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Exploring the Link Between Food Retailers and Obesity-Related Cancers
Obesity has reached alarming levels in the United States, with over 40% of adults classified as obese and more than 70% considered overweight. One frequently proposed strategy to combat this issue is to enhance diet quality by increasing the number of grocery stores that provide healthier food options. However, researchers have noted that this approach alone may not be sufficient to address the problem, leaving many unanswered questions.
A multidisciplinary research team aimed to shed light on consumer behavior at the county level, particularly examining the correlation between shopping locations and the incidence of obesity-related cancers. Their findings are detailed in an article published in BMC Medicine.
The team, which included assistant professor Ran Xu and Ph.D. student Gaofei Zhang from the Department of Allied Health Sciences, as well as associate professor Peter Chen and Ph.D. students Weixuan Lyu and Congcong Miao from the Department of Geography, Sustainability, Community, and Urban Studies, collaborated with Qinyun Lin from the University of Gothenburg in Sweden. They utilized a comprehensive dataset that included large-scale GPS-tracked mobility patterns to identify shopping behaviors across approximately 359,000 retailers throughout the United States. This data was then correlated with statistics on obesity-related cancers.
“The link between obesity and cancer is substantial, accounting for approximately 5% of new cancer cases in men and 10% in women each year, making it a critical public health issue,” Xu explains. “From a policy perspective, it’s common to assume that simply increasing the number of healthy grocery options will lead to improved dietary habits and, in turn, a reduction in obesity.”
Surprisingly, this assumption may not hold true. Previous research conducted by Xu’s team indicated that numerous factors influence dietary choices beyond mere access to healthy food options.
“Our studies revealed that individuals tend to frequent food retailers that are often outside their immediate neighborhoods. Additionally, we observed a strong connection between shopping behaviors and various obesity-related conditions such as hypertension and diabetes. This paper delves deeper into the potential relationship between shopping patterns and the mortality rates associated with obesity-related cancers,” Xu notes.
The researchers analyzed GPS data from 2018 to 2019 provided by SafeGraph and matched it with retailer location data from InfoGroup. Retailers categorized as healthy included grocery stores, large warehouse clubs, and farmer’s markets, while convenience stores and fast-food outlets were labeled as unhealthy food sources. This data was then integrated with obesity-related cancer mortality statistics from the Centers for Disease Control and Prevention covering the period from 2015 to 2020.
To quantify the relationship, the team constructed an activity-based index reflecting the percentage of visits to healthy food establishments by residents of each county, as well as a location-based index represented by the proportion of healthy food sites within each county.
“In summary, we found that monitoring where individuals shop provides a far more accurate predictor of obesity-related cancer mortality than simply considering the geographic distribution of healthy food establishments,” Xu stated.
The activity-based index proved to be twice as effective as the traditional location-based index in predicting the risk of obesity-related cancer. Xu pointed out that this underscores the need for more nuanced research into consumer behavior to develop effective strategies to tackle the obesity epidemic.
Chen, the geographical analyst on the research team, highlighted that the correlation varies among different sociodemographic groups. Notably, the connection appears to be stronger in Hispanic communities, which may relate to the so-called “Hispanic Paradox,” where members of this demographic frequently display better health outcomes and healthier lifestyle choices despite facing numerous socioeconomic disadvantages.
“Our findings also indicated a robust association in individuals with higher socioeconomic status (SES). This could be attributed to the fact that those individuals generally have more financial flexibility to purchase healthier food options when they visit grocery stores,” Chen explained.
Xu and his colleagues are leveraging modern digital tools, including GPS data, to deepen their understanding of how these complex dynamics play out and contribute to conflicting results in current policy approaches.
“Consider the concept of food deserts, which are typically low-income areas lacking access to grocery stores. Policymakers may respond by directing resources to these areas, such as establishing new grocery stores,” Xu noted. “However, our research indicates that most shopping trips occur outside residents’ neighborhoods, challenging the effectiveness of this approach. A focus on actual consumer behaviors and shopping patterns may yield more beneficial policy outcomes.”
The index developed by the researchers marks an important advancement in the study of food habits, and Xu remarked that their future research will aim to further elucidate consumer behaviors and purchasing decisions. In one ongoing study, they are systematically evaluating the impact of new grocery store openings in food deserts. Complementing this quantitative research with qualitative methods like surveys will enhance understanding of the multifaceted factors influencing consumer choices, whether these choices stem from convenience, price, brand loyalty, or other considerations.
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