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Yankey O, Lee J, Gardenhire R, Borawski E. Neighborhood Racial Segregation Predict the Spatial Distribution of Supermarkets and Grocery Stores Better than Socioeconomic Factors in Cleveland, Ohio: a Bayesian Spatial Approach. J Racial Ethn Health Disparities 2024; 11:2009-2021. [PMID: 37368191 PMCID: PMC11236921 DOI: 10.1007/s40615-023-01669-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION The food environment influences the availability and affordability of food options for consumers in a given neighborhood. However, disparities in access to healthy food options exist, affecting Black and low-income communities disproportionately. This study investigated whether racial segregation predicted the spatial distribution of supermarkets and grocery stores better than socioeconomic factors or vice versa in Cleveland, Ohio. METHOD The outcome measure was the count of supermarket and grocery stores in each census tract in Cleveland. They were combined with US census bureau data as covariates. We fitted four Bayesian spatial models. The first model was a baseline model with no covariates. The second model accounted for racial segregation alone. The third model looked at only socioeconomic factors, and the final model combined both racial and socioeconomic factors. RESULTS Overall model performance was better in the model that considered only racial segregation as a predictor of supermarkets and grocery stores (DIC = 476.29). There was 13% decrease in the number of stores for a census tract with a higher majority of Black people compared to areas with a lower number of Black people. Model 3 that considered only socioeconomic factors was less predictive of the retail outlets (DIC = 484.80). CONCLUSIONS These findings lead to the conclusion that structural racism evidenced in policies like residential segregation has a significant influence on the spatial distribution of food retail in the city of Cleveland.
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Affiliation(s)
- Ortis Yankey
- WorldPop Research Group, School of Geography and Environmental Science, University Road, University of Southampton, Southampton, SO17 1BJ, UK.
| | - Jay Lee
- Department of Geography, Kent State University, 413 McGilvrey Hall, 325 S. Lincoln Street, Kent, OH, 44240, USA
| | - Rachel Gardenhire
- Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, 11000 Cedar Ave, Cleveland, OH, 44106, USA
| | - Elaine Borawski
- Department of Population & Quantitative Health Sciences and Nutrition, Case Western Reserve University, 2103 Cornell Road, Cleveland, OH, 44106, USA
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Choi SJ, Jiao J. Developing a transit desert interactive dashboard: Supervised modeling for forecasting transit deserts. PLoS One 2024; 19:e0306782. [PMID: 39046926 PMCID: PMC11268652 DOI: 10.1371/journal.pone.0306782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/20/2024] [Indexed: 07/27/2024] Open
Abstract
Transit deserts refer to regions with a gap in transit services, with the demand for transit exceeding the supply. This study goes beyond merely identifying transit deserts to suggest actionable solutions. Using a multi-class supervised machine learning framework, we analyzed factors leading to transit deserts, distinguishing demand by gender. Our focus was on peak-time periods. After assessing the Support Vector Machine, Decision Tree, Random Forest, and K-nearest Neighbor, we settled on the Random Forest method, supported by Diverse Counterfactual Explanation and SHapley Additive Explanation in our analysis. The ranking of feature importance in the trained Random Forest model revealed that factors such as density, design, distance to transit, diversity in the built environment, and sociodemographic characteristics significantly contribute to the classification of transit deserts. Diverse Counterfactual Explanation suggested that a reduction in population density and an increase in the proportion of green open spaces would likely facilitate the transformation of transit deserts into transit oases. SHapley Additive Explanation highlighted the differential impact of various features on each identified transit desert. Our analysis results indicate that identifying transit deserts can vary depending on whether the data is aggregated or separated by demographics. We found areas that have unique transit needs based on gender. The disparity in transit services was particularly pronounced for women. Our model pinpointed the core elements that define a transit desert. Broadly, to address transit deserts, strategies should prioritize the needs of disadvantaged groups and enhance the design and accessibility of transit in the built environment. Our research extends existing analyses of transit deserts by leveraging machine learning to develop a predictive model. We developed a machine learning-powered interactive dashboard. Integrating participatory planning approaches with the development of an interactive interface could enhance ongoing community engagement. Planning practices can evolve with AI in the loop.
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Affiliation(s)
- Seung Jun Choi
- Urban Information Lab, The School of Architecture, The University of Texas at Austin, Austin, TX, United States of America
| | - Junfeng Jiao
- Urban Information Lab, The School of Architecture, The University of Texas at Austin, Austin, TX, United States of America
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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] [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.
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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
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Lima da Silva JM, Oliveira JS, Casagrande Borges D, Honório OS, Mendes LL, Canuto R. Social inequities in food deserts and food swamps in a northeastern Brazilian capital. J Biosoc Sci 2024; 56:493-503. [PMID: 38415307 DOI: 10.1017/s0021932024000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
This study identified food deserts and swamps, investigating their associations with socioeconomic and demographic conditions. This ecological study was conducted using data from urban census tracts in the city of Recife, which were considered the unit of analysis. Information on food retail was obtained from government sources in 2019. Census tracts below the 25th percentile in the density of healthy food retail (i.e., those that predominantly sell natural or minimally processed foods, mixed businesses, and super- and hypermarkets) were classified as food deserts. Census tracts above the 25th percentile in the density of unhealthy food retail (i.e., those selling primarily ultra-processed foods) were considered food swamps. The socioeconomic and demographic conditions of the census tracts were evaluated using variables from the 2010 census (per capita income, average income, race, literacy of the head of household, and the availability of essential services) and the Health Vulnerability Index. Census tracts considered food deserts (28.5%) were more vulnerable, characterized by lower income and access to essential services, more illiterate residents and more minorities (Black/Indigenous/mixed race). Food swamps (73.47%) were more prevalent in less vulnerable neighbourhoods characterized by higher percentages of literate residents and Whites, greater purchasing power, and better basic sanitation. The characteristics of Recife's food deserts and swamps demonstrate social inequalities in the food environment. Public facilities could play a vital role in promoting healthy eating within food deserts. Additionally, future implementation of taxes on ultra-processed foods and the provision of tax subsidies to natural or minimally processed food sellers might contribute to fostering healthier dietary choices.
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Affiliation(s)
| | | | | | | | | | - Raquel Canuto
- Program in Nutrition, Universidade Federal de Pernambuco, Brazil
- Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul, Brazil
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Sadler RC, Saxe-Custack A. 'Nobody Shops at the Neighborhood Store': Leveraging a Community's Pediatric Fresh Produce Prescription Program to Inform Future Participating Store Redemption Locations. CITIES & HEALTH 2023; 8:70-81. [PMID: 38585045 PMCID: PMC10997326 DOI: 10.1080/23748834.2023.2281764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/06/2023] [Indexed: 04/09/2024]
Abstract
Research examining the nature of food shopping often considers proximity to the nearest or overall distance travelled to multiple stores. Such studies make up a portion of new work on so-called 'food deserts' and the issues inherent in the term, including that most people do not shop at their nearest store, and mobility challenges vary vastly from one person to the next. Increasing the knowledge base on shopping characteristics could be useful for behavioral interventions and programs aimed at increasing healthy food shopping. In this study, we examined the shopping characteristics of 627 caregivers whose children were enrolled in a pediatric fresh produce prescription program at one of three large pediatric clinics in Flint, Michigan. We compared these characteristics to the potential of a new food cooperative to improve geographic accessibility to healthy food. In particular, we propose the expansion of the prescription program to this new cooperative for health-related as well as local economic development reasons. Our work bridges topics of interest to researchers and practitioners working in nutrition, food access, and economic development.
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Affiliation(s)
- Richard C. Sadler
- Departments of Public Health and Family Medicine, Michigan State University, Flint, MI, USA
| | - Amy Saxe-Custack
- Departments of Public Health and Food Science & Human Nutrition, Michigan State University, Flint, MI, USA
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Lim J, Cornwell B. Social network-structural position and obesity: Evidence from a national study. Soc Sci Med 2023; 329:116006. [PMID: 37302274 DOI: 10.1016/j.socscimed.2023.116006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/13/2023]
Abstract
This study expands on research on the social-structural bases of obesity by examining the role played by individuals' positions within their egocentric social networks in shaping body mass index. We argue that individuals' tendency to be a bridge between otherwise unconnected people can affect body mass index. Furthermore, health-specific resources flowing through their networks might interact with this network-structural position to shape this association. Using multivariate analyses of recent nationally representative data on older Americans, we find that occupying a bridging position within a network is negatively related to the likelihood of being obese. Moreover, people who have this bridging potential tend to benefit more from health-related knowledge in their networks than those who do not have it. Our findings underscore the importance of considering social network position and the functional specificity of ties in understanding the structural bases of health problems like obesity. We close by discussing implications of these findings for future work on obesity including potential insights into important health disparities.
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Affiliation(s)
- Jaeun Lim
- Department of Sociology, Cornell University, Ithaca, NY, 14853, USA.
| | - Benjamin Cornwell
- Department of Sociology, Cornell University, Ithaca, NY, 14853, USA.
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Larsen K, Rydz E, Peters CE. Inequalities in Environmental Cancer Risk and Carcinogen Exposures: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095718. [PMID: 37174236 PMCID: PMC10178444 DOI: 10.3390/ijerph20095718] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
Background: Cancer is the leading cause of death in Canada and a major cause of death worldwide. Environmental exposure to carcinogens and environments that may relate to health behaviors are important to examine as they can be modified to lower cancer risks. Built environments include aspects such as transit infrastructure, greenspace, food and tobacco environments, or land use, which may impact how people move, exercise, eat, and live. While environments may play a role in overall cancer risk, exposure to carcinogens or healthier environments is not equitably spread across space. Exposures to carcinogens commonly concentrate among socially and/or economically disadvantaged populations. While many studies have examined inequalities in exposure or cancer risk, this has commonly been for one exposure. Methods: This scoping review collected and synthesized research that examines inequities in carcinogenic environments and exposures. Results: This scoping review found that neighborhoods with higher proportions of low-income residents, racialized people, or same-sex couples had higher exposures to carcinogens and environments that may influence cancer risk. There are currently four main themes in research studying inequitable exposures: air pollution and hazardous substances, tobacco access, food access, and other aspects of the built environment, with most research still focusing on air pollution. Conclusions: More work is needed to understand how exposures to these four areas intersect with other factors to reduce inequities in exposures to support longer-term goals toward cancer prevention.
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Affiliation(s)
- Kristian Larsen
- Health Canada, Office of Environmental Health, Healthy Environments and Consumer Safety Branch, Environmental and Radiation Health Science Directorate, Ottawa, ON K1A 0K9, Canada
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Department of Geography and Planning, University of Toronto, Toronto, ON M5S 3G3, Canada
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Ela Rydz
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Cheryl E Peters
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Prevention, Screening and Hereditary Cancer, BC Cancer, Vancouver, BC V5Z 4E6, Canada
- Population and Public Health, British Columbia Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada
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8
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Agyei K, Weaver DF. Malnourishment masquerading as dementia: Inadequate social support associated with cognitive impairment. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2023; 69:103-105. [PMID: 36813510 PMCID: PMC9945890 DOI: 10.46747/cfp.6902103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Kwame Agyei
- Second-year medical student at the University of Toronto in Ontario
| | - Donald F Weaver
- Neurologist at the University Health Network and Director of the Krembil Research Institute in Toronto.
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Victor A, Silva RDCR, Silva NDJ, Ferreira A, Barreto ML, Campello T. Influence of Unhealthy Food Environment on Premature Cardiovascular Disease Mortality in Brazil: An Ecologic Approach. Am J Prev Med 2023; 64:285-292. [PMID: 36437143 DOI: 10.1016/j.amepre.2022.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/20/2022] [Accepted: 09/07/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Cardiovascular disease is the main cause of general and premature death of adults aged 30-69 years in Brazil and around the world. Unhealthy food environments have been implicated as one of the factors associated with cardiovascular disease morbimortality because they affect people's health conditions and nutrition. This study aims to explore the association between unhealthy food environments (deserts/swamps) and premature cardiovascular disease mortality in the Brazilian population. METHODS This is an ecologic study using data from 5,558 Brazilian municipalities in 2016. The cardiovascular disease mortality data were obtained from the Mortality Information System of the Ministry of Health. The study on mapping food deserts in Brazil, developed by the Interministerial Chamber of Food and Nutrition Security, was used to evaluate the physical dimension of food access. The authors calculated the standardized rates of premature general and specific cardiovascular disease (stroke and ischemic heart disease) causes of death in the same period. To characterize food environments, the density of unprocessed and ultraprocessed foods per 10,000 population in tertiles was used. Crude and adjusted negative binomial regression models were used to study the associations of interest. RESULTS After the necessary adjustments (human development index, gross domestic product per capita, unemployment rate, Gini index and Family Health Strategy coverage), it was found that municipalities with low unprocessed food supply were at the highest risk of increased mortality among women with ischemic heart disease (rate ratio first tertile: 1.08 [95% CI=1.01, 1.15]). Conversely, the municipalities where there was a greater offer of ultraprocessed foods showed a higher risk of death from cardiovascular diseases (rate ratio second tertile: 1.17 [95% CI=1.12, 1.22]; rate ratio third tertile: 1.20 [95% CI=1.14, 1.26]), from strokes (rate ratio second tertile: 1.19 [95% CI=1.13, 1.25]; rate ratio third tertile: 1.22 [95% CI=1.15, 1.30]), and ischemic heart disease (rate ratio second tertile: 1.19 [95% CI=1.12, 1.25]; rate ratio third tertile: 1.22 [95% CI=1.13, 1.29]). CONCLUSIONS This study's findings show an increase in the risk of cardiovascular disease, stroke, and ischemic heart disease mortality, especially in the municipalities where there was a greater offer of ultraprocessed foods. Initiatives aiming to minimize the effects of these food environments are urgently needed in the Brazilian context.
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Affiliation(s)
- Audêncio Victor
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil; School of Public Health, University of São Paulo, São Paulo, Brazil; Department of Nutrition, Ministry of Health of Mozambique, Zambezia, Mozambique.
| | - Rita de Cássia Ribeiro Silva
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil; School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | | | - Andrêa Ferreira
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil; The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Maurício L Barreto
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil; Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Tereza Campello
- School of Public Health, University of São Paulo, São Paulo, Brazil; Fiocruz School of Government, Oswaldo Cruz Foundation, Brasília, Brazil; University of Nottingham, Nottingham, United Kingdom
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Doyle TA, Conboy E, Halverson CME. Diagnostic deserts: Community-level barriers to appropriate genetics services. Am J Med Genet A 2023; 191:296-298. [PMID: 36282041 DOI: 10.1002/ajmg.a.63016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/08/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Tom A Doyle
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Erin Conboy
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Colin M E Halverson
- Indiana University School of Medicine, Indianapolis, Indiana, USA.,Charles Warren Fairbanks Center for Medical Ethics, Indianapolis, Indiana, USA
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Smith DM, Rixson L, Grove G, Ziauddeen N, Vassilev I, Taheem R, Roderick P, Alwan NA. Household food insecurity risk indices for English neighbourhoods: Measures to support local policy decisions. PLoS One 2022; 17:e0267260. [PMID: 36490256 PMCID: PMC9733884 DOI: 10.1371/journal.pone.0267260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In England, the responsibility to address food insecurity lies with local government, yet the prevalence of this social inequality is unknown in small subnational areas. In 2018 an index of small-area household food insecurity risk was developed and utilised by public and third sector organisations to target interventions; this measure needed updating to better support decisions in different settings, such as urban and rural areas where pressures on food security differ. METHODS We held interviews with stakeholders (n = 14) and completed a scoping review to identify appropriate variables to create an updated risk measure. We then sourced a range of open access secondary data to develop an indices of food insecurity risk in English neighbourhoods. Following a process of data transformation and normalisation, we tested combinations of variables and identified the most appropriate data to reflect household food insecurity risk in urban and rural areas. RESULTS Eight variables, reflecting both household circumstances and local service availability, were separated into two domains with equal weighting for a new index, the Complex Index, and a subset of these to make up the Simple Index. Within the Complex Index, the Compositional Domain includes population characteristics while the Structural Domain reflects small area access to resources such as grocery stores. The Compositional Domain correlated well with free school meal eligibility (rs = 0.705) and prevalence of childhood obesity (rs = 0.641). This domain was the preferred measure for use in most areas when shared with stakeholders, and when assessed alongside other configurations of the variables. Areas of highest risk were most often located in the North of England. CONCLUSION We recommend the use of the Compositional Domain for all areas, with inclusion of the Structural Domain in rural areas where locational disadvantage makes it more difficult to access resources. These measures can aid local policy makers and planners when allocating resources and interventions to support households who may experience food insecurity.
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Affiliation(s)
- Dianna M. Smith
- School of Geography and Environmental Science, University of Southampton, Southampton, United Kingdom
- NIHR Applied Research Collaboration Wessex, Southampton, United Kingdom
| | - Lauren Rixson
- School of Geography and Environmental Science, University of Southampton, Southampton, United Kingdom
| | - Grace Grove
- NIHR Applied Research Collaboration Wessex, Southampton, United Kingdom
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Nida Ziauddeen
- NIHR Applied Research Collaboration Wessex, Southampton, United Kingdom
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ivaylo Vassilev
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Ravita Taheem
- Southampton City Council, Southampton, United Kingdom
| | - Paul Roderick
- NIHR Applied Research Collaboration Wessex, Southampton, United Kingdom
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Nisreen A. Alwan
- NIHR Applied Research Collaboration Wessex, Southampton, United Kingdom
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
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Characterizing equitable access to grocery stores during disasters using location-based data. Sci Rep 2022; 12:20203. [PMID: 36424444 PMCID: PMC9691732 DOI: 10.1038/s41598-022-23532-y] [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: 04/27/2022] [Accepted: 10/31/2022] [Indexed: 11/26/2022] Open
Abstract
Natural hazards cause disruptions in access to critical facilities, such as grocery stores, impeding residents' ability to prepare for and cope with hardships during the disaster and recovery; however, disrupted access to critical facilities is not equal for all residents of a community. In this study, we examine disparate access to grocery stores in the context of the 2017 Hurricane Harvey in Harris County, Texas. We utilized high-resolution location-based datasets in implementing spatial network analysis and dynamic clustering techniques to uncover the overall disparate access to grocery stores for socially vulnerable populations during different phases of the disaster. Three access indicators are examined using network-centric measures: number of unique stores visited, average trip time to stores, and average distance to stores. These access indicators help us capture three dimensions of access: redundancy, rapidity, and proximity. The findings show the insufficiency of focusing merely on the distributional factors, such as location in a food desert and number of facilities, to capture the disparities in access, especially during the preparation and impact/short-term recovery periods. Furthermore, the characterization of access by considering combinations of access indicators reveals that flooding disproportionally affects socially vulnerable populations. High-income areas have better access during the preparation period as they are able to visit a greater number of stores and commute farther distances to obtain supplies. The conclusions of this study have important implications for urban development (facility distribution), emergency management, and resource allocation by identifying areas most vulnerable to disproportionate access impacts using more equity-focused and data-driven approaches.
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Morton ME, Gibson-Young L, Sandage MJ. Framing Disparities in Access to Medical Speech-Language Pathology Care in Rural Alabama. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2847-2860. [PMID: 36327492 DOI: 10.1044/2022_ajslp-22-00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Rural-living residents of Alabama depend on rural hospitals and clinics staffed with physicians and allied health professionals including speech-language pathologists (SLPs). The purpose of the exploratory study was to examine the speech-language pathology workforce in health care facilities in nonmetropolitan Alabama counties to determine potential disparities in access and identify medical SLP deserts for rural Alabamians. METHOD The hospitals, rural health clinics, nursing homes, and rehabilitation centers for each of the 37 nonmetropolitan counties were identified through the 2020 Alabama Department of Public Health directories, and phone surveys were completed to determine medical SLP staffing at each facility. Descriptive statistics and regression analysis were conducted. RESULTS The initial review yielded 229 rural health care facilities with 223 ultimately included in the analysis and 176 facilities completing a phone inquiry (76.68%). Sixty-one (35.88%) reported employing at least one SLP and no facility stated staffing SLP assistants. Linear regression indicated a positive, yet moderate effect size between the reported number of SLPs staffed within each county and specific population of the county (r 2 = .519). Anecdotally, facilities reported difficulty in hiring and retaining SLPs due to rural geographical location. CONCLUSIONS The exploratory findings suggest disparities in access to behavioral communication and swallowing care for rural residents in the state. The methodology employed for data collection and analysis may be applied to other states and U.S. territories, in an effort to frame the issue nationally and support rural health care policy across the United States. Further investigation regarding the cost effectiveness of telepractice, the availability of broadband Internet access, the efficacy of community-based service delivery, and the effectiveness of incentivized rural SLP graduate programs is warranted to mitigate the disparities in access.
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Affiliation(s)
| | | | - Mary J Sandage
- Department of Speech, Language, and Hearing Sciences, Auburn University, AL
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Stowell F, Kramarova P. 'Virtual' Action Research: Two examples. SYSTEMIC PRACTICE AND ACTION RESEARCH 2022:1-20. [PMID: 36407879 PMCID: PMC9645311 DOI: 10.1007/s11213-022-09620-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 11/11/2022]
Abstract
Action research is the predominant approach for organisational inquiry, but it comes in many guises and in some cases ends up as all action and no research. A common feature of all action research is the necessity to meet stakeholders in person in order to gain an understanding 'from within', this is particularly the case where 'soft' action research is the basis of the inquiry. In this paper first, we reflect, briefly, upon the history of action research and second, upon the lessons leant from the outcomes from two projects. The first project was conducted 'virtually', between a college in the USA and one in the UK and the second undertaken during the disruption caused by the restrictions arising from the Covid-19 pandemic. The experiences gained from these two 'virtual' action research projects and the lessons learnt are of interest to both the 'traditional' and 'soft' action research community.
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Affiliation(s)
- Frank Stowell
- Emeritus Professor Systems and Information Systems, School of Computing, University of Portsmouth, Portsmouth, UK
| | - Pavla Kramarova
- Portsmouth Business School, University of Portsmouth, Portsmouth, UK
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15
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Bhattacharya P, Klein MD, Beck AF, Xu Y, Kharofa RY. Associations Between Age of Onset of Pediatric Overweight/Obesity, a Child’s Sociodemographic Characteristics, and Characteristics of a Child’s Home Census Tract. Am J Health Promot 2022:8901171221138276. [DOI: 10.1177/08901171221138276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose To identify associations between age of onset of overweight/obesity, a child’s sociodemographic characteristics, and characteristics of a child’s home census tract. Design Retrospective electronic health record review of children with overweight/obesity. Setting Three primary care centers associated with a free-standing, tertiary-care pediatric institution in Cincinnati. Subjects Patients born between August 1, 2013 and July 31, 2014, who had a body mass index (BMI) ≥85th percentile before 5 years of age (n = 794). Measures Primary outcome was the patient’s age at the first encounter when BMI was ≥85th percentile. Patient-level predictors were sex, age, race/ethnicity, health insurance, and number of moves captured in the health record. Census tract-level predictors were density of bus stops, presence of grocery stores, and a Socioeconomic Deprivation Index. Analysis Multivariable linear regression models assessed for independent associations between age of onset of overweight/obesity and predictors. Results Patients were 55.8% female, 73.6% black, and 79.1% publicly insured. Each additional move per year was associated with onset of overweight/obesity occurring 4.05 months earlier ( P < .0001). No significant associations between age of onset of overweight/obesity and census tract-level density of bus stops ( P = .82), presence of grocery stores ( P = .39), and socioeconomic deprivation ( P = .53) were demonstrated. Conclusion Public policy efforts toward improving access to grocery stores or public transportation may not be sufficient to prevent childhood obesity. Population-level interventions related to improving housing may also reduce obesity.
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Affiliation(s)
| | - Melissa D. Klein
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andrew F. Beck
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Yingying Xu
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Roohi Y. Kharofa
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Casellas Connors JP, Safayet M, Rosenheim N, Watson M. Assessing changes in food pantry access after extreme events. AGRICULTURE AND HUMAN VALUES 2022; 40:619-634. [PMID: 36340279 PMCID: PMC9616433 DOI: 10.1007/s10460-022-10373-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 06/07/2023]
Abstract
Food pantries play a growing role in supporting households facing or at risk of food insecurity in the United States. They also support emergency response and recovery following disasters and extreme weather events. Although food pantries are often placed in close proximity to communities with the highest rates of poverty and risk of food insecurity, access to these facilities can be disrupted during and after extreme events. Decreased access to food pantries following disasters can be particularly problematic as the need for these services is also likely to grow after such events. Despite the vast body of research on food retail access and food environments, relatively little research has utilized spatial analysis to understand food pantry access, particularly after extreme events. Using Geographic Information Systems (GIS), we characterize changes in access to food pantries following flooding events in Harris County, Texas-a highly populated and flood prone region with high levels of food insecurity and poverty. Specifically, our study models disruptions in road networks due to flooding and assesses the impacts of these disruptions on proximity to food pantries. The results reveal that much of Harris County sees only small increases in travel distance to food pantries due to extreme flooding, but some areas may be unable to access food pantries at all. This research highlights the potential and some of the limits of private food assistance networks to support emergency response efforts.
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Affiliation(s)
- John P. Casellas Connors
- Department of Geography, Texas A&M University, 3147 TAMU, College Station, TX 77843-3147 USA
- Hazards Reduction and Recovery Center, Texas A&M University, 3137 TAMU, College Station, TX 77843-3137 USA
| | - Mastura Safayet
- Department of Geography, Texas A&M University, 3147 TAMU, College Station, TX 77843-3147 USA
| | - Nathanael Rosenheim
- Hazards Reduction and Recovery Center, Texas A&M University, 3137 TAMU, College Station, TX 77843-3137 USA
- Landscape Architecture and Urban Planning, Texas A&M University, 3137 TAMU, College Station, TX 77843-3137 USA
| | - Maria Watson
- Shimberg Center for Housing Studies, M.E. Rinker, Sr. School of Construction Management, University of Florida, P.O. Box 115703, Gainesville, FL 32611-5703 USA
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17
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Colson-Fearon B, Versey HS. Urban Agriculture as a Means to Food Sovereignty? A Case Study of Baltimore City Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12752. [PMID: 36232052 PMCID: PMC9566707 DOI: 10.3390/ijerph191912752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
A large body of research suggests that neighborhood disparities in food access persist. Emerging evidence suggests that the global COVID-19 pandemic likely exacerbated disparities in food access. Given the potential role that alternative food networks (AFNs) and local food sources may play during times of extreme scarcity, this study examines urban agriculture (e.g., community farms and gardens) as a sustainable strategy to address food insecurity. In-depth qualitative interviews with fifteen community stakeholders revealed several major themes including food insecurity as a feature of systemic racism, food affordability and distance to food as major barriers to food security, and the role of AFNs in creating community empowerment. Our findings indicate that urban agricultural practices help build social capital, inform and educate community members about healthy eating behaviors, and facilitate the distribution of affordable food. Implications for future research and policy targeting sustainable food distribution in marginalized communities of color are discussed.
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18
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Mahdi S, Marr C, Buckland NJ, Chilcott J. Methods for the economic evaluation of obesity prevention dietary interventions in children: A systematic review and critical appraisal of the evidence. Obes Rev 2022; 23:e13457. [PMID: 35478373 PMCID: PMC9542346 DOI: 10.1111/obr.13457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We aim to describe and provide a discussion of methods used to conduct economic evaluations of dietary interventions in children and adolescents, including long-term modelling, and to make recommendations to assist health economists in the design and reporting of such evaluations. METHODS A systematic review was conducted in 11 bibliographic databases and the grey literature with searches undertaken between January 2000 and December 2021. A study was included if it (1) was an economic evaluation or modelling study of an obesity-prevention dietary intervention and (2) targeted 2- to 18-year-olds. RESULTS Twenty-six studies met the inclusion criteria. Twelve studies conducted an economic evaluation alongside a clinical trial, and 14 studies modelled long-term health and cost outcomes. Four overarching methodological challenges were identified: modelling long-term impact of interventions, measuring and valuing health outcomes, cost inclusions and equity considerations. CONCLUSIONS Variability in methods used to predict, measure and value long-term benefits in adulthood from short-term clinical outcomes in childhood was evident across studies. Key recommendations to improve the design and analysis of future economic evaluations include the consideration of weight regain and diminishing intervention effects within future projections; exploration of wider intervention benefits not restricted to quality-of-life outcomes; and inclusion of parental or caregiver opportunity costs.
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Affiliation(s)
- Sundus Mahdi
- School of Health and Related Research, University of Sheffield, Regent Court, Sheffield, UK
| | - Colette Marr
- School of Health and Related Research, University of Sheffield, Regent Court, Sheffield, UK
| | - Nicola J Buckland
- Department of Psychology, University of Sheffield, Cathedral Court, Sheffield, UK
| | - Jim Chilcott
- School of Health and Related Research, University of Sheffield, Regent Court, Sheffield, UK
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19
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Food insecurity in Dutch disadvantaged neighbourhoods: a socio-ecological approach. J Nutr Sci 2022; 11:e52. [PMID: 35836698 PMCID: PMC9257769 DOI: 10.1017/jns.2022.48] [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: 01/11/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/06/2022] Open
Abstract
Food insecurity is an important public health concern; however, research into this phenomenon within the Netherlands is limited. Food insecurity is not solely related to individual factors, but can also be influenced by various factors in the social and physical environment. Therefore, this study aimed to identify determinants of food insecurity within the personal, social and physical environment, based on the social ecological model (SEM), and to identify their relative importance for experiencing food insecurity. The study population consisted of 307 participants living in disadvantaged neighbourhoods of the Dutch city The Hague, of which approximately one-quarter were food insecure. Participant characteristics showing bivariate associations P < 0⋅20 were placed in a predetermined level of the SEM, after which a multivariate logistic regression was performed for each level and the Nagelkerke pseudo R 2 was presented. Determinants of food insecurity were BMI, gross monthly income, highest educational attainment, smoking status, diet quality, employment status, marital status and religion (P < 0⋅05). The results showed that 29⋅7 % of the total variance in food insecurity status was explained by all included determinants together. The personal, social and physical environment explained 20⋅6, 14⋅0 and 2⋅4 % of the total variance, respectively. Our findings suggest that determinants within the personal environment are most important for explaining differences in experienced food insecurity. The present study contributes to furthering the knowledge about the relative importance of the personal, social and physical environment, indicating that determinants within the personal environment may be most promising for developing targeted interventions to reduce food insecurity.
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Key Words
- BMI, body mass index
- DHC, Dutch Health Council
- Determinants
- Explained variance
- FFQ, food frequency questionnaire
- FI, food insecure
- FS, food secure
- Food insecurity
- Food security
- IQR, interquartile range
- ISCED, International Standard Classification of Education
- LUMC, Leiden University Medical Center
- MAR, missing at random
- MCS, mental component summary
- MI, multiple imputation
- NNC, Netherlands Nutrition Center
- PCS, physical component summary
- SEM, social ecological model
- SEP, socio-economic position
- SF-12, 12-Item Short Form Health Survey
- SNAP, Supplement Nutrition and Assistance Program
- Social ecological model
- USDA, United States Department of Agriculture
- WMO, ‘Wet medisch-wetenschappelijk onderzoek’, in English: Medical Research Involving Human Subjects Act
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Grilo MF, Menezes CD, Duran AC. Food swamps in Campinas, Brazil. CIENCIA & SAUDE COLETIVA 2022; 27:2717-2728. [PMID: 35730841 DOI: 10.1590/1413-81232022277.17772021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/16/2022] [Indexed: 11/22/2022] Open
Abstract
The characteristics of the food environment can interfere with physical access to healthy foods and accentuate health inequalities. The presence of food swamps, i.e., the greater availability of ultra-processed food and commercial establishments compared to those that sell healthier options, are associated with the consumption of unhealthy foods. This study identified the spatial distribution of these establishments in Campinas, São Paulo. Fast-food restaurants, open-air organic/agroecological food markets and supermarkets were geocoded. Regional administrations (RAs) with greater social vulnerability according to the 2010 Census and with a greater availability of fast-food restaurants in relation to open-air food markets and supermarkets were considered food swamps. The less vulnerable neighborhoods had a higher concentration of all types of commercial food establishments compared to the most vulnerable regions. In Campinas, of eighteen RAs, five were considered food swamps. The findings reinforce the need for actions to improve exposure to healthy foods in more vulnerable neighborhoods.
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Affiliation(s)
- Mariana Fagundes Grilo
- Programa de Pós-Graduação em Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Cidade Universitária. 13083-887 Campinas SP Brasil.
| | | | - Ana Clara Duran
- Programa de Pós-Graduação em Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Cidade Universitária. 13083-887 Campinas SP Brasil. .,Núcleo de Estudos e Pesquisas em Alimentação, Unicamp. Campinas SP Brasil.,Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
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21
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Yamaguchi M, Praditsorn P, Purnamasari SD, Sranacharoenpong K, Arai Y, Sundermeir SM, Gittelsohn J, Hadi H, Nishi N. Measures of Perceived Neighborhood Food Environments and Dietary Habits: A Systematic Review of Methods and Associations. Nutrients 2022; 14:1788. [PMID: 35565756 PMCID: PMC9099956 DOI: 10.3390/nu14091788] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/14/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
Access to healthy food is a necessity for all people. However, there is still a lack of reviews on the assessment of respondent-based measures of neighborhood food environments (perceived food environments). The aim of this systematic review was to evaluate the measurement tools for perceived food environments by five dimensions of food access and to obtain the overview of their associations with dietary habits among people aged 18 years and older in middle- and high-income countries. Observational studies using perceived food environment measures were identified through a systematic review based on two databases for original studies published from 2010 to 2020. A total of 19 final studies were extracted from totally 2926 studies. Pertaining to the five dimensions of food access, 12 studies dealt with accessibility, 13 with availability, 6 with affordability, 10 with acceptability, 2 with accommodation, and 8 with a combination of two or more dimensions. Perceived healthy food environments were positively associated with healthy dietary habits in 17 studies, but 8 of them indicated statistically insignificant associations. In conclusion, this review found accessibility and availability to be major dimensions of perceived food environments. The relationship between healthy food environments and healthy diets is presumably positive and weak.
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Affiliation(s)
- Miwa Yamaguchi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan;
| | - Panrawee Praditsorn
- Institute of Nutrition, Mahidol University, 999 Phuttamonthon 4, Salaya, Phuttamonthon, Nakhon Pathom 73170, Thailand; (P.P.); (K.S.)
| | - Sintha Dewi Purnamasari
- Alma Ata Graduate School of Public Health, University of Alma Ata, Jl. Brawijaya 99, Tamantirto, Yogyakarta 55183, Indonesia; (S.D.P.); (H.H.)
| | - Kitti Sranacharoenpong
- Institute of Nutrition, Mahidol University, 999 Phuttamonthon 4, Salaya, Phuttamonthon, Nakhon Pathom 73170, Thailand; (P.P.); (K.S.)
| | - Yusuke Arai
- Department of Nutrition, Chiba Prefectural University of Health Sciences, 2-10-1 Wakaba, Mihama-ku, Chiba-shi 261-0014, Japan;
| | - Samantha M. Sundermeir
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe St, Baltimore, MD 21205, USA; (S.M.S.); (J.G.)
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe St, Baltimore, MD 21205, USA; (S.M.S.); (J.G.)
| | - Hamam Hadi
- Alma Ata Graduate School of Public Health, University of Alma Ata, Jl. Brawijaya 99, Tamantirto, Yogyakarta 55183, Indonesia; (S.D.P.); (H.H.)
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan;
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22
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Titis E, Procter R, Walasek L. Assessing physical access to healthy food across United Kingdom: A systematic review of measures and findings. Obes Sci Pract 2022; 8:233-246. [PMID: 35388348 PMCID: PMC8976549 DOI: 10.1002/osp4.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 11/09/2022] Open
Abstract
Background Existing research suggests that physical access to food can affect diet quality and thus obesity rates. When defining retail food environment (RFE) quantitatively, there is a little agreement on how to measure "lack of healthy food" and what parameters to use, resulting in a heterogeneity of study designs and outcome measures. In turn, this leads to a conflicting evidence base being one of the many barriers to using evidence in policy-making. Aims This systematic review aimed to identify and describe methods used to assess food accessibility in the United Kingdom (UK) to overcome heterogeneity by providing a classification of measures. Materials & Methods The literature search included electronic and manual searches of peer-reviewed literature and was restricted to studies published in English between January 2010 and March 2021. A total of 9365 articles were assessed for eligibility, of which 44 articles were included in the review. All included studies were analysed with regards to their main characteristics (e.g., associations between variables of interest, setting, sample, design, etc.) and definition of RFE and its metrics. When defining these metrics, the present review distinguishes between a point of origin (centroid, address) from which distance was calculated, summary statistic of accessibility (proximity, buffer, Kernel), and definition of distance (Euclidean, network distance). Trends, gaps and limitations are identified and recommendations made for food accessibility research in UK. Results Multiple theoretical and methodological constructs are currently used, mostly quantifying distance by means of Euclidean and ring-buffer distance, using both proximity- and density-based approaches, and ranging from absolute to relative measures. The association between RFE and diet and health in rural areas, as well as a spatiotemporal domain of food access, remains largely unaccounted. Discussion Evidence suggests that the duration of exposure may bear a greater importance than the level of exposure and that density-based measures may better capture RFE when compared with proximity-based measures, however, using more complex measures not necessarily produce better results. To move the field forward, studies have called for a greater focus on causality, individual access and the use of various measures, neighbourhood definitions and potential confounders to capture different aspects and dimensions of the RFE, which requires using univariate measures of accessibility and considering the overall context in terms of varying types of neighbourhoods. Conclusion In order to render ongoing heterogeneity in measuring RFE, researchers should prioritise measures that may provide a more accurate and realistic account of people's lives and follow an intuitive approach based on convergence of results until consensus could be reached on using some useful standards.
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Affiliation(s)
- Elzbieta Titis
- Department of Computer ScienceWarwick Institute for the Science of CitiesUniversity of WarwickCoventryUK
| | - Rob Procter
- Department of Computer ScienceUniversity of WarwickCoventryUK
- Alan Turing InstituteLondonUK
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An Analysis of Food Accessibility of Mountain Cities in China: A Case Study of Chongqing. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mountain cities are characterized by undulating terrain, complex road networks, and diverse road facilities, which makes accessing food more difficult than in cities with a flat terrain. This study proposes an enhanced two-step method based on the Baidu map service for the construction of supermarket–market–retail food sales architecture and for calculating food accessibility. The accessibility indices of seven major food categories (grains and oils, fruits, vegetables, seafood, meat, milk, and eggs) were calculated considering the principle of the fairest walking routes in Chongqing. The correlations between food accessibility and house price and house age in Chongqing were explored through local Moran’s analysis and geographically weighted regression. The correlations illustrated the fairness of the distribution of food accessibility in Chongqing among the poor and rich. The experiments showed generally well-developed food accessibility in the main urban areas of Chongqing. However, accessibility to fresh fruits and vegetables lagged in newly built urban areas.
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Wei Y, Shannon J, Lee JS. Impact of Grocery Store Proximity on Store Preference Among Atlanta SNAP-Ed Participants. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:263-268. [PMID: 35277223 DOI: 10.1016/j.jneb.2021.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/29/2020] [Accepted: 01/03/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To assess the association between grocery store proximities and the individual's grocery store preferences among Supplemental Nutrition Assistance Program Education participants in Atlanta. METHODS University of Georgia Supplemental Nutrition Assistance Program Education participants (n = 615, response rate is 36%) in 3 counties provided their preferred grocery store chains. The association between store proximity (both network distance and driving time) and store preference was measured through logistic regression controlling for age, sex, and race. RESULTS Descriptive statistics showed participants had widely varying proximities to grocery stores. Model results were significant for all smaller chains (Aldi, Big Bear, Wayfield, Food Depot, and Save-A-Lot), Kroger (P < 0.01), as well as for Walmart (time only, P = 0.002). CONCLUSIONS AND IMPLICATIONS Future studies might identify whether local groceries are more willing to partner on interventions or are more effective at reaching local residents. Surveys or techniques such as sketch mapping could also show whether individuals shop in neighborhoods close to work or friends and family.
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Affiliation(s)
- Yangjiaxin Wei
- Department of Geography, Franklin College of Arts and Sciences, University of Georgia, Athens, GA.
| | - Jerry Shannon
- Department of Geography, Franklin College of Arts and Sciences, University of Georgia, Athens, GA; Department of Financial Planning, Housing, and Consumer Economics, College of Family and Consumer Sciences, University of Georgia, Athens, GA
| | - Jung Sun Lee
- Department of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia, Athens, GA
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Mathlouthi A, Zarrintan S, Khan MA, Malas M, Barleben A. Contemporary Outcomes of Limb-Salvage Procedures Using Vascular Quality Initiative-Medicare Linked Data: Racial and Ethnic Disparities Persist. J Vasc Surg 2022; 75:2013-2018. [PMID: 35149160 DOI: 10.1016/j.jvs.2022.01.120] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 01/21/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Several reports have shown that ethnic and racial minorities with chronic limb-threatening ischemia (CLTI) are more likely to undergo major amputation. Whether this disparity is driven by limited access to care, statistical discrimination or biological factors remains a matter of debate. We sought to study the effect of race/ethnicity on short and long-term outcomes of limb-salvage procedures among patients with new onset CLTI. METHODS We identified all patients who underwent first time (open or endovascular) revascularization for CLTI between January 2010 and December 2016 in the Vascular Quality Initiative-Medicare linked database. These patients were divided into non-Hispanic whites (NHW) and racial/ethnic minority (REM) groups. Early end points included length of stay and operative mortality, while 2-year outcomes included major amputation, freedom from subsequent revascularization, number of limb salvage reinterventions and all-cause mortality. A sub-analysis comparing NHWs to Hispanics and NHWs to blacks was also performed. RESULTS Of 16,249 presenting with CLTI, 73.9% were non-Hispanic whites. Racial/ethnic minority patients were younger (mean age, 69.9 ± 11.3 years vs 74.2 ± 10.5 years; P < .001) and more likely to be female (45.9% vs 37.7%; P < .001). Other baseline differences included a higher rate of smoking history, coronary artery disease, chronic obstructive pulmonary disease and chronic kidney disease among non-Hispanic whites, whereas racial/ethnic minority patients were more likely to have diabetes and hypertension and more likely to present with tissue loss (78% vs 76.6%; P =.04). Preoperative ankle-brachial index and procedure type (endovascular vs open) were similar between the groups. On multivariable analysis, NHW's had a 13% increase in length of stay and a 25% decrease in operative mortality. In regard to 2-year outcomes, limb salvage estimates were 86% for the NHW group versus 77.1% for the REM group; P < .001. Comparison between the two groups showed similar rates of freedom from subsequent revascularization (67.9% vs 67.1%; P =.2). REM patients achieved higher rates of overall survival (70.3% vs 68.4%; P =.01) when compared to their white counterparts. Patients in the REM group were more likely to undergo more than two limb salvage reinterventions during follow-up (14.2% vs 8.6%; P < .001). After adjusting for potential confounders, REM patients had significantly higher odds of major amputation at 2 years (adjusted hazard ratio, 1.49; 95% confidence interval, 1.36-1.63; P < .001) CONCLUSIONS: In this Vascular Quality Initiative-Medicare matched study, racial and ethnic minority patients continue to face a higher major amputation risk despite having equivalent attempts at limb salvage. Further studies identifying risk factors and evaluating intervention strategies that may be more effective in preventing amputation in this particular population are warranted.
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Affiliation(s)
- Asma Mathlouthi
- Division of Vascular and Endovascular Surgery, University of California, San Diego, La Jolla, Calif
| | - Sina Zarrintan
- Division of Vascular and Endovascular Surgery, University of California, San Diego, La Jolla, Calif
| | - Maryam-Ali Khan
- Division of Vascular and Endovascular Surgery, University of California, San Diego, La Jolla, Calif
| | - Mahmoud Malas
- Division of Vascular and Endovascular Surgery, University of California, San Diego, La Jolla, Calif
| | - Andrew Barleben
- Division of Vascular and Endovascular Surgery, University of California, San Diego, La Jolla, Calif.
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Ravikumar D, Spyreli E, Woodside J, McKinley M, Kelly C. Parental perceptions of the food environment and their influence on food decisions among low-income families: a rapid review of qualitative evidence. BMC Public Health 2022; 22:9. [PMID: 34983469 PMCID: PMC8727174 DOI: 10.1186/s12889-021-12414-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background The food environment within and surrounding homes influences family dietary habits with socio-economic areas at a nutritional disadvantage. Families’ perception of the food environment and how it influences their food decisions is less clear. This rapid review aimed to synthesise qualitative evidence of parental perspectives of the food environment and their influence on food decisions among disadvantaged families. Method Qualitative and mixed-methods peer-reviewed journal articles published after 2000, that explored the perspectives of low-income parents in relation to their food environment and how this impacted food decisions for families with children aged 2-17 years, were included in this review. Embase, Scopus and PsycINFO were the databases chosen for this review. Search strategies included seven concepts related to family, food, perceptions, influences, environment, socio-economic status and study type. Two independent reviewers screened sixty-four studies. Thematic synthesis was employed. Results Two thousand one hundred and forty five results were identified through database searching and 1,650 were screened. Fourteen articles that originated from the US, Australia and the UK were included in this review. No articles were excluded following quality appraisal. Child preferences, financial and time constraints, and location and access to food outlets were barriers to accessing healthy food. Parental nutrition education and feeding approaches varied but positive outcomes from interventions to address these behaviours will be short-lived if inequities in health caused by poverty and access to affordable and healthy food are not addressed. The reliance on social support from families or government sources played an important role for families but are likely to be short-term solutions to health and nutritional inequities. Conclusions This qualitative evidence synthesis provides an insight into the perceptions of low-income parents on the factors influencing food decisions. Findings have implications for public health and the development of effective strategies to improve the dietary habits of children of disadvantaged families. Sustainable changes to dietary habits for families on low-income requires policy responses to low income, food access and to the high cost of healthy foods.
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Affiliation(s)
- Divya Ravikumar
- Health Promotion Research Centre, National University of Ireland Galway, University Rd, Galway, Republic of Ireland
| | - Eleni Spyreli
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, UK.
| | - Jayne Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - Michelle McKinley
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - Colette Kelly
- Health Promotion Research Centre, National University of Ireland Galway, University Rd, Galway, Republic of Ireland
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Grilo MF, Menezes CD, Duran AC. Food swamps in Campinas, Brazil. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022277.17772021en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The characteristics of the food environment can interfere with physical access to healthy foods and accentuate health inequalities. The presence of food swamps, i.e., the greater availability of ultra-processed food and commercial establishments compared to those that sell healthier options, are associated with the consumption of unhealthy foods. This study identified the spatial distribution of these establishments in Campinas, São Paulo. Fast-food restaurants, open-air organic/agroecological food markets and supermarkets were geocoded. Regional administrations (RAs) with greater social vulnerability according to the 2010 Census and with a greater availability of fast-food restaurants in relation to open-air food markets and supermarkets were considered food swamps. The less vulnerable neighborhoods had a higher concentration of all types of commercial food establishments compared to the most vulnerable regions. In Campinas, of eighteen RAs, five were considered food swamps. The findings reinforce the need for actions to improve exposure to healthy foods in more vulnerable neighborhoods.
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Affiliation(s)
| | | | - Ana Clara Duran
- Universidade Estadual de Campinas, Brazil; Unicamp, Brazil; Universidade de São Paulo, Brazil
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Quantifying the Food and Physical Activity Environments in Rural, High Obesity Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413344. [PMID: 34948951 PMCID: PMC8703759 DOI: 10.3390/ijerph182413344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/11/2021] [Accepted: 12/12/2021] [Indexed: 12/01/2022]
Abstract
The built environment contributes to an individual’s health, and rural geographies face unique challenges for healthy eating and active living. The purpose of this descriptive study was to assess the nutrition and physical activity environments in rural communities with high obesity prevalence. One community within each of six high obesity prevalence counties in a rural Midwest state completed the Nutrition Environment Measures Survey for Stores (NEMS-S) and the Rural Active Living Assessment (RALA). Data were collected by trained community members and study staff. All communities had at least one grocery store and five had at least one convenience store. Grocery stores had higher mean total NEMS-S scores than convenience stores (26.6 vs. 6.0, p < 0.001), and higher scores for availability (18.7 vs. 5.3, p < 0.001) and quality (5.4 vs. 0, p < 0.001) of healthful foods (higher scores are preferable). The mean RALA town-wide assessment score across communities was 56.5 + 15.6 out of a possible 100 points. The mean RALA program and policy assessment score was 40.8 + 20.4 out of a possible 100 points. While grocery stores and schools are important for enhancing food and physical environments in rural areas, many opportunities exist for improvements to impact behaviors and address obesity.
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Iliffe S, Bourne R. The myths of NHS privatisation: a commentary on factoids, policy zombies and category errors. J R Soc Med 2021; 114:578-580. [PMID: 34633244 PMCID: PMC8722778 DOI: 10.1177/01410768211049807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Steve Iliffe
- Emeritus Professor, Research Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
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Food deserts and food swamps in a Brazilian metropolis: comparison of methods to evaluate the community food environment in Belo Horizonte. Food Secur 2021. [DOI: 10.1007/s12571-021-01237-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Social Determinants of Health and Cardiovascular Disease: Current State and Future Directions Towards Healthcare Equity. Curr Atheroscler Rep 2021; 23:55. [PMID: 34308497 DOI: 10.1007/s11883-021-00949-w] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW We sought to examine the role of social and environmental conditions that determine an individual's behaviors and risk of disease-collectively known as social determinants of health (SDOH)-in shaping cardiovascular (CV) health of the population and giving rise to disparities in risk factors, outcomes, and clinical care for cardiovascular disease (CVD), the leading cause of death in the United States (US). RECENT FINDINGS Traditional CV risk factors have been extensively targeted in existing CVD prevention and management paradigms, often with little attention to SDOH. Limited evidence suggests an association between individual SDOH (e.g., income, education) and CVD. However, inequities in CVD care, risk factors, and outcomes have not been studied using a broad SDOH framework. We examined existing evidence of the association between SDOH-organized into 6 domains, including economic stability, education, food, neighborhood and physical environment, healthcare system, and community and social context-and CVD. Greater social adversity, defined by adverse SDOH, was linked to higher burden of CVD risk factors and poor outcomes, such as stroke, myocardial infarction (MI), coronary heart disease, heart failure, and mortality. Conversely, favorable social conditions had protective effects on CVD. Upstream SDOH interact across domains to produce cumulative downstream effects on CV health, via multiple physiologic and behavioral pathways. SDOH are major drivers of sociodemographic disparities in CVD, with a disproportionate impact on socially disadvantaged populations. Efforts to achieve health equity should take into account the structural, institutional, and environmental barriers to optimum CV health in marginalized populations. In this review, we highlight major knowledge gaps for each SDOH domain and propose a set of actionable recommendations to inform CVD care, ensure equitable distribution of healthcare resources, and reduce observed disparities.
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Lovasi GS, Johnson NJ, Altekruse SF, Hirsch JA, Moore KA, Brown JR, Rundle AG, Quinn JW, Neckerman K, Siscovick DS. Healthy food retail availability and cardiovascular mortality in the United States: a cohort study. BMJ Open 2021; 11:e048390. [PMID: 34244272 PMCID: PMC8273445 DOI: 10.1136/bmjopen-2020-048390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/26/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We investigated the association of healthy food retail presence and cardiovascular mortality, controlling for sociodemographic characteristics. This association could inform efforts to preserve or increase local supermarkets or produce market availability. DESIGN Cohort study, combining Mortality Disparities in American Communities (individual-level data from 2008 American Community Survey linked to National Death Index records from 2008 to 2015) and retail establishment data. SETTING Across the continental US area-based sociodemographic and retail characteristics were linked to residential location by ZIP code tabulation area (ZCTA). Sensitivity analyses used census tracts instead, restricted to urbanicity or county-based strata, or accounted for non-independence using frailty models. PARTICIPANTS 2 753 000 individuals age 25+ living in households with full kitchen facilities, excluding group quarters. PRIMARY AND SECONDARY OUTCOME MEASURES Cardiovascular mortality (primary) and all-cause mortality (secondary). RESULTS 82% had healthy food retail (supermarket, produce market) within their ZCTA. Density of such retail was correlated with density of unhealthy food sources (eg, fast food, convenience store). Healthy food retail presence was not associated with reduced cardiovascular (HR: 1.03; 95% CI 1.00 to 1.07) or all-cause mortality (HR: 1.05; 95% CI 1.04 to 1.06) in fully adjusted models (with adjustment for gender, age, marital status, nativity, Black race, Hispanic ethnicity, educational attainment, income, median household income, population density, walkable destination density). The null finding for cardiovascular mortality was consistent across adjustment strategies including minimally adjusted models (individual demographics only), sensitivity analyses related to setting, and across gender or household type strata. However, unhealthy food retail presence was associated with elevated all-cause mortality (HR: 1.15; 95% CI 1.11 to 1.20). CONCLUSIONS In this study using food establishment locations within administrative areas across the USA, the hypothesised association of healthy food retail availability with reduced cardiovascular mortality was not supported; an association of unhealthy food retail presence with higher mortality was not specific to cardiovascular causes.
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Affiliation(s)
- Gina S Lovasi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Norman J Johnson
- Center for Administrative Records and Research Applications, Census Bureau, Washington, District of Columbia, USA
| | - Sean F Altekruse
- National Heart Lung and Blood institute, Division of Cardiovascular Sciences, National Institutes of Health, Bethesda, Maryland, USA
| | - Jana A Hirsch
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kari A Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Janene R Brown
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Andrew G Rundle
- Built Environment and Health Research Group, Columbia University, New York, New York, USA
| | - James W Quinn
- Built Environment and Health Research Group, Columbia University, New York, New York, USA
| | - Kathryn Neckerman
- Built Environment and Health Research Group, Columbia University, New York, New York, USA
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Moughames E, Woo H, Galiatsatos P, Romero-Rivero K, Raju S, Tejwani V, Hoffman EA, Comellas AP, Ortega VE, Parekh T, Krishnan JA, Drummond MB, Couper D, Buhr RG, Paine R, Kaufman JD, Paulin LM, Putcha N, Hansel NN. Disparities in access to food and chronic obstructive pulmonary disease (COPD)-related outcomes: a cross-sectional analysis. BMC Pulm Med 2021; 21:139. [PMID: 33906617 PMCID: PMC8077917 DOI: 10.1186/s12890-021-01485-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/22/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Millions of Americans are living in food deserts in the United States, however the role of the local food environment on COPD has not been studied. The aim of this study is to determine the association between food deserts and COPD-related outcomes. METHOD In this cross-sectional analysis we linked data collected from SPIROMICS (SubPopulations and InteRmediate Outcome Measures in COPD Study) between 2010 and 2015 and food desert data, defined as an underserved area that lacks access to affordable healthy foods, from the Food Access Research Atlas. COPD outcomes include percentage of predicted forced expiratory volume in one second (FEV1%), St. George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), 6-min walk distance test (6MWD), exacerbations, and air trapping. We used generalized linear mixed models to evaluate the association between living in food deserts and respiratory outcomes, adjusting for age, gender, race, education, income, marital status, BMI, smoking status, pack years, and urban status RESULTS: Among 2713 participants, 22% lived in food deserts. Participants living in food deserts were less likely to be white and more likely to have a lower income than those who did not live in food deserts. In the adjusted model controlling for demographics and individual income, living in food deserts was associated lower FEV1% (β = - 2.51, P = 0.046), higher air trapping (β = 2.47, P = 0.008), worse SGRQ (β = 3.48, P = 0.001) and CAT (β = 1.20, P = 0.003) scores, and 56% greater odds of severe exacerbations (P = 0.004). Results were consistent when looking at food access alone, regardless of whether participants lived in low income areas. CONCLUSIONS Findings suggest an independent association between food desert and food access alone with COPD outcomes. Health program planning may benefit from addressing disparities in access to food.
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Affiliation(s)
- Eric Moughames
- Department of Medicine, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
| | - Han Woo
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Panagis Galiatsatos
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Karina Romero-Rivero
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Sarath Raju
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Vickram Tejwani
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Eric A Hoffman
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Victor E Ortega
- Department of Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Trisha Parekh
- Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - Jerry A Krishnan
- Department of Medicine, University of Illinois, Chicago, IL, USA
| | - Michael B Drummond
- Department of Medicine, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - David Couper
- Department of Biostatistics, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Russell G Buhr
- Department of Medicine, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
| | - Robert Paine
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Joel D Kaufman
- Department of Medicine and Epidemiology, University of Washington, Seattle, WA, USA
| | - Laura M Paulin
- Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Nirupama Putcha
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care, Johns Hopkins University, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
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Monsivais P, Thompson C, Astbury CC, Penney TL. Environmental approaches to promote healthy eating: Is ensuring affordability and availability enough? BMJ 2021; 372:n549. [PMID: 33785485 PMCID: PMC8008259 DOI: 10.1136/bmj.n549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Pablo Monsivais
- Elson S Floyd College of Medicine, Washington State University, Spokane, USA
| | - Claire Thompson
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK
| | - Chloe Clifford Astbury
- School of Global Health, Global Strategy Lab, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Tarra L Penney
- School of Global Health, Global Strategy Lab, Faculty of Health, York University, Toronto, Ontario, Canada
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Tonumaipe'a D, Cammock R, Conn C. Food havens not swamps: a strength-based approach to sustainable food environments. Health Promot Int 2021; 36:1795-1805. [PMID: 33661307 DOI: 10.1093/heapro/daab021] [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: 11/14/2022] Open
Abstract
The current paper provides a critical review of food environments' literature, with a focus on the metaphoric typology that has been developed over recent decades. This has tended to focus understandably on harmful food environments using well-known metaphors: that of food deserts, food swamps and food mirages. The purpose of the review was to consider the current typology in relation to what constitutes healthy food environments, and the implications for population groups in low socioeconomic environments who are often disadvantaged by current food systems and unhealthy food environments. The paper posits a new term, alongside the notion of the food oasis, that of food havens. Oasis indicates a small place of plenty in a setting of scarcity. Haven extends the boundaries of plenty in society by positing places and settings of refuge and safety, even sanctuary from which health and well-being can be attained and supported. We argue for focusing on creating such sustainable food environments so as to proliferate and promote examples of what needs to be done urgently in the fight to transform global food environments for the health of people particularly those that are vulnerable and the planet. Elements of the food haven as proposed in this paper have been drawn from indigenous perspectives-these include Māori and Pacific worldviews. Future research should consider what food environments might look like in different contexts and how we might move away from food swamps and deserts to food oases and havens; and utilize these positive motifs to go further in creating whole sustainable food environments encompassing all of society.
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Affiliation(s)
- Daysha Tonumaipe'a
- Auckland University of Technology (AUT), Child and Youth Health Research Centre (CYHRC), Auckland, New Zealand
| | - Radilaite Cammock
- Auckland University of Technology (AUT), Child and Youth Health Research Centre (CYHRC), Auckland, New Zealand
| | - Cath Conn
- Auckland University of Technology (AUT), Child and Youth Health Research Centre (CYHRC), Auckland, New Zealand
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Fong AJ, Lafaro K, Ituarte PHG, Fong Y. Association of Living in Urban Food Deserts with Mortality from Breast and Colorectal Cancer. Ann Surg Oncol 2021; 28:1311-1319. [PMID: 32844294 PMCID: PMC8046424 DOI: 10.1245/s10434-020-09049-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/03/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Food deserts are neighborhoods with low access to healthy foods and are associated with poor health metrics. We investigated association of food desert residence and cancer outcomes. METHODS In this population-based study, data from the 2000-2012 California Cancer Registry was used to identify patients with stage II/III breast or colorectal cancer. Patient residence at time of diagnosis was linked by census tract to food desert using the USDA Food Access Research Atlas. Treatment and outcomes were compared by food desert residential status. RESULTS Among 64,987 female breast cancer patients identified, 66.8% were < 65 years old, and 5.7% resided in food deserts. Five-year survival for food desert residents was 78% compared with 80% for non-desert residents (p < 0.0001). Among 48,666 colorectal cancer patients identified, 50.4% were female, 39% were > 65 years old, and 6.4% resided in food deserts. Five-year survival for food desert residents was 60% compared with 64% for non-desert residents (p < 0.001). Living in food deserts was significantly associated with diabetes, tobacco use, poor insurance coverage, and low socioeconomic status (p < 0.05) for both cancers. There was no significant difference in rates of surgery or chemotherapy by food desert residential status for either diagnosis. Multivariable analyses showed that food desert residence was associated with higher mortality. CONCLUSION Survival, despite treatment for stage II/III breast and colorectal cancers was worse for those living in food deserts. This association remained significant without differences in use of surgery or chemotherapy, suggesting factors other than differential care access may link food desert residence and cancer outcomes.
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Affiliation(s)
- Abigail J Fong
- Department of Surgery, Cedar-Sinai Hospital, Los Angeles, CA, USA
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
| | - Kelly Lafaro
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
- Department of Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Philip H G Ituarte
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
| | - Yuman Fong
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
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Azap RA, Paredes AZ, Diaz A, Hyer JM, Pawlik TM. The association of neighborhood social vulnerability with surgical textbook outcomes among patients undergoing hepatopancreatic surgery. Surgery 2020; 168:868-875. [DOI: 10.1016/j.surg.2020.06.032] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/28/2022]
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Young M, Montazer S, Singh D. The Consequences of Living in Childcare Deserts: Evidence from Canada. CANADIAN REVIEW OF SOCIOLOGY = REVUE CANADIENNE DE SOCIOLOGIE 2020; 57:550-578. [PMID: 33152176 DOI: 10.1111/cars.12316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Our study addresses whether working parents with young children living in childcare deserts experience greater work-family conflict and psychological distress compared to those in more resourced areas. We use 2011 individual-level data from Toronto matched to census and administrative childcare data. Results suggest that mothers experience greater conflict than fathers when in high-resourced areas. Fathers who work long hours and reside in a desert report greater psychological distress than fathers in nondeserts. These patterns are contrary to the observed results for mothers' distress by childcare availability. Our study underscores the impact of childcare options and the importance of access for all.
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Kariburyo MS, Andress L, Collins A, Kinder P. Place Effects and Chronic Disease Rates in a Rural State: Evidence from a Triangulation of Methods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186676. [PMID: 32937778 PMCID: PMC7559142 DOI: 10.3390/ijerph17186676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 11/16/2022]
Abstract
High rates of chronic diseases and increasing nutritional polarization between different income groups in the United States are issues of concern to policymakers and public health officials. Spatial differences in access to food are mainly blamed as the cause for these nutritional inequalities. This study first detected hot and cold spots of food providers in West Virginia and then used those places in a quasi-experimental method (entropy balancing) to study the effects of those places on diabetes and obesity rates. We found that although hot spots have lower rates of chronic diseases than non-hot spots and cold spots have higher rates of chronic diseases than non-cold spots-the situation is complicated. With the findings of income induced chronic disease rates in urban areas, where most hot spots are located, there is evidence of another case for "food swamps." However, in cold spots which are located mainly in rural areas, higher rates of chronic diseases are attributed to a combination of access to food providers along with lacking the means (i.e., income for low-income households) to form healthier habits.
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Affiliation(s)
- Mohamed Shabani Kariburyo
- Division of Resource Economics and Management West Virginia University, Morgantown, WV 26506-6108, USA
| | - Lauri Andress
- Health Policy, Management, and Leadership, School of Public Health West Virginia University, Morgantown, WV 26506-9190, USA
| | - Alan Collins
- Division of Resource Economics and Management West Virginia University, Morgantown, WV 26506-6108, USA
| | - Paul Kinder
- Division of Resource Economics and Management West Virginia University, Morgantown, WV 26506-6108, USA
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A Spatial Evaluation of Healthy Food Access: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Participants. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25 Suppl 5, Tribal Epidemiology Centers: Advancing Public Health in Indian Country for Over 20 Years:S91-S96. [PMID: 31348195 DOI: 10.1097/phh.0000000000001013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
CONTEXT It is well known in public health practice that vulnerable populations in rural and inner-city areas may not be able to access healthy foods due to cost, availability, access to transport, and other factors. PROGRAM The Inter Tribal Council of Arizona, Inc (ITCA), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides moderate- and lower-income families with increased access to nutritional information, health care, and healthy foods. IMPLEMENTATION ITCA WIC authorizes and enters into contracts with stores that carry a baseline of healthy foods. To use WIC benefits, participants must go to authorized WIC stores where approved healthy foods are available. EVALUATION ITCA Tribal Epidemiology Center developed a methodological framework using Geographic Information Systems to examine WIC authorized stores in 2014 and 2016 to determine whether there were gaps in the store network. To be considered served by the store network, urban WIC participants were required to be within 1 mile and nonurban WIC participants were required to be within 5 miles of a store. We examined whether additional stores could be added to the network to decrease travel distance and travel time in order to further improve access to healthy foods. DISCUSSION Between 2014 and 2016, 700 stores were examined and WIC authorized 8 new stores to increase the network; all remote and most rural stores were WIC authorized. In 2014, about 50% of participants met the criteria to be considered served. In 2016, 54% met the criteria, indicating a modest increase in store access for WIC participants. Store network access increased in urban areas from 39% to 41% and from 66% to 74% in nonurban areas between 2014 and 2016. By evaluating the ITCA WIC authorized stores, we note that ITCA increased access to WIC approved healthy foods for WIC participants.
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Andress L, Byker Shanks C, Hardison-Moody A, Prewitt TE, Kinder P, Haynes-Maslow L. The Curated Food System: A Limiting Aspirational Vision of What Constitutes "Good" Food. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6157. [PMID: 32854213 PMCID: PMC7504520 DOI: 10.3390/ijerph17176157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/17/2022]
Abstract
In an effort to elucidate an aspirational vision for the food system and explore whether the characteristics of such a system inadvertently set unattainable standards for low-wealth rural communities, we applied discourse analysis to the following qualitative datasets: (1) interviews with food experts and advocates, (2) scholarly and grey literature, (3) industry websites, and (4) email exchanges between food advocates. The analysis revealed eight aspirational food system discourses: production, distribution, and infrastructure; healthy, organic, local food; behavioral health and education; sustainability; finance and investment; hunger relief; demand-side preferences; romanticized, community led transformations. Study findings reveal that of eight discourses, only three encompass the experiences of low-wealth rural residents. This aspirational food system may aggravate the lack of autonomy and powerlessness already experienced by low-wealth rural groups, perpetuate a sense of failure by groups who will be unable to reach the aspirational food vision, silence discourses that might question those that play a role in the inequitable distribution of income while sanctioning discourses that focus on personal or community solutions, and leave out other policy-based solutions that address issues located within the food system. Further research might explore how to draw attention to silenced discourses on the needs and preferences of low-wealth rural populations to ensure that the policies and programs promoted by food system experts mitigate poor diets caused by food insecurity. Further research is needed to inform policies and programs to mitigate food insecurity in low-wealth rural populations.
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Affiliation(s)
- Lauri Andress
- Department of Health Policy, Management, and Leadership, West Virginia University, 64 Medical Center Drive, Morgantown, WV 26506-9190, USA
| | - Carmen Byker Shanks
- Department of Health and Human Development, Food and Health Lab, Montana State University, Bozeman, MT 59718, USA
| | - Annie Hardison-Moody
- Department of Agricultural and Human Sciences, North Carolina State University, Raleigh, NC 27695, USA; (A.H.-M.); (L.H.-M.)
| | - T. Elaine Prewitt
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Paul Kinder
- Natural Resource Analysis Center, West Virginia University, Morgantown, WV 26506, USA;
| | - Lindsey Haynes-Maslow
- Department of Agricultural and Human Sciences, North Carolina State University, Raleigh, NC 27695, USA; (A.H.-M.); (L.H.-M.)
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Smith EJT, Ramirez JL, Wu B, Zarkowsky DS, Gasper WJ, Finlayson E, Conte MS, Iannuzzi JC. Living in a Food Desert is Associated with 30-day Readmission after Revascularization for Chronic Limb-Threatening Ischemia. Ann Vasc Surg 2020; 70:36-42. [PMID: 32628994 DOI: 10.1016/j.avsg.2020.06.052] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Living in a food desert has been associated with increased cardiovascular risk; however, its impact on vascular surgery outcomes is unknown. This study hypothesized that living in a food desert would be associated with increased postoperative complications in patients undergoing revascularization for chronic limb-threatening ischemia (CLTI). METHODS This was a single-center retrospective analysis of open and endovascular infrainguinal revascularization for CLTI between April 2013 and December 2015. A food desert was defined using the US Department of Agriculture's Food Access Research Atlas. Bivariate analyses were performed appropriate to the data. Binary logistic regression was performed assessing the association of food desert status with 30-day postoperative complications. RESULTS In total, 152 cases were included, of which 17% (n = 26) resided in food deserts. Patients in the food desert cohort were less likely to be low income (27% vs. 54%, P = 0.01). Living in a food desert was associated with increased 30-day readmission [(39% vs. 20%, P = 0.04), unadjusted OR: 2.5 (CI: 1.0-6.2)]. FD cases also had a higher proportion of wound complications [12 (46%) vs. 28 (22%), P = 0.01)]. The overall wound complication rate was 27% with the majority being due to infections (63%). On multivariable analysis, food desert status remained associated with increased odds of 30-day readmission (OR: 2.7, CI: 1.2-8.4, P = 0.047). Reasons for readmission in the food desert group were all due to wound complications (100% vs. 72%, P = 0.08). CONCLUSIONS Living in a food desert was associated with nearly three times the odds of 30-day readmission after lower extremity revascularization for CLTI. This increase in readmission may be explained through increased wound complications. These findings support considering access to healthy food as a potential modifiable risk factor for adverse outcomes, particularly in CLTI revascularization.
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Affiliation(s)
- Eric J T Smith
- Department of Surgery, University of California, San Francisco, CA
| | - Joel L Ramirez
- Department of Surgery, University of California, San Francisco, CA
| | - Bian Wu
- Department of Surgery, University of California, San Francisco, CA
| | | | - Warren J Gasper
- Department of Surgery, University of California, San Francisco, CA
| | - Emily Finlayson
- Department of Surgery, University of California, San Francisco, CA
| | - Michael S Conte
- Department of Surgery, University of California, San Francisco, CA
| | - James C Iannuzzi
- Department of Surgery, University of California, San Francisco, CA.
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Rüsing L, Hilger-Kolb J, Schneider S. Desert on the menu? What children are served in German full-service restaurants. Cent Eur J Public Health 2020; 28:87-93. [PMID: 32592552 DOI: 10.21101/cejph.a5878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 03/24/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Prevalence of obesity and overweight among children is rising worldwide. Thus, the importance of restaurants as food environments is also growing. Considering these developments, the present study describes and evaluates menus and meals offered to children in German full-service restaurants. METHODS Using quota sampling procedure, a representative sample of German full-service restaurants was identified. The individual meals were then assessed, using the Children's Menu Assessment tool (CMA). A total of 500 restaurants and 1,877 individual meals were analyzed. RESULTS On average, every menu included 3.76 ± 1.31 meals for children. The arithmetic mean of the CMA score was 0.73 ± 0.85. Around 80% of all offered meals were limited to eight typical dishes and over 50% included French fries or another form of fried potatoes. Not one of the meals included any nutritional information. Healthy entrees were never marked (e.g. by an optional qualitative information such as healthy food symbol or a healthier choice tag). Eighty-one percent of all the main components in the meals were rated as unhealthy and none of the meals used wholegrain products. The automatic inclusion of a drink and free refill options are both rather unusual in Germany, as well as the use of cartoon characters and product logos or giving away promotional toys. A positive correlation was found between the price of the food and its quality. The majority of dishes feature a high energy density while simultaneously having a low nutrient density. CONCLUSIONS Overall, the range of food on offer for children in German restaurants is unhealthy and lacking in variety. There is an urgent need for improvement of both the menus themselves as well as the offered meals. Our study is not only by far the most comprehensive study, but also the study with the worst CMA score values worldwide.
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Affiliation(s)
- Lisa Rüsing
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jennifer Hilger-Kolb
- Mannheim Institute for Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany
| | - Sven Schneider
- Mannheim Institute for Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany
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Sánchez-Ledesma E, Vásquez-Vera H, Sagarra N, Peralta A, Porthé V, Díez È. Perceived pathways between tourism gentrification and health: A participatory Photovoice study in the Gòtic neighborhood in Barcelona. Soc Sci Med 2020; 258:113095. [PMID: 32559574 DOI: 10.1016/j.socscimed.2020.113095] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 10/24/2022]
Abstract
Tourism gentrification is as process of urban change and neighborhoods transformation, according to the needs of affluent visitors, increasing in some global cities. However, the link between tourism gentrification and resident's health is still an understudied topic. Using Photovoice, a participatory action research method, the aim of this study was to identify the perceived pathways that underlie the relationship between tourism gentrification and health among residents of Gòtic neighborhood, in Barcelona. The study was conducted between January 2018 and January 2019. Thirteen residents, recruited from two neighborhood organizations, took photographs of how tourism gentrification of the neighborhood was affecting their health. Participants analyzed and critically discussed their photographs in small group sessions. Through a consensus-building process, participants categorized 35 photographs and identified 7 emerging categories acknowledged as possible pathways between tourism gentrification and health, in Gòtic neighborhood: 1) decline of social networks; 2) loss of identity; 3) environmental changes; 4) pollution; 5) changes in services and stores; 6) property speculation/eviction and; 7) activism by residents. This Photovoice study recognizes important pathways underlying the relationship between tourism gentrification in the Gòtic neighborhood and the health of its residents, by altering the built environment, the social environment or psychological factors. Among them, six pathways were related to negative health outcomes, both physical and mental (respiratory diseases; worse nutrition habits; sleep deprivation; stress, anxiety and depression). 'Activism by residents' was perceived to buffer the negative health effects of living in a touristic area. The study also provides recommendations to tackle this serious urban health issue.
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Affiliation(s)
| | - Hugo Vásquez-Vera
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; CEES-Departamento de Salud Pública, Universidad de La Frontera, Carrera 228, Temuco, Chile; Institut d'Investigació Biomèdica (IBB-Sant Pau), C.de Sant Quintí, 77, 08041, Barcelona, Spain
| | - Natàlia Sagarra
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain
| | - Andrés Peralta
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain
| | - Victoria Porthé
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5 (Pabellón 11. Planta 0), 28029, Madrid, Spain; Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain
| | - Èlia Díez
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Departament of Experimental and Health Sciences, Universitat Pompeu Fabra, Edificio PRBB (Campus del Mar), Doctor Aiguader, 88, 08003, Barcelona, Spain; Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5 (Pabellón 11. Planta 0), 28029, Madrid, Spain; Institut d'Investigació Biomèdica (IBB-Sant Pau), C.de Sant Quintí, 77, 08041, Barcelona, Spain
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Sustaining What Is Unsustainable: A Review of Urban Sprawl and Urban Socio-Environmental Policies in North America and Western Europe. SUSTAINABILITY 2020. [DOI: 10.3390/su12114445] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Urban sprawl and its economic, social, and environmental consequences are central issues for approaching more sustainable forms of life and production. This review provides a broad theoretical exploration of the main features of urban sprawl but also of sustainable urban policies in Western Europe and North America. Urban sprawl can be observed in both continents, as the search for higher standards of economic, social, and environmental sustainability is also an essential feature of urban governance in the last years. Urban sprawl has been slightly weaker in Western Europe, as its are cities generally more compact. Moreover, in Western Europe, urban sprawl has sometimes been confronted with ex-ante preventive policies. However, in North America, urban sprawl from the 1950s has been an essential element of the social ordering and, thus, of the American way of life. In both cases, urban sprawl has generated successive rounds of accumulation of built capital, which is currently managed in sustainable ways essentially through ex-post and palliative measures, that is, trying to “sustain what is unsustainable”. In other words, the idea is to make urban sprawl more sustainable but without altering its main morphological elements.
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Okuyama K, Li X, Abe T, Hamano T, Franks PW, Nabika T, Sundquist K. Fast food outlets, physical activity facilities, and obesity among adults: a nationwide longitudinal study from Sweden. Int J Obes (Lond) 2020; 44:1703-1711. [PMID: 32424265 DOI: 10.1038/s41366-020-0588-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/31/2020] [Accepted: 04/29/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND While neighborhood deprivation is a well-known predictor of obesity, the mechanisms behind this association are unclear and these are important to clarify before designing interventions focusing on modifiable neighborhood environmental factors in order to reduce obesity risk. OBJECTIVES This study examined the longitudinal association between availability of fast-food outlets and physical activity facilities and the risk of obesity among adults. METHODS This study used multiple national register data from Sweden. During the 11-year follow-up period between 2005 and 2015, data from 1,167,449 men and 542,606 women, aged 20-55 years, were accessible for inclusion in this analysis. Incidence of obesity was identified based on a diagnosis of obesity during the follow-up period derived from clinical register data. Neighborhood availability of fast-food outlets and physical activity facilities were assessed in 2005 and Cox regression was used in the statistical analysis. Individual socio-demographic factors and neighborhood deprivation were used as covariates. RESULTS There were no meaningful associations between neighborhood fast-food outlets or physical activity facilities and obesity in men or women. Neighborhood deprivation was, however, consistently and strongly associated with incidence of obesity in both men and women. CONCLUSIONS Availability of fast-food outlets and lack of physical activity facilities appear unlikely to cause obesity in Swedish adults. Other potentially modifiable environmental factors within specific social and cultural settings that may influence obesity risk should be examined in future studies.
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Affiliation(s)
- Kenta Okuyama
- Center for Primary Health Care Research, Lund University, Malmö, Sweden. .,Center for Community-based Healthcare Research and Education, Shimane University, Shimane, Japan.
| | - Xinjun Li
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Takafumi Abe
- Center for Community-based Healthcare Research and Education, Shimane University, Shimane, Japan
| | - Tsuyoshi Hamano
- Center for Community-based Healthcare Research and Education, Shimane University, Shimane, Japan.,Department of Sports Sociology and Health Sciences, Faculty of Sociology, Kyoto Sangyo University, Kyoto, Japan
| | - Paul W Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
| | - Toru Nabika
- Center for Community-based Healthcare Research and Education, Shimane University, Shimane, Japan.,Department of Functional Pathology, Shimane University School of Medicine, Izumo, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden.,Center for Community-based Healthcare Research and Education, Shimane University, Shimane, Japan.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Dietary acculturation among African emigrant students in India: determinants and problems. Public Health Nutr 2020; 23:2402-2409. [PMID: 32389158 DOI: 10.1017/s1368980019005226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Emigrants face a high level of food insecurity. There is a wide research gap in the domain of identifying the determinants and problems of dietary acculturation in the context of emigrant students. This article attempts to study the factors affecting the dietary acculturation of African emigrant students in India. DESIGN For conducting a first-of-its-kind study for African emigrant students in India, we used field survey method, and the primary data were collected using a pre-structured questionnaire. SETTING This was a field survey conducted in Punjab (a state of India). PARTICIPANTS One hundred and twenty African emigrant students participated in the survey. RESULTS Results of logistic regression indicated that food awareness (P = 0·027) and food suitability (P = 0·043) were the major determinants of dietary acculturation. Lack of familiarity and lack of proximity to food access points are the major problems faced by the African emigrant students. African emigrant students prepared for dietary acculturation largely only after coming to India. There is a significant positive correlation (P = 0·013) between problems faced by the respondents and tendency to prepare for acculturation after coming to India. CONCLUSIONS Information regarding local food environment plays a significant role in dietary acculturation. There is a pertinent need to educate emigrant students regarding food availability and access by developing suitable educational content.
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Food Access and Nutritional Status of Rural Adolescents in India: Pune Maternal Nutrition Study. Am J Prev Med 2020; 58:728-735. [PMID: 31982230 DOI: 10.1016/j.amepre.2019.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The relationships among food access, foods consumed, and nutritional status and health in developing countries are not well understood. Between 2013 and 2018, differences in the rural food environment and access to food, nutritional status, and body size in the rural villages where the Pune Maternal Nutrition birth cohort was recruited were measured and analyzed. METHODS Food access measures included the number of shops per 1,000 population, water availability, and distance from the highway. A total of 418 adolescents (223 boys, 195 girls) aged 18 years had diet assessed by a quantitative food frequency questionnaire; height, weight, and waist measured; body fat percentage determined by dual x-ray absorptiometry; and blood biomarkers (vitamin B12 and hemoglobin) assayed. RESULTS By village, the number of shops per 1,000 population ranged from 3.85 to 23.29. Boys and girls from the 2 villages with the highest food access, year-round water availability, and closest to the highway were heavier and had higher BMI, waist circumference, and body fat percentage compared with those from the lowest tertile of food access (p<0.05 for all, adjusted for SES). Across all villages, dietary diversity was poor and B12 insufficiency and anemia were prevalent. With easier access to food, consumption of staple foods decreased and outside food increased. On multivariate regression analysis, higher BMI of the adolescents was significantly associated with higher food access, along with higher weight at birth, socioeconomic scores, and daily energy consumption. CONCLUSIONS Results demonstrate a strong link between rural food access, foods consumed, and measures of nutritional status in an undernourished, mostly vegetarian, rural population.
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Abstract
Food insecurity is a substantial problem in nearly every advanced capitalist nation, with sizable portions of residents in many affluent countries struggling to eat healthily every day. Over time, a very large literature has developed that documents food insecurity, evaluates programs meant to reduce that insecurity, and proposes solutions to attenuate the problem. The purpose of the current review is to provide a very broad overview of the food insecurity literature, including definitions, measurement, areas of study, and impacts on health. Importantly, this review suggests there are two major causes of food insecurity in the advanced nations: economic inequality and neoliberalism. The food insecurity literature suggests that diminished government responsibility in advanced capitalist nations corresponds to an increase in feeding programs run by non-profit and charitable organizations. This review concludes by suggesting that, while a massive amount of research on food insecurity currently exists, more research is still needed to address gaps in the literature when it comes to significant events, coping strategies and disadvantaged populations.
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Kelli HM, Kim JH, Samman Tahhan A, Liu C, Ko YA, Hammadah M, Sullivan S, Sandesara P, Alkhoder AA, Choudhary FK, Gafeer MM, Patel K, Qadir S, Lewis TT, Vaccarino V, Sperling LS, Quyyumi AA. Living in Food Deserts and Adverse Cardiovascular Outcomes in Patients With Cardiovascular Disease. J Am Heart Assoc 2020; 8:e010694. [PMID: 30741595 PMCID: PMC6405658 DOI: 10.1161/jaha.118.010694] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background Food deserts (FDs), defined as low‐income communities with limited access to healthy food, are a growing public health concern. We evaluated the impact of living in FDs on incident cardiovascular events. Methods and Results We recruited 4944 subjects (age 64±12, 64% male) undergoing cardiac catheterization into the Emory Cardiovascular Biobank. Using the US Department of Agriculture definition of FD, we determined whether their residential addresses had (1) poor access to healthy food, (2) low income, or (3) both (=FD). Subjects were prospectively followed for a median of 3.2 years for myocardial infarction (MI) and death. Fine and Gray's subdistribution hazard models for MI and Cox proportional hazard models for death/MI were used to examine the association between area characteristics (FD, poor access, and low income) and the rates of adverse events after adjusting for traditional risk factors. A total of 981 (20%) lived in FDs and had a higher adjusted risk of MI (subdistribution hazard ratio, 1.44 [95% CI, 1.06–1.95]) than those living in non‐FDs. In a multivariate analysis including both food access and area income, only living in a low‐income area was associated with a higher adjusted risk of MI (subdistribution hazard ratio, 1.40 [1.06–1.85]) and death/MI (hazard ratio, 1.18 [1.02–1.35]) while living in a poor‐access area was not significantly associated with either (subdistribution hazard ratio, 1.05 [0.80–1.38] and hazard ratio, 0.99 [0.87–1.14], respectively). Conclusions Living in an FD is associated with a higher risk of adverse cardiovascular events in those with coronary artery disease. Specifically, low area income of FDs, not poor access to food, was significantly associated with worse outcomes.
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Affiliation(s)
- Heval M Kelli
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Jeong Hwan Kim
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Ayman Samman Tahhan
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Chang Liu
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Yi-An Ko
- 2 Department of Biostatistics and Bioinformatics Rollins School of Public Health Emory University Atlanta GA
| | - Muhammad Hammadah
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Samaah Sullivan
- 3 Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA
| | - Pratik Sandesara
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Ayman A Alkhoder
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Fahad K Choudhary
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - M Mazen Gafeer
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Keyur Patel
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Saqib Qadir
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Tené T Lewis
- 3 Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA
| | - Viola Vaccarino
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA.,3 Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA
| | - Laurence S Sperling
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Arshed A Quyyumi
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
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