1. Manuel Franco MD, PhD CLF Innovation Grant 2006 Johns Hopkins Bloomberg School of Public Health Department of Epidemiology Availability of Healthy Foods in Baltimore: Associations with Diet Quality and BMI

2. Presenter’s Name Date Healthy Foods, Diet Quality and Obesity 2005 Dietary Guidelines: A variety of fruits and vegetables Whole grains Fat-free or low-fat milk Prevention of obesity, diabetes and heart disease Large racial and economic health disparities Hypotheses: Disparities in the availability of healthy foods exist. Availability of healthy foods relates to the quality of diet and body weight

3. Presenter’s Name Date Specific Aims Aim 1 Investigate the association of neighborhood availability of healthy foods with racial and income composition of 159 neighborhoods in Baltimore Aim 2 Investigate the cross-sectional association between availability of healthy foods of 749 individuals’ and their diet quality and BMI

4. Presenter’s Name Date 226 food stores completed in 159 neighborhoods Supermarkets (41), Grocery stores (110), Convenience stores (54), Behind glass stores (21) –Original list: 365 –Misclassified: 130 (34%) –Refusals : 21 (8%) –New Stores : 12 Data Collectors: Amanda Rosecrans, Brooke Mickle, Gila Neta, Krissett Loya Data Collection: May – July 2006

5. Presenter’s Name Date Grocery Store in West Baltimore 83 MESA participants within 1 mile

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9. Presenter’s Name Date Healthy Foods Availability Index (HFAI) of two supermarkets LocationBaltimore CityBaltimore County Racial Composition97% Black93% White Median HH Income$ 20,833$ 57,391 Avail.PointsAvail.Points Skim milkYes2 3 Fruits172594 Vegetables383744 Lean meatNo2Yes3 Frozen foodsNo0Yes3 Low Na foodsNo0Yes2 100% whole wheat bread Yes2 4 Low sugar cerealsYes2 2 HFAI (0 to 27)1325

10. Presenter’s Name Date 749 men and women, free of CVD, 45 – 84 years 159 Baltimore census tracts For each participant we built 3 complementary measures of availability: – Neighborhood = mean stores HFAI in CT – Closest Store = HFAI closest store – Availability in 1 mile radius Availability of Healthy Foods in the Baltimore MESA participants

11. Presenter’s Name Date Dietary Patterns and BMI “Fats and processed meats” pattern: high consumption of “fats and oils,” “high-fat and processed meats,” “fried potatoes” “Whole grains and fruit” pattern: high consumption of whole-grain bread, fruit and low fat milk Weight and height measured using valid tools and following a standard protocol. (BMI) = Kg/m 2

12. Presenter’s Name Date 159 contiguous census tracts and the 226 food stores located within them Availability of healthy foods and neighborhoods’ racial composition

13. Presenter’s Name Date Availability of healthy foods in Baltimore neighborhoods by racial compositions Neighborhood characteristics % Low food availability % Medium food availability % High food availability % No Stores Pred. Black 30%**25%13%**32% Mixed 11%28%39%22% Pred. White 2%17%41%40% **P<0.001, compared to predominantly white neighborhoods

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15. Presenter’s Name Date Means and 95 % CI of dietary patterns by availability of healthy foods assessments Dietary patterns scores ** P for trend < 0.05

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17. Presenter’s Name Date Availability of healthy foods and BMI

18. Presenter’s Name Date Policy Implications and following steps Support existing stores in inner city neighborhoods Encourage the distribution of locally farmed fruits and vegetables to improve the HFAI in Baltimore stores Collaboration with Baltimore City Health Department and Urban Planning Department 2009 CLF Report: Food Environment in Baltimore First city to have a full map of food stores (Data collection currently ongoing)

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