Assessment of community food resources: A Latino neighborhood study in upstate New York

Structural racism and geographic access to food retailers in the United States: A scoping review

This scoping review summarized findings and key measures from U.S.-based studies that 1) examined associations between geographic indicators of structural racism (e.g., redlining, racial segregation) and access to food retailers (e.g., supermarkets, convenience stores) or 2) documented disparities in access by neighborhood racial/ethnic composition. In 2022, relevant scientific literature was reviewed using Covidence software. Independent reviewers examined 13,069 citations; 163 citations advanced to the full-text review stage and 70 were selected for inclusion. Twenty-one studies (30%) linked one or more indicator of structural racism to food retailer access while 49 (70%) solely examined differences in access by neighborhood racial/ethnic composition. All studies featuring indicators of structural racism reported significant findings; however, indicators varied across studies making it difficult to make direct comparisons. Key indicators of structural racism in the food access literature included redlining (n = 3), gentrification (n = 3), and racial segregation (n = 4). Many U.S.-based studies have evaluated food retailer access by neighborhood racial/ethnic composition. Moving forward, studies should model indicators of structural racism and determine their influence on geographic access to large and small food retailers.

Using the National Institute on Minority Health and Health Disparities framework to better understand disparities in major amputations

Recently, the United States experienced its first resurgence of major amputations in more than 20 years. Compounding this rise is a longstanding history of disparities. Patients identifying as non-Hispanic Black are twice as likely to lose a limb as those identifying as non-Hispanic White. Those identifying as Latino face a 30% increase. Rural patients are also more likely to undergo major amputations, and the rural-urban disparity is widening. We used the National Institute on Minority Health and Health Disparities framework to better understand these disparities and identify common factors contributing to them. Common factors were abundant and included increased prevalence of diabetes, possible lower rates of foot self-care, transportation barriers to medical appointments, living in disadvantaged neighborhoods, and lack of insurance. Solutions within and outside the health care realm are needed. Health care-specific interventions that embed preventative and ambulatory care services within communities may be particularly high yield.

Who shops at their nearest grocery store? A cross-sectional exploration of disparities in geographic food access among a low-income, racially/ethnically diverse cohort in Central Texas

We examined whether Central Texans shop at their nearest supermarket, how far they travel for groceries, and explored differences by race/ethnicity, urbanicity, motivations for store selection and other demographic characteristics. Using cross-sectional data and GIS, continuous network distances from participants' homes to nearest and usual supermarkets were calculated and multivariate linear regression assessed differences. <19% shopped at their nearest supermarket. Regression models found that urbanicity played a large role in distance traveled to preferred supermarket, but other factors varied by race/ethnicity. Our findings demonstrate racial/ethnic and urbanicity disparities in food access and multiple domains of food access need greater consideration.

Examining Geographic Food Access, Food Insecurity, and Urbanicity among Diverse, Low-Income Participants in Austin, Texas

The purpose of this study was to explore the association between geographic food access and food insecurity and the potential role of race/ethnicity, income, and urbanicity among a low-income, diverse sample in Central Texas. Utilizing a cross-sectional study design, secondary data analysis of an existing cohort was used to examine the association between food insecurity; geographic food access; and sociodemographic factors of race/ethnicity, income, urbanicity, and additional covariates using binomial logistic regression models. The existing cohort was recruited from lower-income communities in Travis County, Texas. The sample (N = 393) was predominantly Hispanic, lived in urban areas, and nearly 40% were food insecure. Geographic food access was not found to be significantly associated with food insecurity. However, rural residents had greater odds of being food insecure than urban residents. Also, participants who earned USD 45,000-64,999 and over USD 65,000 had lower odds of being food insecure than participants who earned under USD 25,000. These findings add to the inconsistent literature about the association between geographic food access and food insecurity and contribute to urbanicity and income disparities in food-insecurity literature. Future work should consider urbanicity, income, and utilize community-specific data to gain greater understanding of the association between geographic food access and food insecurity.

Mapping Food Insecurity-Related 2-1-1 Calls in a 10-County Area of Central Texas by Zip Code: Exploring the Role of Geographic Food Access, Urbanicity and Demographic Indicators

Food insecurity is a public health issue that affects 12% of Americans. Individuals living in food insecure households are more likely to suffer from conditions such as undernutrition, obesity and chronic diseases. Food insecurity has been linked to limited geographic access to food; however, past studies have used limited measures of access which do not fully capture the nuances of community context. The purpose of this study was to explore the association between food insecurity and geographic food access by level of urbanicity. 2-1-1 calls made in 2018 in Central Texas were classified as food needs versus non-food needs. Supermarket and convenience stores were mapped using ArcGIS. Geographic food access was operationalized as the presence of supermarkets and convenience stores: within the zip code; only in neighboring zip codes; and not located within or in neighboring zip codes. Descriptive statistics and binomial logistic regression were used to examine associations between geographic access and 2-1-1 food calls, stratified by level of urbanicity. 11% of the 2-1-1 calls made in 2018 (N = 55,405) were regarding food needs. Results showed that peri-urban and rural callers living in zip codes that only had supermarkets in neighboring zip codes had greater odds of calling about food needs compared to those that had supermarkets within the zip code. These findings indicate that geographic food access is associated with food insecurity, but this relationship varies by urbanicity. Thus, the development of food insecurity mitigation programs in peri-urban and rural areas is needed.

Perceived neighbourhood food environment and overweight and obesity among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) participants in the Midwest US

OBJECTIVE

To evaluate the relationship between neighbourhood food environment perceptions and obesity among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) or Expanded Food and Nutrition Education Program (EFNEP) participants.

DESIGN

A cross-sectional study conducted during SNAP-Ed or EFNEP programme participation in six states in the Midwest US between May 2016 and November 2017.

SETTING

Community centres, food pantries and other SNAP-Ed or EFNEP recruitment locations.

PARTICIPANTS

Convenience sample of 1743 low-income, adult nutrition education programme participants.

RESULTS

Controlling for participant location and other demographic variables, those who perceived that a large selection of fruits and vegetables were available to them were 22 % less likely to be obese (adjusted odds ratio 0·78, 95 % CI 0·63, 0·97). In addition, participants who perceived the distance to the grocery store where they purchased most of their groceries to be greater than 5 miles were 1·36 times more likely to be overweight or obese than those who travelled shorter distances for their groceries.

CONCLUSIONS

SNAP-Ed or EFNEP participants' weight status may be associated with their perceptions of their neighbourhood food environments. Programmes incorporating nutrition education and food access initiatives should attempt to better understand participant perceptions in order to address barriers in their efforts and to ensure that healthy food is accessible to low-income residents.

Disability and food access and insecurity: A scoping review of the literature

A scoping review was conducted, using a social ecological model approach, of 106 articles examining the effect of disability on food access and (in)security. Results of the review show a consistently increased risk of food insecurity among people with disabilities with a higher risk for mental health disabilities, and among disabled younger adults. Mediators of this relationship were underexplored. Disability was mainly conceptualized as a problematic category preventing food access while ignoring disabling social and environmental barriers. A social model of disability can inform future research by acknowledging the role of socio-environmental influences on the production and experience(s) of disability.

Trends of fruit and vegetable availability in neighbourhoods in Albany, NY, USA, 2003–2012

Objective

To investigate a 9-year trend of fresh fruit and vegetable availability and factors associated with the net availability change in two contrasting neighbourhoods.

Design

Longitudinal design. Data were collected in 2003, 2009 and 2012 through in-store observations. Fresh fruit and vegetable availability was presented by weight-adjusted counts of stores having designated varieties per 10 000 population.

Setting

A low-income minority neighbourhood and an adjacent middle-income racially mixed neighbourhood in Albany, NY, USA. These neighbourhoods became sites of fresh produce interventions after baseline data were collected.

Subjects

A total of 111, 128 and 146 eligible food stores in respective years.

Results

Fresh fruit availability (two or more varieties) increased in both neighbourhoods. Inventory expansion of existing stores and the convenience store intervention contributed to the significant increase (P for trend=0·04) of fresh fruit availability in the minority neighbourhood. Although not statistically significant (P>0·05), the availability of two or more dark-coloured fresh vegetables also increased in the mixed neighbourhood, but declined slightly in the minority neighbourhood. The secular (non-intervention) fresh vegetable availability rate ratio by neighbourhood reached 3·0 in 2012 (P<0·01). The net decline of fresh vegetable availability in the minority neighbourhood was primarily attributed to inventory reduction of existing stores.

Conclusions

Longitudinal observations revealed narrowed neighbourhood disparities of fresh fruit availability and widened gaps of fresh vegetable availability. Inventory shifts of existing stores impacted the net availability change more profoundly than store opening or closing in the minority neighbourhood. Findings support increasing the programme capacity of the convenience store intervention to address the fresh vegetable disparity.

Conceptions of acculturation: a review and statement of critical issues

This article reviews evidence for re-conceptualizing acculturation status and acculturation process in health care research with United States (U.S.) Latino populations. Prior literature on acculturation has focused on: (a) acculturative change towards the dominant culture, (b) acculturation as it occurs with Mexican Americans, and (c) language as the principal component of acculturation. We review empirically based health research on acculturation and propose an ecodevelopmental framework for better understanding the process of acculturation. We then offer recommendations that may assist public health researchers, policymakers and program developers in better understanding "real world" acculturation. This includes understanding acculturation within this ecodevelopmental context for a more complete understanding of the acculturation process and its influences on health-related behaviors, with aims of reducing or eliminating health disparities in Latino populations.