Obesity-Promoting Food Environments and the Spatial Clustering of Food Outlets Around Schools

Department of Geography, University of Canterbury, Christchurch, New Zealand.
American journal of preventive medicine (Impact Factor: 4.28). 02/2011; 40(2):113-21. DOI: 10.1016/j.amepre.2010.10.018
Source: PubMed

ABSTRACT The increasing prevalence of overweight and obesity in school-aged children is potentially linked to contextual influences such as the food environment around schools. The proximity of fast-food and convenience stores to schools may enhance access to unhealthy foods and have a negative impact on diet.
This study used spatial cluster analysis to determine whether food outlets are clustered around schools and evaluated the extent of food outlet clustering by school and school neighborhood sociodemographic characteristics.
The locations in 2008 of all schools, fast-food outlets, and convenience stores in five urban regions across New Zealand were geocoded. Using GIS analysis conducted in 2009, the number and proportion of outlets within 400-m and 800-m road distance around each school was calculated. The spatial clustering of food outlets within 1.5 km of schools was determined using a multi-type K-function. Food outlet type, school level, SES, the degree of population density, and commercial land use zoning around each school were compared.
Primary/intermediate schools had a total proportion of 19.3 outlets per 1000 students within 800 m compared to 6.6 for secondary schools. The most socially deprived quintile of schools had three times the number and proportion of food outlets compared to the least-deprived quintile. There was a high degree of clustering of food outlets around schools, with up to 5.5 times more outlets than might be expected. Outlets were most clustered up to 800 m from schools and around secondary schools, socially deprived schools, and schools in densely populated and commercially zoned areas.
Food environments in New Zealand within walking proximity to schools are characterized by a high density of fast-food outlets and convenience stores, particularly in more-socially deprived settings. These obesogenic environments provide ready access to obesity-promoting foods that may have a negative impact on student diet and contribute to inequalities in health.

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    • "There is a growing body of research examining the food environments around schools, much of which focuses on the distance between food stores and fast food restaurants and schools (Austin et al., 2005; Day and Pearce, 2011; Jennings et al., 2011; Kestens and Daniel, 2010; Robitaille et al., 2010; Skidmore et al., 2009; Frank et al., 2006; Seliske et al., 2009). A greater density of fast-food restaurants or convenience stores around schools in lower socio-economic status (SES) neighbourhoods has been found in various communities in Canada and elsewhere (Day and Pearce, 2011; Kestens and Daniel, 2010; Robitaille et al., 2010). The distance to and density of fast-food restaurants have been associated with children's poorer food choice (Skidmore et al., 2009) and increased weight status (Jennings et al., 2011). "
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    ABSTRACT: We examined location-related accessibility to healthy and unhealthy food sources for school going children in Saskatoon, Saskatchewan. We compared proximity to food sources from school sites and from small clusters of homes (i.e., dissemination blocks) as a proxy for home location. We found that 1) unhealthy food sources are more prevalent near schools in lower income than higher income neighbourhoods; 2) unhealthy compared to healthy food sources are more accessible from schools as well as from places of residence; and 3) while some characteristics of neighbourhood low socio-economic status are associated with less accessibility to healthy food sources, there is no consistent pattern of access. Greater access to unhealthy food sources from schools in low-income neighbourhoods is likely a reflection of the greater degree of commercialization. Our spatial examination provides a more nuanced understanding of accessibility through our approach of comparing place of residence and school access to food sources.
    Spatial and Spatio-temporal Epidemiology 08/2014; DOI:10.1016/j.sste.2014.07.001
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    • "•Examine whether there is geographical clustering of tobacco outlets around secondary schools and whether there are changes in clustering over the study period. Using methods trialed by one of the research team (JP) in previous work [16], we will examine the spatial clustering of tobacco outlets within 1.5 km of each school. "
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    ABSTRACT: Tobacco advertising and product promotions have been largely banned in the UK but point of sale (POS) tobacco advertising is one of the few places where tobacco products may be legitimately advertised. POS displays have been shown to increase susceptibility to smoking, experimentation and initiation into smoking. These displays may also influence perceived prevalence of smoking and the perception that tobacco products are easily obtained and are a 'normal' product. A ban of POS tobacco advertising was introduced in Scotland in large tobacco retail outlets of over 280m2 internal sales floor areas (mainly supermarkets) in April 2013 and will be extended to include smaller tobacco retail outlets in April 2015. However, the impact of POS bans on smoking attitudes, behaviours and prevalence has yet to be determined.Methods/design: This study has a multi-modal before and after design and uses mixed methods to collect data, at baseline and then with longitudinal follow-up for 4 years, in four purposively selected communities. For the purposes of the study, community is defined as the catchment areas of the secondary schools selected for study. There are four main components to the on-going study. In each of the four communities, at baseline and in follow-up years, there will be: mapping and spatial analyses of tobacco retail outlets; tobacco advertising and marketing audits of tobacco retail outlets most used by young people; cross-sectional school surveys of secondary school pupils; and focus group interviews with purposive samples of secondary school pupils. The tobacco audit is supplemented by interviews and observations conducted with a panel of tobacco retailers recruited from four matched communities. This study examines the impact of the implementation of both a partial and comprehensive ban on point of sale (POS) tobacco advertising on attitudes to smoking, brand awareness, perceived ease of access to tobacco products and youth smoking prevalence. The results will be of considerable interest to policy makers both from the UK and other jurisdictions where they are considering the development and implementation of similar legislation.
    BMC Public Health 03/2014; 14(1):251. DOI:10.1186/1471-2458-14-251 · 2.32 Impact Factor
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    • "We used GIS to create buffer zones, with straight-line boundaries of 400m and 800m around each school, and a count of food retailers was calculated for each school. These distances approximate a five and ten minute walk, respectively (Day and Pearce, 2011). Copies of all secondary school food policies in the borough were requested and obtained (n ¼ 15). "
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    ABSTRACT: Purpose – The purpose of this paper is to explore the location of fast-food outlets around secondary schools and the influence of fast-food availability on the food choices of school children in an inner-London borough. Design/methodology/approach – A number of methods including: mapping of outlets relative to schools; sampling food; gathering data on secondary school food policies; observing food behaviour in fast food outlets and focus groups with young people. Findings were fed back to a committee consisting of representatives from nutrition, public health, planning services and local community groups. Findings – There are concentrations of fast-food outlets near schools and students reported use of these, including "stories" of skipping lunch in order to save money and eat after school at these outlets. Food from fast-food outlets was high in fat, saturated fat and salt, but these are not the only source of high such foods, with many of the students reporting buying from shops near the school or on the way to or from school. At lunchtime food outlets were less likely to be used by school students in areas near schools that have a "closed gate" policy. Research limitations/implications – The "snapshot" nature of the research limited what can be said about the food behaviours of the children outside school hours. Practical implications – The local policy context requires action to improve both the food offered in schools and the immediate environment around the school in order to tackle fast-food and other competitive foods on offer outside the school. Originality/value – This is one of the first studies in the UK to systematically map fast food outlets around schools and explore what might be done. This research shows how it is possible to link the findings of local research and develop local responses from both public health and local authority planning perspectives. The research moves away from a mere documenting of problems to devising integrated public health solutions. The findings show how public health and planning services can work together to the mutual benefit of each other.
    British Food Journal 02/2014; 116(3). DOI:10.1108/BFJ-02-2012-0042 · 0.77 Impact Factor
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