The Inequitable Distribution of Tobacco Outlet Density: The Role of Income in Two Black Mid-Atlantic Geopolitical Areas
Published Date:Apr 10 2016
Source:Public Health. 136:35-40.
Pubmed Central ID:PMC4930734
Funding:K01 CA134939/CA/NCI NIH HHS/United States
P60 MD000214/MD/NIMHD NIH HHS/United States
T32 DA007292/DA/NIDA NIH HHS/United States
U01 CE001954/CE/NCIPC CDC HHS/United States
Studies have shown that communities with higher concentrations of low-income racial and ethnic minorities correlate with a greater presence of tobacco outlets. Community-level income has consistently been among the strongest predictors of tobacco outlet density. This study analyzes two Maryland geopolitical areas with similar racial concentrations yet differing income levels in an attempt to disentangle the race-income relationship with tobacco outlet density.
In this cross-sectional examination of tobacco outlet and census tract-level sociodemographic data, Baltimore City, Maryland and Prince George's County, Maryland were geocoded to determine tobacco outlet density.
Tobacco outlet density was defined as the mean number of tobacco outlets per 1,000 persons per census tract. Comparisons of tobacco outlet density and sociodemographic variables were analyzed via two-sample t-tests, and the direct effect of sociodemographic variables on tobacco outlet density for each area was analyzed via spatial lag regressions.
Prince George's County, the area with the higher income level ($77,190 vs. $43,571), has a significantly lower tobacco outlet density than Baltimore City (p < .001). Prince George's County has a 67.5% Black population and an average of 3.94 tobacco outlets per 1,000 persons per tract. By contrast, Baltimore City has a 65.3% Black population and an average of 7.95 tobacco outlets per 1,000 persons per tract. Spatial lag regression model results indicate an inverse relationship between income and tobacco outlet density in Baltimore City and Prince George's County (β = -0.03, p < 0.01 β -0.01, p = 0.02, respectively), and a significant interaction term indicating a greater magnitude in the relationship between income and tobacco outlet density in Baltimore City (β = -0.05, p < 0.01).
Results suggest that higher socioeconomic status, even in primarily underrepresented racial and ethnic geopolitical areas, is linked to lower tobacco outlet density.
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