Measurement and analytical issues involved in the estimation of the effects of local food environments on health behaviors and health outcomes

Abstract

Diet-related health conditions such as cardiovascular disease, diabetes, hypertension, some cancers, and obesity have been concerns of public health professionals for many years (U.S. Department of Agriculture and U.S. Department of Health and Human Services 2012). More recently, these professionals have been asking questions about how environmental factors may contribute to these conditions. As researchers, policymakers, practitioners, and others think about how to change the environment to support diet and health and how different features of local food environments (LFEs) affect dietary behaviors and related health outcomes, determining how the LFE varies by area and what drives that variability is not easy. The difficulty in answering these questions arises from a myriad of study design, measurement, and analytical issues. Each of these issues can significantly affect inferences regarding what influence the LFE has on purchasing behaviors, diet, and health. In this chapter, the reader is introduced to common design, measurement, and analytical issues in the research of food environments. The strengths and limitations of various design and analytical approaches with respect to their ability to estimate the causal effects of the LFE on health behaviors and health outcomes are detailed. Both established and newer methods are also discussed.