The Association of Racial Residential Segregation on Physical Activity and Diet among Older African American Church Members in the Urban South: A Mixed Methods Study Public Deposited

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  • March 22, 2019
  • Armstrong-Brown, Janelle M.
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
  • Background: Physical inactivity and poor diet are two factors contributing to disproportionate disease rates among older African Americans. Previous research indicates that older African Americans are more likely to live in racially segregated neighborhoods and that racial residential segregation is associated with limited opportunities for physical activity and availability of healthy food. Using the concept of therapeutic landscapes, the objective of this study was to examine the relationship between racial residential segregation, physical activity and fruit and vegetable intake among older African American church members living in urban areas of the Southeastern, US. Methods: In this mixed methods study, 472 participants from three counties in NC completed a baseline survey for a cancer screening and physical activity intervention. Participant addresses were geocoded and linked to census data. Racial residential segregation was measured as the proportion of African Americans residing in a participant's census tract. The study measured a neighborhood walkability score, counts of recreational facilities within a 1-mile radius, and counts of supermarkets, fast food restaurants, and conveniences stores within a 3-mile radius of a participant. Descriptive statistics and multilevel logistic and linear regression analyses were done using Mplus to determine bivariate and mediational relationships among variables. Qualitative in-depth interviews were conducted with 12 participants from racially segregated areas in order to understand the perception of the neighborhood environment on physical activity and diet and to further explain findings from the quantitative analyses. Results: Participants living in predominantly African American census tracts had more minutes of physical activity, but were less likely to meet physical activity recommendations. Census tracts with greater proportions of African American residents were found to have more convenience stores. No significant association was found between racial residential segregation and fruit and vegetable intake. In the qualitative interviews, participants discussed neighborhood features that facilitated physical activity and characteristics of places where they purchased food. Participants were able to be physically active in their neighborhoods, but had limited food options in their local supermarkets and traveled outside of their neighborhoods to find quality food at a reasonable price. Conclusion: The Southeastern US has a different historical and social context, which may operate differently to impact physical activity and fruit and vegetable intake among older African American church members, as compared to other regions of the US. Future research is needed to determine the mechanisms by which racial residential segregation can operate as a therapeutic landscape for older African Americans, which may lead to the design of effective interventions for this population.
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  • ... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Health Behavior and Health Education in the Gillings School of Global Public Health.
  • Eng, Eugenia

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