Looking to the past: Investigating 10-year place histories as a determinant of home food environments in the Healthy Communities Study

Abstract

Emerging research suggests there is a need to consider the importance of place histories in studying neighborhood effects. Guided by a life course of place framework, the objective of this study is to investigate the relationship between two place history exposures and three contemporary home food environment outcomes. Exposures included 10-year neighborhood socioeconomic status (SES) histories and multi-year nutrition community programming and policy (CPP) histories. Outcomes included the availability of healthy foods in the home, the availability of unhealthy foods in the home, and household food insecurity. Associations are investigated using cross-sectional and retrospective data on 4210 US families in the national, observational Healthy Communities Study (2013–2015). Multilevel regression models, adjusted for household income and other factors, were fit for each exposure and outcome. Households residing in neighborhoods with intermittently low, consistently moderate, intermittently high, and consistently high SES histories had greater availability of healthy foods in the home than households in neighborhoods with consistently low SES histories (adjusted βs: 0.11 [95% CI: 0.02, 0.20], 0.13 [95% CI: 0.06, 0.21], 0.23 [95% CI: 0.13, 0.34], and 0.24 [95% CI: 0.15, 0.33], respectively). Households in consistently high SES neighborhoods also had a lower likelihood of household food insecurity than those in consistently low SES neighborhoods (adjusted OR: 0.54 [95% CI: 0.42, 0.71]). Neighborhood SES histories were not significantly associated with the availability of unhealthy foods in the home. Nutrition CPP histories were not significantly associated with food insecurity or the availability of unhealthy foods in the home. However, more intense nutrition CPP histories were significantly associated with greater availability of healthy foods in the home. Moreover, effect estimates increased with more long-term historical accounts of CPPs (adjusted βs: 1-year CPP histories, 0.21 [95% CI: 0.03, 0.39]; 3-year CPP histories, 0.22 [95% CI: 0.03, 0.41]; 6-year CPP histories, 0.25 [95% CI: 0.04, 0.46]; 10-year CPP histories, 0.28 [95% CI: 0.05, 0.50]). To curb food insecurity and promote the availability of healthy foods, the findings suggest considering how neighborhoods develop and evolve over time with respect to SES and nutrition CPP implementation.