• Hao Huang.
• Department of Social Sciences, Lewis College of Science and Letters, Illinois Institute of Technology, IL, Chicago, USA. hhuang48@iit.edu.
• J Urban Health. 2021 Oct 1; 98 (5): 676-686.

AbstractThe obesity rate in Chicago has increased up to more than 30% in the last two decades. Obesity is a major problem in Chicago, where 36% of the city's high school students and 61% of adults in the metropolitan area are overweight or obese. Simultaneously, Chicago remains highly segregated by race-a phenomenon that begs for spatial analysis of health. Extant work exploring associations between the food retail environment and obesity has provided mixed findings, and virtually, none of this work has been done with the effects of the interaction between racial segregation and the food retail environment on obesity, where obesity rates are among the highest in the segregation area for the city defined by racial segregation. This study explores whether being overweight or obese is associated with urban food environments, such as access to different types of food retail outlets, and how its associations interact with racial factors, at the community level. This study uses the 2016-2018 data from the Healthy Chicago Survey to investigate the spatial variations in obesity and their association with food environments in Chicago. Also, this study examines the moderating effects of racial segregation on associations between obesity and access to food retail outlets. Using spatial statistics and regression models with interaction terms, this study assesses how the urban food environment can interact with racial segregation to explain the spatial distribution of obesity. The results indicate that the obesity population is highly concentrated in the African American community. In Chicago, each additional convenience store in a community is associated with a 0.42% increase in the obesity rate. Fast food restaurant access is predictive of a greater obesity rate, and grocery store access is predictive of less obesity rate in a community with a higher percentage of African American population. Findings can be used to promote equitable access to food retail outlets, which may help reduce broader health inequities in Chicago.© 2021. The New York Academy of Medicine.

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