The role of racialized urban planning in shaping inequitable urban food environments and obesity disparities

项目总结 美国黑人承受着不成比例的肥胖负担，肥胖是最重要的公共健康之一 21世纪的挑战。肥胖是多种慢性病的主要风险因素，包括糖尿病， 高血压、骨关节炎和抑郁症，并与较低的生活质量和缩短的寿命有关。 尽管几十年来采取了公共卫生干预措施来解决这一问题，但肥胖症方面的种族差异依然存在， 在某些情况下，正在扩大。大量证据表明，社区环境，包括 隔离、贫困和食物环境与肥胖风险有关，这些社区 黑人和白人群体的特征有系统地不同。然而，一个关键的科学鸿沟 仍然是在了解肤色结构种族主义社区中肥胖的根本原因。其影响 结构性种族主义与历史种族主义政策和当今城市规划决策的不公平 食物环境和肥胖差距几乎没有得到系统的调查。我们建议研究 从20世纪30年代末开始的三项历史性的种族主义政策和做法--红线、清除贫民窟和 高速公路位置-被假设为巩固了居民区种族隔离和 通过限制商业、住房和经济，保持白人人口的优势地位 为黑人人口提供的机会。据我们所知，还没有研究调查这些种族主义 政策是肥胖差距的结构性决定因素。我们的目标是：1)确定在多大程度上 累积暴露于红线类别(红、黄、蓝、绿)、“贫民窟”清理和高速公路发展 与种族构成、经济指标的同期和纵向变化有关， 社区的饮食环境；2)考察这些环境的历史和当代社会政治背景 通过对城市总体规划、报纸媒体和重点项目的定性分析，实现三项种族主义政策 线人访谈；以及3)检查社区层面对这三个因素的累积暴露程度 种族主义政策与BMI增加和肥胖风险有关。我们提出了一个短期的， 开发R21研究拨款，以测试将新汇编的空间和背景城市联系起来的可行性 计划和政策数据与动脉粥样硬化多种族研究(MESA)队列，其中包含深入的， 最初从六个城市招募的人的纵向健康数据。这项工作的结果将是 将科学注意力重新集中在肥胖环境和肥胖的上游原因上的结果 在预防肥胖症方面，我们将继续关注不同种族之间的差异，并确定促进种族公平的结构性解决方案。在未来，我们 将在这一发展拨款(R21提案)的基础上增加包括BMI和糖尿病健康在内的队列 数据在不同城市扩大样本量和地域范围。

PROJECT SUMMARY Black Americans experience a disproportionate burden of obesity, one of the most significant public health challenges of the 21st century. Obesity is a major risk factor for multiple chronic conditions, including diabetes, hypertension, osteoarthritis, and depression, and is associated with a lower quality of life and shortened life span. Despite decades of public health interventions to address this problem, racial disparities in obesity persist and, in some cases, are widening. Substantial evidence shows that neighborhood environments, including segregation, deprivation, and food environments are associated with obesity risk and that these neighborhood characteristics vary systematically between Black and White populations. However, a critical scientific gap remains in understanding the root cause of obesity among communities of color – structural racism. The impact of structural racism vis-à-vis historical racialized policies and urban planning decisions on current day inequitable food environments and obesity disparities has received little systematic investigation. We propose to examine three historical racialized policies and practices, starting in the late 1930s – redlining, “slum” clearance, and highway placement – that have been hypothesized to have cemented residential racial segregation and maintained an advantaged status of White populations by limiting commercial, housing, and economic opportunities afforded to Black populations. To our knowledge, no studies have investigated these racialized policies as structural determinants of obesity disparities. Our aims are to: 1) determine the extent to which cumulative exposure to redlining category (red, yellow, blue, green), “slum” clearance, and highway development is associated with contemporaneous and longitudinal change in racial composition, economic indicators, and food environments of neighborhoods; 2) examine the historical and contemporary sociopolitical context of these three racialized policies through qualitative analysis of city comprehensive plans, newspaper media, and key informant interviews; and 3) examine the extent to which cumulative neighborhood-level exposure to these three racialized policies is associated with increases in BMI and risk of obesity. We are proposing a short-term, developmental R21 research grant to test the feasibility of linking newly compiled spatial and contextual urban planning and policy data with the Multi-ethnic Study of Atherosclerosis (MESA) cohort, which contains in-depth, longitudinal health data for people who were initially recruited from six cities. Findings from this work will be consequential for refocusing scientific attention on upstream causes of obesogenic environments and obesity disparities, and identifying structural solutions to advance racial equity in obesity prevention. In the future, we will build on this developmental grant (R21 proposal) with additional cohorts that include BMI and diabetes health data in different cities to expand the sample size and geographic scope.