Obesity is the most pressing nutritional problem in the United States. Neighborhood environments may contribute to this problem by providing excess availability of calorie-dense snack foods and insufficient availability of low-calorie nutritious foods such as fruits and vegetables. Low-income individuals -- who often have difficult access to fresh fruits and vegetables -- consume less of these foods and are more likely to be overweight than others. To better our understanding of how neighborhood food availability influences consumer choice, and potentially contributes to the obesity problem, we propose an exploratory R21 study of these relationships. We will take advantage of two ongoing data collection efforts. In the first study, we are conducting in store observations on prices and shelf space devoted to fruits, vegetables, and calorie-dense snack foods in all retail stores in 114 urban census tracts in the southeastern part of Louisiana, combined with phone interviews with residents in these census tracts on their consumption of these foods. The second study, known as the Louisiana Behavioral Risk Factor Surveillance System, is an ongoing telephone survey of health-related behaviors of Louisiana residents, to which we will add questions on consumption of these foods. This will be combined with data on food store availability statewide. Our analysis will integrate concepts and methods from the fields of public health nutrition, geography, and retail marketing into a consumer economics framework. We will analyze data from both Louisiana studies using multilevel modeling methods to quantify the relationship between measures of neighborhood food availability and consumption of these foods by residents. Specifically, we will test whether the availability of fruits and vegetables and calorie-dense snack foods at the neighborhood level is associated with consumption of these foods by individuals, after controlling for prices, household income and individual socio-demographic characteristics. We hypothesize there will be independent and positive effects of availability on consumption. Public health importance: Through this project we will learn whether persons who live in neighborhoods with limited access to food stores with healthy items, specifically fruits and vegetables, and abundant access to food stores with high calorie snack foods are more likely to have eating habits that favor obesity. This information will help guide community efforts to create neighborhoods that promote health.
