Geospatial Analysis of Food Deserts and Their Impact on Health Outcomes in Children with Cystic Fibrosis

Food insecurity (FI) is defined as “the limited or uncertain access to adequate food.” One root cause of FI is living in a food desert. FI rates among people with cystic fibrosis (CF) are higher than the general United States (US) population. There is limited data on the association between food deserts and CF health outcomes. We conducted a retrospective review of people with CF under 18 years of age at a single pediatric CF center from January to December 2019 using demographic information and CF health parameters. Using a Geographic Information System, we conducted a spatial overlay analysis at the census tract level using the 2015 Food Access Research Atlas to assess the association between food deserts and CF health outcomes. We used multivariate logistic regression analysis and adjusted for clinical covariates and demographic covariates, using the Child Opportunity Index (COI) to calculate odds ratios (OR) with confidence intervals (CI) for each health outcome. People with CF living in food deserts and the surrounding regions had lower body mass index/weight-for-length (OR 3.18, 95% CI: 1.01, 9.40, p ≤ 0.05 (food desert); OR 4.41, 95% CI: 1.60, 12.14, p ≤ 0.05 (600 ft buffer zone); OR 2.83, 95% CI: 1.18, 6.76, p ≤ 0.05 (1200 ft buffer zone)). Food deserts and their surrounding regions impact pediatric CF outcomes independent of COI. Providers should routinely screen for FI and proximity to food deserts. Interventions are essential to increase access to healthy and affordable food.

Download Full-text

Targeting the Root Cause of Cystic Fibrosis

Current Drug Targets ◽

10.2174/1389450115999141030144247 ◽

2015 ◽

Vol 16 (9) ◽

pp. 933-944

Author(s):

Laura Trescott ◽

Joshua Holcomb ◽

Nicholas Spellmon ◽

Cathy Mcleod ◽

Leala Aljehane ◽

...

Keyword(s):

Cystic Fibrosis ◽

Root Cause

Download Full-text

Health Disparities among adults cared for at an urban cystic fibrosis program

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-021-01965-4 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Emily DiMango ◽

Kaitlyn Simpson ◽

Elizabeth Menten ◽

Claire Keating ◽

Weijia Fan ◽

...

Keyword(s):

Cystic Fibrosis ◽

New York ◽

New York City ◽

Health Disparities ◽

Pulmonary Function ◽

Health Outcomes ◽

York City ◽

Median Income ◽

Cross Sectional ◽

Caucasian Patients

Abstract Background Evidence is conflicting regarding differential health outcomes in racial and ethnic minorities with cystic fibrosis (CF), a rare genetic disease affecting approximately 28,000 Americans. We performed a cross-sectional analysis of health outcomes in Black/Latinx patients compared with non-Hispanic Caucasian patients cared for in a CF center in New York City. Adult patients enrolled in the CF Foundation Patient Registry at the Columbia University Adult CF Program and seen at least once during 2019 were included. Health metrics were compared between Black/Latinx and non-Hispanic Caucasian patients. Results 262 patients were eligible. 39 patients (15%) identified as Black/Latinx or non-Hispanic Caucasian. Descriptive statistics are reported with mean (standard deviation). Current age was 35.9 (13.3) years for non-Hispanic Caucasian and 32.0 (9.3) years for Black/Latinx patients (p = 0.087). Age of diagnosis did not differ between groups; 9.56 (15.96) years versus 11.59 (15.8) years for non-Hispanic Caucasian versus Black/Latinx respectively (p = 0.464). Pulmonary function, measured as mean forced expiratory volume in one second (FEV1) was 70.6 (22.5) percent predicted in non-Hispanic Caucasian versus 59.50 (27.9) percent predicted in Black/Latinx patients (p = 0.010). Number of visits to the CF clinic were similar between groups. When controlled for age, gender, co-morbidities, median income, and insurance status, there was a continued association between minority status and lower FEV1. Conclusions Minorities with CF have significantly lower pulmonary function, the major marker of survival, than non-Hispanic Caucasians, even when controlled for a variety of demographic and socioeconomic factors that are known to affect health status in CF. Significant health disparities based on race and ethnicity exist at a single CF center in New York City, despite apparent similarities in access to guideline based care at an accredited CF Center. This data confirms the importance of design of culturally appropriate preventative and management strategies to better understand how to direct interventions to this vulnerable population with a rare disease.

Download Full-text

Spreading of Food Deserts in Time and Space: The Case of the City of Nitra (Slovakia)

Sustainability ◽

10.3390/su13137138 ◽

2021 ◽

Vol 13 (13) ◽

pp. 7138

Author(s):

Miroslava Trembošová ◽

Imrich Jakab

Keyword(s):

Planning Process ◽

Local Politics ◽

Food Deserts ◽

Business Community ◽

Food Desert ◽

Hierarchical Level ◽

Grocery Stores ◽

Territorial Development ◽

Time Availability ◽

The City

The aim of the article is to evaluate the time availability of food stores for the population permanently residing in the city of Nitra (Slovakia). Parts of the city where poor accessibility has been identified can be described as “food deserts”. In the last two decades, there have been dramatic changes in the retail network in Nitra, as well as extensive housing construction and an aging change in the demographic structure. Therefore, we evaluated the years 2008 and 2019 separately. This made it possible to evaluate the changes in time availability and the number of inhabitants located in individual zones. During the years 2008–2019, the residential zones of the city of Nitra increased by 43.86%, the area of food desert increased by up to 68.78%, and the number of inhabitants endangered by the food desert increased by 1100 residents, i.e., 23.9%. In 2008, 5.51% of Nitra’s residents lived in the food deserts, in approximately twelve years this percentage increased to 7.45% of the population (2019). The proximity to the nearest grocery was in Nitra in 2008 median 504 m, while in 2019 median 623 m. Evaluating the time availability of grocery stores and identifying so-called “food deserts” can be interesting for both the city’s residents and the business community, especially for potential developers. It can also be used effectively in the spatial planning process and in the rational management of complex territorial development, as well as in local politics. Given the character of the city of Nitra, it can be assumed that the acquired knowledge can be extrapolated to other post-socialist cities of a similar size and hierarchical level.

Download Full-text

An ecological study of food desert prevalence and 4th grade academic achievement in New York State school districts

Journal of Public Health Research ◽

10.4081/jphr.2014.319 ◽

2014 ◽

Vol 3 (3) ◽

Cited By ~ 2

Author(s):

Seth E. Frndak

Keyword(s):

Academic Achievement ◽

New York ◽

School District ◽

School Districts ◽

Ecological Study ◽

New York State ◽

Food Deserts ◽

Food Desert ◽

Achievement Scores ◽

York State

Background. This ecological study examines the relationship between food desert prevalence and academic achievement at the school district level. Design and methods. Sample included 232 suburban and urban school districts in New York State. Multiple open-source databases were merged to obtain: 4th grade science, English and math scores, school district demographic composition (NYS Report Card), regional socioeconomic indicators (American Community Survey), school district quality (US Common Core of Data), and food desert data (USDA Food Desert Atlas). Multiple regression models assessed the percentage of variation in achievement scores explained by food desert variables, after controlling for additional predictors. Results. The proportion of individuals living in food deserts significantly explained 4th grade achievement scores, after accounting for additional predictors. School districts with higher proportions of individuals living in food desert regions demonstrated lower 4th grade achievement across science, English and math. Conclusions. Food deserts appear to be related to academic achievement at the school district level among urban and suburban regions. Further research is needed to better understand how food access is associated with academic achievement at the individual level.

Download Full-text

P463 Cost of poverty and deprivation on health outcomes in children with cystic fibrosis: is it time to re-think medically based tariffs for cystic fibrosis care?

Journal of Cystic Fibrosis ◽

10.1016/s1569-1993(19)30755-6 ◽

2019 ◽

Vol 18 ◽

pp. S188

Author(s):

T. Newson ◽

L. Berry ◽

O. Smith

Keyword(s):

Cystic Fibrosis ◽

Health Outcomes

Download Full-text

Do Urban Food Deserts Exist in the Global South? An Analysis of Nairobi and Mexico City

Sustainability ◽

10.3390/su11071963 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1963 ◽

Cited By ~ 1

Author(s):

Jeremy Wagner ◽

Lucy Hinton ◽

Cameron McCordic ◽

Samuel Owuor ◽

Guénola Capron ◽

...

Keyword(s):

Food Insecurity ◽

Mexico City ◽

Dietary Diversity ◽

Food Deserts ◽

Household Survey ◽

Global South ◽

Food Desert ◽

Food Sources ◽

Household Food ◽

Household Survey Data

Recent conceptualizations of ‘food deserts’ have expanded from a sole focus on access to supermarkets, to food retail outlets, to all household food sources. Each iteration of the urban food desert concept has associated this kind of food sourcing behavior to poverty, food insecurity, and dietary diversity characteristics. While the term continues to evolve, there has been little empirical evidence to test whether these assumed associations hold in cities of the Global South. This paper empirically tests the premises of three iterations of the urban food desert concept using household survey data collected in Nairobi, Kenya, and Mexico City, Mexico. While these associations are statistically significant and show the expected correlation direction between household food sourcing behavior and food security, the strength of these relationships tends to be weak. These findings indicate that the urban food desert concept developed in North American and UK cities may have limited relevance to measuring urban food insecurity in the Global South.

Download Full-text

Racial Differences in Perceived Food Swamp and Food Desert Exposure and Disparities in Self-Reported Dietary Habits

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17197143 ◽

2020 ◽

Vol 17 (19) ◽

pp. 7143

Author(s):

Kristen Cooksey Stowers ◽

Qianxia Jiang ◽

Abiodun Atoloye ◽

Sean Lucan ◽

Kim Gans

Keyword(s):

Logistic Regression ◽

Health Status ◽

Racial Differences ◽

Weight Status ◽

Dietary Habits ◽

Multinomial Logistic Regression ◽

Food Deserts ◽

Food Desert ◽

Desert Area ◽

Food Swamp

Both food swamps and food deserts have been associated with racial, ethnic, and socioeconomic disparities in obesity rates. Little is known about how the distribution of food deserts and food swamps relate to disparities in self-reported dietary habits, and health status, particularly for historically marginalized groups. In a national U.S. sample of 4305 online survey participants (age 18+), multinomial logistic regression analyses were used to assess by race and ethnicity the likelihood of living in a food swamp or food desert area. Predicted probabilities of self-reported dietary habits, health status, and weight status were calculated using the fitted values from ordinal or multinomial logistic regression models adjusted for relevant covariates. Results showed that non-Hispanic, Black participants (N = 954) were most likely to report living in a food swamp. In the full and White subsamples (N = 2912), the perception of residing in a food swamp/desert was associated with less-healthful self-reported dietary habits overall. For non-Hispanic Blacks, regression results also showed that residents of perceived food swamp areas (OR = 0.66, p < 0.01, 95% CI (0.51, 0.86)) had a lower diet quality than those not living in a food swamp/food desert area. Black communities in particular may be at risk for environment-linked diet-related health inequities. These findings suggest that an individual’s perceptions of food swamp and food desert exposure may be related to diet habits among adults.

Download Full-text