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Introduction: There is great disparity in tobacco outlet density (TOD), with density highest in low-income areas and areas with greater proportions of minority residents, and this disparity may affect cancer incidence. We sought to better understand the nature of this disparity by assessing how these socio-demographic factors relate to TOD at the national level., Methods: Using mixture regression analysis and all of the nearly 65,000 census tracts in the contiguous United States, we aimed to determine the number of latent disparity classes by modeling the relations of proportions of Blacks, Hispanics, and families living in poverty with TOD, controlling for urban/rural status., Results: We identified six disparity classes. There was considerable heterogeneity in relation to TOD for Hispanics in rural settings. For Blacks, there was no relation to TOD in an urban moderate disparity class, and for rural census tracts, the relation was highest in a moderate disparity class., Conclusions: We demonstrated the utility of classifying census tracts on heterogeneity of tobacco risk exposure. This approach provides a better understanding of the complexity of socio-demographic influences of tobacco retailing and creates opportunities for policy makers to more efficiently target areas in greatest need.

In food-environment research, an alternative to resource-intensive direct observation on the ground has been the use of commercial business lists. We sought to determine how well a frequently used commercial business list measures a dense urban food environment like the Bronx, NY. On 155 Bronx street segments, investigators compared two different levels for matches between the business list and direct ground observation: lenient (by business type) and strict (by business name). For each level of matching, researchers calculated sensitivities and positive predictive values (PPVs) for the business list overall and by broad business categories: General Grocers (eg, supermarkets), Specialty Food Stores (eg, produce markets), Restaurants, and Businesses Not Primarily Selling Food (eg, newsstands). Even after cleaning the business list (eg, for cases of multiple listings at a single location), and allowing for inexactness in listed street addresses and spellings of business names, the overall performance of the business list was poor. For strict matches, the business list had an overall sensitivity of 39.3% and PPV of 45.5%. Sensitivities and PPVs by broad business categories were not meaningfully different from overall values, although sensitivity for General Grocers and PPV for Specialty Food Stores were particularly low: 26.2% and 32%, respectively. For lenient matches, sensitivities and PPVs were somewhat higher but still poor: 52.4% to 60% and 60% to 75%, respectively. The business list is inadequate to measure the actual food environment in the Bronx. If results represent performance in other settings, findings from prior studies linking food environments to diet and diet-related health outcomes using such business lists are in question, and future studies of this type should avoid relying solely on such business lists., (Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objectives: We examined whether the geographic density of alcohol retailers was greater in geographic areas with higher levels of demographic characteristics that predict health disparities., Methods: We obtained the locations of all alcohol retailers in the continental United States and created a map depicting alcohol retail outlet density at the US Census tract level. US Census data provided tract-level measures of poverty, education, crowding, and race/ethnicity. We used multiple linear regression to assess relationships between these variables and retail alcohol density., Results: In urban areas, retail alcohol density had significant nonlinear relationships with Black race, Latino ethnicity, poverty, and education, with slopes increasing substantially throughout the highest quartile for each predictor. In high-proportion Latino communities, retail alcohol density was twice as high as the median density. Retail alcohol density had little or no relationship with the demographic factors of interest in suburban, large town, or rural census tracts., Conclusions: Greater density of alcohol retailers was associated with higher levels of poverty and with higher proportions of Blacks and Latinos in urban census tracts. These disparities could contribute to higher morbidity in these geographic areas.