Georgia State University ScholarWorks @ Georgia State University Public Health Capstone Projects School of Public Health 1-6-2017 BANKHEAD VERSUS BUCKHEAD: Analyzing the Environmental Justice Issues in Atlanta Kristen G. Vales Georgia State University Follow this and additional works at: https://scholarworks.gsu.edu/iph_capstone Recommended Citation Vales, Kristen G., "BANKHEAD VERSUS BUCKHEAD: Analyzing the Environmental Justice Issues in Atlanta." , Georgia State University, 2017. https://scholarworks.gsu.edu/iph_capstone/54 This Capstone Project is brought to you for free and open access by the School of Public Health at ScholarWorks @ Georgia State University. It has been accepted for inclusion in Public Health Capstone Projects by an authorized administrator of ScholarWorks @ Georgia State University. For more information, please contact [email protected]. BANKHEAD VERSUS BUCKHEAD: Analyzing the Environmental Justice Issues in Atlanta By Kristen G. Vales B.S., GEORGIA STATE UNIVERSITY A Capstone Submitted to the Graduate Faculty Of Georgia State University in Partial Fulfillment Of the Requirements for the Degree MASTER OF PUBLIC HEALTH ATLANTA, GEORGIA 30303 APPROVAL PAGE Bankhead versus Buckhead: Analyzing the Environmental Justice Issues in Atlanta By Kristen G. Vales Approved: John A. Steward, B.S., M.P.H. Committee Chair Monica Robinson, B.S., M.B.A. Committee Member Christina Hemphill Fuller, ScD, SM Committee Member December 8, 2016 1 ACKNOWLEDGMENTS I would like to thank my husband, Wilford Vales, for his help in this project. He has served as a soundboard for ideas, a photographer, a videographer, and an errand runner. I would not have been able to complete this project without you. Thank you to Dr. Matt Hayat and Garrett Mahon with Georgia State University’s School of Public Health, Division of Epidemiology and Biostatistics whose ingenuity assisted me with my data analysis. I would also like to thank Michelle Eichinger giving me a chance to work with Planning4Health Solutions and the many projects we worked on that introduced me to health equity, equity assessment tools and policies on incorporating health equity for all. Lastly, thank you to my committee members who believed in me and helped me through this process. The many hours, days, weeks and months that you dedicated to assisting me is greatly appreciated. I have learned much during this process and it is all because of each of you. Thank you. 2 Author’s Statement Page In presenting this capstone as a partial fulfillment of the requirements for an advanced degree from Georgia State University, I agree that the Library of the University shall make it available for inspection and circulation in accordance with its regulations governing materials of this type. I agree that permission to quote from, to copy from, or to publish this capstone may be granted by the author or, in his/her absence, by the professor under whose direction it was written, or in his/her absence, by the Associate Dean, School of Public Health. Such quoting, copying, or publishing must be solely for scholarly purposes and will not involve potential financial gain. It is understood that any copying from or publication of this capstone which involves potential financial gain will not be allowed without written permission of the author. Signature of Author 3 ABSTRACT Introduction: In Atlanta, minority and low-income communities have a higher risk of cardiovascular disease, diabetes and obesity. There are many factors that can contribute to the risk of these poor health outcomes. While these personal factors play a part, there are environmental factors that can contribute as well. In lower income and high minority communities, there is an abundance of fast food restaurants, convenience stores and broken or missing sidewalks but a scarcity of healthy food options and fewer parks or poorer access to parks within their communities. As more health officials realized the connection between built environmental factors, environmental justice movement was formed. Robert Bullard first documented the movement while investigating the correlation of environmental quality and race. Aim: This project examined the environmental justice issues with regards to a community’s food and physical activity built environment by comparing two areas, Bankhead and Buckhead. The Bankhead area is a high minority populated area with a median income of roughly $32,000. The Buckhead area has a majority white population with an average median income of about $63,000. Methods: Using the modified Retail Food Environment Index and the Physical Activity Resource Assessment, we surveyed the differences between the two areas in regards to food access and physical activity facilities. Statistical tests were performed to describe and compare the findings between the two areas. The study focused on: 1) measuring healthy food availability with the mRFEI; 2) comparing number of food stores and food restaurants; 3) measuring availability of physical activity resources; and 4) observing park amenities. Results: Findings confirmed low access to healthy food retailers as well as a high percentage of limited-service restaurants in the Bankhead area. Park access and availability was adequate for 4 both areas and even showed a higher availability for the Bankhead area. However, park features were low for the parks located in the Bankhead area. The parks within the Buckhead area typically had several well-kept features such as basketball courts, tennis courts, soccer and baseball fields, etc. The Bankhead parks would usually have two of those features available but in adequate or poor conditions. Discussion: Findings were similar to prior studies and could be useful to guide changes in Atlanta. Policies were suggested in order to provide local government and community level interventions to address the environmental justice issues. Conclusions: These findings highlighted lack of food access and lack of park amenities using the mRFEI and PARA instruments. The results also brought to light a shortcoming of the tools. Although they can be used to examine the food and physical activity environments, they do not take population into account. Future work should look for tools that will take into account population to ensure equity is being properly addressed. 5 TABLE OF CONTENTS LIST OF TABLES……………………..…………………………….…………………….……...7 LIST OF FIGURES……………………..…………………………….…………………...……...8 INTRODUCTION……………………..…………………………….…………………...…….....9 1.1 Defining Environmental Justice……………………..…………………………….....…...11 1.2 Bankhead Area………………….……………….….………………………..…..…..12 1.3 Buckhead Area………………………………….….…………………………..…….13 1.4 Cardiovascular disease, diabetes and obesity………….………………………....….18 REVIEW OF THE LITERATURE……………………..…………………………….…..……..19 2.1 Food environment ………………………......……………………………............….19 2.2 Physical activity environment ………………………...…………………......…...….22 2.3 Role of built environment in health outcomes……………...…………………..…....26 METHODS………………………...……………………………………………….......………….29 3.1 Analyzing Food Environment ………………………...………………......………….29 3.2 Analyzing Physical Activity environment.…………….……………….................…33 RESULTS ….................................................................................................................................34 4.1 Food Environment…………….…………………………..………………..…...…...34 4.2 Physical Activity Environment………………………………..……………...……...39 DISCUSSION …...........................................................................................................................43 5.1 Action Plan………………………….…………………………..…………..…...…...46 5.1.1 Policy Suggestions ……….…………………………..…………….....…...47 5.1.2 Recommendations ……….…………………………..…………...…….….52 5.2 Importance of Community Involvement for Implementing Change…………….......54 5.3 Knowing your Target Population ……………………..…………………………......55 5.4 Limitations. ……………………………………………………………………….…56 5.5 Video Observation. ……………………………………………………………….…59 CONCLUSION ….........................................................................................................................62 APPENDIX…………………………………….…...…………………………………………....64 REFERENCES..............................................................................................................................70 6 LIST OF TABLES Table 1. Combined racial composition for Bankhead and Buckhead Census tracts pg. 15 Table 2. North America Industry Classification System (NAICS) codes and examples of food stores and food service stores pg. 32-33 Table 3. CDC 2011 Distribution of mRFEI scores in Bankhead and Buckhead Communities pg. 36 Table 4. 2016 Distribution of mRFEI scores in Bankhead and Buckhead Communities pg. 36 Table 5. Average mRFEI score for neighborhoods comparison by year pg. 37 Table 6. Statistical analysis of Food industry by neighborhood pg. 38 Table 7. Statistical Analysis of Park Acreage by Neighborhood pg. 40 Table 8. Statistical analysis of Park classification by Neighborhood pg. 41 Table 9. Identified Parks within City of Atlanta pg. 42 Table 10. Example of government opportunities in Health in All policies approach pg. 49 7 LIST OF FIGURES Figure 1. Map of Bankhead NPUs and Census Tracts pg. 13 Figure 2. Map of Buckhead NPUs and Census Tracts pg. 14 Figure 3. Racial Composition from 2010 Census- City of Atlanta White population pg. 16 Figure 4. Racial Composition from 2010 Census- City of Atlanta Black population pg. 17 Figure 5. Modified Retail Food Environment Index pg. 29 Figure 6. referenceUSA Map-based