The Impact of Differential Treatment by Race and Ethnicity on Diet Quality

There is a growing focus on addressing differential access to resources by race and ethnicity in order to combat the negative impacts of diet-related diseases in the Black and Hispanic communities. A healthy food retail environment is one resource that has been heavily studied, but its role in contributing to the disparity in health outcomes by race and ethnicity is debated. One reason may be that previous food retail environment measures often only account for interaction with the built environment. In contrast, we adapt a household-specific food retail environment measure to include exposure to both the built environment and the people in that environment. Using information from the National Food Acquisition and Purchase Survey and population data from the U.S. Census, we find that the potential for differential treatment by race and ethnicity in the food retail environment is associated with a reduction in the nutritional quality of food acquisitions for Black and Hispanic households. The negative association is larger for households with additional constraints, such as lower income. Our results suggest that additionally considering the social environment where a store is located may increase the effectiveness of healthy food access programs like those in the Healthy Food Financing Initiative.