Neighborhood Food Environment and Obesity in Community-Dwelling Older Adults: Individual and Neighborhood Effects

OBJECTIVES: We tested hypotheses about the relationship between neighborhood-level food sources and obesity, controlling for individual-level characteristics. METHODS: Data (collected November 2006-April 2008) derived from a random-digit-dial sample of 5688 community-dwelling adults aged 50 to 74 years residing in 1644 census tracts in New Jersey. Using multilevel structural equation models, we created latent constructs representing density of fast-food establishments and storefronts (convenience stores, bars and pubs, grocery stores) and an observed indicator for supermarkets at the neighborhood level, simultaneously modeling obesity and demographic characteristics (age, gender, race, education, household income) at the individual level. RESULTS: When we controlled for individual-level age, gender, race, education, and household income, densities of fast-food establishments and storefronts were positively associated with obesity. Supermarkets were not associated with obesity. CONCLUSIONS: Because people living in neighborhoods with a higher density of fast food and storefronts are more likely to be obese, these neighborhoods may be optimal sites for interventions.