The area of public health research that aims to investigate the health effects associated with disparities between local food environments stems from earlier epidemiology investigations that have identified difference in disease rates by geographic regions. Within these studies, researchers have found geographic clustering of diseases. For instance, it is well documented that the highest mortality resulting from stroke is clustered in the Southeast region of the United States, known as the Stroke Belt (Figure 4.1). Black Americans are also concentrated in the Southeast region of the United States. Furthermore, although the incidence of stroke is higher among African-Americans and Hispanic Americans compared to Caucasians, the geographic difference in rates cannot be fully explained by traditional risk factors for stroke among these groups of Americans (National Institutes of Health 2009).