The Impact of a City-Level Minimum-Wage Policy on Supermarket Food Prices in Seattle-King County

Assessing impacts of redeveloping public housing communities on obesity in low-income minority residents: Rationale, study design, and baseline data from the Watts Neighborhood Health Study

Introduction

Obesogenic built- and social-environments in low-income and minority communities are often blamed for the higher rates of obesity in this population, but existing evidence is based largely on observational studies. This study leverages a natural experiment created by the redevelopment of a public housing community to examine the impact of major improvements to the housing, built, and social environments on obesity among residents.

Methods/design

The study design is a natural experiment where residents from the redeveloped community (treatment group) will be compared to those from a similar community (control group) in terms of their pre/post changes in primary outcomes using annual longitudinal data on a cohort of residents. Quasi-experimental variation in the timing of exposure to various redevelopment components within the treated community will be further leveraged within a stepped-wedge research design to assess the impact of the redevelopment components. Primary outcome measures include body mass index, overweight, and obese status.

Results

A cohort of 868 adults and 704 children (ages 2–17 years) was recruited during 2018–2019 with up to two waves of baseline data. At baseline, the prevalence of obesity (overweight or obesity) was 57.2% (81.3%) in adults and 33.1% (52.4%) among children, with no significant differences by treatment status. No differential trends in primary outcomes were observed by treatment status during the two years of baseline.

Discussion

This natural experiment study offers a unique opportunity to assess whether improvements to housing, built, and social environment in low-income minority communities can lead to reductions in obesity.

Assessing the Cost of Healthy and Unhealthy Diets: A Systematic Review of Methods

PURPOSE OF REVIEW

Poor diets are a leading risk factor for chronic disease globally. Research suggests healthy foods are often harder to access, more expensive, and of a lower quality in rural/remote or low-income/high minority areas. Food pricing studies are frequently undertaken to explore food affordability. We aimed to capture and summarise food environment costing methodologies used in both urban and rural settings.

RECENT FINDINGS

Our systematic review of high-income countries between 2006 and 2021 found 100 relevant food pricing studies. Most were conducted in the USA (n = 47) and Australia (n = 24), predominantly in urban areas (n = 74) and cross-sectional in design (n = 76). All described a data collection methodology, with just over half (n = 57) using a named instrument. The main purpose for studies was to monitor food pricing, predominantly using the 'food basket', followed by the Nutrition Environment Measures Survey for Stores (NEMS-S). Comparatively, the Healthy Diets Australian Standardised Affordability and Price (ASAP) instrument supplied data on relative affordability to household incomes. Future research would benefit from a universal instrument reflecting geographic and socio-cultural context and collecting longitudinal data to inform and evaluate initiatives targeting food affordability, availability, and accessibility.

Online Food Shopping: A Conceptual Analysis for Research Propositions

Shopping foods online is different from shopping other things online. To stimulate more thinking and enrich potential future research imagination, this paper reviews for online food shopping features, offers a commentary, and proposes future research directions. The propositions include the following: (1) The design and implementation of online food shopping (eco)systems should engage the consumers and other stakeholders to co-create collective and social values; (2) A better fit between technologies’ and food businesses’ natures could generate better applications for online food shopping; (3) A business model with sound finance systems becomes the core of a healthy online food ecosystem; (4) The interaction and transformation between online (virtual) and offline (virtual) food businesses determines the dynamic development of future food shopping.

Small increments in diet cost can improve compliance with the Dietary Guidelines for Americans

Adherence to the Dietary Guidelines for Americans (DGA) may involve higher diet costs. This study assessed the relation between two measures of food spending and diet quality among adult participants (N = 768) in the Seattle Obesity Study (SOS III). All participants completed socio-demographic and food expenditure surveys and the Fred Hutch food frequency questionnaire. Dietary intakes were joined with local supermarket prices to estimate individual-level diet costs. Healthy Eating Index (HEI- 2015) scores measured compliance with DGA. Multiple linear regressions using Generalized Estimating Equations with robust standard errors showed that lower food spending was associated with younger age, Hispanic ethnicity, and lower socioeconomic status. Even though higher HEI-2015 scores were associated with higher diet costs per 2000 kcal, much individual variability was observed. A positive curvilinear relationship was observed in adjusted models. At lower cost diets, a $100/month increase in cost (from $150 to $250) was associated with a 20.6% increase in HEI-2015. For higher levels of diet cost (from $350 to $450) there were diminishing returns (2.8% increase in HEI- 2015). These findings indicate that increases in food spending at the lower end of the range have the most potential to improve diet quality.

Obesity and the Built Environment: A Reappraisal

The built environment (BE) has been viewed as an important determinant of health. Numerous studies have linked BE exposure, captured using a variety of methods, to diet quality and to area prevalence of obesity, diabetes, and cardiovascular disease. First-generation studies defined the neighborhood BE as the area around the home. Second-generation studies turned from home-centric to person-centric BE measures, capturing an individual's movements in space and time. Those studies made effective uses of global positioning system tracking devices and mobile phones, sometimes coupled with accelerometers and remote sensors. Activity space metrics explored travel paths, modes, and destinations to assess BE exposure that was both person and context specific. However, as measures of the contextual exposome have become ever more fine-grained and increasingly complex, connections to long-term chronic diseases with complex etiologies, such as obesity, are in danger of being lost. Furthermore, few studies on obesity and the BE have included intermediate energy balance behaviors, such as diet and physical activity, or explored the potential roles of social interactions or psychosocial pathways. Emerging survey-based applications that identify habitual destinations and associated travel patterns may become the third generation of tools to capture health-relevant BE exposures in the long term.

The Culture Of Health In Early Care And Education: Workers' Wages, Health, And Job Characteristics

Little is known about the health of the 2.2 million early care and education (ECE) workers responsible for the care, well-being, and success of the approximately ten million children younger than age six enrolled in ECE, or the extent to which ECE environments and employers play a role in workers' health. The purpose of this analysis was to describe the health of an ECE worker sample by wage and by job and center characteristics and to begin to explore the relationships between these factors and workers' health. Our data indicate that ECE workers earn low wages and experience poor mental well-being and high rates of food insecurity. Lower-wage workers worked at centers with more children enrolled in subsidy programs and were more likely to work at centers that did not offer health insurance, paid sick leave, or parental or family leave. Policies and programs that raised workers' wages or mandated the provision of meals to both children and workers could better support teacher health and the quality of ECE for children. Our results suggest that the culture of health in ECE settings and equity-related outcomes could be improved by helping centers provide support and flexibility to teachers (for example, offsetting workers' benefit costs or reducing teacher-to-child ratios to reduce stress) who are managing their own health in the context of demanding work.

The Impact of a City-Level Minimum Wage Policy on Supermarket Food Prices by Food Quality Metrics: A Two-Year Follow Up Study

Objective: To examine the effects of increasing minimum wage on supermarket food prices in Seattle over 2 years of policy implementation, overall and differentially across food quality metrics. Methods: Prices for the UW Center for Public Health Nutrition (CPHN) market basket of 106 foods were obtained for 6 large supermarket chain stores in Seattle (“intervention”) and for the same chain stores in King County (“control”) at four time points: 1-month pre- (March 2015), 1-month post- (May 2015), 1-year post- (May 2016), and 2-years post-policy implementation (May 2017). Prices for all food items were standardized and converted to price per 100 kcal. Food quality metrics were used to explore potential differential price increases by (a) food groups, as defined by US Department of Agriculture; (b) NOVA food processing categories, and (c) nutrient density quartiles, based on the Nutrient Rich Foods Index 9.3. Separate difference-in-differences linear regression models with robust standard errors, examined price differences per 100 kcal overall, clustered by store chain, and stratified by each food quality metric. Results: There were no overall market basket price changes attributable to Seattle’s minimum wage policy. Moreover, no minimum wage effect was detected by USDA food group, food processing, or nutrient density categories. Conclusions: Local area supermarket food prices were not impacted by Seattle’s minimum wage policy 2 years into policy implementation and after the first increase to $15/h overall or by sub-classification. Low-income workers may be able to afford higher quality diets if wages increase yet supermarket prices stay the same.

Seattle's minimum wage ordinance did not affect supermarket food prices by food processing category

OBJECTIVE

To examine the impacts of Seattle's minimum wage ordinance on food prices by food processing category.

DESIGN

Supermarket food prices were collected for 106 items using a University of Washington Center for Public Health Nutrition market basket at affected and unaffected supermarket chain stores at three times: March 2015 (1-month pre-policy enactment), May 2015 (1-month post-policy enactment) and May 2016 (1-year post-policy enactment). Food items were categorized into four food processing groups, from minimally to ultra-processed. Data were analysed across time using a multilevel, linear difference-in-differences model at the store and price level stratified by level of food processing.

SETTING

Six large supermarket chain stores located in Seattle ('intervention') affected by the policy and six same-chain but unaffected stores in King County ('control'), Washington, USA.

SUBJECTS

One hundred and six food and beverage items.

RESULTS

The largest change in average price by food item was +$US 0·53 for 'processed foods' in King County between 1-month post-policy and 1-year post-policy enactment (P < 0·01). The smallest change was $US 0·00 for 'unprocessed or minimally processed foods' in Seattle between 1-month post-policy and 1-year post-policy enactment (P = 0·94). No significant changes in averaged chain prices were observed across food processing level strata in Seattle v. King County stores at 1-month or 1-year post-policy enactment.

CONCLUSIONS

Supermarket food prices do not appear to be differentially impacted by Seattle's minimum wage ordinance by level of the food's processing. These results suggest that the early implementation of a city-level minimum wage policy does not alter supermarket food prices by level of food processing.