Hiran Ratnayake
Senior Communications Manager
Department of External Affairs
Request an Interview

ChristianaCare Researchers Use Data to Understand How Retail Tobacco Disproportionally Impacts Health in Communities of Color

Authors propose zoning solutions as new way to fight tobacco use

In the first study of its kind, researchers at ChristianaCare’s Institute for Research on Equity and Community Health (iREACH) have unearthed new insights about the impact of smoking on Delaware’s communities of color – and potential new solutions.

Published in the peer-reviewed journal Cities & Health, the study involved the use of geospatial analyses. It showed disproportionately higher counts of convenience store tobacco retailers located in medium- and high-density residential zones – in predominantly African-American and LatinX neighborhoods – within the city of Wilmington relative to the surrounding county.

By linking anonymized data from patient electronic health records and U.S. Census Bureau data, the researchers found that approximately 80% of Wilmington smokers and 60% of Wilmington youth lived in these residential zones. The findings highlight the potential to more equitably reduce tobacco retailer exposure through a residentially focused zoning approach.

“We know that communities of color are just as interested in quitting smoking and make just as many quit attempts as any other community,” said Scott Siegel, Ph.D., MHCDS, director of population health research at ChristianaCare and lead author of the study. “But living in neighborhoods where they are surrounded by tobacco marketing, smoking cues and easy access to cigarettes undermines their efforts to quit and creates barriers to their ability to achieve their personal health goals.”

The study analyzed New Castle County, which has a population of about 559,000 residents, and represents 57% of Delaware’s population. In Wilmington, the state’s largest city, there were 10 times the proportion of tobacco retailers located in residential zones versus other municipal and non-municipal areas.

In addition, the largest share of tobacco retailers in Wilmington was located in medium- and high-density residential zones, whereas in low-density residential zones, the share was as low as 0%.

The researchers propose that public officials consider the use of zoning policy to decrease the number of corner stores and retailers that sell tobacco products in vulnerable communities.

Since high-density residential neighborhoods often lack easy access to healthy foods, corner stores serve a vital role in providing goods and services, Siegel noted. He and the other researchers propose engaging with these store owners by helping them partner with healthy and affordable food programs that can generate new forms of revenue to help offset reduced tobacco sales. Similar efforts have been successful in other areas, such as Philadelphia through their Healthy Corner Store Initiative and in San Francisco through their Tobacco Free Project.

“As part of our reimagining New Castle County, this report will help us address key health inequities in our working-class neighborhoods,” said Matt Meyer, Executive of New Castle County in Delaware. “This study presents us with hard facts when it comes to developing future public policy. I am thankful to the hard work of Dr. Siegel and iREACH at ChristianaCare and I look forward to more of their work.”

The study was conducted by iREACH, which is composed of experts in epidemiology, biostatistics, program evaluation and data management. Researchers at iREACH partner closely with ChristianaCare’s population health, community health, health equity and virtual health programs to transform health care.

“By investing our resources in research that impacts the social determinants of health, we are able to come up with innovative solutions to some of today’s toughest clinical challenges,” said LeRoi Hicks, M.D., MPH, physician leader of iREACH and chief medical officer of ChristianaCare’s Wilmington Hospital. “This study is a shining example of the type of research that iREACH is committed to conducting.”


Need an expert source?

Our Experts, ChristianaCare's expert database, can help you find the right source for your next news story.

Request an interview ➜

About ChristianaCare

Headquartered in Wilmington, Delaware, ChristianaCare is one of the country’s most dynamic health care organizations, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of primary care and outpatient services, home health care, urgent care centers, three hospitals (1,430 beds), a freestanding emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health. It also includes the pioneering Gene Editing Institute.

ChristianaCare is nationally recognized as a great place to work, rated by Forbes as the 2nd best health system for diversity and inclusion, and the 29th best health system to work for in the United States, and by IDG Computerworld as one of the nation’s Best Places to Work in IT. ChristianaCare is rated by Healthgrades as one of America’s 50 Best Hospitals and continually ranked among the nation’s best by U.S. News & World Report, Newsweek and other national quality ratings. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. With its groundbreaking Center for Virtual Health and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.