Grocery Store Access and the Food Insecurity–Obesity Paradox

Abstract

This research tests for an association between grocery store access and paradoxical occurrences of coexisting obesity and food insecurity. Approximately 5000 respondents from the US Centers for Disease Control Behavior Risk Factor Surveillance System's Social Context Module were matched to grocery access measures constructed by the Department of Agriculture. Bivariate probit regression analysis models the probability of obesity conditional on food insecurity. Results indicate that each additional percentage point of the local population without a car living farther than a mile from a grocery store is associated with a 1.4 percentage point greater likelihood of obesity for food insecure households. This finding supports claims that the healthy food inaccessibility is a determinant of the insecurity–obesity paradox.

Keywords:

• food insecurity
• obesity
• food environment
• healthy food access
• urban health

Acknowledgments

The author acknowledges the Dan E. Sweat Dissertation Fellowship for research support and deeply thanks both an anonymous reviewer and especially Inas Rashad Kelly, who provided many valuable comments. Dr. Kelly also supplied algorithms to correct for self-reported height and weight. All errors belong to the author alone.