We have completed a series of studies showing that neighborhood access to small and medium size retail businesses that provide for community member’s living needs – the goods and services we need to function, live and thrive, such as banks, supermarkets, drug stores, gyms, corner markets – is associated with better health.  Nearby access to such businesses in a residential neighborhood is associated with greater engagement in walking and active transport to complete living needs like shopping, banking and socializing, which increases overall physical activity.  These businesses also provide opportunities for purchasing healthy food, engagement in physical activity and social connections. 

In our work with the NYC Department of Health and Mental Health (DOHMH) to study neighborhood influences on pregnancy health we showed that a higher density of these types of businesses was associated with lower risk of excessive gestational weight gain and lower risk of gestation diabetes. In another project with DOHMH we showed that a higher density of retail food outlets overall in a residential neighborhood is associated with lower body mass index. In earlier work studying childhood obesity in ~94,000 NYC school children we observed that greater retail presence in a neighborhood was associated with lower risk of obesity.  We have also shown that a higher density of businesses that support living needs are associated with lower risk of incident cardiovascular events. In each study we theorize that access to these retail outlets increases engagement in active transport, and thus physical activity, among residents of the neighborhood.

The density of these types of retail businesses is also one of two components, along with population density, that make up our national neighborhood walkability index. Using this index we have shown that higher walkability (measured as population density and business density) is associated with lower risk of obesity related cancers, lower risk of developing diabetes, and lower weight gain through time.         

We have also shown in NYC that access to supermarkets, grocery stores and health food stores is associated with lower body mass index and that access to farmer’s markets is associated with greater consumption of fruits, vegetables and meat.  Our work is part of the scientific rationale for the NYC FRESH Initiative that uses loan, zoning, building design and tax incentives to bring grocery stores into underserved neighborhoods.  We testified about our research at NYC Council and Zoning Board meetings as part of the efforts to establish the FRESH Initiative.   

Lastly, we have shown that higher neighborhood access to commercial physical activity venues – gyms, dance studios, martial arts schools, exercise facilities, tennis clubs – is associated with higher levels of physical activity and lower risk of incident cardiovascular events.

Together this work shows that residential neighborhoods with a vibrant retail business environment, that provides commonly and frequently needed goods and services to residents, support healthy behaviors and, in turn, improved health.