May 2013

Document Type


Degree Name



Dept. of Public Health and Preventive Medicine


Oregon Health & Science University


Objectives. We used the Retail Food Environment Index (RFEI) to evaluate the relationship between neighborhood food imbalance and obesity among Cowlitz American Indians (AIs) and non-Hispanic white residents of Washington State. Methods. We examined adult Cowlitz AIs (n = 339) and adult white Washingtonians (n = 15,930) using a Behavioral Risk Factor Surveillance System (BRFSS) telephone survey and the 2010 Washington BRFSS. We defined obesity as BMI ≥ 30 kg/m2 using self-reported height and weight. For each residential ZIP Code neighborhood, RFEI scores were calculated as the total number of limited service restaurants and convenience stores divided by the total number of grocery stores, produce vendors, and farmers markets. We used logistic regression to analyze the relationship between neighborhood food imbalance (RFEI ≥ 4.0) and obesity. Results. The odds ratio for obesity in imbalanced versus balanced neighborhood food environments was 1.83 among Cowlitz AIs (95% CI = 1.12, 3.00




School of Medicine



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