Public Health Nutrition

HOT TOPIC – Food environment

A food desert in Detroit: associations with food shopping and eating behaviours, dietary intakes and obesity

Katarzyna Budzynskaa1a2, Patricia Westa3, Ruth T Savoy-Moorea4, Darlene Lindseya3, Michael Wintera5 and PK Newbya6a7a8 c1

a1 Section of General Internal Medicine, Department of Medicine, Primary Care Academic Fellowship, Boston University School of Medicine, Boston, MA, USA

a2 Department of Family Medicine, Henry Ford Hospital and Medical Center, Detroit, MI, USA

a3 Department of Family Medicine, St. John Hospital and Medical Center, Detroit, MI, USA

a4 Department of Graduate Medical Education, St. John Hospital and Medical Center, Detroit, MI, USA

a5 Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA

a6 Department of Pediatrics & Program in Graduate Medical Nutrition Sciences, Boston University School of Medicine, 88 E. Newton Street, Vose Hall 308, Boston, MA 02118, USA

a7 Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

a8 Program in Gastronomy, Culinary Arts, and Wine Studies, Boston University Metropolitan College, Boston, MA, USA


Objective Currently 67 % of the US population is overweight or obese and obesity is associated with several chronic medical conditions. Geographic areas where individuals lack access to healthy foods have been termed ‘food deserts’. The study aim was to examine if area of residence within Metro Detroit was associated with dietary intake, food and shopping behaviours, and BMI.

Design Cross-sectional study.

Settings Participants were recruited in the waiting area of four primary-care clinics.

Subjects Individuals (n 1004) completed a questionnaire comprising four sections: demographics; personal health status including self-reported height and weight; a modified diet, transportation and shopping survey; and a subscale from the Diet and Health Knowledge Survey.

Results Seventy-four per cent of participants were female and the mean age was 46·7 (sd 15·0) years. In univariate analyses, living in Detroit was associated with being African American, unemployment, less education, no regular exercise, worse health self-rating and obesity (P < 0·0005 for all). Participants living in Detroit had a 3·06 (95 % CI 1·91, 4·21) kg/m2 larger BMI compared with people living outside the city (P < 0·0005) in univariate analyses, but the effect was attenuated when adjusted for demographics, disease status, shopping and eating behaviours, dietary intakes and diet knowledge (β = −0·46 kg/m2, 95 % CI −2·23, 1·30 kg/m2, P = 0·60).

Conclusions Overweight and obesity are highly prevalent both inside (82·9 %) and outside (72·8 %) the city of Detroit, presenting a major public health problem. However, living in this food desert was not significantly associated with BMI after potential covariates were considered.

(Received September 13 2012)

(Revised February 11 2013)

(Accepted February 26 2013)

(Online publication May 07 2013)


  • Food deserts;
  • Shopping;
  • Eating;
  • Obesity


c1 Corresponding author: Email