Comparing nutrition environments in bodegas and fast-food restaurants.

Many small grocery stores or "bodegas" sell prepared or ready-to-eat items, filling a niche in the food environment similar to fast-food restaurants. However, little comparative information is available about the nutrition environments of bodegas and fast-food outlets. This study compared the nutrition environments of bodegas and national chain fast-food restaurants using a common audit instrument, the Nutrition Environment Measures Study in Restaurants (NEMS-R) protocol. The analytic sample included 109 bodegas and 107 fast-food restaurants located in New York City neighborhoods in the upper third and lower third of the census tract poverty rate distribution. Inter-rater reliability was evaluated in 102 food outlets, including 31 from the analytic sample and 71 from a supplementary convenience sample. The analysis compared scores on individual NEMS-R items, a total summary score, and subscores indicating healthy food availability, nutrition information, promotions of healthy or unhealthy eating, and price incentives for healthy eating, using t tests and χ(2) statistics to evaluate differences by outlet type and neighborhood poverty. Fast-food restaurants were more likely to provide nutrition information, and bodegas scored higher on healthy food availability, promotions, and pricing. Bodegas and fast-food restaurants had similar NEMS-R total scores (bodegas 13.09, fast food 14.31; P=0.22). NEMS-R total scores were higher (indicating healthier environments) in low- than high-poverty neighborhoods among both bodegas (14.79 vs 11.54; P=0.01) and fast-food restaurants (16.27 vs 11.60; P<0.01). Results imply different policy measures to improve nutrition environments in the two types of food outlets.

Associations between body mass index and park proximity, size, cleanliness, and recreational facilities.

PURPOSE: To determine whether body mass index (BMI) is associated with proximity to neighborhood parks, the size of the parks, their cleanliness, and the availability of recreational facilities in the parks. DESIGN: Cross-sectional. SETTING: New York City. SUBJECTS: Adults (13,102) were recruited from 2000 to 2002 (median age 45 years, 36% male). MEASURES: Anthropometric and sociodemographic data from study subjects were linked to Department of Parks & Recreation data on park space, cleanliness, and facilities. Neighborhood-level sociodemographic and park proximity metrics were created for half-mile-radius circular buffers around each subject's residence. Proximity to park space was measured as the proportion of the subject's neighborhood buffer area that was total park space, large park space (a park > 6 acres) and small park space (a park ≤ 6 acres). Analysis. Hierarchical linear models were used to determine whether neighborhood park metrics were associated with BMI. RESULTS: Higher proximity to large park space was significantly associated with lower BMI (beta  =  -1.69, 95% confidence interval  =  -2.76, -.63). Across the population distribution of proximity to large park space, compared to subjects living in neighborhoods at the 10th percentile of the distribution, the covariate-adjusted average BMI was estimated to be .35 kg/m lower for those living in neighborhoods at the 90th percentile. The proportion of neighborhood area that was small park space was not associated with BMI, nor was park cleanliness or the availability of recreational facilities. CONCLUSION: Neighborhood proximity to large park spaces is modestly associated with lower BMI in a diverse urban population.

Disparities in neighborhood food environments: implications of measurement strategies.

Public health researchers have begun to map the neighborhood "food environment" and examine its association with the risk of overweight and obesity. Some argue that "food deserts"­areas with little or no provision of fresh produce and other healthy food­may contribute to disparities in obesity, diabetes, and related health problems. While research on neighborhood food environments has taken advantage of more technically sophisticated ways to assess distance and density, in general, it has not considered how individual or neighborhood conditions might modify physical distance and thereby affect patterns of spatial accessibility. This study carried out a series of sensitivity analyses to illustrate the effects on the measurement of disparities in food environments of adjusting for cross-neighborhood variation in vehicle ownership rates, public transit access, and impediments to pedestrian travel, such as crime and poor traffic safety. The analysis used geographic information systems data for New York City supermarkets, fruit and vegetable markets, and farmers' markets and employed both kernel density and distance measures. We found that adjusting for vehicle ownership and crime tended to increase measured disparities in access to supermarkets by neighborhood race/ethnicity and income, while adjusting for public transit and traffic safety tended to narrow these disparities. Further, considering fruit and vegetable markets and farmers' markets, as well as supermarkets, increased the density of healthy food outlets, especially in neighborhoods with high concentrations of Hispanics, Asians, and foreign-born residents and in high-poverty neighborhoods.