Date Published: June 12, 2019
Publisher: Public Library of Science
Author(s): Brian Elbel, Kosuke Tamura, Zachary T. McDermott, Dustin T. Duncan, Jessica K. Athens, Erilia Wu, Tod Mijanovich, Amy Ellen Schwartz, Donald R. Olson.
Demographic and income disparities may impact food accessibility. Research has not yet well documented the precise location of healthy and unhealthy food resources around children’s homes and schools. The objective of this study was to examine the food environment around homes and schools for all public school children, stratified by race/ethnicity and poverty status. This cross-sectional study linked data on the exact home and school addresses of a population-based sample of public school children in New York City from 2013 to all corner stores, supermarkets, fast-food restaurants, and wait-service restaurants. Two measures were created around these addresses for all children: 1) distance to the nearest outlet, and 2) count of outlets within 0.25 miles. The total analytic sample included 789,520 K-12 graders. The average age was 11.78 years (SD ± 4.0 years). Black, Hispanic, and Asian students live and attend schools closer to nearly all food outlet types than White students, regardless of poverty status. Among not low-income students, Black, Hispanic, and Asian students were closer from home and school to corner stores and supermarkets, and had more supermarkets around school than White students. The context in which children live matters, and more nuanced data is important for development of appropriate solutions for childhood obesity. Future research should examine disparities in the food environment in other geographies and by other demographic characteristics, and then link these differences to health outcomes like body mass index. These findings can be used to better understand disparities in food access and to help design policies intended to promote healthy eating among children.
The epidemic of childhood obesity poses a public health crisis in the United States (U.S.). About one in five U.S. children is obese. Racial disparities continue, with Black and Hispanic youth having a greater obesity prevalence than non-Hispanic White and Asian children[2,3]. The causes of the epidemic of childhood obesity are thought to be multifaceted, and include individual, social, and environmental factors.
This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects were approved by the New York University School of Medicine Institutional Review Board; study #S13-00403. The study uses data previously collected as part of students’ education. Students who do not want to participate in the activity, or parents who do not want their children to participate, are able to opt out of participation in the activity through their schools. However there is no consent process as it is a part of education; the NYU School of Medicine’s Institutional Review Board approved a waiver of consent.
Students’ socio-demographic characteristics are shown in Table 1. Students were predominantly Hispanic (41%) and Black (26%), followed by Asian & Other (17%) and White (16%). The majority of the students (85%) were classified as low-income. The mean age of the students was 11.8 years (SD ± 4.0 years). Most students resided in Queens (32%), followed by Brooklyn (29%), the Bronx (22%), Manhattan (11%), and Staten Island (6%).
In our study of nearly 800,000 public school students in NYC, we examined disparities in food access by calculating the nearest distance to and the count of food outlet types, including corner stores, fast-food, wait-service, and supermarkets within 0.25 miles around the students’ home and school addresses. Overall, we found that Black, Hispanic, and Asian students live and attend schools closer to nearly all food outlets (corner stores, fast food outlets, wait service restaurants, and supermarkets) compared with White students, regardless of poverty status. Among not low-income students, Black, Hispanic, and Asian students were closer from home and school to corner stores and supermarkets, and had more supermarkets around their schools than White students. The majority of mean nearest distances to and counts of food outlets by type differed by poverty status across race/ethnicity.
We examined food access around homes and schools among a large sample of public school students in NYC, by race/ethnicity and poverty status interactions. Our findings unexpectedly show that among this sample there is significant access to all types of food outlets, not just unhealthy food outlets as hypothesized. Black, Hispanic, and Asian students, regardless of poverty status, had greater access to corner stores, fast-food restaurants, and supermarkets around homes and schools than did White students. Our findings can be used to better understand the disparities in food access and to design policies promoting healthy eating among children. In particular, we believe these findings demonstrate a need to develop policies that are not focused predominantly or exclusively on access. Rather than just working to improve access to stores like supermarkets—which are already available and abundant around children’s homes and schools—more attention could be given to improving other aspects of the food environment, such as the quality and cost of food that is available in these existing food outlets. This study establishes a base through which we can consider additional research and policy and program implications; in describing the existing disparities, we can better validate how such disparities come about, shifting the focus of policies and programs from equality in access to equity in access. Future research should examine disparities in the food environment in other geographies and by other demographic characteristics, and then link these differences to health outcomes like body mass index (BMI).