Amy H. Auchincloss PhD, MPH , Rick L. Riolo PhD , Daniel G. Brown PhD , Jeremy Cook BA , Ana V. Diez Roux MD, PhD
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引用次数: 152
Abstract
Background
Low dietary quality is a key contributor to obesity and related illnesses, and lower income is generally associated with worse dietary profiles. The unequal geographic distribution of healthy food resources could be a key contributor to income disparities in dietary profiles.
Purpose
To explore the role that economic segregation can have in creating income differences in healthy eating and to explore policy levers that may be appropriate for countering income disparities in diet.
Methods
A simple agent-based model was used to identify segregation patterns that generate income disparities in diet. The capacity for household food preferences and relative pricing of healthy foods to overcome or exacerbate the differential was explored.
Results
Absent other factors, income differentials in diet resulted from the segregation of high-income households and healthy food stores from low-income households and unhealthy food stores. When both income groups shared a preference for healthy foods, low-income diets improved but a disparity remained. Both favorable preferences and relatively cheap healthy foods were necessary to overcome the differential generated by segregation.
Conclusions
The model underscores the challenges of fostering favorable behavior change when people and resources are residentially segregated and behaviors are motivated or constrained by multiple factors. Simulation modeling can be a useful tool for proposing and testing policies or interventions that will ultimately be implemented in a complex system where the consequences of multidimensional interactions are difficult to predict.
期刊介绍:
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.