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Individual and Neighborhood Differences in Diet Among Low-Income Foreign and U.S.-Born Women

  • Author Footnotes
    1 Tamara Dubowitz is a public health researcher with interests in women and children's health and policy across the life span, and particularly in public health nutrition and the social context of vulnerable populations. Her research interests include neighborhood effects, particularly that of the built physical and social environment, obesity and diet related disease.
    Tamara Dubowitz
    Correspondence
    Correspondence to: Tamara Dubowitz, ScD, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213; Phone: 412-683-2300, X4400; Fax: 412-683-2800.
    Footnotes
    1 Tamara Dubowitz is a public health researcher with interests in women and children's health and policy across the life span, and particularly in public health nutrition and the social context of vulnerable populations. Her research interests include neighborhood effects, particularly that of the built physical and social environment, obesity and diet related disease.
    Affiliations
    RAND Corporation, Pittsburgh, Pennsylvania
    Search for articles by this author
  • Author Footnotes
    2 S.V. Subramanian is a geographer who specializes in multilevel statistical methods. His research focuses mainly on understanding how different contextual settings influence individual health outcomes and the population disparities in health achievements. His work has demonstrated the need to explicitly consider a multilevel methodological framework while conceptualizing and estimating contextual effects on public health issues.
    S.V. Subramanian
    Footnotes
    2 S.V. Subramanian is a geographer who specializes in multilevel statistical methods. His research focuses mainly on understanding how different contextual settings influence individual health outcomes and the population disparities in health achievements. His work has demonstrated the need to explicitly consider a multilevel methodological framework while conceptualizing and estimating contextual effects on public health issues.
    Affiliations
    Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts
    Search for articles by this author
  • Author Footnotes
    3 Dolores Acevedo-Garcia has a doctoral degree in public policy and demography. Her research interests include the effect of social determinants (e.g., residential segregation, immigrant integration) on health disparities, especially along racial and ethnic lines, and the role of non-health policies (e.g., housing policies, immigrant policies) in reducing those disparities.
    Dolores Acevedo-Garcia
    Footnotes
    3 Dolores Acevedo-Garcia has a doctoral degree in public policy and demography. Her research interests include the effect of social determinants (e.g., residential segregation, immigrant integration) on health disparities, especially along racial and ethnic lines, and the role of non-health policies (e.g., housing policies, immigrant policies) in reducing those disparities.
    Affiliations
    Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts
    Search for articles by this author
  • Author Footnotes
    4 Theresa L. Osypuk is a social epidemiologist researching racial/ethnic, nativity, and socioeconomic health disparities and their geographic patterns. Her research examines why, when, and for whom place matters for health and health disparities, specifically in relation to housing markets, residential segregation, and neighborhoods, as well as how social policies may mitigate racial/ethnic health disparities.
    Theresa L. Osypuk
    Footnotes
    4 Theresa L. Osypuk is a social epidemiologist researching racial/ethnic, nativity, and socioeconomic health disparities and their geographic patterns. Her research examines why, when, and for whom place matters for health and health disparities, specifically in relation to housing markets, residential segregation, and neighborhoods, as well as how social policies may mitigate racial/ethnic health disparities.
    Affiliations
    Department of Health Sciences, Northeastern University Bouve College of Health Sciences, Ann Arbor, Michigan
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  • Author Footnotes
    5 Karen E. Peterson's research considers determinants of intergenerational patterns of growth and the design and evaluation of domestic and international surveillance systems and community-based nutrition interventions in low income, multi-ethnic populations.
    Karen E. Peterson
    Footnotes
    5 Karen E. Peterson's research considers determinants of intergenerational patterns of growth and the design and evaluation of domestic and international surveillance systems and community-based nutrition interventions in low income, multi-ethnic populations.
    Affiliations
    Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts
    Search for articles by this author
  • Author Footnotes
    1 Tamara Dubowitz is a public health researcher with interests in women and children's health and policy across the life span, and particularly in public health nutrition and the social context of vulnerable populations. Her research interests include neighborhood effects, particularly that of the built physical and social environment, obesity and diet related disease.
    2 S.V. Subramanian is a geographer who specializes in multilevel statistical methods. His research focuses mainly on understanding how different contextual settings influence individual health outcomes and the population disparities in health achievements. His work has demonstrated the need to explicitly consider a multilevel methodological framework while conceptualizing and estimating contextual effects on public health issues.
    3 Dolores Acevedo-Garcia has a doctoral degree in public policy and demography. Her research interests include the effect of social determinants (e.g., residential segregation, immigrant integration) on health disparities, especially along racial and ethnic lines, and the role of non-health policies (e.g., housing policies, immigrant policies) in reducing those disparities.
    4 Theresa L. Osypuk is a social epidemiologist researching racial/ethnic, nativity, and socioeconomic health disparities and their geographic patterns. Her research examines why, when, and for whom place matters for health and health disparities, specifically in relation to housing markets, residential segregation, and neighborhoods, as well as how social policies may mitigate racial/ethnic health disparities.
    5 Karen E. Peterson's research considers determinants of intergenerational patterns of growth and the design and evaluation of domestic and international surveillance systems and community-based nutrition interventions in low income, multi-ethnic populations.
Published:January 29, 2008DOI:https://doi.org/10.1016/j.whi.2007.11.001

      Background

      Research on the “immigrant” or “Latino health paradox” has demonstrated that Latinos exhibit better health than U.S.-born whites, for multiple health outcomes, despite adjusting for socioeconomic status. However, little empirical research has focused on women and even less has focused on how the neighborhood residential environment is associated with these health differences, particularly in the area of diet.

      Methods

      We analyzed baseline data from 641 low-income women, nested within 184 census tracts, enrolled in a nutrition intervention trial for postpartum women. Individual-level variables, including race/ethnicity, nativity, duration of time in the United States, language acculturation, emotional and instrumental support, and socioeconomic position, were merged with tract-level variables from U.S. Census data (2000) based on residential address. We assessed daily fruit and vegetable servings through a semiquantitative food frequency questionnaire. Using MLWin 2.0 software, we employed a 2-level linear regression model to ascertain associations of neighborhood immigrant, racial, and socioeconomic composition with individual diet, adjusting for individual-level sociodemographic characteristics.

      Results

      In our fully adjusted model, we observed a statistically significant increase of 1/3 of fruit and vegetable daily servings for each 10-percentage point increase in the tract foreign-born population. Each 10-percentage point increase in the tract Black population was associated with a significant 1/5 serving decrease in individual daily fruit and vegetable intake.

      Conclusions

      Among this population of U.S. and foreign-born women, neighborhood composition was associated with individual diet, above and beyond individual-level characteristics, illuminating neighborhood context, immigrant health, and diet.
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