Individual and Neighborhood Differences in Diet Among Low-Income Foreign and U.S.-Born Women
Latinos are the largest and most rapidly growing minority group in the United States, and the most current census estimates show that of the U.S. Latino population, 43% are born outside of the United States (Lollock, 2001). Research on the “immigrant” or “Latino health paradox” has demonstrated that Latinos exhibit better health than U.S.-born whites, for outcomes that include birthweight, infant mortality, and diet, even after adjusting for socioeconomic status ([Abrams and Guendelman 1995], [Dubowitz et al 2007], [Norman et al 2004], [Singh and Siahpush 2001] and [Sorlie et al 1993]).
Limited research to date has looked at the role of the neighborhood residential environment with respect to health and dietary behaviors across immigrants and U.S.-born populations. We investigated how neighborhood context might be associated with diet above and beyond individual level factors, among a population of predominantly Latina foreign- and U.S.-born, low-income women in Massachusetts, United States.
Data analyzed to understand individual and neighborhood influences on diet
We analyzed baseline data from 641 low-income women, nested within 184 census tracts (i.e. neighborhoods), and enrolled in a nutrition intervention trial for postpartum women. Individual-level covariates analyzed included race/ethnicity, nativity, duration of time in the United States, language acculturation, emotional and instrumental support, and socioeconomic position. We assessed daily fruit and vegetable servings through a semi-quantitative food frequency questionnaire.
On the individual-level, age, nativity (born inside or outside of the U.S.), native language, race/ethnicity, and social support were significantly associated with fruit and vegetable intake. Foreign-born women living in the United States for 0 to 14 years had significantly higher consumption than those born in the United States, although the consumption of foreign born living in the United States for >14 years was not significantly different. Older women, Latina women and women with higher levels of social support had higher fruit and vegetable consumption.
When we examined the neighborhood-level variables, we found that each additional 10 percentage points of foreign born population in the tract translated to an individual increase in 0.3 fruit and vegetable servings daily. We observed a significant inverse association between proportion of Black population in the census tract and individual-level daily servings of fruit and vegetables. For each additional 10 percentage points of Black population as a proportion of the tract, individual fruit and vegetable consumption decreased by approximately 0.2 servings per day.
We found that women who lived in immigrant neighborhoods demonstrated higher fruit and vegetable intake, regardless of whether they themselves were immigrants. One important question that emerges from this work is what it might be about immigrant neighborhoods that may improve diet. We hypothesize that immigrant neighborhoods may have differential material resources that improve diet (e.g., better supply or availability of produce, or fewer unhealthy resources like access to fast foods high in Added sugars and fats).
We observed that as the proportion of Black population in a neighborhood increased, women had a lower than average consumption of fruit and vegetables. In the U.S., differential neighborhood risks and resources are distributed across racial lines, which often operate in conjunction with concentrated poverty to influence health ([Massey and Denton 1988], [Massey and Denton 1993], [Williams and Collins 2001], [Williams 1996], [Williams 1997] and [Williams 1998]). We might have found a detrimental diet effect in Black neighborhoods owing to an increased presence of fast food, or decreased presence of healthy food. Alternately, there may be other neighborhood characteristics, such as less developed transportation infrastructure, or lower neighborhood walkability and access to services, which facilitate women's shopping at healthier venues outside of their own neighborhood.
Our analysis found associations with individual diet on both the individual and neighborhood levels. The findings highlight potential mechanisms that might exist to influence diet, such as social and language networks in different racial and nativity groups. Our results also suggest that immigrant neighborhoods may be beneficial to the diet of women who live there, regardless of whether the women themselves are US or foreign born.
- Lollock 2001 L. Lollock, Profile of the foreign-born Population in the United States 2000. In: L. Lollock, Editor, Current population reports, U.S. Department of Commerce Economics and Statistics Administration; US Census Bureau, Washington, DC (2001).
- Abrams and Guendelman 1995 B. Abrams and S. Guendelman, Nutrient intake of Mexican-American and non-Hispanic white women by reproductive status: Results of two national studies, Journal of the American Dietetic Association 95 (8) (1995), pp. 916–918.
- Norman et al 2004 S. Norman, C. Castro, C. Albright and A. King, Comparing
acculturation models in evaluating dietary habits among low-income Hispanic women, Ethnicity & Disease 14 (2004), pp. 399–404.
- Singh and Siahpush 2001 G.K. Singh and M. Siahpush, All-cause and cause-specific mortality of immigrants and native-born in the United States, American
Journal of Public Health 91 (2001), pp. 392–399.
- Sorlie et al 1993 P.D. Sorlie, E. Backlund, N.J. Johnson and E. Rogot, Mortality by Hispanic status in the United States, Journal of the American Medical Association 270 (1993), pp. 2464–2468.
- Massey and Denton 1988 D.S. Massey and N. Denton, The dimensions of residential segregation, Social Forces 67 (1988), pp. 281–315.
- Massey and Denton 1993 D.S. Massey and N.A. Denton, American apartheid: Segregation and the making of the underclass, Harvard University Press, Cambridge, MA (1993).
- Williams and Collins 2001 D.R. Williams and C. Collins, Racial residential segregation: a fundamental cause of racial disparities in health, Public Health Reports 116 (2001), pp. 404–416.
- Williams 1996 In: D.R. Williams, Editor, Racism and health: A research agenda Ethnicity & Disease 6 (1996), pp. 1–8.
- Williams 1997 D.R. Williams, Race and health: Basic questions, emerging direction, Annals of Epidemiology 7 (1997), pp. 322–333.
- Williams 1998 D.R. Williams, African-American health: The role of the social environment, Journal of Urban Health 75 (1998), pp. 300–321.