scholarly journals Understanding the Intersection of Race/Ethnicity, Socioeconomic Status, and Geographic Location: A Scoping Review of U.S. Consumer Food Purchasing

2020 ◽  
Vol 17 (20) ◽  
pp. 7677 ◽  
Author(s):  
Chelsea Singleton ◽  
Megan Winkler ◽  
Bailey Houghtaling ◽  
Oluwafikayo Adeyemi ◽  
Alexandra Roehll ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Scoping Review ◽  
Low Income ◽  
Geographic Location ◽  
Healthy Eating Index ◽  
Food Purchasing ◽  
Food Purchases ◽  
Sweetened Beverages ◽  
Food And Beverage ◽  
Race Ethnicity

Disparities in diet quality persist in the U.S. Examining consumer food purchasing can provide unique insight into the nutritional inequities documented by race/ethnicity, socioeconomic status (SES), and geographic location (i.e., urban vs. rural). There remains limited understanding of how these three factors intersect to influence consumer food purchasing. This study aimed to summarize peer-reviewed scientific studies that provided an intersectional perspective on U.S. consumer food purchasing. Thirty-four studies were examined that presented objectively measured data on purchasing outcomes of interest (e.g., fruits, vegetables, salty snacks, sugar-sweetened beverages, Healthy Eating Index, etc.). All studies were of acceptable or high quality. Only six studies (17.6%) assessed consumer food purchases at the intersection of race/ethnicity, SES, or geographic location. Other studies evaluated racial/ethnic or SES differences in food purchasing or described the food and/or beverage purchases of a targeted population (example: low-income non-Hispanic Black households). No study assessed geographic differences in food or beverage purchases or examined purchases at the intersection of all three factors. Overall, this scoping review highlights the scarcity of literature on the role of intersectionality in consumer food and beverage purchasing and provides recommendations for future studies to grow this important area of research.

scholarly journals AB0142 SOCIOECONOMIC STATUS (SES) AND MEDICATION USE IN RHEUMATOID ARTHRITIS (RA): A SCOPING REVIEW

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1098.2-1099
Author(s):  
O. Russell ◽  
S. Lester ◽  
R. Black ◽  
C. Hill
Keyword(s):  
Rheumatoid Arthritis ◽  
Socioeconomic Status ◽  
Scoping Review ◽  
Research Training ◽  
Medication Use ◽  
Study Group ◽  
Knowledge Gaps ◽  
Coverage Area ◽  
Race Ethnicity ◽  
The Impact

Background:Socioeconomic status (SES) influences disease outcomes in rheumatoid arthritis (RA) patients. (1, 2) Differences in medication use could partly explain this association. (3) A scoping review was used to identify research conducted on this topic and determine what knowledge gaps remain.Objectives:To determine what research has been conducted on this topic, how this research has defined SES and medication use, and establish what knowledge gaps remain.Methods:MEDLINE, EMBASE and PsychInfo were searched from their inception until May 2019 for studies which assessed SES and medication use as outcome variables. Studies were included if they measured medication use and incorporated an SES measure as a comparator variable.SES was defined using any of the “PROGRESS” framework variables (4) including patients’ stated gender, age, educational attainment, employment, occupational class, personal income, marital status, health insurance coverage, area- (neighbourhood) level SES, or patients’ stated race and/or ethnicity. Medication use was broadly defined as either prescription or dispensation of a medicine, medication adherence, or delays in treatment. Data was extracted on studies’ primary objectives, measurement of specific SES measures, patients’ medication use, and whether studies assessed for differences in patients’ medication use according to SES variables.Results:1464 studies were identified by this search from which 74 studies were selected for inclusion, including 52 published articles. Studies’ publication year ranged from 1994-2019, and originated from 20 countries; most commonly from the USA.Studies measured a median of 4 SES variables (IQR 3-6), with educational achievement, area level SES and race/ethnicity the most frequently recorded.Likelihood of disease modifying antirheumatic drug (DMARD) prescription was the most frequent primary objective recorded.96% of studies reported on patients’ use of DMARDs, with glucocorticoids and analgesics being reported in fewer studies (51% and 23% respectively.)Most included studies found at least one SES measure to be significantly associated with differences in patients’ medication use. In some studies, however, this result was not necessarily drawn from the primary outcome and therefore may not have been adjusted for covariates.70% of published studies measuring patients’ income (n=14 of 20) and 58% of those that measured race/ethnicity (n=14 of 24) documented significant differences in patients’ medication use according to these SES variables, although the direction of this effect – whether it led to ‘greater’ or ‘lesser’ medication use – varied between studies.Conclusion:Multiple definitions of SES are used in studies of medication use in RA patients. Despite this, most identified studies found evidence of a difference in medication use by patient groups that differed by an SES variable, although how medication use differed was found to vary between studies. This latter observation may relate to contextual factors pertaining to differences in countries’ healthcare systems. Further prospective studies with clearly defined SES and medication use measures may help confirm the apparent association between SES and differences in medication use.References:[1]Jacobi CE, Mol GD, Boshuizen HC, Rupp I, Dinant HJ, Van Den Bos GA. Impact of socioeconomic status on the course of rheumatoid arthritis and on related use of health care services. Arthritis Rheum. 2003;49(4):567-73.[2]ERAS Study Group. Socioeconomic deprivation and rheumatoid disease: what lessons for the health service? ERAS Study Group. Early Rheumatoid Arthritis Study. Annals of the rheumatic diseases. 2000;59(10):794-9.[3]Verstappen SMM. The impact of socio-economic status in rheumatoid arthritis. Rheumatology (Oxford). 2017;56(7):1051-2.[4]O’Neill J, Tabish H, Welch V, Petticrew M, Pottie K, Clarke M, et al. Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health. J Clin Epidemiol. 2014;67(1):56-64.Acknowledgements:This research was supported by an Australian Government Research Training Program Scholarship.Disclosure of Interests:None declared

scholarly journals Where do food desert residents buy most of their junk food? Supermarkets

2016 ◽  
Vol 20 (14) ◽  
pp. 2608-2616 ◽  
Author(s):  
Christine A Vaughan ◽  
Deborah A Cohen ◽  
Madhumita Ghosh-Dastidar ◽  
Gerald P Hunter ◽  
Tamara Dubowitz
Keyword(s):  
Low Income ◽  
Food Desert ◽  
Healthy Foods ◽  
Food Retail ◽  
Limited Access ◽  
Food Purchases ◽  
Convenience Stores ◽  
Food And Beverage ◽  
Predominantly Female ◽  
Access To Healthy Foods

Abstract Objective To examine where residents in an area with limited access to healthy foods (an urban food desert) purchased healthier and less healthy foods. Design Food shopping receipts were collected over a one-week period in 2013. These were analysed to describe where residents shopped for food and what types of food they bought. Setting Two low-income, predominantly African-American neighbourhoods with limited access to healthy foods in Pittsburgh, PA, USA. Subjects Two hundred and ninety-three households in which the primary food shoppers were predominantly female (77·8 %) and non-Hispanic black (91·1 %) adults. Results Full-service supermarkets were by far the most common food retail outlet from which food receipts were returned and accounted for a much larger proportion (57·4 %) of food and beverage expenditures, both healthy and unhealthy, than other food retail outlets. Although patronized less frequently, convenience stores were notable purveyors of unhealthy foods. Conclusions Findings highlight the need to implement policies that can help to decrease unhealthy food purchases in full-service supermarkets and convenience stores and increase healthy food purchases in convenience stores.

scholarly journals Impact of Socioeconomic Status and Race on Sepsis Epidemiology and Outcomes

2020 ◽  
Author(s):  
Emi Minejima ◽  
Annie Wong-Beringer
Keyword(s):  
Socioeconomic Status ◽  
Low Income ◽  
Formal Education ◽  
Geographic Location ◽  
The United States ◽  
Risk Scores ◽  
Low Ses ◽  
The Relationship ◽  
Poor Health Literacy ◽  
Hispanic White

Abstract Background Socioeconomic status (SES) is a complex variable that is derived primarily from an individual’s education, income, and occupation and has been found to be inversely related to outcomes of health conditions. Sepsis is the sixth most common admitting diagnosis and one of the most costly conditions for in-hospital spending in the United States. The objective of this review is to report on the relationship between SES and sepsis incidence and associated outcomes. Content Sepsis epidemiology varies when explored by race, education, geographic location, income, and insurance status. Sepsis incidence was significantly increased in individuals of Black race compared with non-Hispanic white race; in persons who have less formal education, who lack insurance, and who have low income; and in certain US regions. People with low SES are likely to have onset of sepsis significantly earlier in life and to have poorly controlled comorbidities compared with those with higher SES. Sepsis mortality and hospital readmission is increased in individuals who lack insurance, who reside in low-income or medically underserved areas, who live far from healthcare, and who lack higher level education; however, a person’s race was not consistently found to increase mortality. Summary Interventions to minimize healthcare disparity for individuals with low SES should target sepsis prevention with increasing measures for preventive care for chronic conditions. Significant barriers described for access to care by people with low SES include cost, transportation, poor health literacy, and lack of a social network. Future studies should include polysocial risk scores that are consistently defined to allow for meaningful comparison across studies.

scholarly journals Enhancing understanding of food purchasing patterns in the Northeast US using multiple datasets

2019 ◽  
pp. 1-15 ◽  
Author(s):  
Anne Palmer ◽  
Alessandro Bonanno ◽  
Kate Clancy ◽  
Clare Cho ◽  
Rebecca Cleary ◽  
...  
Keyword(s):  
Low Income ◽  
Race And Ethnicity ◽  
Geographic Location ◽  
Secondary Data ◽  
Research Area ◽  
Primary Data ◽  
Income Levels ◽  
Food Purchasing ◽  
New Findings ◽  
Purchasing Patterns

Abstract Due to correlations between purchasing patterns and diet disparities, differences in food shopping patterns and strategies across income levels and other socio-economic characteristics is a widely-studied research area. Most extant literature uses either primary or secondary data, which are often characterized by, respectively, limited geographical scope and considerable level of detail, or wide geographical reach but low detail. That literature also reveals contrasting results based on methods, data sources and geographic location. In this paper, we use three different datasets to characterize the differences in purchasing patterns across income levels, rural–urban status and other variables of food shoppers in the Northeastern USA and compare these trends with existing research. While many of the findings corroborate previous studies, new findings include less reliance on superstores overall, except for rural respondents, and a greater reliance on limited assortment supermarkets for SNAP and low-income households. Food purchasing differences are described by race and ethnicity, income and education, and children in the household. The analysis presented here includes a portion of the work performed by an interdisciplinary team of researchers engaged in the USDA National Institute of Food and Agriculture's Agriculture and Food Research Initiative project Enhancing Food Security in the Northeast (EFSNE). By using primary data from shoppers' intercept surveys, and secondary data from two large datasets, one of household food purchases and the other of food expenditures, we identify purchasing decisions holding at both the case-study (limited geography) and broader geographic (entire Northeast) levels, which both support previous findings and reveal the need for additional research in this area.

scholarly journals Food and beverage purchases in corner stores, gas-marts, pharmacies and dollar stores

2016 ◽  
Vol 20 (14) ◽  
pp. 2587-2597 ◽  
Author(s):  
Caitlin E Caspi ◽  
Kathleen Lenk ◽  
Jennifer E Pelletier ◽  
Timothy L Barnes ◽  
Lisa Harnack ◽  
...  
Keyword(s):  
Nutritional Quality ◽  
Healthy Eating Index ◽  
Traditional Food ◽  
Dietary Recommendations ◽  
Food Stores ◽  
Sweetened Beverages ◽  
Food Retailers ◽  
Corner Stores ◽  
Food And Beverage

Abstract Objective Little is known about customer purchases of foods and beverages from small and non-traditional food retailers (i.e. corner stores, gas-marts, dollar stores and pharmacies). The present study aimed to: (i) describe customer characteristics, shopping frequency and reasons for shopping at small and non-traditional food retailers; and (ii) describe food/beverage purchases and their nutritional quality, including differences across store type. Design Data were collected through customer intercept interviews. Nutritional quality of food/beverage purchases was analysed; a Healthy Eating Index-2010 (HEI-2010) score for purchases was created by aggregating participant purchases at each store. Setting Small and non-traditional food stores that were not WIC-authorized in Minneapolis and St. Paul, MN, USA. Subjects Customers (n 661) from 105 food retailers. Results Among participants, 29 % shopped at the store at least once daily; an additional 44 % shopped there at least once weekly. Most participants (74 %) cited convenient location as the primary draw to the store. Customers purchased a median of 2262 kJ (540 kcal), which varied by store type (P=0·04). The amount of added sugar far surpassed national dietary recommendations. At dollar stores, participants purchased a median of 5302 kJ (1266 kcal) for a median value of $US 2·89. Sugar-sweetened beverages were the most common purchase. The mean HEI-2010 score across all stores was 36·4. Conclusions Small and non-traditional food stores contribute to the urban food environment. Given the poor nutritional quality of purchases, findings support the need for interventions that address customer decision making in these stores.

scholarly journals The Healthy Start scheme and its association with food expenditure in low-income families in the UK

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Parnham ◽  
C Millett ◽  
K Chang ◽  
S von Hinke ◽  
J Pearson-Stuttard ◽  
...  
Keyword(s):  
United Kingdom ◽  
Infant Formula ◽  
Low Income ◽  
Healthy Start ◽  
Fruit And Vegetable ◽  
Food Purchasing ◽  
Food Purchases ◽  
The United Kingdom ◽  
Low Income Families ◽  
The Uk

Abstract Background The Healthy Start programme is a statutory benefit-in-kind in the United Kingdom (UK) which aims to enable low-income families to purchase fruit, vegetables, cow's milk and infant formula through the provision of vouchers. The scheme was introduced in 2006, however, the effect on food purchasing in participating households has not been evaluated within an eligible population. This study aimed to determine whether participation in the Healthy Start (HS) scheme is associated with differences in food purchasing in a representative sample of households in the United Kingdom. Methods Cross-sectional analysis of the Living Costs and Food Survey dataset (2010-2017). All households with a child (0-3 years) or pregnant woman were included in the analysis (n = 4,869). Multivariable quantile regression was used to compare the expenditure and quantity of fruit and vegetable, infant formula and total food purchases between Healthy Start participating, eligible non-participating, nearly-eligible and ineligible households. Results 54% (n = 475) of eligible households participated in Healthy Start. After accounting for covariates, no significant difference was found in the quantity or expenditure of fruit and vegetable purchases between Healthy Start participating and non-participating households. Fruit and vegetable expenditure (£/week) was found to be higher in nearly eligible (β1.60; 95% CI 0.79, 2.41) and ineligible households (β2.56; 95% CI 1.77, 3.35) compared to Healthy Start eligible households. Conclusions The present study did not demonstrate significant differences in the fruit and vegetable expenditure of HS participating and non-participating households. The analysis demonstrates that inequalities in fruit and vegetable purchasing persists in the UK. Improved participation and increased voucher value may be needed to promote well-being and counteract the harmful effect of poverty on fruit and vegetables purchasing. Key messages The study found no evidence of different food purchases between Healthy Start participating and non-participating households. Increased voucher value may be needed to counteract food-price inflation. The paper reflected persistent socioeconomic inequalities in the UK, indicating the Healthy Start scheme does not sufficiently counteract the harmful effects of poverty on food purchasing.

scholarly journals Disparities in Vulnerability to Severe Complications from COVID-19 in the United States

2020 ◽  
Author(s):  
Emily E. Wiemers ◽  
Scott Abrahams ◽  
Marwa AlFakhri ◽  
V. Joseph Hotz ◽  
Robert F. Schoeni ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Low Income ◽  
Respiratory Infections ◽  
Panel Study ◽  
The United States ◽  
Adverse Outcomes ◽  
Income Dynamics ◽  
High School Degree ◽  
Race Ethnicity ◽  
Nationally Representative

AbstractThis paper provides the first nationally representative estimates of vulnerability to severe complications from COVID-19 overall and across race-ethnicity and socioeconomic status. We use the Panel Study of Income Dynamics (PSID) to examine the prevalence of specific health conditions associated with complications from COVID-19 and to calculate, for each individual, an index of the risk of severe complications from respiratory infections developed by DeCaprio et al. (2020). We show large disparities across race-ethnicity and socioeconomic status in the prevalence of conditions which are associated with the risk of severe complications from COVID-19. Moreover, we show that these disparities emerge early in life, prior to age 65, leading to higher vulnerability to such complications. While vulnerability is highest among older adults regardless of their race-ethnicity or socioeconomic status, our results suggest particular attention should also be given to the risk of adverse outcomes in midlife for non-Hispanic Blacks, adults with a high school degree or less, and low-income Americans.

Food purchasing behaviour of shoppers from different South African socio-economic communities: results from grocery receipts, intercept surveys and in-supermarkets audits

2020 ◽  
pp. 1-12
Author(s):  
Feyisayo A Odunitan-Wayas ◽  
Kufre J Okop ◽  
Robert VH Dover ◽  
Olufunke A Alaba ◽  
Lisa K Micklesfield ◽  
...  
Keyword(s):  
South African ◽  
Low Income ◽  
Fruits And Vegetables ◽  
Economic Status ◽  
Descriptive Analysis ◽  
Healthy Foods ◽  
Shelf Space ◽  
Food Purchasing ◽  
Food Items ◽  
Food Purchases

Abstract Objective: To identify factors associated with food purchasing decisions and expenditure of South African supermarket shoppers across income levels. Design: Intercept surveys were conducted, grocery receipts collated and expenditure coded into categories, with each category calculated as percentage of the total expenditure. In-supermarket food quality audit and shelf space measurements of foods such as fruits and vegetables (F&V) (healthy foods), snacks and sugar-sweetened beverages (SSB) (unhealthy foods) were also assessed. Shoppers and supermarkets were classified by high-, middle- and low-income socio-economic areas (SEA) of residential area and location, respectively. Shoppers were also classified as “out-shoppers” (persons shopping outside their residential SEA) and “in-shoppers” (persons shopping in their residential SEA). Data were analysed using descriptive analysis and ANOVA. Setting: Supermarkets located in different SEA in urban Cape Town. Participants: Three hundred ninety-five shoppers from eleven purposively selected supermarkets. Results: Shelf space ratio of total healthy foods v. unhealthy foods in all the supermarkets was low, with supermarkets located in high SEA having the lowest ratio but better quality of fresh F&V. The share expenditure on SSB and snacks was higher than F&V in all SEA. Food secure shoppers spent more on food, but food items purchased frequently did not differ from the food insecure shoppers. Socio-economic status and food security were associated with greater expenditure on food items in supermarkets but not with overall healthier food purchases. Conclusion: Urban supermarket shoppers in South Africa spent substantially more on unhealthy food items, which were also allocated greater shelf space, compared with healthier foods.

scholarly journals Opticourses: promoting healthier food purchases at no additional cost in low-income households

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Tharrey ◽  
M Perignon ◽  
C Dubois ◽  
H Gaigi ◽  
N Darmon
Keyword(s):  
Low Income ◽  
Prevention Program ◽  
Nutritional Quality ◽  
Target Population ◽  
Intervention Research ◽  
Food Prices ◽  
Additional Cost ◽  
Food Purchasing ◽  
Food Purchases ◽  
Disadvantaged Population

Abstract Introduction Healthy diets are generally more expensive than unhealthy diets, explaining why socially disadvantaged individuals perceive food prices as a barrier to improve their diets. It is thus crucial to develop strategies enabling the achievement of good nutritional quality with a low budget, taking into account actual beliefs and expectations of the target population. A co-construction approach is thus recommended, involving participants at each step of the intervention to maximize its impact. Methods The “Opticourses” program was launched in 2010 with a feasibility study, followed by an intervention research in 2012-2014, in order to develop and evaluate a prevention program aiming at improving the nutritional quality of food purchases at no additional cost in a socioeconomically disadvantaged population. In order to implement activities tailored to the target population, participants were involved in the development of the protocol and the tools of the intervention and evaluation processes. Results Opticourses’s workshops (8 to 12 participants) include different activities displayed in four 2h sessions around real food purchases of participants, and games and exchanges aimed at promoting food and food choices of good nutritional quality for their price. The intervention research showed improvements in food purchasing behaviors of Opticourses participants. A transferability phase was conducted in 2015-2017. Since 2017, Opticourses is spreading in several regions of France, through training of professionals, in particular the courses organized by the Health Education Regional Committee (CRES) in the South of France. Discussion Bringing an original, concrete, co-constructed and scientifically based response to an everyday life problem is the main strength of the program. One important risk of failure for such prevention program is the underestimation of the requirements of the intervention research, in terms of time and human and budgetary resources. Key messages From a research point of view, getting access to new food purchasing data will allow a continuous refinement and innovation in the improvement of the diet for people with budgetary constraints. By focusing on food purchasing, a familiar activity that most adults feel able to handle, the Opticourses program is engaging and pragmatic, in accordance with health promotion principles.

scholarly journals Healthy food purchasing among African American youth: associations with child gender, adult caregiver characteristics and the home food environment

2010 ◽  
Vol 14 (4) ◽  
pp. 670-677 ◽  
Author(s):  
Pamela J Surkan ◽  
Anastasia J Coutinho ◽  
Karina Christiansen ◽  
Lauren A Dennisuk ◽  
Sonali Suratkar ◽  
...  
Keyword(s):  
Low Income ◽  
Food Environment ◽  
Healthy Food ◽  
Food Preparation ◽  
Healthy Foods ◽  
Home Food Environment ◽  
Behavioural Intentions ◽  
Food Purchasing ◽  
Food Purchases ◽  
Home Food

AbstractObjectiveTo examine how factors related to the home food environment and individual characteristics are associated with healthy food purchasing among low-income African American (AA) youth.SubjectsA total of 206 AA youth (ninety-one boys and 115 girls), aged 10–14 years, and their primary adult caregivers.SettingFourteen Baltimore recreation centres in low-income neighbourhoods.DesignCross-sectional study. We collected information about food purchasing, the home food environment, sociodemographic and psychosocial factors drawn from social cognitive theory. Multivariable logistic regression was used to examine the factors associated with the frequency and proportion of healthy food purchases in all youth and stratified by gender. Low-fat or low-sugar foods were defined as healthy.ResultsYouth purchased an average of 1·5 healthy foods (range = 0–15) in the week before the interview, comprising an average of 11·6 % (range = 0–80 %) of total food purchases. The most commonly purchased healthy foods included water and sunflower seeds/nuts. Healthier food-related behavioural intentions were associated with a higher frequency of healthy foods purchased (OR = 1·4, P < 0·05), which was stronger in girls (OR = 1·9, P < 0·01). Greater caregiver self-efficacy for healthy food purchasing/preparation was associated with increased frequency of healthy purchasing among girls (OR = 1·3, P < 0·05). Among girls, more frequent food preparation by a family member (OR = 6·6, P < 0·01) was associated with purchasing a higher proportion of healthy foods. No significant associations were observed for boys.ConclusionsInterventions focused on AA girls should emphasize increasing food-related behavioural intentions. For girls, associations between caregiver self-efficacy and home food preparation suggest the importance of the caregiver in healthy food purchasing.

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