title: The role of race and poverty in access to foods that enable individuals to adhere to dietary guidelines.
abstract: BACKGROUND
  The increase in obesity and disparities in obesity and related chronic diseases across racial and ethnic and income groups have led researchers to focus on the social and environmental factors that influence dietary intake. The question guiding the current study was whether all communities have equal access to foods that enable individuals to make healthy dietary choices.
  
  
  METHODS
  We conducted audits of community supermarkets and fast food restaurants to assess location and availability of food choices that enable individuals to meet the dietary guidelines established by the U.S. Department of Agriculture (e.g., fruit and vegetable consumption, low-fat options). We used 2000 census data to assess the racial distribution and the percentage of individuals living below the federal poverty level in a defined area of St Louis, Mo. Spatial clustering of supermarkets and fast food restaurants was determined using a spatial scan statistic.
  
  
  RESULTS
  The spatial distribution of fast food restaurants and supermarkets that provide options for meeting recommended dietary intake differed according to racial distribution and poverty rates. Mixed-race or white high-poverty areas and all African American areas (regardless of income) were less likely than predominantly white higher-income communities to have access to foods that enable individuals to make healthy choices.
  
  
  CONCLUSIONS
  Without access to healthy food choices, individuals cannot make positive changes to their diets. If certain eating behaviors are required to reduce chronic disease and promote health, then some communities will continue to have disparities in critical health outcomes unless we increase access to healthy food.
authors.affiliation: Saint Louis University School of Public Health, Salus Center, 3545 Lafayette Ave, St Louis, MO 63104, USA. bakerpa@slu.edu
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Baker
authors.forename: Mario
authors.initials: M
authors.lastname: Schootman
authors.forename: Ellen
authors.initials: E
authors.lastname: Barnidge
authors.forename: Cheryl
authors.initials: C
authors.lastname: Kelly
mesh_terms: D001741:Black or African American; D004032:Diet / Q000191:economics*; D005502:Food / Q000191:economics*; D015438:Health Behavior; D006801:Humans; D012147:Restaurants; D012959:Socioeconomic Factors; D044465:White People