Mounting evidence shows a direct correlation between people living in neighborhoods with higher availability of fast-food outlets and the likelihood of residents’ chronic diseases, including type 2 diabetes. Findings have also suggested that the availability of more supermarkets impacts the amount of type 2 diabetes cases, particularly in rural and suburban neighborhoods.
One study published in the JAMA Network Open used data from a cohort of more than 9-million veterans living across the country. The study counted fast-food restaurants and supermarkets relative to other food outlets to examine the relationship between the availability of this food and health issues.
According to researchers, this study is the first to explore this relationship in four distinct neighborhoods (high density urban, low density urban, rural, and suburban).
“Most studies that examine the built food environment and its relationship to chronic diseases have been much smaller or conducted in localized areas,” said Rania Kanchi, MPH, lead author of the study.
“Our study design is national in scope and allowed us to identify the types of communities that people are living in, characterize their food environment, and observe what happens to them over time. The size of our cohort allows for geographic generalizability in a way that other studies do not.”
Researchers analyzed more than 9 million veterans seen at more than 1,200 health facilities around the country. Using the data, researchers constructed a national cohort of more than 4,000,000 veterans without diabetes. Each veteran’s health status was followed for a median of five and a half years, or until the individual either developed diabetes, died, or had no more appointments for more than two years.
When researchers analyzed community types, 14.3% of veterans living in high-density urban communities were found to have developed type 2 diabetes. The lowest incidence (12.6%) was among veterans residing in suburban and small-town communities.
Overall, it was established that the effect of the food environment on type 2 diabetes incidence varied by how urban the community was and the availability of fast-food outlets. A neighborhood-built environment with high availability of poor food choices directly correlated with the likelihood that residents may develop chronic diseases such as heart disease, type 2 diabetes, and certain types of cancers. These residents are also at greater risk of disability, obesity, and other chronic conditions.
Policymakers Need to Make Improvements
Researchers believe that the more that is learned about the relationship between food environment and chronic diseases, the more policymakers can act by improving the mix of healthy food options for its residents.
The next phase of the research would be to understand better the built environment’s impact on diabetes risk by subgroups. Researchers plan to analyze the relationships between fast-food restaurants, supermarkets, and community types such as race/ethnicity, socioeconomic status, and gender.