Disparities in food consumption between economically segregated urban neighbourhoods. Issue 3 (16th December 2019) - Lopes, Mariana Souza
Abstract: Objective: To examine associations between economic residential segregation and prevalence of healthy and unhealthy eating markers. Design: Cross-sectional. A stratified sample was selected in a three-stage process. Prevalence of eating markers and their 95 % CI were estimated according to economic residential segregation: high (most segregated); medium (integrated) and low (less segregated or integrated). Segregation was measured at the census tract and assessed using the Getis–Ord local $G_i^{\rm{\ast}}$ statistic based on the proportion of heads of household in a neighbourhood earning a monthly income of 0–3 minimum wages. Binary logistic regression using generalized estimating equations were used to model the associations. Setting: Belo Horizonte, Brazil. Participants: Adults ( n 1301) residing in the geographical environment (178 census tracts) of ten units of the Brazilian primary-care service known as the Health Academy Program. Results: Of the 1301 participants, 27·7 % lived in highly segregated neighbourhoods, where prevalence of regular consumption of fruit was lower compared with more affluent areas (34·6 v . 53·2 %, respectively). Likewise, regular consumption of vegetables (70·1 v . 87·6 %), fish (23·6 v . 42·3 %) and replacement of lunch or dinner with snacks (0·8 v . 4·7 %) were lower in comparison to more affluent areas. In contrast, regular consumption of beans was higher (91·0 v . 79·5 %). The associations of high-segregated neighbourhood with consumption of vegetables (OR = 0·62; 95 % CI 0·39, 0·98) and beans (OR = 1·85; 95 % CI 1·07, 3·19) remained significant after adjustments. Conclusions: Economic residential segregation was associated with healthy eating markers even after adjustments for individual-level factors and perceived food environment.