PHRESH Findings

PHRESH is composed of several separate research studies sponsored by the National Institutes of Health (NIH). We are committed to sharing the results with participants, local stakeholders, and communities nationwide. Below are highlights from our findings to date. See our publications page for more details on the results.

Think PHRESH 2022

In November 2022, we launched data collection to study risk and protective factors operating across the lifespan to better understand the lived experiences of Black Americans, and how such experiences contribute to aging and Alzheimer’s disease risk. We are also seeking to understand how modifiable factors, including sleep and blood pressure contribute to healthy aging.

PHRESH 2021

In 2021 we collected surveys from Hill District and Homewood participants around neighborhood perceptions, including access to services, neighborhood satisfaction, social cohesion, neighborhood safety, relatability to police, perceptions of police bias, and neighborhood aesthetics. We also collected data on perception of air quality, perceptions of food availability and purchasing/shopping behaviors, food security, physical health, psychological functioning and behavioral health, stressful life experiences, perceived stress, hopelessness, resilience, home environment, and demographics. Data collection ended in late 2021, and results were published beginning in 2022.

While the Hill District is preparing for a new store to open in the former Shop N Save location, we have compiled information that shows where Hill District PHRESH participants have been shopping over time. This includes some 2021 data collection through October 11, 2021.

Where do Hill District residents shop?

COVID-19 Check-In

Between March and May of 2020, we conducted 605 phone interviews with residents of the Hill District and Homewood. We used data that we had collected beginning in 2011 among the same participants to examine trends in food insecurity over time and the impact of the COVID-19 pandemic on food insecurity. We compared the trends with national trends and found that our sample had a greater increase in food insecurity resulting from the COVID-19 pandemic.

In the early days of the pandemic, we did not observe changes in Supplemental Nutrition Assistance Program (SNAP) or food bank use. The existing safety nets may have failed to reach those with emerging needs particularly in the early days of the pandemic. However, difficulties enrolling in SNAP, problems accessing food banks during shutdowns, or feelings of stigma or uncertainty regarding eligibility may also be to blame. Other factors contributing to the food insecurity spike may be loss of work, increased psychological distress, and concerns about leaving one’s home for food shopping. We continue to analyze other findings from this survey, including psychological health and economic outcomes.

PHRESH 2018

In 2018, we continued to collect data related to all of our major PHRESH aims from 2016, which included diet, physical activity, sleep, and heart health. In addition, we have been funded to continue examining more closely the effects of diet within the neighborhood (rePHRESH).

Papers involving data from this data collection are being released so please see our publications page for more information on new releases.

A summary of findings is also available in our community newsletter.

PHRESH 2020 Hill District Community Newsletter PHRESH 2020 Homewood Community Newsletter

PHRESH 2016

Since 2013, we have been funded to extend our analysis to include other important health indicators and a broader focus on other changes that are occurring in the neighborhood. We are building on the PHRESH study by examining residents’ heart health, physical activity, sleep, and use of neighborhood green spaces and public areas—in addition to food choices, neighborhood perceptions, and overall health and well-being.

In 2016, we collected data to assess the longer-term effects of neighborhood changes. In this phase of the study, we focused on diet, physical activity, sleep, and heart health, among other measures of health and well-being.

Additional analysis was done on the opening of the supermarket in the Hill District. The introduction of a supermarket did not result in higher healthy food availability per se. However, we concluded that opening new supermarkets may improve residents’ health, well-being, and their satisfaction their neighborhood as a place to live.

Certain neighborhood characteristics, such as cohesion and lower poverty, may lead to better sleep. Neighborhood disadvantage could be associated with disrupted or shorter sleep.

Residents’ perceived safety and physical activity could also be important aspects in the connection between crime and BMI. Also their social networks and social support can play a role in improvement of physical activity and BMI.

PHRESH Follow-Up (2014)

In 2014, we repeated the 2011 data collection after a new grocery store was built in the Hill District.

Improvements in Dietary Intake, Body Mass Index, and Neighborhood Perceptions

Compared with Homewood residents, Hill District residents had somewhat healthier diets in 2014. They consumed fewer calories, less added sugar, and fewer "empty calories." However, there was no statistically significant change in other dietary outcomes, such as consumption of fruits, vegetables, and whole grain foods.

There was no significant change in BMI in the Hill District, the main indicator used to measure obesity, and there were no significant changes in rates of obesity or overweight since 2011. In Homewood, average BMI, obesity, and overweight were all slightly worse than in 2011.

Perceptions of access to healthy foods improved significantly for Hill District residents, as did overall satisfaction with the neighborhood. After the arrival of the full-service grocery store, 80% of Hill District respondents said they were satisfied or very satisfied with their neighborhood (compared with 66% in 2011).

No Clear Connection Between Improvements and the Grocery Store's Opening

We could not link the gains in the Hill District to the store's opening, but we might see more definitive outcomes as the study progresses.

• Nearly all dietary improvements were related to reduced food intake. Over time, this could translate to lower obesity rates. The observation period (approximately one year after the store opened) may not have been long enough to detect changes.
• Other changes in the neighborhood could explain improvements in residents' diets. Although the store's opening was the largest change in the Hill District during the study period, it stimulated additional neighborhood investment and improvements.
• The new Hill District grocery store was the result of extensive community organizing, advocacy, and investment. It is difficult to separate the effects of this campaign from the effects of the new grocery store in improving residents' dietary choices.

PHRESH Plus Baseline 2013

Exercising regularly can help bring many positive changes to people's health. There is evidence of a relationship between a neighborhood's green space environment and residents' participation in exercise. PHRESH Plus, a five year study connected with PHRESH, shares PHRESH's mission of understanding neighborhood health and well-being, with special attention to the exercise and physical activity choices of residents in the Hill District and Homewood.

The first publication from PHRESH Plus, Are Food Deserts Also Play Deserts?, found that:

• Residents of food desert neighborhoods used their nearby parks significantly less than residents of other areas both locally and nationally.
• Few organized or supervised activities were observed in the low-income neighborhood parks.
• Individuals residing near the observed parks experienced disproportionate amounts of disability and physical limitations.
• Park users in the observed areas were not representative of the demographic mix of local residents; substantially more males used the parks than females, and children and teens used the parks more than older adults.
• Over 85 percent of neighborhood residents considered the nearby parks safe to use during daylight hours.

PHRESH Baseline (2011)

In 2011, we randomly selected 1,809 households in the Hill District neighborhood, and 896 participated in our interview. We also randomly selected 1,091 households in Homewood, our comparison neighborhood, and 476 participated. This initial data collection provided us with baseline characteristics of the two neighborhoods.

In addition to the data reported below, we asked residents about their dietary intake and perceived access to healthy food. We also recorded participants' height and weight to calculate their body mass index (BMI).

Demographics

• 90% of respondents in both neighborhoods were African-American.
• 66% of respondents had a household income of less than $20,000 per year.
• Hill District respondents had lived in their neighborhood for an average of 32 years; Homewood residents had lived in their neighborhood for an average of 18 years.

Neighborhood Perceptions

• 66% of Hill District respondents and more than half of Homewood respondents were satisfied/very satisfied with their neighborhood as a place to live.
• Although most respondents felt safe walking around their neighborhoods at night, two-thirds of Hill District respondents and 79% of Homewood respondents expressed concern about crime and violence.

Food Security and Health

Hill District

• There were limited produce options in Hill District food stores:
  • There was no full-service grocery store at the start of our study.
  • Three of the 14 food stores sold fresh fruit, and only one sold fresh vegetables.
• 40–50% of households experienced food insecurity, compared with 13% of households across Pennsylvania.
• One in two residents had high blood pressure; one in five had diabetes, high cholesterol, or heart disease; and two in five had arthritis.

Homewood

• There were limited produce options in Homewood food stores:
  • There was no full-service grocery story in the neighborhood.
  • None of the 14 food stores in the neighborhood sold fresh fruit or vegetables.
• 36% of households experienced food insecurity.
• One in two residents had high blood pressure; one in four had high cholesterol, one in five had diabetes or heart disease, and two in five had arthritis.

Community Partners

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PHRESH is funded by the National Cancer Institute and the National Heart Lung and Blood Institute of the National Institutes of Health (NIH).