Community food environments and healthy food access among older adults: A review of the evidence for the Senior Farmers' Market Nutrition Program (SFMNP)

Measuring Food Insecurity: The Problem with Semantics

Rising rates of hunger and food insecurity have sparked a major re-evaluation of all aspects of food systems. Because of the multifaceted nature of food insecurity, however, determining what actions should be taken is challenging, especially since reevaluation efforts are led by experts from several disciplines and there is no consensus about which indicators should be used and how they should be measured. Confusion surrounding the meaning of the terms 'food security' and 'food insecurity' has contributed to this lack of consensus. As indicators inform action, such confusion has slowed those committed to alleviating hunger in identifying the most pressing targets. This review highlights (1) the importance of clearly defining food security and food insecurity and (2) how such definitions affect measures of food insecurity in the United States. While some might say that definitions are an issue of the past or a trivial matter of semantics, we believe that the world's present rates of hunger and malnutrition are attributable, at least in part, to the lack of consensus on these definitions and their accompanying measurements and indicators. Although the present review can be helpful to academics and policy makers, the primary purpose is to be a resource to those involved in the day-to-day production of food, such as ranchers and farmers by providing an overview of definitions, indicators, and measurements used when discussing food security.

LGBTQ+ food insufficiency in New England

As a group, LGBTQ+ people experience food insecurity at a disproportionately high rate, yet food security scholars and practitioners are only beginning to uncover patterns in how food insecurity varies by subgroups of this diverse community. In this paper, we use data from the U.S. Census Bureau's Household Pulse Survey-which added measures of gender identity and sexuality for the first time in 2021-to analyze New Englanders' food insufficiency rates by gender, sexuality, race, and ethnicity. We find that (1) in the past seven days, 13.0 percent of LGB + (lesbian, gay, bisexual, and other non-heterosexual) New Englanders experience food insufficiency-which is nearly twice the rate of heterosexual people-and 19.8 percent of transgender+ (transgender, genderqueer, gender non-binary, and other non-cisgender people) New Englanders experience food insufficiency-which is two to three times the rate of cisgender men and women. (2) Whereas cisgender New Englanders experience food insufficiency at a lower rate than their counterparts in the rest of the nation (about two percentage points lower for both cisgender men and women), transgender+ New Englanders experience no such New England advantage compared to transgender+ people in the country as a whole. (3) LGBTQ+ New Englanders of color experience devastatingly high rates of food insufficiency, with, for example, one in three Black transgender+ New Englanders not having enough food to eat in the past seven days. These findings suggest that addressing food insecurity in New England demands approaching the problem with an intersectional queer lens, with attention to the ways in which racism, cissexism, and heterosexism are creating a systemic, ongoing food crisis for LGBTQ+ New Englanders, especially those who are transgender+ and/or people of color.

Older Adults and the Food Security Infrastructure

This project explores the correlates of state variation in food security using data from the 2008 to 2018 Current Population Survey's Food Security Supplements. The focus is on the relationship between state-level availability and accessibility of congregate and home-delivered meal programs, the Supplemental Nutrition Assistance Program (SNAP), the Senior Farmer's Market Nutrition Program (SFMNP) and the Commodity Supplemental Food Program (CSFP) on food security among lower-income households headed by older adults (ages 60 and up). Results show evidence that a senior-specific state level food security infrastructure plays a role in the food security status of households headed by older adults.

Toward Sustainable Communities: A Case Study of the Eastern Market in Detroit

Community development tends to focus on large-scale, government-funded transformations or on small-scale, grassroot initiatives. In the US, the financial resources, available infrastructure, and broad-based civic support to implement large-scale community transformations are frequently lacking. In contrast, niche interventions, while often locally successful, tend to be unscalable. Accordingly, many community development programs either do not go beyond an ideational stage, or they are unscalable or unsustainable in the long run. In this qualitative case study, we analyze the Eastern Market in Detroit, Michigan, a local institution that contributes considerably and in several ways to the sustainability of multiple communities. Using Content Configuration Analysis (CCA), we conduct a bottom-up exploratory analysis of fieldwork notes, nonparticipant observations, as well as audio, visual, and written materials including policy and strategy documents from the City of Detroit, Wayne County, and the State of Michigan, academic publications, strategy and annual reports, websites, blogs, vlogs, social media outlets, newspapers, podcasts, and interviews along two lines of inquiry: first, to examine how the market contributes to sustainable community development and, second, to explore the systemic underpinnings that facilitate such development. Specifically, we focus on the Eastern Market to identify system-relevant actors, interests, relations, interventions, and outcomes that illustrate an institution which operates well beyond the ideational confines of a conventional farmers market. In the process of exploring the adaptive nature of the Eastern Market within its financial and infrastructural constraints, we also exemplify with this case that a well-established institution, a farmers market, can reinvent itself to serve multiple needs of larger, heterogeneous communities, and that the successful adaptations associated with this reinvention reimagine the community in which it is embedded.

Protocol for an evaluation of the Designing Communities to Support Healthy Living in Aging Residents Study

BACKGROUND

In collaboration with building developers, the Housing for Health team is contributing to the design of community-based congregate living facilities to support healthy living in older adults. There may also be opportunities to improve the surrounding neighbourhoods by collaborating with the municipalities where the developments are located. We will evaluate whether one or more of these comprehensive interventions lead to changes in the perceived, microscale, and macroscale neighbourhood-built environment (BE) and amenities, and impacts on the physical activity (PA), healthy eating, and social connections of residents. In parallel, we will gather qualitative data to provide a more in-depth understanding of how the BE may facilitate or hinder resident's healthy living outcomes.

METHODS

This project employs a quasi-experimental pre-post design with at least one or more intervention and control sites. The quantitative BE evaluation will include pre- and post-intervention assessments of neighbourhood macroscale (e.g., layout of communities) and microscale (e.g., street details and characteristics) changes using Geographical Information Systems (GIS) and Microscale Audit Pedestrian Streetscapes (MAPS) audits, respectively. The quantitative resident evaluation will include self-report (i.e., surveys) and objective assessments (i.e., accelerometers, Global Positioning System [GPS]) of residents at baseline (3-6-months pre-move-in) and follow-up (3-6-months and 9-12-months post-move-in if possible). The qualitative resident-environment component will involve in-depth semi-structured interviews post-intervention with building residents, family members, and stakeholders involved in the design/development and/or operation of the intervention site(s). Participant observations will be completed in the building and neighbourhood environments of the intervention site(s).

DISCUSSION

Findings will provide evidence on whether and how comprehensive changes to the BE and amenities of at least one congregate living facility and the surrounding neighbourhood can impact PA, healthy eating, and social connections of older adults. Successful intervention elements will be scaled up in future work. We will disseminate findings to a broad audience including the scientific community via peer-reviewed publications, conference presentations, and discussion panels; and the private, public, and not-for-profit sectors via reports, public presentations, and/or communications via our partners and their networks.

TRIAL REGISTRATION

Protocol ID: 1819-HQ-000051. ClinicalTrials.gov ID: NCT05031273. Registered 29 June 2021 with ClinicalTrials.gov.

Food Insecurity in Older Adults in Canada and the United States: A Concept Analysis

A concept analysis using the method of Walker and Avant was undertaken to clarify the concept of food insecurity in older adults in Canada and the United States. A literature review was undertaken to conduct a concept analysis of food insecurity in older people. Food insecurity is associated with multiple negative health outcomes and may be experienced differently by older adults as compared to younger adults. It is therefore important to understand the concept of food insecurity as is relates to older adults. Four defining attributes of food insecurity in older adults in Canada and the United States were identified: (i) inability to acquire or prepare enough food, (ii) compromising on food quality or preference, (iii) uncertainty or anxiety around the ability to acquire or prepare food, and (iv) socially unacceptable or non-normative practices. These attributes may allow for improved policies and programs aimed at addressing food insecurity in older adults by better meeting the needs of older individuals. Additional research into food insecurity as experienced by Canadian and American older adults could help to further clarify the concept.

The Economic, Social, and Environmental Impacts of Farmers Markets: Recent Evidence from the US

Farmers markets are regular, recurring gatherings at a common facility or area where farmers and ranchers directly sell a variety of fresh fruits, vegetables, and other locally grown farm products to consumers. Markets rebuild and maintain local and regional food systems, leading to an outsized impact on the food system relative to their share of produce sales. Previous research has demonstrated the multifaceted impacts that farmers markets have on the communities, particularly economically. Recent scholarship in the United States has expanded inquiry into social impacts that markets have on communities, including improving access to fresh food products and increasing awareness of the sustainable agricultural practices adopted by producers, as well developing tools for producers and market stakeholders to measure their impact on both producers and communities. This paper reviews the recent scholarship on farmers markets to identify recent trends and synthesizes the current evidence describing the ways in which farmers markets contribute to the wellbeing of their communities, as well as identifying areas for additional future research.

Effectiveness of a machine-assisted healthy physical fitness promotion program for community elderly

BACKGROUND

Maintaining physical fitness is important for health of the elderly. How to implement an effective and efficient model is a practical issue. A healthy physical fitness promotion program with machine-assisted exercises was designed for elderly and executed in a community in 2015 and 2016. The program was implemented for 10 to 12 weeks with two (group 1) or three (group 2) sessions per week, and functional fitness tests were conducted before, at the end, and 3 months after the training. This study is to investigate the effectiveness of machine-assisted physical fitness promotion program for the community elderly.

METHODS

A retrospective analysis was conducted on the participants' data, including sex, age, height, weight, waist-hip ratio, grip strength, back stretch, chair sit-and-reach, 30-second chair stand, 30-second arm curl, 2-minute step, single-leg standing, 8-ft up-and-go, and body composition. The differences in test results before, at the end, and 3 months after the training and the percentage change at different time intervals between the two groups were compared.

RESULTS

After training, body mass index in group 2 and the test completion time for 8-ft up-and-go in group 1 decline significantly; furthermore, significant increase was noted in the height and number of times of 2-minute step in both groups, and grip strength, number of times of their 30-second arm curl, and 30-second chair stand in group 2. The training effect sustained 3 months after the training in height and number of times of 2-minute step in both groups, and grip strength, number of times of their 30-second arm curl, and 30-second chair stand in group 2.

CONCLUSION

This study discovered that 10 to 12 weeks of machine-assisted exercise training can improve the elderly community members' body composition, muscle strength, muscle endurance, agility, dynamic balance, and cardiorespiratory endurance. Moreover, with three sessions per week, its effects were even maintained for 3 months after the training.

Harnessing Knowledge for Improving Access to Fruits and Vegetables at Farmers Markets: Interactive Data Visualization to Inform Food Security Programs and Policy

High consumption of fruits and vegetables leads to decreased risk of various chronic diseases, including obesity and cardiovascular disease. Community-level barriers to access fruits and vegetables include the high cost, limited availability, and transportation. Farmers markets are a priority strategy for improving community access to fresh fruits and vegetables. The U.S. Department of Agriculture (USDA) National Farmers Market Directory is a voluntary self-reported data source on farmers markets. The objective of this investigation of the USDA farmers markets data directory was to determine how farmers markets in the United States are grouped according to (1) availability of fruits and vegetables and (2) the payment accepted. We designed and implemented interactive data visualizations in visual analytics software to understand access to fruits and vegetables at farmers markets from 8,497 entries in the USDA Farmers Market Directory. Among the 665 new or updated entries in year 2018, a subset of 641 (96%) farmers markets with availability of fresh fruits and vegetables had 16 subgroups. Additionally, a subgroup of 102 (16%) farmer markets accepted all four federal nutrition assistance benefits (SFMNP, SNAP, WIC CVVs, and WIC FMNP). The interactive data visualizations including geographic maps connected to social media resources can be useful in advocacy efforts and can inform policy improvements designed to improve physical, social, and economic access to fruits and vegetables at farmers markets.

Farmers’ Market Actors, Dynamics, and Attributes: A Bibliometric Study

Farmers’ markets aim to bring producers and consumers together under direct marketing schemes, also known as alternative food networks, for local and sustainable production and consumption of food. A number of studies concerning this subject have been published, however, as yet no updated reviews exist that might allow us to understand the trends in research on farmers’ markets. The objective of this study was to examine the farmers’ market literature using bibliometric tools. A total of 438 peer-reviewed publications, indexed in the abstract and citation meta-database Scopus (Elsevier®), for the period of 1979 to September 24, 2018, were considered. In the second phase, publications in the area of medicine were excluded, resulting in 295 publications being analyzed for the same period. The results showed that these publications focused on three main areas: markets, health programs, and food safety. Upon exclusion of the medical publications, the remaining works focused on farmers’ market actors, dynamics, and attributes: vendors (producers and others), consumers, the community, and supporting actors and institutions (government, NGOs, individuals). Therefore, it is concluded that there is no single type of farmers’ market, nor of farmers’ market vendors or consumers. This makes the reproduction of such spaces difficult, especially when the goals are to benefit local production systems or the nutrition of the local community.

New frontiers in community initiatives to increase vegetable consumption

ISSUE ADDRESSED

Public health concerns about insufficient consumption of vegetables across all demographics in Australia have led to 20 years of behaviour change interventions ranging from social marketing to interactive small group programs, with modest results. To maximise health promotion intervention outcomes, practitioners need up-to-date information that helps them navigate the complexity of food systems and eating behaviours.

METHODS

This scoping review of Australian and international research, including peer-reviewed and grey literature, provides a picture of health promotion nutrition interventions, as well as other initiatives that may promote increased vegetable consumption. Search terms related to nutrition and vegetable consumption, type of intervention or initiative, for example, campaign; and consumer values and behaviour. A wide range of data sources were used including scholarly papers, market research reports and publicly available websites of community organisations (eg, OOOOBY). A broad food systems typology was developed to provide a framework for the review.

RESULTS

The review finds an emerging group of community-driven initiatives within local food systems that appear to have positive impacts on vegetable consumption. These initiatives sit within a multi-faceted approach to health and well-being that is consistent with the tenets of the Ottawa Charter for Health Promotion, including community engagement, social justice and sustainability goals.

CONCLUSIONS

More research into the impact of these new frontiers is needed, but our preliminary findings point to the potential for health promotion practitioners to collaborate on local/community food system initiatives that are not motivated primarily by health goals, but have the potential to deliver multiple health and environmental outcomes. SO WHAT?: This review demonstrated community-driven initiatives around local food systems show the most promise in promoting vegetable consumption and addressing the determinants of health. Health promotion efforts to encourage food security and healthy eating could be strengthened through collaborations within these new frontiers.