For years, researchers have been trying to document a connection between obesity among the poor and the limited selection of healthy foods in their local grocery stores. Now, a new study suggests the relationship might be even more complicated than previously thought.

Where people live may influence their food choices as much or more than where they themselves shop, said study lead author Sanae Inagami, M.D., a researcher with the Rand Corporation in Los Angeles.

“My feeling is that your neighbors do influence your health,” Inagami said. “Who you know and where you go shopping is related to your level of obesity.”

Inagami and her colleagues examined census figures from 2000 and linked them to 2,144 Los Angeles County residents who were surveyed about their eating and health habits from 2000 to 2002. The researchers report their findings in the July issue of the American Journal of Preventive Medicine.

According to the study, residents who lived in poor neighborhoods and shopped in even poorer neighborhoods were more overweight than those who shopped in grocery stores in wealthier areas.

The shopping habits of neighbors were also an important factor. A 5-foot-5-inch person who lived in a poor neighborhood whose neighbors shopped in a wealthier area would weigh an average 9.2 pounds less than if he or she lived in a poor neighborhood whose residents shopped in a poorer area.

Why does this matter? “I don’t think we’re going to be making any impact on obesity without looking at how social factors play a role,” Inagami said.

Thomas Farley, M.D., chair of the Department of Community Health Sciences at Tulane University, said that while the study adds to existing knowledge about the link between obesity and poor neighborhoods, it doesn’t break much new ground.

There are still mysteries about exactly why poor people are more overweight, especially considering that they used to be thinner than the general population, he said. “One thing we know that calorie-dense food is cheap, sugar is cheap, sodas are cheap and snacks are cheap. That’s at least part of the explanation. But we don’t fully understand it.”

Inagami S, et al. You are where you shop: grocery store locations, weight and neighborhood. Am J Prev Med 31(1), 2006.

Health Behavior News Service