title: Maternal anemia associated with walkable distance to healthy food sources in Bronx, New York.
abstract: The relationship between walkable access to healthy food sources and risk of anemia in pregnancy was evaluated for a cohort of 4678 women who initiated prenatal care in the year 2010 at an academic medical center in Bronx, New York. After geocoding patient residences, street network distances were obtained for the closest healthy food sources, which were identified from multiple databases. For lower-income patients, as indicated by Medicaid or lack of health insurance, those who lived less than 0.25miles from a healthy food source were less likely to be anemic when compared to those who lived farther (adjusted OR=0.65, 95% CI 0.48, 0.88). Patients with commercial insurance showed no effect. These results help to understand how a nutritionally-mediated condition such as anemia during pregnancy can be affected by one's built environment, while also highlighting the importance of conditioning on socioeconomic status for these types of studies.
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Bottalico
authors.affiliation: City University of New York, Lehman College, Department of Health Sciences, Bronx, NY, USA.
authors.forename: Glen D
authors.initials: GD
authors.lastname: Johnson
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY, USA; Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Chazotte
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY, USA; Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Bronx, NY, USA. Electronic address: ekarkows@montefiore.org.
authors.forename: Chavi Eve
authors.initials: CE
authors.lastname: Karkowsky
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology*; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology*; D005260:Female; D005522:Food Services / Q000706:statistics & numerical data*; D020073:Gravidity; D006297:Health Services Accessibility; D006801:Humans; D009519:New York City / Q000453:epidemiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology*; D011295:Prenatal Care; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012306:Risk; D012959:Socioeconomic Factors; D062206:Spatial Analysis; D016138:Walking / Q000706:statistics & numerical data*
keywords: Anemia; Built environment; Maternal health; Street network analysis; Urban health; Walkable food access