Mariana Souza Lopes1, Waleska Teixeira Caiaffa1, Amanda Cristina de Souza Andrade2, Deborah Carvalho Malta3, Sharrelle Barber4, Amélia Augusta de Lima Friche1. 1. Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Av. Alfredo Balena 190, Centro, Belo Horizonte, MG 30130-100, Brazil. 2. Observatório de Saúde Urbana, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil. 3. Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. 4. Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
Abstract
OBJECTIVE: To examine associations between economic residential segregation and prevalence of healthy and unhealthy eating markers. DESIGN: Cross-sectional. A stratified sample was selected in a three-stage process. Prevalence of eating markers and their 95 % CI were estimated according to economic residential segregation: high (most segregated); medium (integrated) and low (less segregated or integrated). Segregation was measured at the census tract and assessed using the Getis-Ord local $G_i^{\rm{\ast}}$ statistic based on the proportion of heads of household in a neighbourhood earning a monthly income of 0-3 minimum wages. Binary logistic regression using generalized estimating equations were used to model the associations. SETTING: Belo Horizonte, Brazil. PARTICIPANTS: Adults (n 1301) residing in the geographical environment (178 census tracts) of ten units of the Brazilian primary-care service known as the Health Academy Program. RESULTS: Of the 1301 participants, 27·7 % lived in highly segregated neighbourhoods, where prevalence of regular consumption of fruit was lower compared with more affluent areas (34·6 v. 53·2 %, respectively). Likewise, regular consumption of vegetables (70·1 v. 87·6 %), fish (23·6 v. 42·3 %) and replacement of lunch or dinner with snacks (0·8 v. 4·7 %) were lower in comparison to more affluent areas. In contrast, regular consumption of beans was higher (91·0 v. 79·5 %). The associations of high-segregated neighbourhood with consumption of vegetables (OR = 0·62; 95 % CI 0·39, 0·98) and beans (OR = 1·85; 95 % CI 1·07, 3·19) remained significant after adjustments. CONCLUSIONS: Economic residential segregation was associated with healthy eating markers even after adjustments for individual-level factors and perceived food environment.
OBJECTIVE: To examine associations between economic residential segregation and prevalence of healthy and unhealthy eating markers. DESIGN: Cross-sectional. A stratified sample was selected in a three-stage process. Prevalence of eating markers and their 95 % CI were estimated according to economic residential segregation: high (most segregated); medium (integrated) and low (less segregated or integrated). Segregation was measured at the census tract and assessed using the Getis-Ord local $G_i^{\rm{\ast}}$ statistic based on the proportion of heads of household in a neighbourhood earning a monthly income of 0-3 minimum wages. Binary logistic regression using generalized estimating equations were used to model the associations. SETTING: Belo Horizonte, Brazil. PARTICIPANTS: Adults (n 1301) residing in the geographical environment (178 census tracts) of ten units of the Brazilian primary-care service known as the Health Academy Program. RESULTS: Of the 1301 participants, 27·7 % lived in highly segregated neighbourhoods, where prevalence of regular consumption of fruit was lower compared with more affluent areas (34·6 v. 53·2 %, respectively). Likewise, regular consumption of vegetables (70·1 v. 87·6 %), fish (23·6 v. 42·3 %) and replacement of lunch or dinner with snacks (0·8 v. 4·7 %) were lower in comparison to more affluent areas. In contrast, regular consumption of beans was higher (91·0 v. 79·5 %). The associations of high-segregated neighbourhood with consumption of vegetables (OR = 0·62; 95 % CI 0·39, 0·98) and beans (OR = 1·85; 95 % CI 1·07, 3·19) remained significant after adjustments. CONCLUSIONS: Economic residential segregation was associated with healthy eating markers even after adjustments for individual-level factors and perceived food environment.
Entities:
Keywords:
Brazil; Food consumption; Residential segregation; Urban health
Authors: Joanna M N Guimarães; Goro Yamada; Sharrelle Barber; Waleska Teixeira Caiaffa; Amélia Augusta de Lima Friche; Mariana Carvalho de Menezes; Gervasio Santos; Isabel Santos; Leticia de Oliveira Cardoso; Ana V Diez Roux Journal: Am J Epidemiol Date: 2022-05-20 Impact factor: 5.363