Neighborhood Food Environment and Health Outcomes in U.S. Low-Socioeconomic Status, Racial/Ethnic Minority, and Rural Populations: A Systematic Review

Introduction. This review examined associations between the neighborhood food environment and health outcomes in populations with the highest obesity rates in the United States: people of low-socioeconomic status (SES), racial/ethnic minorities, and rural residents. Methods. We searched multiple databases using preselected search terms through June 2017. Forty-three sources met criteria of peer-reviewed U.S. studies that tested food environment-health associations (e.g. obesity, diabetes) in the populations of interest. Results. Evidence was sparse for multiple populations. For populations with multiple studies of adequate sample size, few found significant food environment-health associations. Modest evidence indicates that negative health outcomes were associated with (1) convenience store access for Black and Hispanic youth and (2) fast food access for Black and Hispanic adults and youth. Additionally, lower body weights were associated with supermarket and grocery store access in low-SES adults. Conclusion. Food environment interventions may have health benefits for some populations, but additional research is needed.