Food Environments around American Indian Reservations: A Mixed Methods Study

Area of Science:

• Public Health
• Health Disparities
• Food Environments

Background:

• Food environments significantly impact community health outcomes.
• Understanding disparities in food access is crucial for public health interventions.
• American Indians residing on tribal lands often experience unique socioeconomic and environmental challenges.

Purpose of the Study:

• To characterize the food environments on tribal lands inhabited by American Indians in California.
• To compare the availability of healthy and unhealthy food outlets on tribal versus non-tribal lands.
• To explore tribal members' perceptions of their local food environment.

Main Methods:

• Utilized geocoded food business data to categorize vendors as healthy, unhealthy, or intermediate.
• Employed multivariate linear regression to compare the distance to and density of food vendor categories between tribal and non-tribal lands.
• Triangulated quantitative findings with qualitative data from 24 in-depth interviews with tribal members.

Main Results:

• Tribal areas exhibited significantly lower densities of healthy food outlets per square mile compared to non-tribal areas, even after adjusting for urbanicity and income.
• No significant difference was found in the density of unhealthy food outlets between tribal and non-tribal areas.
• Tribal members reported negative perceptions of their food environment and identified barriers to accessing healthy food.

Conclusions:

• Socioeconomic factors like urbanicity and per capita income do not fully explain the observed disparities in food environments on tribal lands.
• The documented disparities in access to healthy food on tribal lands may impede efforts to adopt healthier dietary behaviors.
• Targeted interventions are needed to improve healthy food access in these underserved communities.