1
|
Ares G, Turra S, Bonilla L, Costa M, Verdier S, Brunet G, Alcaire F, Curutchet MR, Vidal L. WEIRD and non-consensual food deserts and swamps: A scoping review of operational definitions. Health Place 2024; 89:103315. [PMID: 39013213 DOI: 10.1016/j.healthplace.2024.103315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/02/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
The aim of the present study was to critically analyze operational definitions of food deserts and food swamps included in empirical studies published in peer-reviewed journals. A scoping review was conducted following the recommendations of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews. A search of the scientific literature was performed on August 2023 to identify empirical studies including operational definitions of food deserts and/or food swamps in three databases: Scopus, PubMed, and Scielo. A total of 932 scientific articles were identified in the three databases, from which 157 articles, published between 2002 and 2023, were included in the review. The included studies were mainly conducted in WEIRD (Western, Educated, Industrilaized, Rich and Democractic) countries. They presented a total of 107 operational definitions of food deserts and 30 operational definitions of food swamps. Large heterogeneity in the operational definitions of food deserts and food swamps was found. Published studies differed in all the elements of the operational definitions analyzed in the present work. Results stress the need for standardization and the development of more objective and multivariate continuous measures of physical food accessibility that reflect the complexity of modern food environments globally. A series of recommendations to advance food environment research are derived.
Collapse
Affiliation(s)
- Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay.
| | - Sergio Turra
- Escuela de Nutrición, Universidad de la República, Av. Ricaldoni S/N, CP 11600, Montevideo, Uruguay
| | - Luciana Bonilla
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - María Costa
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Sofía Verdier
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Gerónimo Brunet
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP 11200, Montevideo, Uruguay
| | - Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay
| | - María Rosa Curutchet
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay
| |
Collapse
|
2
|
Patrascu FI, Mostafavi A, Vedlitz A. Disparities in access and association between access to critical facilities during day-to-day and disrupted access as a result of storm extreme weather events. Heliyon 2023; 9:e18841. [PMID: 37576234 PMCID: PMC10412829 DOI: 10.1016/j.heliyon.2023.e18841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023] Open
Abstract
This study examines the relationship between households' access to critical facilities day-to-day and during weather-related extreme events. Despite a robust understanding of both day-to-day access and access during disasters, the interplay between the two remains unclear. To bridge this knowledge gap, we propose a novel empirical approach, using a Texas statewide household survey (N = 810). The survey evaluates day-to-day and past events access, exploring the experiences of respondents during multiple recent disasters, rather than focusing on a specific hazard. Using correlation analysis, we examined various access-related factors such as day-to-day trip duration, alternative trip duration, and loss of access during past events. Additionally, we evaluated the association between access-related factors and sociodemographic characteristics such as income, ethnicity, and urban status. The results indicate: (1) daily trip duration to critical facilities is associated with disrupted access during storm events, and (2) disparities persist during both day-to-day times and during extreme events. These results bring new insights to the existing body of knowledge on day-to-day access and access during disasters. The findings provide scientifically grounded evidence to city managers and planners, emphasizing the need for equitable distribution of facilities to enhance access to essential facilities both in daily life and during extreme weather-related events.
Collapse
Affiliation(s)
- Flavia Ioana Patrascu
- Urban Resilience.AI Lab, Zachry Department of Civil and Environmental Engineering, Texas A&M University, College Station, TX, 77843, USA
| | - Ali Mostafavi
- Urban Resilience.AI Lab, Zachry Department of Civil and Environmental Engineering, Texas A&M University, College Station, TX, 77843, USA
| | - Arnold Vedlitz
- Public Policy, Bush School of Government and Public Service, A&M University, College Station, TX, 77843, USA
| |
Collapse
|
3
|
Wittenauer R, Shah PD, Bacci JL, Stergachis A. Pharmacy deserts and COVID-19 risk at the census tract level in the State of Washington. Vaccine X 2022; 12:100227. [PMID: 36275889 PMCID: PMC9574851 DOI: 10.1016/j.jvacx.2022.100227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 08/12/2022] [Accepted: 10/13/2022] [Indexed: 11/02/2022] Open
Abstract
Community pharmacies are a crucial component of healthcare infrastructure, including for COVID-19 pandemic prevention services like testing and vaccination. Communities that are "pharmacy deserts," experience healthcare inequities. However, little research has characterized where these communities are, making it difficult for local leaders to prioritize resources for them. This study identifies pharmacy deserts at the census tract level in Washington state for the first time and explores their association with COVID-19 risk. Out of 1,441 tracts, 127 were pharmacy deserts, comprising approximately 454,000 adults, or 8% of the state's adult population. Among those tracts identified as pharmacy deserts, 67% were considered high risk for COVID-19. Solutions are needed to expand equitable access to pharmacy services in these communities. The methods and data presented herein provide healthcare leaders with information to address this pharmacy access gap in Washington and could be similarly applied to other settings. Three categories of policy changes could address health inequities found in our study: 1) improve financial incentives for pharmacists to practice in underserved areas, 2) prevent pharmacy closures, and 3) deploy innovative care delivery methods such as telehealth services.
Collapse
Affiliation(s)
- Rachel Wittenauer
- School of Pharmacy, CHOICE Institute, University of Washington. 1956 NE Pacific St H362, Seattle, WA 98195, USA,Corresponding author at: Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington School of Pharmacy, Seattle, WA 98195, USA.
| | - Parth D. Shah
- Hutchinson Institute for Cancer Outcomes Research (HICOR), Fred Hutch. 1100 Fairview Ave N, Seattle, WA 98109, USA
| | - Jennifer L. Bacci
- School of Pharmacy, CHOICE Institute, University of Washington. 1956 NE Pacific St H362, Seattle, WA 98195, USA
| | - Andy Stergachis
- School of Pharmacy, CHOICE Institute, University of Washington. 1956 NE Pacific St H362, Seattle, WA 98195, USA,Department of Global Health, School of Public Health, University of Washington. Hans Rosling Center, 3980 15th Ave NE, Seattle, WA 98105, USA
| |
Collapse
|
4
|
Janda KM, Salvo D, Ranjit N, Hoelscher DM, Nielsen A, Lemoine P, Casnovsky J, van den Berg A. 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. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022; 19:355-375. [PMID: 38800668 PMCID: PMC11114093 DOI: 10.1080/19320248.2022.2128962] [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] [Indexed: 10/10/2022]
Abstract
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.
Collapse
Affiliation(s)
- Kathryn M. Janda
- UTHealth School of Public Health in Austin, 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA
- Michael and Susan Dell Center for Healthy Living 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA
- Baylor University, Department of Public Health, Robbins College of Health and Human Sciences, One Bear Place #97343, Waco, TX, 76798, USA
| | - Deborah Salvo
- Department of Kinesiology and Health Education, College of Education, The University of Texas at Austin, 1212 Speedway Stop D5000, Austin, Texas 78712
| | - Nalini Ranjit
- UTHealth School of Public Health in Austin, 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA
- Michael and Susan Dell Center for Healthy Living 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA
| | - Deanna M. Hoelscher
- UTHealth School of Public Health in Austin, 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA
- Michael and Susan Dell Center for Healthy Living 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA
| | - Aida Nielsen
- UTHealth School of Public Health in Austin, 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA
- Michael and Susan Dell Center for Healthy Living 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA
| | - Pablo Lemoine
- Centro Nacional de Consultoría, Calle 82 651 Bogotá, D.C., 801, Colombia
| | - Joy Casnovsky
- Sustainable Food Center, 2921 E. 17 Street, Building C, Austin, Texas, 78702, USA
| | - Alexandra van den Berg
- UTHealth School of Public Health in Austin, 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA
- Michael and Susan Dell Center for Healthy Living 1616 Guadalupe Street, Suite 6.300, Austin, Texas, 78701, USA
| |
Collapse
|
5
|
Janda KM, Ranjit N, Salvo D, Hoelscher DM, Nielsen A, Casnovsky J, van den Berg A. Examining Geographic Food Access, Food Insecurity, and Urbanicity among Diverse, Low-Income Participants in Austin, Texas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095108. [PMID: 35564504 PMCID: PMC9104388 DOI: 10.3390/ijerph19095108] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/10/2022]
Abstract
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.
Collapse
Affiliation(s)
- Kathryn M. Janda
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (D.M.H.); (A.N.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
- Correspondence:
| | - Nalini Ranjit
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (D.M.H.); (A.N.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA;
| | - Deanna M. Hoelscher
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (D.M.H.); (A.N.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Aida Nielsen
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (D.M.H.); (A.N.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | | | - Alexandra van den Berg
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (D.M.H.); (A.N.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| |
Collapse
|
6
|
Janda KM, Ranjit N, Salvo D, Nielsen A, Akhavan N, Diaz M, Lemoine P, Casnovsky J, van den Berg A. A Multi-Pronged Evaluation of a Healthy Food Access Initiative in Central Texas: Study Design, Methods, and Baseline Findings of the FRESH-Austin Evaluation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10834. [PMID: 34682578 PMCID: PMC8535966 DOI: 10.3390/ijerph182010834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 10/13/2021] [Indexed: 11/17/2022]
Abstract
Food insecurity and limited healthy food access are complex public health issues and warrant multi-level evaluations. The purpose of this paper was to present the overall study design and baseline results of the multi-pronged evaluation of a healthy food access (i.e., Fresh for Less (FFL)) initiative in Central Texas. The 2018-2021 FRESH-Austin study was a natural experiment that utilized a cluster random sampling strategy to recruit three groups of participants (total n = 400): (1) customers at FFL assets, (2) residents that lived within 1.5 miles of an FFL asset, and (3) residents from a comparison community. Evaluation measures included annual cohort surveys, accelerometers and GPS devices, store-level audits, and built environment assessments. Data are being used to inform and validate an agent-based model (ABM) to predict food shopping and consumption behaviors. Sociodemographic factors and food shopping and consumption behaviors were similar across the three groups; however, customers recruited at FFL assets were lower income and had a higher prevalence of food insecurity. The baseline findings demonstrate the need for multi-level food access interventions, such as FFL, in low-income communities. In the future, ABM can be used as a cost-effective way to determine potential impacts of future large-scale food environment programs and policies.
Collapse
Affiliation(s)
- Kathryn M. Janda
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Nalini Ranjit
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA;
| | - Aida Nielsen
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Nika Akhavan
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Martha Diaz
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Pablo Lemoine
- Centro Nacional de Consultoría, Bogotá 110221, Colombia;
| | | | - Alexandra van den Berg
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (N.A.); (M.D.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| |
Collapse
|
7
|
Janda KM, Salvo Dominguez D, Ranjit N, Hoelscher DM, Price A, van den Berg A. 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. J Community Health 2021; 46:86-97. [PMID: 32447543 PMCID: PMC10009650 DOI: 10.1007/s10900-020-00847-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
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.
Collapse
Affiliation(s)
- Kathryn M Janda
- UTHealth School of Public Health in Austin, Austin, TX, USA.
| | - Deborah Salvo Dominguez
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, USA
| | - Nalini Ranjit
- UTHealth School of Public Health in Austin, Austin, TX, USA.,Michael & Susan Dell Center for Healthy Living, Austin, USA
| | - Deanna M Hoelscher
- UTHealth School of Public Health in Austin, Austin, TX, USA.,Michael & Susan Dell Center for Healthy Living, Austin, USA
| | - Amy Price
- United Way for Greater Austin, Austin, USA
| | - Alexandra van den Berg
- UTHealth School of Public Health in Austin, Austin, TX, USA.,Michael & Susan Dell Center for Healthy Living, Austin, USA
| |
Collapse
|
8
|
Huang Y, Tovar A, Taylor J, Vadiveloo M. Staple Food Item Availability among Small Retailers in Providence, RI. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1052. [PMID: 30909551 PMCID: PMC6466143 DOI: 10.3390/ijerph16061052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 11/17/2022]
Abstract
Inventory requirements for authorized Supplemental Nutrition Assistance Program (SNAP) retailers have undergone several revisions to increase the availability of healthful foods. A proposed rule of 84 staple food items was not implemented due to concerns that stores would not withstand this expansion, resulting in a final rule requiring 36 items. This study used the Food Access Research Atlas data to characterize food provisions in 30 small retailers in areas with high and low proportions of SNAP and racial minority residents in Providence, Rhode Island (RI). Stores were assessed with an audit instrument to tally variety, perishability, and depth of stock of four staple food categories. Descriptive, analysis of variance, and chi-square analyses were performed. Across stores, 80% were compliant with the final rule, but 66.7% would need to expand their offerings to meet the proposed rule. Mean dairy variety was lowest among all categories (p < 0.05). Most stores met the perishability (92.3%) and depth-of-stock requirements (96.1%) under both rules. No difference was detected between areas with high and low proportions of SNAP and racial minority residents. Future expansion of requirements may increase healthful food availability without imposing undue burdens on retailers in Providence, RI, excluding increased requirements for dairy variety.
Collapse
Affiliation(s)
- Yuyao Huang
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| | - John Taylor
- Department of Plant Sciences and Entomology, University of Rhode Island, Kingston, RI 02881, USA.
| | - Maya Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| |
Collapse
|
9
|
Abstract
Several community level measures of healthy food access exist, but evaluation efforts have been limited leaving uncertainty about how to prioritize communities for intervention. This study aimed to assess several existing measures to inform statewide public health planning efforts in New Jersey, USA. We assessed agreement between community measures of healthy food access and then evaluated the predictive validity of each measure by describing its association with complete fruit and vegetable cash-value voucher redemption (proportion redeemed ≥70, ≥80, ≥90%) among 30,078 low-income households participating in the New Jersey Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during 2013-2014. The United States Department of Agriculture's (USDA) food desert measure agreed with the Centers for Disease Control and Prevention's (CDC) no healthier food retailers (NHFR) measure for 76.5% of New Jersey census tracts, but the Kappa statistic was only 0.10. For urban households, the NHFR measure was negatively associated with complete redemption after adjusting for demographic factors and Supplemental Nutrition Assistance Program participation (≥70% odds ratio (OR) 0.68, 95% confidence interval (CI) 0.61-0.75; ≥80% OR 0.67, 95% CI 0.62-0.73; ≥90% OR 0.72, 95% CI 0.66-0.77). For rural households, a negative association was observed for the USDA's low-income/low-vehicle access measure (≥70% OR 0.48, 95% CI 0.26-0.90). The CDC's NHFR measure is more appropriate for prioritizing urban areas while the USDA's low-income/low-vehicle access measure may be better for rural areas.
Collapse
|
10
|
Doogan NJ, Roberts ME, Wewers ME, Tanenbaum ER, Mumford EA, Stillman FA. Validation of a new continuous geographic isolation scale: A tool for rural health disparities research. Soc Sci Med 2018; 215:123-132. [PMID: 30227352 DOI: 10.1016/j.socscimed.2018.09.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/26/2018] [Accepted: 09/06/2018] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to develop and test a new continuous measure for rural health disparities research that characterizes geographic areas according to a perspective of access to resources. We call the measure Isolation and anticipate it will be useful as an alternative to commonly used rural classification schemes (e.g., the Census Bureau's measure). Following the best known standards for measuring rurality, it captures the trade-off between access to resource-rich, high-population-density areas and the cost of travel to those areas; thus even intrinsically low-resource areas may have high access to nearby resources. Validity was tested with proxies such as distance to hospitals, physician availability, and access to high quality food. The Isolation scale demonstrated good construct validity (i.e., both convergent and criterion validity). Fit statistics indicated that, compared to other commonly-used urban/rural definitions, the Isolation scale was the best overall measure when predicting several proxies for rurality, even when categorized. We also show that the measure does a substantially better job at explaining national health outcome data at the state level. This new continuous Isolation scale shows considerable promise for improving our conceptualization, theorization, and measurement of the features of rurality that are pertinent to rural health disparities research, and can also be useful to policy makers who may find value in using isolation thresholds that are most relevant to their policy planning needs.
Collapse
Affiliation(s)
- Nathan J Doogan
- College of Public Health, The Ohio State University, Columbus, OH, USA.
| | - Megan E Roberts
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Mary Ellen Wewers
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | | | | | | |
Collapse
|
11
|
Sohi I, Bell BA, Liu J, Battersby SE, Liese AD. Differences in food environment perceptions and spatial attributes of food shopping between residents of low and high food access areas. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:241-249. [PMID: 24560861 PMCID: PMC4205937 DOI: 10.1016/j.jneb.2013.12.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 12/18/2013] [Accepted: 12/22/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To explore potential differences in food shopping behaviors and healthy food availability perceptions between residents living in areas with low and high food access. DESIGN A cross-sectional telephone survey to assess food shopping behaviors and perceptions. Data from an 8-county food environment field census used to define the Centers for Disease Control and Prevention (CDC) healthier food retail tract and US Department of Agriculture Economic Research Service food desert measure. PARTICIPANTS A total of 968 residents in 8 South Carolina counties. MAIN OUTCOME MEASURES Residents' food shopping behaviors and healthy food availability perceptions. ANALYSIS Linear and logistic regression. RESULTS Compared with residents in high food access areas, residents in low food access areas traveled farther to their primary food store (US Department of Agriculture Economic Research Service: 8.8 vs 7.1 miles, P = .03; CDC: 9.2 vs 6.1 miles, P < .001), accumulated more total shopping miles per week (CDC: 28.0 vs 15.4 miles; P < .001), and showed differences in perceived healthy food availability (P < .001) and shopping access (P < .001). CONCLUSIONS AND IMPLICATIONS These findings lend support to ongoing community and policy interventions aimed at reducing food access disparities.
Collapse
Affiliation(s)
- Inderbir Sohi
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Bethany A Bell
- College of Education, University of South Carolina, Columbia, SC
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, SC.
| |
Collapse
|