A food desert in Detroit: associations with food shopping and eating behaviours, dietary intakes and obesity

Objective: Currently 67% of the US population is overweight or obese and obesity is associated with several chronic medical conditions. Geographic areas where individuals lack access to healthy foods have been termed 'food deserts'. The study aim was to examine if area of residence within Metro Detroit was associated with dietary intake, food and shopping behaviours, and BMI. Design: Cross-sectional study. Settings: Participants were recruited in the waiting area of four primary-care clinics. Subjects: Individuals (n 1004) completed a questionnaire comprising four sections: demographics; personal health status including self-reported height and weight; a modified diet, transportation and shopping survey; and a subscale from the Diet and Health Knowledge Survey. Results: Seventy-four per cent of participants were female and the mean age was 46.7 (SD 15.0) years. In univariate analyses, living in Detroit was associated with being African American, unemployment, less education, no regular exercise, worse health self-rating and obesity (P<0.0005 for all). Participants living in Detroit had a 3.06 (95% CI 1.91, 4.21) kg/m(2) larger BMI compared with people living outside the city (P<0.0005) in univariate analyses, but the effect was attenuated when adjusted for demographics, disease status, shopping and eating behaviours, dietary intakes and diet knowledge (beta = -0.46 kg/m(2), 95% CI -2.23, 1.30 kg/m(2), P = 0.60). Conclusions: Overweight and obesity are highly prevalent both inside (82.9%) and outside (72.8%) the city of Detroit, presenting a major public health problem. However, living in this food desert was not significantly associated with BMI after potential covariates were considered.