The neighborhood food resource environment and the health of residents with chronic conditions - The food resource environment and the health of residents

BACKGROUND: Residence in disadvantaged neighborhoods is associated with poorer access to healthy foods. OBJECTIVE: To understand associations between the neighborhood food resource environment and residents' health status and body mass index (BMI) for adults with and without chronic conditions. DESIGN: Cross-sectional multilevel analysis. PARTICIPANTS: 2,536 adults from the 2000-2001 Los Angeles Family and Neighborhood Survey. MEASUREMENTS: The food resource environment was defined as the number of chain supermarkets, independent supermarkets, small markets, or convenience stores per roadway miles in the census tract. The main dependent variables were self-rated health, dichotomized as excellent or fair/poor, and body mass index (BMI). Multilevel regression models examined the association between the food resource environment and both BMI and the odds of reporting excellent health after adjustment for neighborhood SES and individual characteristics. RESULTS: More chain supermarkets per roadway mile in a census tract was associated with higher adjusted rates of reporting excellent health (33%, 38%, and 43% for those in the lowest, middle, and highest tertiles of chain supermarkets) and lower adjusted mean BMI (27, 26, and 25 kg/m(2)) for residents without a chronic condition, but not those with a chronic condition. In contrast, having more convenience stores per roadway mile was associated with lower health ratings only among adults with a chronic condition (39%, 32%, and 27% for the lowest to highest tertile of convenience stores). CONCLUSION: Health status and BMI are associated with the local food environment, but the associations differ by type of market and presence of a chronic condition.