experiences changes in its food environment and by extension in its residents' health. Using a mixed methods approach, the proposed study will examine how the changing food environment in a community of color shapes its residents' food-related dispositions and practices and, in turn, determines obesity prevalence. This investigation, the first study of its kind in the United States, will inform obesity prevention polcy and practice, improve the design of multi-level interventions addressing disparities in the obesity epidemic, and enhance our theoretical framework for bridging structural factors to individual health practices.