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Chuvileva YE, Manangan A, Chew A, Rutherford G, Barillas-Basterrechea M, Barnoya J, Breysse PN, Blanck H, Liburd L. What North American retail food environment indices miss in Guatemala: Cultural considerations for the study of place and health. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2024; 164:10.1016/j.apgeog.2024.103204. [PMID: 38532832 PMCID: PMC10964928 DOI: 10.1016/j.apgeog.2024.103204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
We evaluated the cross-context validity and equivalence of the US- and Canada-originated Retail Food Environment Index (RFEI) and modified RFEI (mRFEI) against a retail food environment dataset from the indigenous-majority city of Quetzaltenango (Xela), Guatemala. The RFEI/mRFEI failed to identify 77% of retailers and misclassified the healthiness of 42% of the remaining retailers in Xela, inaccurately labeling the city a food swamp. The RFEI/mRFEI are not currently suitable for mapping retail food environments in places like Quetzaltenango. Alternative functional and temporal classifications of retail food environments may provide measures with greater contextual fit, highlighting important cultural considerations for the study of place and dietary health.
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Affiliation(s)
- Yulia E. Chuvileva
- Division of Adolescent and School Health (DASH), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), USA
| | - Arie Manangan
- Division of Environmental Health Science and Practice (DEHSP), National Center for Environmental Health (NCEH), CDC, Atlanta, GA, USA
| | - Aiken Chew
- Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - George Rutherford
- University of California San Francisco (UCSF), San Francisco, CA, USA
| | | | - Joaquín Barnoya
- Unidad de Cirugía Cardiovascular de Guatemala and Universidad Rafael Landivar, Guatemala City, Guatemala
| | - Patrick N. Breysse
- NCEH/Agency for Toxic Substances and Disease Registry (ATSDR), CDC, Atlanta, GA, USA
| | - Heidi Blanck
- Division of Nutrition, Physical Activity, and Obesity (DNPAO), NCCDPHP, CDC, Atlanta, GA, USA
| | - Leandris Liburd
- Office of Minority Health and Health Equity (OMHHE), CDC, Atlanta, GA, USA
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Zuercher MD, Harvey DJ, Au LE, Shadyab AH, Santiago-Torres M, Liu S, Shivappa N, Hébert JR, Robbins JA, Garcia L. Energy-Adjusted Dietary Inflammatory Index and Diabetes Risk in Postmenopausal Hispanic Women. J Acad Nutr Diet 2023:S2212-2672(23)01310-2. [PMID: 37544374 PMCID: PMC10839112 DOI: 10.1016/j.jand.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Type 2 diabetes is a major public health concern in the United States and worldwide. The dietary inflammatory index (DII) and the energy-adjusted DII (E-DII) are tools that assess dietary inflammation. Previous evidence suggests that obesity can modify the association between inflammation and disease. OBJECTIVE The aim of this study was to evaluate the association between the DII/E-DII and incident diabetes in self-identified Hispanic women from the Women's Health Initiative (WHI). The secondary aim was to evaluate whether obesity modifies the association between the DII/E-DII scores and incident diabetes. DESIGN Participants were from the WHI Observational Study and the Clinical Trial Components (except women from the treatment arm in the Dietary Modification Trial) conducted among postmenopausal women in the United States. DII/E-DII scores were calculated from a self-administered food frequency questionnaire at baseline that included 122 food items, of which 12 are representative of Hispanic eating patterns. PARTICIPANTS/SETTINGS Participants included 3,849 postmenopausal women who self-identified as Hispanic that were recruited for the WHI from 1993 to 1998 at 40 US clinical centers. MAIN OUTCOME MEASURES The outcome was incident diabetes. STATISTICAL ANALYSIS PERFORMED Cox regression models were used to assess the association between DII/E-DII and incident diabetes. Models were adjusted for age at baseline, lifestyle-related risk factors, known type 2 diabetes mellitus (T2DM) risk factors, and neighborhood socioeconomic status. Interaction was tested between the DII/E-DII scores and obesity. RESULTS The incidence of diabetes was 13.1% after a median follow-up of 13 years. Higher E-DII scores were associated with a higher risk of incident diabetes (hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.04-1.14). There was no interaction between E-DII scores and obesity (P = 0.73). CONCLUSIONS Pro-inflammatory diets, as measured by higher E-DII scores, were associated with a higher risk of incident diabetes. Future research is needed for understanding how the inflammatory potential of diets can be decreased.
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Affiliation(s)
| | | | | | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA
| | | | - Simin Liu
- Public Health and Medicine, Brown University, Providence, RI
| | - Nitin Shivappa
- Cancer Prevention and Control Program & Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, & Department of Nutrition, Connecting Health Innovations, LLC, Columbia, SC
| | - James R Hébert
- Cancer Prevention and Control Program & Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, & Department of Nutrition, Connecting Health Innovations, LLC, Columbia, SC
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Fuster M, Kodali H, Ray K, Elbel B, Handley MA, Huang TTK, Johnson G. Area Characteristics and Consumer Nutrition Environments in Restaurants: an Examination of Hispanic Caribbean Restaurants in New York City. J Racial Ethn Health Disparities 2022; 9:1454-1463. [PMID: 34152587 PMCID: PMC8216094 DOI: 10.1007/s40615-021-01083-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/29/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022]
Abstract
Hispanics in the USA, particularly those of Caribbean descent, experience high levels of diet-related diseases and dietary risk factors. Restaurants are an increasingly important yet understudied source of food and may present opportunities to positively influence urban food environments. We sought to explore food environments further, by examining the association between neighborhood characteristics and restaurant consumer nutrition environments within New York City's Hispanic Caribbean (HC) restaurant environments. We applied an adapted version of the Nutrition Environment Measurements Survey for Restaurants (NEMS-R) to evaluate a random sample of HC restaurants (n=89). NEMS-HCR scores (continuous and categorized as low, medium, and high based on data distribution) were examined against area sociodemographic characteristics using bivariate and logistic regression analysis. HC restaurants located in Hispanic geographic enclaves had a higher proportion of fried menu items (p<0.01) but presented fewer environmental barriers to healthy eating, compared with those in areas with lower Hispanic concentrations. No significant differences in NEMS-R scores were found by other neighborhood characteristics. Size was the only significant factor predicting high NEMS-HCR scores, where small restaurants were less likely to have scores in the high category (NEMS-HCR score>6), compared with their medium (aOR: 6.6, 95% CI: 1.8-24.6) and large counterparts (aOR: 5.6, 95% CI: 1.5-21.4). This research is the first to examine the association between restaurant location and consumer nutrition environments, providing information to contribute to future interventions and policies seeking to improve urban food environments in communities disproportionately affected by diet-related conditions, as in the case of HC communities in New York City.
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Affiliation(s)
- Melissa Fuster
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, NY, USA.
| | - Hanish Kodali
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Krishnendu Ray
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Brian Elbel
- Department of Population Health, Grossman School of Medicine, and Wagner Graduate School of Public Service, New York University, New York, NY, USA
| | - Margaret A Handley
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Terry T-K Huang
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, City University of New York, New York, NY, USA
| | - Glen Johnson
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
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Medina C, Piña-Pozas M, Aburto TC, Chavira J, López U, Moreno M, Olvera AG, Gonzalez C, Huang TTK, Barquera S. Systematic literature review of instruments that measure the healthfulness of food and beverages sold in informal food outlets. Int J Behav Nutr Phys Act 2022; 19:89. [PMID: 35842649 PMCID: PMC9288710 DOI: 10.1186/s12966-022-01320-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informal food outlets, defined as vendors who rarely have access to water and toilets, much less shelter and electricity, are a common component of the food environment, particularly in many non-Western countries. The purpose of this study was to review available instruments that measure the quality and particularly the healthfulness of food and beverages sold within informal food outlets. METHODS PubMed, LILACS, Web of Science, and Scopus databases were used. Articles were included if they reported instruments that measured the availability or type of healthy and unhealthy foods and beverages by informal food outlets, were written in English or Spanish, and published between January 1, 2010, and July 31, 2020. Two trained researchers reviewed the title, abstract and full text of selected articles; discrepancies were solved by two independent researchers. In addition, the list of references for selected articles was reviewed for any additional articles of relevance. The quality of published articles and documents was evaluated using JBI Critical appraisal checklist for analytical cross-sectional studies. RESULTS We identified 1078 articles of which 14 were included after applying the selection criteria. Three additional articles were considered after reviewing the references from the selected articles. From the final 17 articles, 13 measurement tools were identified. Most of the instruments were used in low- and middle-income countries (LMIC). Products were classified as healthy/unhealthy or produce/non-produce or processed/unprocessed based on availability and type. Six studies reported psychometric tests, whereas one was tested within the informal food sector. CONCLUSIONS Few instruments can measure the healthfulness of food and beverages sold in informal food outlets, of which the most valid and reliable have been used to measure formal food outlets as well. Therefore, it is necessary to develop an instrument that manages to measure, specifically, the elements available within an informal one. These actions are extremely important to better understand the food environment that is a central contributor to poor diets that are increasingly associated with the obesity and Non-communicable disease (NCD) pandemic.
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Affiliation(s)
- Catalina Medina
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Maricela Piña-Pozas
- Center for Information for Public Health Decisions, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Tania C Aburto
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Julissa Chavira
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Uzzi López
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Mildred Moreno
- School of Engineering and Architecture (ESIA), National Polytechnic Institute (IPN), México, Avenida Fuentes de los Leones 28, Lomas de Tecamachalco. CP. 53955. Tecamachalco, Naucalpan, Mexico
| | - Armando G Olvera
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Citlali Gonzalez
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Terry T-K Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, 55W. 125 Street, Room 803, New York, NY, 10027, USA
| | - Simón Barquera
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico.
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Food Environments and Their Influence on Food Choices: A Case Study in Informal Settlements in Nairobi, Kenya. Nutrients 2022; 14:nu14132571. [PMID: 35807752 PMCID: PMC9268418 DOI: 10.3390/nu14132571] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022] Open
Abstract
The food environments that people have access to shape their food choices. The purpose of this study was to use mixed methods to characterize the external food environment in informal settlements in Nairobi, Kenya and to examine the individual factors that influence the way in which women interact with those environments to make food choices. We used a combination of food environment assessments (vendor mapping, collection of food prices, food quality assessments) and five focus group discussions with women (n = 26) in four villages within two informal settlements in Nairobi (Mukuru and Kibera) to better understand the drivers of food choice. We found a large number (n = 1163) of vendors selling a variety of food within the settlements. The highest number of vendors were selling fruits and/or vegetables; however, there was limited diversity of fruits available. Animal-source foods were considered relatively expensive as compared to plant-based foods, including prepared fried snacks. We found that the way women interacted with their food environments was influenced by individual factors such as income, time, convenience, and preferences. Our findings suggest that interventions targeting both the external food environment as well as individual factors such as income will be necessary to support healthy diets among low-income populations living in informal settlements in Kenya.
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Ali SH, Imbruce VM, Russo RG, Kaplan S, Stevenson K, Mezzacca TA, Foster V, Radee A, Chong S, Tsui F, Kranick J, Yi SS. Evaluating Closures of Fresh Fruit and Vegetable Vendors During the COVID-19 Pandemic: Methodology and Preliminary Results Using Omnidirectional Street View Imagery. JMIR Form Res 2021; 5:e23870. [PMID: 33539310 PMCID: PMC7894620 DOI: 10.2196/23870] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/11/2021] [Accepted: 01/17/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly disrupted the food retail environment. However, its impact on fresh fruit and vegetable vendors remains unclear; these are often smaller, more community centered, and may lack the financial infrastructure to withstand supply and demand changes induced by such crises. OBJECTIVE This study documents the methodology used to assess fresh fruit and vegetable vendor closures in New York City (NYC) following the start of the COVID-19 pandemic by using Google Street View, the new Apple Look Around database, and in-person checks. METHODS In total, 6 NYC neighborhoods (in Manhattan and Brooklyn) were selected for analysis; these included two socioeconomically advantaged neighborhoods (Upper East Side, Park Slope), two socioeconomically disadvantaged neighborhoods (East Harlem, Brownsville), and two Chinese ethnic neighborhoods (Chinatown, Sunset Park). For each neighborhood, Google Street View was used to virtually walk down each street and identify vendors (stores, storefronts, street vendors, or wholesalers) that were open and active in 2019 (ie, both produce and vendor personnel were present at a location). Past vendor surveillance (when available) was used to guide these virtual walks. Each identified vendor was geotagged as a Google Maps pinpoint that research assistants then physically visited. Using the "notes" feature of Google Maps as a data collection tool, notes were made on which of three categories best described each vendor: (1) open, (2) open with a more limited setup (eg, certain sections of the vendor unit that were open and active in 2019 were missing or closed during in-person checks), or (3) closed/absent. RESULTS Of the 135 open vendors identified in 2019 imagery data, 35% (n=47) were absent/closed and 10% (n=13) were open with more limited setups following the beginning of the COVID-19 pandemic. When comparing boroughs, 35% (28/80) of vendors in Manhattan were absent/closed, as were 35% (19/55) of vendors in Brooklyn. Although Google Street View was able to provide 2019 street view imagery data for most neighborhoods, Apple Look Around was required for 2019 imagery data for some areas of Park Slope. Past surveillance data helped to identify 3 additional established vendors in Chinatown that had been missed in street view imagery. The Google Maps "notes" feature was used by multiple research assistants simultaneously to rapidly collect observational data on mobile devices. CONCLUSIONS The methodology employed enabled the identification of closures in the fresh fruit and vegetable retail environment and can be used to assess closures in other contexts. The use of past baseline surveillance data to aid vendor identification was valuable for identifying vendors that may have been absent or visually obstructed in the street view imagery data. Data collection using Google Maps likewise has the potential to enhance the efficiency of fieldwork in future studies.
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Affiliation(s)
- Shahmir H Ali
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Valerie M Imbruce
- Environmental Studies Program, Binghamton University, State University of New York, New York, NY, United States
| | - Rienna G Russo
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | | | | | | | - Victoria Foster
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Ashley Radee
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Stella Chong
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Felice Tsui
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Julie Kranick
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Stella S Yi
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
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A Model Depicting the Retail Food Environment and Customer Interactions: Components, Outcomes, and Future Directions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207591. [PMID: 33086537 PMCID: PMC7589434 DOI: 10.3390/ijerph17207591] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/06/2020] [Accepted: 10/16/2020] [Indexed: 12/26/2022]
Abstract
The retail food environment (RFE) has important implications for dietary intake and health, and dramatic changes in RFEs have been observed over the past few decades and years. Prior conceptual models of the RFE and its relationships with health and behavior have played an important role in guiding research; yet, the convergence of RFE changes and scientific advances in the field suggest the time is ripe to revisit this conceptualization. In this paper, we propose the Retail Food Environment and Customer Interaction Model to convey the evolving variety of factors and relationships that convene to influence food choice at the point of purchase. The model details specific components of the RFE, including business approaches, actors, sources, and the customer retail experience; describes individual, interpersonal, and household characteristics that affect customer purchasing; highlights the macro-level contexts (e.g., communities and nations) in which the RFE and customers behave; and addresses the wide-ranging outcomes produced by RFEs and customers, including: population health, food security, food justice, environmental sustainability, and business sustainability. We believe the proposed conceptualization helps to (1) provide broad implications for future research and (2) further highlight the need for transdisciplinary collaborations to ultimately improve a range of critical population outcomes.
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Racial Differences in Perceived Food Swamp and Food Desert Exposure and Disparities in Self-Reported Dietary Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197143. [PMID: 33003573 PMCID: PMC7579470 DOI: 10.3390/ijerph17197143] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 01/24/2023]
Abstract
Both food swamps and food deserts have been associated with racial, ethnic, and socioeconomic disparities in obesity rates. Little is known about how the distribution of food deserts and food swamps relate to disparities in self-reported dietary habits, and health status, particularly for historically marginalized groups. In a national U.S. sample of 4305 online survey participants (age 18+), multinomial logistic regression analyses were used to assess by race and ethnicity the likelihood of living in a food swamp or food desert area. Predicted probabilities of self-reported dietary habits, health status, and weight status were calculated using the fitted values from ordinal or multinomial logistic regression models adjusted for relevant covariates. Results showed that non-Hispanic, Black participants (N = 954) were most likely to report living in a food swamp. In the full and White subsamples (N = 2912), the perception of residing in a food swamp/desert was associated with less-healthful self-reported dietary habits overall. For non-Hispanic Blacks, regression results also showed that residents of perceived food swamp areas (OR = 0.66, p < 0.01, 95% CI (0.51, 0.86)) had a lower diet quality than those not living in a food swamp/food desert area. Black communities in particular may be at risk for environment-linked diet-related health inequities. These findings suggest that an individual's perceptions of food swamp and food desert exposure may be related to diet habits among adults.
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Lucan SC, Maroko AR, Jin A, Chen A, Pan C, Sosa G, Schechter CB. Change in an urban food environment within a single year: Considerations for food-environment research and community health. Prev Med Rep 2020; 19:101102. [PMID: 32642401 PMCID: PMC7334403 DOI: 10.1016/j.pmedr.2020.101102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/17/2020] [Accepted: 04/20/2020] [Indexed: 12/11/2022] Open
Abstract
Past research on food-environment change has been limited in critical ways. This study demonstrates business-level changes: openings, closings, new offerings. The number and proportion of businesses offering any food/drink increased in a year. Businesses offering less-healthful items increased and remained more numerous. Changes have implications for both food-environment research and community health.
Past research on food-environment change has been limited in key ways: (1) considering only select storefront businesses; (2) presuming items sold based on businesses category; (3) describing change only in ecological terms; (4) considering multi-year intervals. The current study addressed past limitations by: (1) considering a full range of both storefront and non-storefront businesses; (2) focusing on items actually offered (both healthful and less-healthful varieties); (3) describing individual-business-level changes (openings, closings, changes in offerings); (4) evaluating changes within a single year. Using a longitudinal, matched-pair comparison of 119 street segments in the Bronx, NY (October 2016-August 2017), investigators assessed all businesses—food stores, restaurants, other storefront businesses (OSBs), street vendors—for healthful and less-healthful food/drink offerings. Changes were described for individual businesses, individual street segments, and for the area overall. Overall, the number (and percentage) of businesses offering any food/drink increased from 45 (41.7%) in 2016 to 49 (45.8%) in 2017; businesses newly opening or newly offering food/drink cumulatively exceeded those shutting down or ceasing food/drink sales. In 2016, OSBs (gyms, barber shops, laundromats, furniture stores, gas stations, etc.) together with street vendors represented 20.0% and 27.3% of businesses offering healthful and less-healthful items, respectively; in 2017, the percentages were 31.0% and 37.0%. While the number of businesses offering healthful items increased, the number offering less-healthful items likewise increased and remained greater. If change in a full range of food/drink availability is not appreciated: food-environment studies may generate erroneous conclusions; communities may misdirect resources to address food-access disparities; and community residents may have increasing, but unrecognized, opportunities for unhealthful consumption.
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Affiliation(s)
- Sean C Lucan
- Department of Family and Social Medicine, Albert Einstein College of Medicine
- Montefiore Health System, Bronx, NY, United States
| | - Andrew R Maroko
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Aurora Jin
- Albert Einstein College of Medicine, Bronx, NY, United States
| | - Aixin Chen
- Albert Einstein College of Medicine, Bronx, NY, United States
| | - Charles Pan
- Albert Einstein College of Medicine, Bronx, NY, United States
| | | | - Clyde B Schechter
- Department of Family and Social Medicine, Albert Einstein College of Medicine
- Montefiore Health System, Bronx, NY, United States
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