Essays on Environmental Determinants of Health Behaviors and Outcomes
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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.
Table of Contents
Literature Review and Proposed Methodologies
Alcohol Environments: Disparities in Exposure and Adolescent Drinking in California
Spatial Location of Alcohol Outlets and Problem Drinking among Adults in California
Does the Obesity Epidemic Widen Sociodemographic Health Disparities in the US?
Food Environments and the Obesity Epidemic
Research conducted by
This document was submitted as a dissertation in August 2007 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Roland Sturm (Chair), Rosalie Liccardo Pacula, and Lionel Galway. Brian Finch of San Diego State University was the external reader for the dissertation.
This publication is part of the RAND Corporation Dissertation series. Pardee RAND dissertations are produced by graduate fellows of the Pardee RAND Graduate School, the world's leading producer of Ph.D.'s in policy analysis. The dissertations are supervised, reviewed, and approved by a Pardee RAND faculty committee overseeing each dissertation.
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