Food Deserts and Their Association with Obesity and Diabetes in Ohio

...........................................................................................................................................4 Introduction ......................................................................................................................................5 Statement of Purpose .......................................................................................................................6 Literature Review.............................................................................................................................6 Research Questions ........................................................................................................................12 Methods..........................................................................................................................................12 Results ............................................................................................................................................17 Discussion/Conclusion ...................................................................................................................22 References ......................................................................................................................................26 Appendix A: List of Public Health Competencies Met .................................................................31 FOOD DESERTS HEALTH EFFECTS IN OHIO 4 Abstract ObjectiveThe purpose of this study was to explore the association of food access, and availability, on prevalence of diabetes and obesity in Ohio census tracts designated as food deserts. MethodsCounty and census tract-level data were combined from the USDA Food Environment Atlas and USDA Food Desert Locator respectively. Statistical analysis was conducted using IBM Statistical Package for Social Sciences (SPSS). Non-normally distributed variables wereObjectiveThe purpose of this study was to explore the association of food access, and availability, on prevalence of diabetes and obesity in Ohio census tracts designated as food deserts. MethodsCounty and census tract-level data were combined from the USDA Food Environment Atlas and USDA Food Desert Locator respectively. Statistical analysis was conducted using IBM Statistical Package for Social Sciences (SPSS). Non-normally distributed variables were assessed using the Mann-Whitney nonparametric U-test and Spearman’s correlation coefficient. Significance was considered at the p<0.05 level. ResultsThe mean rate of obesity and diabetes in Ohio in food deserts are 29.5% and 10.7%, when compared to Ohio (29.2%, 10.7%) rates, and US rates (35.7%, 8.3%), respectively. No significant difference was found in the mean percentages of the population with diabetes in rural versus urban communities. Rural communities were found to have a significantly higher rate of obesity. Supercenters and convenience stores without gas were found to be directly related to the incidence of diabetes in the overall observed population. Convenience stores with no gas, fast food restaurants and recreational facilities were found to be negatively correlated to the percentage of the population comprised of African Americans. Poverty had a strong influence in the African American population. Low poverty communities were found to have nearly twice as many farmers’ markets as communities with a high poverty level. ConclusionThis study concludes that the accessibility of supermarkets and club stores were correlated to the number of cases of obesity, as was the number of convenience stores with gas, and farmers; markets. Future research should highlight the association of food deserts and diabetes. Futures studies should also feature analysis of data collected on an individual level. FOOD DESERTS HEALTH EFFECTS IN OHIO 5 Food deserts and their health effects in Ohio Many Americans are aware of the recommended food intake guidelines in order to lead a healthy life. However, not all are meeting the daily-recommended intake of fruits and vegetables, and are far exceeding the recommended intake of fat, added sugars and sodium. This contributes to several adverse health outcomes including obesity and numerous chronic diseases. The American Dietetic Association, the National Institutes of Health, and many other national organizations recommend a balanced diet based on the US Department of Agriculture's Food Guide Pyramid (Story, Kaphingst, Robinson-O'Brien, & Glanz, 2008). Recently, the USDA's food guide pyramid has been replaced with the concept of “My plate” to provide Americans with a simpler, easier guide. All foods are placed in one of five categories: grains, vegetables, fruits, dairy, and protein foods (with the exception of beans and peas, which are considered both protein foods and vegetables) (USDA, 2011). Chronic diseases are responsible for 7 out of 10 deaths in United States each year. In the year 2005 alone the prevalence of chronic disease among Americans totaled 133 million (CDC, 2012). The most prevalent chronic diseases are cardiovascular disease, diabetes, and cancer. Poor diet, lack of physical activity, tobacco use and excessive consumption of alcohol are all modifiable behaviors that are known to contribute to the onset of these chronic illnesses (CDC, 2012). Poor eating habits contribute to the increased epidemics of obesity and chronic diseases, more than individual factors like knowledge, skills or motivation (Story et al., 2008). The concept of "food deserts" was first introduced in Scotland in the early 1990s to explain disparities in food pricing. It is a term applied to areas with limited access to chain grocery stores. A food desert is any area where it is difficult to obtain healthy food. Food deserts are environments that are not conducive to health, presenting barriers that restrict access to FOOD DESERTS HEALTH EFFECTS IN OHIO 6 healthy food. Barriers to be considered are lack of access to food retailers, availability of nutritious foods, or affordability of foods. Currently, there are some sections of the population that lack access to healthy food. For instance, people living in low-income and/or predominantly black neighborhoods generally have less access to grocery stores and supermarkets (Zenk et al., 2011). Food deserts are most prevalent in areas of low socio-economic minority communities (Beaulac, Kristjansson, & Cummins, 2009). Statement of Purpose The purpose of this study is to explore the effect of foods deserts on prevalence of diabetes and obesity and population characteristics in Ohio.