Characteristics of Prepared Food Sources in Low-Income Neighborhoods of Baltimore City

Center for Human Nutrition, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205-2179, USA.
Ecology of Food and Nutrition (Impact Factor: 0.81). 11/2010; 49(6):409-30. DOI: 10.1080/03670244.2010.524102
Source: PubMed


The food environment is associated with obesity risk and diet-related chronic diseases. Despite extensive research conducted on retail food stores, little is known about prepared food sources(PFSs). We conducted an observational assessment of all PFSs(N = 92) in low-income neighborhoods in Baltimore. The most common PFSs were carry-outs, which had the lowest availability of healthy food choices. Only a small proportion of these carry-outs offered healthy sides, whole wheat bread, or entrée salads (21.4%, 7.1%, and 33.9%, respectively). These findings suggest that carry-out-specific interventions are necessary to increase healthy food availability in low-income urban neighborhoods.

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Available from: Joel Gittelsohn,
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    • "In the U.S., poorer places and neighborhoods with a high concentration of African Americans often have fewer grocery stores or supermarkets, but have more carry-out and fast food restaurants [10,11]. Supermarkets or large size grocery stores are more likely to provide wholesome food choices, while carry-out and fast food restaurants often provide ready-to-go foods prepared using efficient procedures but with less healthy ingredients [11-18]. These neighborhoods are more likely to be “food deserts,” lacking availability or accessibility to healthy food options [19]. "
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    ABSTRACT: Little is known about the dynamics of the food outlet distributions associated with local contextual factors in the U.S. This study examines the changes in food stores/services at the 5-digit Zip Code Tabulated Area (ZCTA5) level in the U.S., and assesses contextual factors associated with the changes. Data from 27,878 ZCTA5s in the contiguous United States without an extreme change in the number of 6 types of food stores/services (supermarkets, small-size grocery stores, convenience stores, fresh/specialty food markets, carry-out restaurants, and full-service restaurants) were used. ZCTA5s' contextual factors were from the 2000 Census. Numbers of food stores/services were derived from the Census Business Pattern databases. Linear regression models assessed contextual factors' influences (racial/ethnic compositions, poverty rate, urbanization level, and foreign-born population%) on 1-year changes in food stores/services during 2000-2001, adjusted for population size, total business change, and census regions. Small-size grocery stores and fresh/specialty food markets increased more and convenience stores decreased more in Hispanic-predominant than other areas. Among supermarket-free places, new supermarkets were less likely to be introduced into black-predominant than white-predominant areas (odds ratio (OR) = 0.52, 95% CI = 0.30-0.92). However, among areas without the following type of store at baseline, supermarket (OR = 0.48 (0.33-0.70)), small-size grocery stores (OR = 1.32 (1.08-1.62)), and fresh/specialty food markets (OR = 0.70 (0.53-0.92)) were less likely to be introduced into areas of low foreign-born population than into areas of high foreign-born population. Higher poverty rate was associated with a greater decrease in supermarket, a less decrease in small-size grocery stores, and a less increase in carry-out restaurants (all p for trends <0.001). Urban areas experienced more increases in full-service and carry-out restaurants than suburban areas. Local area characteristics affect 1-year changes in food environment in the U.S. Hispanic population was associated with more food stores/services capable of supplying fresh food items. Black-predominant and poverty-afflicted areas had a greater decrease in supermarkets. Full-service and carry-out restaurants increased more in urban than suburban areas. Foreign-born population density was associated with introduction of grocery stores and fresh/specialty food markets into the areas.
    BMC Public Health 01/2014; 14(1):42. DOI:10.1186/1471-2458-14-42 · 2.26 Impact Factor
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    • "The high prevalence of prepared food sources and the increased consumption of prepared foods are particularly problematic for low-income urban areas. The most common food sources in these areas are small prepared food sources such as fast food restaurants and carry-outs [9-11]. Carry-outs are defined as non-franchised small local food establishments that sell ready-to-eat food and beverages for off-premise consumption [12]. "
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    ABSTRACT: Prepared food sources, including fast food restaurants and carry-outs, are common in low-income urban areas. These establishments provide foods high in calories, sugar, fat, and sodium. The aims of the study were to (1) describe the development and implementation of a carry-out intervention to provide and promote healthy food choices in prepared food sources, and (2) to assess its feasibility through a process evaluation. To promote healthy eating in this setting, a culturally appropriate intervention was developed based on formative research from direct observation, interviews and focus groups. We implemented a 7-month feasibility trial in 8 carry-outs (4 intervention and 4 comparison) in low-income neighborhoods in Baltimore, MD. The trial included three phases: 1) Improving menu boards and labeling to promote healthier items; 2) Promoting healthy sides and beverages and introducing new items; and 3) Introducing affordable healthier combo meals and improving food preparation methods. A process evaluation was conducted to assess intervention reach, dose received, and fidelity using sales receipts, carry-out visit observations, and an intervention exposure assessment. On average, Baltimore Healthy Carry-outs (BHC) increased customer reach at intervention carry-outs; purchases increased by 36.8% at the end of the study compared to baseline. Additionally, menu boards and labels were seen by 100.0% and 84.2% of individuals (n = 101), respectively, at study completion compared to baseline. Customers reported purchasing specific foods due to the presence of a photo on the menu board (65.3%) or menu labeling (42.6%), suggesting moderate to high dose received. Promoted entree availability and revised menu and poster presence all demonstrated high fidelity and feasibility. The results suggest that BHC is a culturally acceptable intervention. The program was also immediately adopted by the Baltimore City Food Policy Initiative as a city-wide intervention in its public markets.
    BMC Public Health 07/2013; 13(1):638. DOI:10.1186/1471-2458-13-638 · 2.26 Impact Factor
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    • "Using Arc GIS10 we constructed a separate kernel density of fast food chain outlets within a half-mile radius of each non-supermarket store. Of note, focusing on national and regional fast food chains leaves out other sources of prepared food, which in some low-income urban areas have been shown to be more prevalent than fast food restaurants (Lee, et al., 2010). "

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