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Essays on Environmental Determinants of Health Behaviors and Outcomes

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Abstract:

This dissertation consists of four stand-alone essays that focus on alcohol and food environments. They examine the following: (1) Disparities in alcohol environments and their relationship to adolescent drinking. Nineteen percent of all expenditure on alcohol in 1999 was attributed to underage drinking. Alcohol outlets located in close proximity to homes are significantly associated with adolescents' binge drinking and driving after drinking. (2) The spatial location of alcohol outlets and problem drinking among the adult population. There is consistent evidence of a concentration of alcohol retailers in minority and low-income neighborhoods in California. Some types of alcohol outlets are found to be associated with excess alcohol consumption and heavy episodic drinking among the adult population with indirect effects such as drunk driving and violent crime. (3) Weight gain trends across sociodemographic groups in the United States. Although sociodemographic disparities in obesity are well-documented, weight gain trend is quite similar across sociodemographic groups, probably due in part to broadly environmental factors such as transportation and community design. (4) Retail food environments. Retail food outlets are associated with individual obesity status. Improving the supply of and access to healthy food choices can play a role in the prevention of obesity.