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Food availability, personal constraints, and community resources

¹ Center on Social Disparities in Health, University of California San Francisco, Department of Family and Community Medicine, 500 Parnassus Avenue, MU-3E, Box 0900, San Francisco, California 94143-0900, USA; and Population Research Center, University of Texas at Austin, 1 University Station G1800/1800 Main Building, Austin, Texas 78712-0543, USA
² Stanford Prevention Research Center, Stanford University School of Medicine, 211 Quarry Road, Room N229, Stanford, California 94305-5705, USA

Correspondence to:
Marilyn Winkleby, PhD, MPH, Professor of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, 211 Quarry Road, Room N229, Stanford, California 94305-5705, USA; winkleby{at}stanford.edu

Received for publication 12 March 2007. Revision received 12 March 2007.

Accepted for publication 20 May 2007

In the USA, a wide variety of affordable, nutritious food, such as vegetables, fruits, whole grains and lean proteins, found in supermarkets is often less available in economically deprived neighbourhoods compared with more affluent neighbourhoods.^1–3 At the same time, availability of inexpensive, energy-dense nutrient-poor foods, such as salty snacks, sweets and non-diet soft drinks found in convenience stores (fig 1A) are highly prevalent in deprived neighbourhoods.^{4 5} This double burden (lack of affordable, nutritious foods, combined with a plethora of inexpensive, unhealthy foods) is thought to contribute to high rates of obesity and its deleterious consequences, including diabetes, hypertension and cardiovascular disease, which are also more prevalent in deprived neighbourhoods. Compounding this burden are the challenges faced by people with low incomes (those most likely to live in deprived neighbourhoods) to find sufficient time, energy, and financial resources to pursue lifestyles that support healthy dietary habits and adequate physical activity in safe environments. These constraints are given little attention in the research literature. Furthermore, innovative resources that residents of deprived neighbourhoods often mobilise to enhance their health, such as transporting local produce directly to residents (fig 1B), are rarely acknowledged.

View larger version (71K): [in this window] [in a new window] [PowerPoint for Teaching]   Figure 1 (A) Inexpensive, energy-dense, nutrient-poor foods found in a convenience store; (B) truck containing fresh produce for sale to local residents.

	ACKNOWLEDGMENTS

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This study was funded as part of the National Institute of Environmental Health Sciences Initiative, in collaboration with six other National Institutes of Health (National Heart, Lung, and Blood Institute grant R01 HL67731 to Dr Winkleby). We wish to thank Alana Koehler for technical and administrative assistance.

	REFERENCES

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1. Morland K, Wing S, Diez Roux A, et al. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med 2002; 22: 23–9.[CrossRef][Medline]
2. Moore LV, Diez Roux AV. Associations of neighborhood characteristics with the location and type of food stores. Am J Public Health 2006; 96: 325–31.[Abstract/Free Full Text]
3. Jetter KM, Cassady DL. The availability and cost of healthier food alternatives. Am J Prev Med 2006; 3: 38–44.
4. Chuang YC, Cubbin C, Ahn D, et al. Effects of neighborhood socioeconomic status and convenience store concentration on individual-level smoking. J Epidemiol Community Health 2005; 5: 568–73.
5. Block JP, Scribner RA, DeSalvo KB. Fast food, race/ethnicity, and income: A geographic analysis. Am J Prev Med 2004; 27: 211–17.[Medline]

This Article Extract Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cubbin, C. Articles by Winkleby, M. A Search for Related Content PubMed PubMed Citation Articles by Cubbin, C. Articles by Winkleby, M. A Topic Collections JECH Gallery