title: The changing food outlet distributions and local contextual factors in the United States.
abstract: BACKGROUND
  Little is known about the dynamics of the food outlet distributions associated with local contextual factors in the U.S. This study examines the changes in food stores/services at the 5-digit Zip Code Tabulated Area (ZCTA5) level in the U.S., and assesses contextual factors associated with the changes.
  
  
  METHODS
  Data from 27,878 ZCTA5s in the contiguous United States without an extreme change in the number of 6 types of food stores/services (supermarkets, small-size grocery stores, convenience stores, fresh/specialty food markets, carry-out restaurants, and full-service restaurants) were used. ZCTA5s' contextual factors were from the 2000 Census. Numbers of food stores/services were derived from the Census Business Pattern databases. Linear regression models assessed contextual factors' influences (racial/ethnic compositions, poverty rate, urbanization level, and foreign-born population%) on 1-year changes in food stores/services during 2000-2001, adjusted for population size, total business change, and census regions.
  
  
  RESULTS
  Small-size grocery stores and fresh/specialty food markets increased more and convenience stores decreased more in Hispanic-predominant than other areas. Among supermarket-free places, new supermarkets were less likely to be introduced into black-predominant than white-predominant areas (odds ratio (OR) = 0.52, 95% CI = 0.30-0.92). However, among areas without the following type of store at baseline, supermarket (OR = 0.48 (0.33-0.70)), small-size grocery stores (OR = 1.32 (1.08-1.62)), and fresh/specialty food markets (OR = 0.70 (0.53-0.92)) were less likely to be introduced into areas of low foreign-born population than into areas of high foreign-born population. Higher poverty rate was associated with a greater decrease in supermarket, a less decrease in small-size grocery stores, and a less increase in carry-out restaurants (all p for trends <0.001). Urban areas experienced more increases in full-service and carry-out restaurants than suburban areas.
  
  
  CONCLUSIONS
  Local area characteristics affect 1-year changes in food environment in the U.S. Hispanic population was associated with more food stores/services capable of supplying fresh food items. Black-predominant and poverty-afflicted areas had a greater decrease in supermarkets. Full-service and carry-out restaurants increased more in urban than suburban areas. Foreign-born population density was associated with introduction of grocery stores and fresh/specialty food markets into the areas.
authors.forename: Hsin-Jen
authors.initials: HJ
authors.lastname: Chen
authors.affiliation: Johns Hopkins Global Center on Childhood Obesity, Department of International Health, Human Nutrition Program, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. youfawan@buffalo.edu.
authors.forename: Youfa
authors.initials: Y
authors.lastname: Wang
mesh_terms: D001741:Black or African American; D003132:Commerce / Q000639:trends*; D016208:Databases, Factual; D005523:Food Supply; D006630:Hispanic or Latino; D006801:Humans; D016014:Linear Models; D016017:Odds Ratio; D012147:Restaurants / Q000706:statistics & numerical data; D014481:United States