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Thatcher E, Johnson C, Zenk SN, Kulbok P. Retail Food Store Access in Rural Appalachia: A Mixed Methods Study. Public Health Nurs 2016; 34:245-255. [PMID: 27862244 DOI: 10.1111/phn.12302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe how characteristics of food retail stores (potential access) and other factors influence self-reported food shopping behavior (realized food access) among low-income, rural Central Appalachian women. DESIGN AND SAMPLE Cross-sectional descriptive. Potential access was assessed through store mapping and in-store food audits. Factors influencing consumers' realized access were assessed through in-depth interviews. Results were merged using a convergent parallel mixed methods approach. Food stores (n = 50) and adult women (n = 9) in a rural Central Appalachian county. RESULTS Potential and realized food access were described across five dimensions: availability, accessibility, affordability, acceptability, and accommodation. Supermarkets had better availability of healthful foods, followed by grocery stores, dollar stores, and convenience stores. On average, participants lived within 10 miles of 3.9 supermarkets or grocery stores, and traveled 7.5 miles for major food shopping. Participants generally shopped at the closest store that met their expectations for food availability, price, service, and atmosphere. Participants' perceptions of stores diverged from each other and from in-store audit findings. CONCLUSIONS Findings from this study can help public health nurses engage with communities to make affordable, healthy foods more accessible. Recommendations are made for educating low-income consumers and partnering with food stores.
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Affiliation(s)
- Esther Thatcher
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,School of Nursing, University of Virginia, Charlottesville, Virginia
| | - Cassandra Johnson
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Shannon N Zenk
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Pamela Kulbok
- School of Nursing, University of Virginia, Charlottesville, Virginia
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Barnes TL, Pelletier JE, Erickson DJ, Caspi CE, Harnack LJ, Laska MN. Healthfulness of Foods Advertised in Small and Nontraditional Urban Stores in Minneapolis-St. Paul, Minnesota, 2014. Prev Chronic Dis 2016; 13:E153. [PMID: 27831683 PMCID: PMC5109932 DOI: 10.5888/pcd13.160149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction Shopping at small food stores, such as corner stores and convenience stores, is linked with unhealthful food and beverage purchases, poor diets, and high risk of obesity. However, information on how foods and beverages are marketed at small stores is limited. The objective of this study was to examine advertisements and product placements for healthful and less healthful foods and beverages at small stores in Minneapolis–St. Paul, Minnesota. Methods We conducted in-store audits of 119 small and nontraditional food retailers (corner/small grocery stores, food–gas marts, pharmacies, and dollar stores) randomly selected from licensing lists in Minneapolis–St. Paul in 2014. We analyzed data on exterior and interior advertisements of foods and beverages and product placement. Results Exterior and interior advertisements for healthful foods and beverages were found in less than half of stores (exterior, 37% [44 of 119]; interior, 20% [24 of 119]). Exterior and interior advertisements for less healthful items were found in approximately half of stores (exterior, 46% [55 of 119]); interior, 66% [78 of 119]). Of the 4 store types, food–gas marts were most likely to have exterior and interior advertisements for both healthful and less healthful items. Corner/small grocery stores and dollar stores had fewer advertisements of any type. Most stores (77%) had at least 1 healthful item featured as an impulse buy (ie, an item easily reached at checkout), whereas 98% featured at least 1 less healthful item as an impulse buy. Conclusion Findings suggest imbalanced advertising and product placement of healthful and less healthful foods and beverages at small food stores in Minneapolis–St. Paul; less healthful items were more apt to be featured as impulse buys. Future interventions and polices should encourage reductions in advertisements and impulse-buy placements of unhealthful products, particularly in food–gas marts, and encourage advertisements of healthful products.
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Affiliation(s)
- Timothy L Barnes
- Children's Hospitals and Clinics of Minnesota, Research and Sponsored Programs, 2525 Chicago Ave S, MS 40-LL08, Minneapolis, MN 55404.
| | - Jennifer E Pelletier
- University of Minnesota, Division of Epidemiology and Community Health, Minneapolis, Minnesota
| | - Darin J Erickson
- University of Minnesota, Division of Epidemiology and Community Health, Minneapolis, Minnesota
| | - Caitlin E Caspi
- University of Minnesota, Department of Family Medicine and Community Health, Minneapolis, Minnesota
| | - Lisa J Harnack
- University of Minnesota, Division of Epidemiology and Community Health, Minneapolis, Minnesota
| | - Melissa N Laska
- University of Minnesota, Division of Epidemiology and Community Health, Minneapolis, Minnesota
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Prescott SL, Logan AC. Transforming Life: A Broad View of the Developmental Origins of Health and Disease Concept from an Ecological Justice Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111075. [PMID: 27827896 PMCID: PMC5129285 DOI: 10.3390/ijerph13111075] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/21/2016] [Accepted: 10/28/2016] [Indexed: 12/20/2022]
Abstract
The influential scientist Rene J. Dubos (1901–1982) conducted groundbreaking studies concerning early-life environmental exposures (e.g., diet, social interactions, commensal microbiota, housing conditions) and adult disease. However, Dubos looked beyond the scientific focus on disease, arguing that “mere survival is not enough”. He defined mental health as fulfilling human potential, and expressed concerns about urbanization occurring in tandem with disappearing access to natural environments (and elements found within them); thus modernity could interfere with health via “missing exposures”. With the advantage of emerging research involving green space, the microbiome, biodiversity and positive psychology, we discuss ecological justice in the dysbiosphere and the forces—financial inequity, voids in public policy, marketing and otherwise—that interfere with the fundamental rights of children to thrive in a healthy urban ecosystem and learn respect for the natural environment. We emphasize health within the developmental origins of health and disease (DOHaD) rubric and suggest that greater focus on positive exposures might uncover mechanisms of resiliency that contribute to maximizing human potential. We will entrain our perspective to socioeconomic disadvantage in developed nations and what we have described as “grey space”; this is a mental as much as a physical environment, a space that serves to insidiously reinforce unhealthy behavior, compromise positive psychological outlook and, ultimately, trans-generational health. It is a dwelling place that cannot be fixed with encephalobiotics or the drug-class known as psychobiotics.
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Affiliation(s)
- Susan L Prescott
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), 35 Stirling Hwy, Crawley 6009, Australia.
- School of Paediatrics and Child Health Research, University of Western Australia, P.O. Box D184, Princess Margaret Hospital, Perth 6001, Australia.
| | - Alan C Logan
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), 35 Stirling Hwy, Crawley 6009, Australia.
- PathLight Synergy, 23679 Calabassas Road, Suite 542, Calabassas, CA 91302, USA.
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Taber DR, Chriqui JF, Quinn CM, Rimkus LM, Chaloupka FJ. Cross-sector analysis of socioeconomic, racial/ethnic, and urban/rural disparities in food policy enactment in the United States. Health Place 2016; 42:47-53. [PMID: 27639105 PMCID: PMC5332138 DOI: 10.1016/j.healthplace.2016.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 07/05/2016] [Accepted: 08/03/2016] [Indexed: 01/17/2023]
Abstract
We examined racial/ethnic, socioeconomic, and urban/rural disparities in food policy enactment across different sectors, as well as retail food access, throughout the United States. Policy and retail food store data were obtained from 443 communities as part of the Bridging the Gap Community Obesity Measures Project. Our results indicated that median household income was inversely associated with healthier retail food zoning policies in Hispanic communities, where competitive food policies for schools were also healthier and mean fruit/vegetable access in stores was higher. In contrast, income was positively associated with healthier retail food zoning in rural communities, where competitive food policies were weaker. Black communities had low scores across all policy domains. Overall, Hispanic communities had the strongest food policies across sectors. Barriers to policy adoption in both rural and Black communities must be explored further.
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Affiliation(s)
- Daniel R Taber
- Healthy Food America, 1200 12th Ave. S, Suite 710, Seattle, WA 98144, USA.
| | - Jamie F Chriqui
- Division of Health Policy and Administration, University of Illinois at Chicago, 1603 W. Taylor St. (MC 923), Chicago, IL 60612, USA; Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA.
| | - Christopher M Quinn
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA.
| | - Leah M Rimkus
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA
| | - Frank J Chaloupka
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL 60608, USA; Department of Economics, University of Illinois at Chicago, 601 S. Morgan St., Chicago, IL 60607, USA.
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55
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Food Environments around American Indian Reservations: A Mixed Methods Study. PLoS One 2016; 11:e0161132. [PMID: 27560132 PMCID: PMC4999270 DOI: 10.1371/journal.pone.0161132] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 07/29/2016] [Indexed: 11/26/2022] Open
Abstract
Objectives To describe the food environments experienced by American Indians living on tribal lands in California. Methods Geocoded statewide food business data were used to define and categorize existing food vendors into healthy, unhealthy, and intermediate composite categories. Distance to and density of each of the composite food vendor categories for tribal lands and nontribal lands were compared using multivariate linear regression. Quantitative results were concurrently triangulated with qualitative data from in-depth interviews with tribal members (n = 24). Results After adjusting for census tract-level urbanicity and per capita income, results indicate there were significantly fewer healthy food outlets per square mile for tribal areas compared to non-tribal areas. Density of unhealthy outlets was not significantly different for tribal versus non-tribal areas. Tribal members perceived their food environment negatively and reported barriers to the acquisition of healthy food. Conclusions Urbanicity and per capita income do not completely account for disparities in food environments among American Indians tribal lands compared to nontribal lands. This disparity in access to healthy food may present a barrier to acting on the intention to consume healthy food.
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DeWeese RS, Todd M, Karpyn A, Yedidia MJ, Kennedy M, Bruening M, Wharton CM, Ohri-Vachaspati P. Healthy store programs and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but not the Supplemental Nutrition Assistance Program (SNAP), are associated with corner store healthfulness. Prev Med Rep 2016; 4:256-61. [PMID: 27419041 PMCID: PMC4939392 DOI: 10.1016/j.pmedr.2016.06.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/16/2016] [Accepted: 06/27/2016] [Indexed: 11/29/2022] Open
Abstract
In response to lack of access to healthy foods, many low-income communities are instituting local healthy corner store programs. Some stores also participate in the United States Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). This study used two assessment tools to compare the healthfulness of offerings at stores participating in local healthy store programs (upgraded stores), WIC, and/or SNAP to that of similar non-participating stores. Based on store audits conducted in 315 New Jersey corner stores in 2014, we calculated healthy food availability scores using subsections of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS-Availability) and a short-form corner store audit tool (SCAT). We used multivariable regression to examine associations between program participation and scores on both instruments. Adjusting for store and block group characteristics, stores participating in a local healthy store program had significantly higher SCAT scores than did non-participating stores (upgraded: M = 3.18, 95% CI 2.65-3.71; non-upgraded: M = 2.52, 95% CI 2.32-2.73); scores on the NEMS-CS-Availability did not differ (upgraded: M = 12.8, 95% CI 11.6-14.1; non-upgraded: M = 12.5, 95% CI 12.0-13.0). WIC-participating stores had significantly higher scores compared to non-participating stores on both tools. Stores participating in SNAP only (and not in WIC) scored significantly lower on both instruments compared to non-SNAP stores. WIC-participating and non-SNAP corner stores had higher healthfulness scores on both assessment tools. Upgraded stores had higher healthfulness scores compared to non-upgraded stores on the SCAT.
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Affiliation(s)
- Robin S DeWeese
- Arizona State University, School of Nutrition and Health Promotion, 500 N 3rd St, Phoenix, AZ 85004-0698, USA
| | - Michael Todd
- Arizona State University, College of Nursing and Health Innovation, 500 N 3rd St, Phoenix, AZ 85004-0690, USA
| | - Allison Karpyn
- University of Delaware, Center for Research in Education, and Social Policy, 16 W Main St, Newark, DE 19716, USA
| | - Michael J Yedidia
- Rutgers University, Center for State Health Policy, 112 Paterson, New Brunswick, NJ 08901-1293, USA
| | - Michelle Kennedy
- Rutgers University, Center for State Health Policy, 112 Paterson, New Brunswick, NJ 08901-1293, USA
| | - Meg Bruening
- Arizona State University, School of Nutrition and Health Promotion, 500 N 3rd St, Phoenix, AZ 85004-0698, USA
| | - Christopher M Wharton
- Arizona State University, School of Nutrition and Health Promotion, 500 N 3rd St, Phoenix, AZ 85004-0698, USA
| | - Punam Ohri-Vachaspati
- Arizona State University, School of Nutrition and Health Promotion, 500 N 3rd St, Phoenix, AZ 85004-0698, USA
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Price promotions for food and beverage products in a nationwide sample of food stores. Prev Med 2016; 86:106-13. [PMID: 26827618 DOI: 10.1016/j.ypmed.2016.01.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 01/13/2016] [Accepted: 01/18/2016] [Indexed: 11/23/2022]
Abstract
Food and beverage price promotions may be potential targets for public health initiatives but have not been well documented. We assessed prevalence and patterns of price promotions for food and beverage products in a nationwide sample of food stores by store type, product package size, and product healthfulness. We also assessed associations of price promotions with community characteristics and product prices. In-store data collected in 2010-2012 from 8959 food stores in 468 communities spanning 46 U.S. states were used. Differences in the prevalence of price promotions were tested across stores types, product varieties, and product package sizes. Multivariable regression analyses examined associations of presence of price promotions with community racial/ethnic and socioeconomic characteristics and with product prices. The prevalence of price promotions across all 44 products sampled was, on average, 13.4% in supermarkets (ranging from 9.1% for fresh fruits and vegetables to 18.2% for sugar-sweetened beverages), 4.5% in grocery stores (ranging from 2.5% for milk to 6.6% for breads and cereals), and 2.6% in limited service stores (ranging from 1.2% for fresh fruits and vegetables to 4.1% for breads and cereals). No differences were observed by community characteristics. Less-healthy versus more-healthy product varieties and larger versus smaller product package sizes generally had a higher prevalence of price promotion, particularly in supermarkets. On average, in supermarkets, price promotions were associated with 15.2% lower prices. The observed patterns of price promotions warrant more attention in public health food environment research and intervention.
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58
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Stern D, Poti JM, Ng SW, Robinson WR, Gordon-Larsen P, Popkin BM. Where people shop is not associated with the nutrient quality of packaged foods for any racial-ethnic group in the United States. Am J Clin Nutr 2016; 103:1125-34. [PMID: 26912495 PMCID: PMC4807703 DOI: 10.3945/ajcn.115.121806] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/14/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In the literature, it has been suggested that there are race-ethnic disparities in what Americans eat. In addition, some studies have shown that residents of African American and low-income neighborhoods have less access to grocery stores and supermarkets, which tend to stock healthier foods. However, it is unclear whether differences in food shopping patterns contribute to the poorer nutrient profile of food purchases made by racial-ethnic minorities. OBJECTIVES We examined whether the mix of food stores where people shop (i.e., food-shopping patterns) was associated with the nutrient profile of packaged food purchases (PFPs) and the types of foods and beverages purchased, and we determined whether these associations differ across racial-ethnic groups. DESIGN We used PFPs by US households (Nielsen National Consumer Panel) from 2007 to 2012 and implemented a cluster analysis to categorize households according to their food-shopping patterns. Longitudinal random-effects linear regression models were used to examine the association between food shopping patterns and the nutrient qualities and types of packaged foods and beverages purchased by race-ethnicity in US households. RESULTS Shopping primarily at grocery chains was not associated with a better nutrient profile of household PFPs or the food and beverages that households purchased than was shopping primarily at mass merchandisers (value-oriented stores that sell merchandise lines in multiple departments) or at a combination of large and small stores. These results were consistent across racial-ethnic groups. Regardless of where households shopped, non-Hispanic African American households purchased foods with higher energy, total sugar, and sodium densities than did non-Hispanic white and Hispanic households. CONCLUSION Policy initiatives that focus on increasing physical access to stores or helping stores sell healthier products to encourage healthier purchases may be ineffective because other factors may be more important determinants of food and beverage purchases than where people shop or what is available in the store.
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Affiliation(s)
| | | | - Shu Wen Ng
- Departments of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and USDA Duke-University of North Carolina Collaborative Center for Behavioral Economics and Healthier Food Choice Research (BECR), Durham-Chapel Hill, NC
| | - Whitney R Robinson
- Epidemiology, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
| | - Penny Gordon-Larsen
- Departments of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
| | - Barry M Popkin
- Departments of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
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Feuillet T, Charreire H, Roda C, Ben Rebah M, Mackenbach JD, Compernolle S, Glonti K, Bárdos H, Rutter H, De Bourdeaudhuij I, McKee M, Brug J, Lakerveld J, Oppert JM. Neighbourhood typology based on virtual audit of environmental obesogenic characteristics. Obes Rev 2016; 17 Suppl 1:19-30. [PMID: 26879110 DOI: 10.1111/obr.12378] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 12/15/2015] [Indexed: 11/30/2022]
Abstract
Virtual audit (using tools such as Google Street View) can help assess multiple characteristics of the physical environment. This exposure assessment can then be associated with health outcomes such as obesity. Strengths of virtual audit include collection of large amount of data, from various geographical contexts, following standard protocols. Using data from a virtual audit of obesity-related features carried out in five urban European regions, the current study aimed to (i) describe this international virtual audit dataset and (ii) identify neighbourhood patterns that can synthesize the complexity of such data and compare patterns across regions. Data were obtained from 4,486 street segments across urban regions in Belgium, France, Hungary, the Netherlands and the UK. We used multiple factor analysis and hierarchical clustering on principal components to build a typology of neighbourhoods and to identify similar/dissimilar neighbourhoods, regardless of region. Four neighbourhood clusters emerged, which differed in terms of food environment, recreational facilities and active mobility features, i.e. the three indicators derived from factor analysis. Clusters were unequally distributed across urban regions. Neighbourhoods mostly characterized by a high level of outdoor recreational facilities were predominantly located in Greater London, whereas neighbourhoods characterized by high urban density and large amounts of food outlets were mostly located in Paris. Neighbourhoods in the Randstad conurbation, Ghent and Budapest appeared to be very similar, characterized by relatively lower residential densities, greener areas and a very low percentage of streets offering food and recreational facility items. These results provide multidimensional constructs of obesogenic characteristics that may help target at-risk neighbourhoods more effectively than isolated features.
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Affiliation(s)
- T Feuillet
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France
| | - H Charreire
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France.,Paris Est University, Lab-Urba, UPEC, Urban School of Paris, Créteil, France
| | - C Roda
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France
| | - M Ben Rebah
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France
| | - J D Mackenbach
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - S Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - K Glonti
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - H Bárdos
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - H Rutter
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - M McKee
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - J Brug
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J Lakerveld
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J-M Oppert
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France.,Sorbonne Universités, Université Pierre et Marie Curie, Université Paris 06, Institute of Cardiometabolism and Nutrition, Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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Reitzel LR, Okamoto H, Hernandez DC, Regan SD, McNeill LH, Obasi EM. The Built Food Environment and Dietary Intake among African-American Adults. Am J Health Behav 2016; 40:3-11. [PMID: 26685808 DOI: 10.5993/ajhb.40.1.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The built food environment surrounding people's homes may influence their dietary intake. This exploratory study examined how the density of different sources of food in the residential environment was associated with dietary consumption among 77 African-American adults in Houston, Texas. METHODS The number of fast-food-type restaurants, large grocery stores, and convenience-type stores within 2- and 5-mile residential buffers were divided by the respective areas to obtain food environment density variables. Intake of fruit and vegetables [FV], fiber [FI], and percent energy from fat [PEF] was assessed using National Health Interview Survey items. Covariate-adjusted regressions were used to assess relations of interest. RESULTS Greater density of fast-food-type restaurants within 2 miles was associated with greater FV, FI, and PEF (ps ≤ .012); and for FV and FI within 5 miles (ps ≤ .004). Density of large grocery stores was unrelated to intake. Greater density of convenience-type stores within 2 miles was negatively associated with FV and FI (ps ≤ .03); results became marginal at 5 miles for FV (p = .10) but not FI (p = .03). CONCLUSION Maximizing healthy offerings in venue-rich metropolitan areas might provide direction for policies to reduce obesity.
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Affiliation(s)
- Lorraine R Reitzel
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, USA
| | - Hiroe Okamoto
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, USA
| | - Daphne C Hernandez
- The University of Houston, Department of Health and Human Performance, Houston, TX, USA
| | | | - Lorna H McNeill
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX, USA
| | - Ezemenari M Obasi
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, USA
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Luan H, Law J, Quick M. Identifying food deserts and swamps based on relative healthy food access: a spatio-temporal Bayesian approach. Int J Health Geogr 2015; 14:37. [PMID: 26714645 PMCID: PMC4696295 DOI: 10.1186/s12942-015-0030-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 12/22/2015] [Indexed: 11/26/2022] Open
Abstract
Background Obesity and other adverse health outcomes are influenced by individual- and neighbourhood-scale risk factors, including the food environment. At the small-area scale, past research has analysed spatial patterns of food environments for one time period, overlooking how food environments change over time. Further, past research has infrequently analysed relative healthy food access (RHFA), a measure that is more representative of food purchasing and consumption behaviours than absolute outlet density. Methods This research applies a Bayesian hierarchical model to analyse the spatio-temporal patterns of RHFA in the Region of Waterloo, Canada, from 2011 to 2014 at the small-area level. RHFA is calculated as the proportion of healthy food outlets (healthy outlets/healthy + unhealthy outlets) within 4-km from each small-area. This model measures spatial autocorrelation of RHFA, temporal trend of RHFA for the study region, and spatio-temporal trends of RHFA for small-areas. Results For the study region, a significant decreasing trend in RHFA is observed (-0.024), suggesting that food swamps have become more prevalent during the study period. For small-areas, significant decreasing temporal trends in RHFA were observed for all small-areas. Specific small-areas located in south Waterloo, north Kitchener, and southeast Cambridge exhibited the steepest decreasing spatio-temporal trends and are classified as spatio-temporal food swamps. Conclusions This research demonstrates a Bayesian spatio-temporal modelling approach to analyse RHFA at the small-area scale. Results suggest that food swamps are more prevalent than food deserts in the Region of Waterloo. Analysing spatio-temporal trends of RHFA improves understanding of local food environment, highlighting specific small-areas where policies should be targeted to increase RHFA and reduce risk factors of adverse health outcomes such as obesity.
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Affiliation(s)
- Hui Luan
- Faculty of Environment, School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada.
| | - Jane Law
- Faculty of Environment, School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada. .,Faculty of Applied Health Sciences, School of Public Health and Health System, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada.
| | - Matthew Quick
- Faculty of Environment, School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada.
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Rimkus L, Isgor Z, Ohri-Vachaspati P, Zenk SN, Powell LM, Barker DC, Chaloupka FJ. Disparities in the Availability and Price of Low-Fat and Higher-Fat Milk in US Food Stores by Community Characteristics. J Acad Nutr Diet 2015; 115:1975-85. [PMID: 26048532 DOI: 10.1016/j.jand.2015.04.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 04/01/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND National surveillance data identify disparities in low-fat milk consumption by race/ethnicity and income. Some localized studies have shown disparities in access to low-fat milk by community characteristics. OBJECTIVE Our aim was to assess the availability and price of low-fat and higher-fat milk in food stores throughout the United States and examine associations with community characteristics. DESIGN We conducted a cross-sectional study involving observational data collection in 2010, 2011, and 2012. PARTICIPANTS/SETTINGS The study included 8,959 food stores in 468 communities where nationally representative samples of students attending traditional public middle and high schools resided. MAIN OUTCOME MEASURES We studied the availability and price of whole, 2%, 1%, and skim milk. STATISTICAL ANALYSES PERFORMED Multivariate logistic regression and ordinary least squares regression analyses were performed. Models included store type, race/ethnicity, median household income, urbanicity, US Census division, and year of data collection. RESULTS Less than half of all stores carried 1% and skim milk, and more than three-quarters of stores carried whole and 2% milk. Regression results indicated that the odds of carrying any type of milk were 31% to 67% lower in stores in majority black and 26% to 45% lower in other/mixed race compared with majority white communities. The odds of carrying specifically low-fat milk were 50% to 58% lower in majority Hispanic compared with majority white communities, and 32% to 44% lower in low-income compared with high-income communities. Some significant differences in milk prices by community characteristics were observed in grocery and limited-service stores. On average, low-fat milk options were more expensive in grocery stores in majority black and rural and suburban communities compared with such stores in majority white and urban communities. CONCLUSIONS This is the first nationwide study to examine the availability and price of low-fat and higher-fat milk in food stores and show disparities in access by community characteristics. Policies and programs can play a role in increasing accessibility of low-fat milk in stores in nonwhite and low-income communities.
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Zenk SN, Powell LM, Isgor Z, Rimkus L, Barker DC, Chaloupka FJ. Prepared Food Availability in U.S. Food Stores: A National Study. Am J Prev Med 2015; 49:553-62. [PMID: 25913149 DOI: 10.1016/j.amepre.2015.02.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/18/2015] [Accepted: 02/18/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Prepared, ready-to-eat foods comprise a significant part of Americans' diets and are increasingly obtained from food stores. Yet, little is known about the availability and healthfulness of prepared, ready-to-eat food offerings at stores. This study examines associations among community characteristics (racial/ethnic composition, poverty level, urbanicity) and availability of both healthier and less-healthy prepared foods in U.S. supermarkets, grocery stores, and convenience stores. METHODS Observational data were collected from 4,361 stores in 317 communities spanning 42 states in 2011 and 2012. Prepared food availability was assessed via one healthier food (salads or salad bar), three less-healthy items (pizza, hot dog/hamburger, taco/burrito/taquito), and one cold sandwich item. In 2014, multivariable generalized linear models were used to test associations with community characteristics. RESULTS Overall, 63.6% of stores sold prepared foods, with 20.0% offering prepared salads and 36.4% offering at least one less-healthy item. Rural stores were 26% less likely to carry prepared salads (prevalence ratio [PR]=0.74, 95% CI=0.62, 0.88) and 14% more likely to carry at least one less-healthy prepared food item (PR=1.14, 95% CI=1.00, 1.30). Convenience stores in high-poverty communities were less likely to carry prepared salads than those in low-poverty communities (PR=0.64, 95% CI=0.47, 0.87). Among supermarkets, prepared salads were more likely to be carried in majority-white, low-poverty communities than in non-white, high-poverty communities. CONCLUSIONS Increasing the healthfulness of prepared foods within stores may offer an important opportunity to improve the food environment.
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Affiliation(s)
- Shannon N Zenk
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois.
| | - Lisa M Powell
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Zeynep Isgor
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Leah Rimkus
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Dianne C Barker
- Barker Bi-Coastal Health Consultants Inc., Calabasas, California
| | - Frank J Chaloupka
- Department of Economics, University of Illinois at Chicago, Chicago, Illinois
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Patton SR, Goggin K, Clements MA. The Cost of a Healthier Diet for Young Children With Type 1 Diabetes Mellitus. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:361-6.e1. [PMID: 26164132 PMCID: PMC4509633 DOI: 10.1016/j.jneb.2015.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 03/06/2015] [Accepted: 03/15/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This study used a market-basket approach to examine the availability and cost of a standard food shopping list (R-TFP) vs a healthier food shopping list (H-TFP) in the grocery stores used by a sample of 23 families of young children with type 1 diabetes mellitus (T1DM). METHODS The researchers used frequency counts to measure availability. The average cost of the R-TFP and H-TFP was compared using paired t test. RESULTS Small or independent markets had the highest percentage of missing foods (14%), followed by chain supermarkets (3%) and big box stores (2%). There was a significant difference in average cost for the R-TFP vs the H-TFP ($324.71 and $380.07, respectively; P < .001). CONCLUSIONS AND IMPLICATIONS Families may encounter problems finding healthier foods and/or incur greater costs for healthier foods. Nutrition education programs for T1DM need to teach problem solving to help families overcome these barriers.
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Affiliation(s)
- Susana R Patton
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS.
| | - Kathy Goggin
- Health Outcomes Research, Children's Mercy Hospital and Clinics, Kansas City, MO
| | - Mark A Clements
- Division of Endocrinology, Children's Mercy Hospital and Clinics, Kansas City, MO
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Firth CL, Drach L, Maher JE, Peters CS. Lack of healthier food alternatives can compromise inmate health. Am J Public Health 2015; 105:e4-5. [PMID: 25879145 DOI: 10.2105/ajph.2015.302666] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Caislin L Firth
- Caislin L. Firth, Linda Drach, and Julie E. Maher are with Program Design and Evaluation Services, Multnomah County Health Department and Oregon Public Health Division, Portland. Colette S. Peters is with the Oregon Department of Corrections, Salem
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Clary CM, Ramos Y, Shareck M, Kestens Y. Should we use absolute or relative measures when assessing foodscape exposure in relation to fruit and vegetable intake? Evidence from a wide-scale Canadian study. Prev Med 2015; 71:83-7. [PMID: 25481095 DOI: 10.1016/j.ypmed.2014.11.023] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 10/24/2014] [Accepted: 11/26/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This paper explores which of absolute (i.e. densities of "healthy" and "unhealthy" food outlets taken separately) or relative (i.e. the percentage of "healthy" outlets) measures of foodscape exposure better predicts fruit and vegetable intake (FVI), and whether those associations are modified by gender and city in Canada. METHODS Self-reported FVI from participants of four cycles (2007-2010) of the repeated cross-sectional Canadian Community Health Survey living in the five largest metropolitan areas of Canada (n=49,403) was analyzed. Absolute and relative measures of foodscape exposure were computed at participants' residential postal codes. Linear regression models, both in the whole sample and in gender- and city-stratified samples, were used to explore the associations between exposure measures and FVI. RESULTS The percentage of healthy outlets was strongly associated with FVI among men both in Toronto/Montreal (β=0.012; P<0.001), and in Calgary/Ottawa/Vancouver (β=0.008; P<0.001), but not among women. Observed associations of absolute measures with FVI were either weak or faced multicollinearity issues. Overall, models with the relative measure showed the best fit. CONCLUSIONS Relative measures should be more widely used when assessing foodscape influences on diet. The absence of a single effect of the foodscape on diet positions sub-group analysis as a promising avenue for research.
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Affiliation(s)
- Christelle M Clary
- Université de Montréal, Département de médecine sociale et préventive, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada; Centre de recherche du CHUM, 850 St-Denis, Montréal, QC H2X 0A9, Canada.
| | - Yuddy Ramos
- Centre de recherche du CHUM, 850 St-Denis, Montréal, QC H2X 0A9, Canada; Université de Montréal - Département de géographie, 520 ch. de la Côte-Sainte-Catherine, Montréal, QC H3C 3J7, Canada
| | - Martine Shareck
- Université de Montréal, Département de médecine sociale et préventive, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada; Centre de recherche du CHUM, 850 St-Denis, Montréal, QC H2X 0A9, Canada; Institut de Recherche en Santé Publique de l'Université de Montréal (IRSPUM), 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Yan Kestens
- Université de Montréal, Département de médecine sociale et préventive, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada; Centre de recherche du CHUM, 850 St-Denis, Montréal, QC H2X 0A9, Canada
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Food labelling, food retail availability and food pricing – moving from research to action? Public Health Nutr 2014. [DOI: 10.1017/s1368980014002638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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