title: Food Environments around American Indian Reservations: A Mixed Methods Study.
abstract: OBJECTIVE
  To describe the food environments experienced by American Indians living on tribal lands in California.
  
  
  METHODS
  Geocoded statewide food business data were used to define and categorize existing food vendors into healthy, unhealthy, and intermediate composite categories. Distance to and density of each of the composite food vendor categories for tribal lands and nontribal lands were compared using multivariate linear regression. Quantitative results were concurrently triangulated with qualitative data from in-depth interviews with tribal members (n = 24).
  
  
  RESULTS
  After adjusting for census tract-level urbanicity and per capita income, results indicate there were significantly fewer healthy food outlets per square mile for tribal areas compared to non-tribal areas. Density of unhealthy outlets was not significantly different for tribal versus non-tribal areas. Tribal members perceived their food environment negatively and reported barriers to the acquisition of healthy food.
  
  
  CONCLUSIONS
  Urbanicity and per capita income do not completely account for disparities in food environments among American Indians tribal lands compared to nontribal lands. This disparity in access to healthy food may present a barrier to acting on the intention to consume healthy food.
authors: Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors: Gwen M
authors: GM
authors: Chodur
authors: Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors: Ye
authors: Y
authors: Shen
authors: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
authors: Stephen
authors: S
authors: Kodish
authors: Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors: Vanessa M
authors: VM
authors: Oddo
authors: Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland United States of America.
authors: Daniel A
authors: DA
authors: Antiporta
authors: Department of Social and Behavioral Interventions, Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland United States of America.
authors: Brittany
authors: B
authors: Jock
authors: Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.|Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland United States of America.
authors: Jessica C
authors: JC
authors: Jones-Smith
mesh_terms: D000328:Adult; D000368:Aged; D002140:California; D003132:Commerce; D004777:Environment; D057140:Fast Foods; D005260:Female; D005502:Food; D005523:Food Supply; D006801:Humans; D007182:Income; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012111:Residence Characteristics; D055815:Young Adult