Fruit and vegetable accessibility as a risk factor for hypertension in blacks living in DeKalb & Fulton County, GA: A comparative case study Open Access

Abstract

Hypertension is a risk factor for coronary heart disease, stroke, and a vast number of other related cardiovascular diseases (CVD). Coronary heart disease (CHD) and stroke rates alone are disproportionally higher for Blacks. A healthy diet has been proven to lower blood pressure and hypertension (HTN) rates in all people regardless of race or socio-economic status. Blacks are a vulnerable population to HTN due to the fact that they develop high blood pressure earlier in life and tend to have higher mortality rates than any other race. Access to healthy and fresh food has been shown to have an effect on eating behaviors. The impact of location of food stores and its influence diet and hypertension health status still remains unclear. The purpose of the study is to evaluate the correlation between food accessibility and its affect in hypertension rates in the Black community living in DeKalb and Fulton counties. Data was obtained using the U.S. Census Bureau database to gather data for population demographics. A list of businesses where people can buy food in DeKalb and Fulton County was compiled using the SNAP Retail Locator. The final list of stores was plotted on a map via GIS technology. The relative risk was calculated to determine the probability of developing hypertension or a cardiovascular disease for those living in a "low" or "no" accessibility area compared to the probability of the event happening in the population that lives in a "moderate" or "high" accessibility area. The results show there were slight associations between hypertension prevalence and food accessibility for DeKalb county (RR= 1.004). The opposite was found for DeKalb County's cardiovascular morbidity relative risk factor (RR = 0.5367). There was no significance between fruit and vegetable accessibility and hypertension rates in Fulton County. However, there was an association between cardiovascular related deaths and food accessibility (RR = 1.0002) for Fulton County. The results also confirm that there are fewer major grocery retailers located in predominately Black neighborhoods in DeKalb and Fulton County.

Table of Contents

Chapter I: Introduction..........................................Page 1

Chapter II: Literature Review..................................Page 4

Chapter III: Methods..............................................Page 16

Chapter IV: Results................................................Page 20

Chapter V: Discussion............................................Page 24

Figures..................................................................Page 31

Figure 4.1..............................................................Page 31

Figure 4.2..............................................................Page 31

Figure 4.3..............................................................Page 32

Figure 4.4..............................................................Page 32

Figure 4.5..............................................................Page 33

Figure 4.6..............................................................Page 34

Tables...................................................................Page 35

Table 4A................................................................Page 35

Table 4B................................................................Page 36

Table 4C................................................................Page 37

Table 4D................................................................Page 38

Table 4E................................................................Page 39

Appendices............................................................Page 40

Bibliography..........................................................Page 47

About this Master's Thesis

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School	Rollins School of Public Health
Department	Executive Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Food Accessibility Hypertension Blacks
Committee Chair / Thesis Advisor	Smith, Iris E, Emory University
Committee Members	Al-Amin, Jessie, Dr.

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