SAVI Community Trends Report: Unequal Access Tobacco Epidemic Report 2017 FINAL | Page 7

Finally, we compared sociodemographic
characteristics 3 and health behaviors across
these three different access levels. To do this,
we tested the results for significance to ensure
the differences between the means for each
indicator in each access group were not the
result of random occurrence.

In the Indy metropolitan
area, tobacco retail outlets
are concentrated where
maternal smoking rates are
the highest.
We tested all three combinations of groups
(low vs. high, medium vs. high, and medium
vs. low) for significance using a two-tailed t-test.
For low vs. high and low vs. medium, differenc-
es in every indicator were significant with 95%
confidence. For high vs. medium, differences
were significant with 95% confidence for four
of the seven indicators. See Appendix B for the
p-values resulting from the significance testing. Tobacco Access and
Vulnerable Populations
In the Indianapolis metro area tobacco retail
outlets are concentrated where vulnerable
populations live.
Poverty is more than three times greater in
high tobacco access areas in the Indianapolis
metro area than in low access areas. High ac-
cess areas also have almost three times more
adults without high school diplomas than low
access areas. Or, nearly one in four adults in
high access areas do not have a high school
diploma. In low access areas, that rate is fewer
than one in ten.
The results demonstrate that in Indianapolis,
as in other U.S. cities, tobacco retail outlets are
concentrated where smoking rates are pre-
dicted to be the highest. In medium and high
access groups, the 2014 adult smoking rates,
predicted by the 500 Cities Project using the
Behavioral Risk Factor Surveillance System
(BRFSS) and sociodemographic characteristics,
exceed the rate for Indiana. Tobacco access is
only part of the issue in Indianapolis, as even
in the low access groups, the estimated smok-
ing rate exceeds the rate for the United States
(16.8%). [51]

In Indianapolis, poverty
is more than three times
greater in high access areas
than in low access areas.
Individuals with poor mental health are also
more vulnerable to tobacco. Nationally, people
with psychiatric or addictive disorders consume
about 40% of cigarettes purchased and are
more likely to be regular and heavy smokers.
[9, 54] In Indianapolis, residents with the
highest access to tobacco also have the
highest rate of self-reported poor mental
health. This suggests that this vulnerable
population could benefit from actions that
decrease tobacco access.
More significant, the measured rate of
maternal smoking is nearly twice as high in
high access areas than in low access areas and
is also significantly higher in high access areas
than in medium access areas. The maternal
s moking rate in high access areas is 1.5 times
higher than the 2015 maternal smoking rate in
Indiana (14.3%). [52] Maternal smoking rates
for all three access groups are higher than the
U.S. rate (7.8%). [53] This illustrates that maternal
smoking is a significant health issue in India-
napolis regardless of level of tobacco access,
but also that some geographic communities in
Indianapolis are at greater risk than others.
The percentage of households without access
to a vehicle is more than four times higher
in the high access group than the low access
group, which may indicate that residents in
The reported population characteristics of high, medium, and low access areas are based upon census tract level variables for
2010-2014, the latest available at the time of initial analysis.
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