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Interplay of Socioeconomic Status and Supermarket Distance Is Associated with Excess Obesity Risk: A UK Cross-Sectional Study

UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, P.O. Box 7057, Amsterdam 1007MB, The Netherlands
Department of Public Health and Primary Care, Institute of Public Health, Forvie Site, Robinson Way, University of Cambridge, Cambridge CB2 0SR, UK
Author to whom correspondence should be addressed.
Current address: Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99210, USA.
Int. J. Environ. Res. Public Health 2017, 14(11), 1290;
Received: 30 June 2017 / Revised: 16 October 2017 / Accepted: 16 October 2017 / Published: 25 October 2017
(This article belongs to the Special Issue Food Environment, Diet, and Health)
PDF [322 KB, uploaded 25 October 2017]


U.S. policy initiatives have sought to improve health through attracting neighborhood supermarket investment. Little evidence exists to suggest that these policies will be effective, in particular where there are socioeconomic barriers to healthy eating. We measured the independent associations and combined interplay of supermarket access and socioeconomic status with obesity. Using data on 9702 UK adults, we employed adjusted regression analyses to estimate measured BMI (kg/m2), overweight (25 ≥ BMI < 30) and obesity (≥30), across participants’ highest educational attainment (three groups) and tertiles of street network distance (km) from home location to nearest supermarket. Jointly-classified models estimated combined associations of education and supermarket distance, and relative excess risk due to interaction (RERI). Participants farthest away from their nearest supermarket had higher odds of obesity (OR 1.33, 95% CI: 1.11, 1.58), relative to those living closest. Lower education was also associated with higher odds of obesity. Those least-educated and living farthest away had 3.39 (2.46–4.65) times the odds of being obese, compared to those highest-educated and living closest, with an excess obesity risk (RERI = 0.09); results were similar for overweight. Our results suggest that public health can be improved through planning better access to supermarkets, in combination with interventions to address socioeconomic barriers. View Full-Text
Keywords: supermarkets; distance; education; body mass index; obesity; interaction supermarkets; distance; education; body mass index; obesity; interaction
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Burgoine, T.; Mackenbach, J.D.; Lakerveld, J.; Forouhi, N.G.; Griffin, S.J.; Brage, S.; Wareham, N.J.; Monsivais, P. Interplay of Socioeconomic Status and Supermarket Distance Is Associated with Excess Obesity Risk: A UK Cross-Sectional Study. Int. J. Environ. Res. Public Health 2017, 14, 1290.

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