title: The inequitable distribution of tobacco outlet density: the role of income in two Black Mid-Atlantic geopolitical areas.
abstract: OBJECTIVE
  Studies have shown that communities with higher concentrations of low-income racial and ethnic minorities correlate with a greater presence of tobacco outlets. Community-level income has consistently been among the strongest predictors of tobacco outlet density. This study analyzes two Maryland geopolitical areas with similar racial concentrations yet differing income levels in an attempt to disentangle the race-income relationship with tobacco outlet density.
  
  
  METHODS
  In this cross-sectional examination of tobacco outlet and census tract-level sociodemographic data, Baltimore City, Maryland, and Prince George's County, Maryland, were geocoded to determine tobacco outlet density.
  
  
  METHODS
  Tobacco outlet density was defined as the mean number of tobacco outlets per 1000 persons per census tract. Comparisons of tobacco outlet density and sociodemographic variables were analysed via two-sample t-tests, and the direct effect of sociodemographic variables on tobacco outlet density for each area was analysed via spatial lag regressions.
  
  
  RESULTS
  Prince George's County, the area with the higher income level ($77,190 vs $43,571), has a significantly lower tobacco outlet density than Baltimore City (P < 0.001). Prince George's County has a 67.5% Black population and an average of 3.94 tobacco outlets per 1000 persons per tract. By contrast, Baltimore City has a 65.3% Black population and an average of 7.95 tobacco outlets per 1000 persons per tract. Spatial lag regression model results indicate an inverse relationship between income and tobacco outlet density in Baltimore City and Prince George's County (β = -0.03, P < 0.01 &β = -0.01, P = 0.02, respectively), and a significant interaction term indicating a greater magnitude in the relationship between income and tobacco outlet density in Baltimore City (β = -0.05, P < 0.01).
  
  
  CONCLUSIONS
  Results suggest that higher socio-economic status, even in primarily underrepresented racial and ethnic geopolitical areas, is linked to lower tobacco outlet density.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States. Electronic address: dfakunl1@jhu.edu.
authors.forename: D O
authors.initials: DO
authors.lastname: Fakunle
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; School of Medicine, Wayne State University, Detroit, MI, United States.
authors.forename: A J
authors.initials: AJ
authors.lastname: Milam
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
authors.forename: C D
authors.initials: CD
authors.lastname: Furr-Holden
authors.affiliation: Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, United States.
authors.forename: J
authors.initials: J
authors.lastname: Butler
authors.affiliation: Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
authors.forename: R J
authors.initials: RJ
authors.lastname: Thorpe
authors.affiliation: Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Health Policy and Management, George Washington University Milken Institute School of Public Health, Washington, DC, United States.
authors.forename: T A
authors.initials: TA
authors.lastname: LaVeist
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D003132:Commerce / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008396:Maryland; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D062789:Tobacco Products / Q000706:statistics & numerical data*
keywords: Census tracts; Communities; Geopolitical areas; Income; Race; Tobacco outlets