Abstract TU279: Neighborhood as a Window to Women’s Health 15 Years After Pregnancy: Do Income and Food Access Play a Role?

Abstract

Introduction: Food environment is directly related to food choice, diet quality, and health outcomes. Access, availability, and food cost are all factors in a food environment. Purpose: To determine if neighborhood factors can provide insight into women’s health in the years after pregnancy and examine if income and food accessibility relate to diet quality. Hypothesis: Women in low-income (LI), low-access (LA) areas in the Pittsburgh area will have lower Cardiovascular health (CVH) diet scores (less ideal diet quality). Methods: CVH was evaluated in the first 149 women (mean age 44 years; 15 years after pregnancy) recruited into the Window Brain Study with completed diet surveys (MEPA), using the American Heart Association’s Life’s Essential 8 (LE8). CVH scores (0-100, higher is healthier) were generated using LE8 components, including diet. Neighborhoods (census tracts) were assigned GeoIDs and matched with the USDA’s Food Access Research Atlas to assess access to food-stores (within ½-mile in urban areas or 10-miles in rural areas). It also identifies LI areas based on the Department of Treasury’s Markets Tax Credit program (tract poverty rate of 20+%; or a tract median family income is < 80% of their area’s median family income). Results: Women classified as LILA (N=35, 23%) had significantly lower CVH diet scores (25(25,50) vs 50(25,50) P=0.001) compared to not LILA (N=114) and scored significantly lower on the MEPA questionnaire ((7(6,9) vs 8(7, 10) P=0.005), as seen in Table 1. LILA also had higher HbA1C levels (5.55(5.20, 5.95) vs 5.40(5.10,5.50)) P= 0.021) and a history of gestational diabetes (17% vs 8% P=0.103). Overall CVH scores of the LILA group tended to be less healthy (63.3 ±12.7 vs 68.4 ± 13.6 P=0.108). Of the health behaviors, diet and physical activity (PA) had the lowest mean CVH scores in both groups. Conclusion: Enhanced nutrition education and awareness of food accessibility are critical to improve CVH. Diet quality and PA posit opportunities to improve overall CVH among women residing in LILA neighborhoods.