Neighbourhood differences in diet: the Atherosclerosis Risk in Communities (ARIC) Study.

STUDY OBJECTIVE: To investigate whether neighbourhood characteristics are related to dietary patterns independently of individual level variables. DESIGN: A cross sectional analysis of the relation between neighbourhood median household income and food and nutrient intakes, before and after adjustment for individual level variables. SETTING: Four United States communities (Washington Co, MD; Suburban Minneapolis, MN; Forsyth Co, NC, and Jackson, MS). PARTICIPANTS: 13,095 adults aged 45 to 64 years participating in the baseline examination of the Atherosclerosis Risk in Communities (ARIC) Study, a prospective study of atherosclerosis. MEASUREMENTS AND MAIN RESULTS: Information on diet and individual level income was obtained from the baseline examination of the ARIC Study. Diet was assessed using a semi-quantitative food frequency questionnaire. Information on neighbourhood (census defined block groups) median household income was obtained from the 1990 US Census. Multilevel models were used to account for the multilevel structure of the data. Living in lower income neighbourhoods was generally associated with decreased energy adjusted intake of fruits, vegetables, fish, and increased intake of meat. Patterns generally persisted after adjustment for individual level income, but were often not statistically significant. Inconsistent associations were recorded for the intake of saturated fat, polyunsaturated fat, and cholesterol. Overall, individual level income was a more consistent predictor of diet than neighbourhood income. CONCLUSION: Despite limitations in the definition and characterisation of neighbourhoods, this study found consistent (albeit small) differences across neighbourhoods in food intake, suggesting that more in depth research into potential neighbourhood level determinants of diet is warranted.

[1]  B. Psaty,et al.  Do communities differ in health behaviors? , 1993, Journal of clinical epidemiology.

[2]  J. Feldman,et al.  National trends in educational differentials in mortality. , 1989, American journal of epidemiology.

[3]  Meir J. Stampfer,et al.  Total energy intake: implications for epidemiologic analyses. , 1986, American journal of epidemiology.

[4]  H. Morgenstern.  The changing association between social status and coronary heart disease in a rural population. , 1980, Social science & medicine. Medical psychology & medical sociology.

[5]  A. Sooman,et al.  Health and perceptions of the local environment in socially contrasting neighbourhoods in glasgow , 1995 .

[6]  S Wing,et al.  Geographic and socioeconomic variation in the onset of decline of coronary heart disease mortality in white women. , 1992, American journal of public health.

[7]  A. Anderson,et al.  Diets for Disease? Intraurban Variation in Reported Food Consumption in Glasgow , 1994, Appetite.

[8]  W Willett,et al.  Total energy intake: implications for epidemiologic analyses. , 1986, American journal of epidemiology.

[9]  J. Goldberger.  A Study of the Relation oí Family Income and other Economic Factors to Pellagra Incidence in Seven Cotton-Mill Villages of South Carolina in 1916. , 1920 .

[10]  M J Shipley,et al.  Magnitude and causes of socioeconomic differentials in mortality: further evidence from the Whitehall Study. , 1990, Journal of epidemiology and community health.

[11]  A. Ellaway,et al.  Does where you live predict health related behaviours?: a case study in Glasgow. , 1996, Health bulletin.

[12]  S. Macintyre,et al.  Area, Class and Health: Should we be Focusing on Places or People? , 1993, Journal of Social Policy.

[13]  O. Williams,et al.  Dietary intake patterns and sociodemographic factors in the atherosclerosis risk in communities study. ARIC Study Investigators. , 1994, Preventive medicine.

[14]  F. Thompson,et al.  Dietary assessment resource manual. , 1994, The Journal of nutrition.

[15]  J E Keil,et al.  Socioeconomic factors and cardiovascular disease: a review of the literature. , 1993, Circulation.

[16]  H A Lindberg,et al.  Relationship of Education to Major Risk Factors and Death from Coronary Heart Disease, Cardiovascular Diseases and All Causes Findings of Three Chicago Epidemiologic Studies , 1982, Circulation.

[17]  P Diehr,et al.  Community-level comparisons between the grocery store environment and individual dietary practices. , 1991, Preventive medicine.

[18]  C. Basch,et al.  The availability of low-fat milk in an inner-city Latino community: implications for nutrition education. , 1995, American journal of public health.

[19]  M. Szklo,et al.  Social inequalities and atherosclerosis. The atherosclerosis risk in communities study. , 1995, American journal of epidemiology.

[20]  Edward Steinman,et al.  Improving Access to Food in Low-Income Communities: An Investigation of Three Bay Area Neighborhoods , 1996 .

[21]  S Wing,et al.  Socioenvironmental characteristics associated with the onset of decline of ischemic heart disease mortality in the United States. , 1988, American journal of public health.

[22]  B. Popkin,et al.  A comparison of dietary trends among racial and socioeconomic groups in the United States. , 1996, The New England journal of medicine.

[23]  M. Haan,et al.  Poverty and health: Prospective evidence for the Alameda County Study , 1987 .

[24]  A. Folsom,et al.  The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators. , 1989, American journal of epidemiology.

[25]  Gower Street,et al.  Health inequalities among British civil servants: the Whitehall II study , 1991, The Lancet.

[26]  W. P. Noall.  The Treatment of Neglected Cases of Club-foot * , 1921, British medical journal.

[27]  V. Carstairs,et al.  Deprivation and mortality: an alternative to social class? , 1989, Community medicine.

[28]  D. Jones,et al.  Approaches to studying the effect of socio-economic circumstances on geographic differences in mortality in England and Wales. , 1984, British medical bulletin.

[29]  P. Sorlie,et al.  Mortality Effects of Community Socioeconomic Status , 1997, Epidemiology.

[30]  R. Ecob,et al.  People, places and coronary heart disease risk factors: a multilevel analysis of the Scottish Heart Health Study archive. , 1997, Social science & medicine.

[31]  C. Mooney.  Cost and availability of healthy food choices in a London health district , 1990 .

[32]  P. Savage,et al.  Diet, body size, and plasma lipids-lipoproteins in young adults: differences by race and sex. The Coronary Artery Risk Development in Young Adults (CARDIA) study. , 1991, American journal of epidemiology.

[33]  A. Adelstein,et al.  Changing social-class distribution of heart disease. , 1978, British medical journal.

[34]  D. Cook,et al.  SOCIAL CLASS DIFFERENCES IN ISCHAEMIC HEART DISEASE IN BRITISH MEN , 1987, The Lancet.

[35]  Anthony S. Bryk,et al.  Hierarchical Linear Models: Applications and Data Analysis Methods , 1992 .

[36]  A. Folsom,et al.  Educational attainment and nutrient consumption patterns: the Minnesota Heart Survey. , 1988, Journal of the American Dietetic Association.

[37]  G W Comstock,et al.  Neighborhood environments and coronary heart disease: a multilevel analysis. , 1997, American journal of epidemiology.

[38]  C. Basch,et al.  Independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease. , 1991, American journal of epidemiology.

[39]  D. Jacobs,et al.  Scoring systems for evaluating dietary pattern effect on serum cholesterol. , 1979, Preventive medicine.

[40]  W. Willett,et al.  Reproducibility and validity of a semiquantitative food frequency questionnaire. , 1985, American journal of epidemiology.

[41]  Barbara Entwisle,et al.  Contextual analysis through the multilevel linear model. , 1983 .

[42]  P. Metcalf,et al.  Reliability of a food frequency questionnaire by ethnicity, gender, age and education , 1996 .

[43]  David Caplovitz,et al.  The Poor Pay More , 1967 .

[44]  J. Buring,et al.  Occupation and risk of death from coronary heart disease. , 1987, JAMA.

[45]  N. Krieger.  Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology. , 1992, American journal of public health.

[46]  A. Anderson,et al.  Scotland's health--a more difficult challenge for some? The price and availability of healthy foods in socially contrasting localities in the west of Scotland. , 1993, Health bulletin.

[47]  V. Carstairs,et al.  Deprivation: explaining differences in mortality between Scotland and England and Wales. , 1989, BMJ.

[48]  Samuel Leinhardt,et al.  Sociological Methodology 1983-1984. , 1984 .

[49]  E A Frongillo,et al.  Sources of fiber and fat in diets of US women aged 19 to 50: implications for nutrition education and policy. , 1992, American journal of public health.