Physical, Consumer, and Social Aspects of Measuring the Food Environment Among Diverse Low-Income Populations

Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205-2179, USA.
American journal of preventive medicine (Impact Factor: 4.53). 04/2009; 36(4 Suppl):S161-5. DOI: 10.1016/j.amepre.2009.01.007
Source: PubMed


Obesity and other diet-related chronic diseases are directly related to the food environment. We describe how to better assess the food environment in specific ethnic minority settings for designing and implementing interventions, based on a review of our previous work on the food environment in American Indian reservations, Canadian First Nations reserves, the Republic of the Marshall Islands, and inner-city Baltimore. The types of food stores available within each setting and the range of healthy foods available varied greatly across these geographic regions. In all settings, proximity to food stores/supermarkets, cost, and limited availability of healthful foods were common features, which limited access to health-promoting food options. Features specific to each population should be considered in an assessment of the food environment, including physical (e.g., openness of stores, mix of types of food sources); consumer (e.g., adequacy of the food supply, seasonal factors); and social (e.g., inter-household food sharing, perceptions of food quality, language differences) aspects. The food environments common in low-income ethnic subpopulations require special focus and consideration due to the vulnerability of the populations and to specific and unique aspects of each setting.

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Available from: Joel Gittelsohn, Oct 01, 2015
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    • "Globalization, free trade, economic growth and urbanization are macro-level factors that increased utilization of new food production technologies, and influenced the types of foods available in neighborhoods worldwide (Monteiro, Levy, Claro, de Castro, & Cannon, 2011; Monteiro, Moubarac, Cannon, Ng, & Popkin, 2013; Pérez-Cueto et al., 2010; Townshend & Lake, 2009). Although the availability of healthy foods is a significant influence on food choice (Hawkes, 2009; Larson & Story, 2009; Murakami, Sasaki, Takahashi, & Uenishi, 2009; Walker, Block, & Kawachi, 2012), the consumer decisions are also motivated by other factors, including: perceived barriers to obtaining healthy food (such as distance to food sources), quality of food sold, prices, and store attributes such as store size, food safety, cleanliness, customer service, and brands sold (Blitstein, Snider, & Evans, 2012; Gittelsohn & Sharma, 2009; Krukowski, McSweeney, Sparks, & West, 2012; Larson & Story, 2009; Macdonald, Ellaway, Ball, & Macintyre, 2011; Morland & Evenson, 2009; Thornton, Pearce, Macdonald, Lamb, & Ellaway, 2012; Walker et al., 2012). These factors may interact with community ☆ Acknowledgements: The authors wish to thank all the families who participated in the study and the interviewers for their cooperation in collecting the data. "
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    ABSTRACT: Objective: This cross-sectional study examined the association between local food environment and consumers' acquisition of ultra-processed food. Methods: Households were randomly selected from 36 census tracts in Santos City, Brazil. Mothers, of varying economic status, who had children ages 10 or younger (n = 538) were interviewed concerning: their household food acquisition of 31 groups of food and beverages, perceptions of local food environment, food sources destinations, means of transportation used, and socioeconomic status. Food acquisition patterns were classified based on the degree of industrial food processing. Logistic regression models were fitted to assess the association between consumer behaviors and acquisition patterns. Results: The large variety of fresh produce available in supermarkets was significantly related to lower odds of ultra-processed food purchases. After adjusting for sociodemographic characteristics, higher odds for minimally-processed food acquisition were associated with: frequent use of specialized markets to purchase fruits and vegetables (OR 1.89, 95% CI 1.01-2.34), the habit of walking to buy food (OR 1.58, 95% CI 1.08-2.30), and perceived availability of fresh produce in participants' neighborhood (OR 1.58, 95% CI 1.08-2.30). Acquisition of ultra-processed food was positively associated with the use of taxis as principal means of transportation to food sources (OR 2.35, 95% CI 1.08-5.13), and negatively associated with perceived availability of a variety of fruits and vegetables in the neighborhood (OR 0.57, 95% CI 0.37-0.88). Conclusion: The results suggest that interventions aiming to promote acquisition of less processed food in settings similar to Santos, may be most effective if they focus on increasing the number of specialized fresh food markets in local neighborhood areas, improve residents' awareness of these markets' availability, and provide appropriate transportation.
    Appetite 01/2015; 87. DOI:10.1016/j.appet.2014.12.229 · 2.69 Impact Factor
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    • "The nutritional status of AI/ANs has dramatically shifted in the past few decades from one of under-nutrition to that of poor nutrition characterized by excessive caloric intake of food with poor nutritional content [45], [46]. Access to healthy foods, especially fresh fruits and vegetables, are impeded by low income, geographical isolation, and the paucity of inexpensive vendors on reservation land, resulting in food deserts for many AI/AN nations [47], [48], [49]. Sustained, wide-scale, traditional agriculture has been challenged by limited water access, pest control, and regulatory requirements for commercial production [50]. "
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    ABSTRACT: American Indians and Alaska Native (AI/AN) populations experience significant health disparities compared to non-Hispanic white populations. Cardiovascular disease and related risk factors are increasingly recognized as growing indicators of global health disparities. However, comparative reports on disparities among this constellation of diseases for AI/AN populations have not been systematically reviewed. We performed a literature review on the prevalence of diabetes, metabolic syndrome, dyslipidemia, obesity, hypertension, and cardiovascular disease; and associated morbidity and mortality among AI/AN. A total of 203 articles were reviewed, of which 31 met study criteria for inclusion. Searches were performed on PUBMED, MEDLINE, the CDC MMWR, and the Indian Health Services. Published literature that were published within the last fifteen years and provided direct comparisons between AI/AN to non-AI/AN populations were included. We abstracted data on study design, data source, AI/AN population, comparison group, and. outcome measures. A descriptive synthesis of primary findings is included. Rates of obesity, diabetes, cardiovascular disease, and metabolic syndrome are clearly higher for AI/AN populations. Hypertension and hyperlipidemia differences are more equivocal. Our analysis also revealed that there are likely regional and gender differences in the degree of disparities observed. Studies using BRFSS telephone surveys administered in English may underestimate disparities. Many AI/AN do not have telephones and/or speak English. Regional variability makes national surveys difficult to interpret. Finally, studies using self-reported data may not be accurate. Profound health disparities in cardiovascular diseases and associated risk factors for AI/AN populations persist, perhaps due to low socioeconomic status and access to quality healthcare. Successful programs will address social determinants and increase healthcare access. Community-based outreach to bring health services to the most vulnerable may also be very helpful in this effort. N/A.
    PLoS ONE 01/2014; 9(1):e80973. DOI:10.1371/journal.pone.0080973 · 3.23 Impact Factor
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    • "Since the beginning of the 1970s, UA projects have been developed " as a way to counteract inflation, civic unrest, abandoned properties, and to satisfy new environmental ethics and open space needs " (Lawson, 2004, p. 163). As a subversive movement, the practice of UA generally increases social capital, civic involvement, community efficacy, and empowerment (Armstrong, 2000; Ferris, Norman, & Sempik, 2001; Gittelsohn & Sharma, 2009; Teig et al., 2009). In addition, studies have identified public participation as a crucial component of the food security planning process (Jacobsen, "
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    ABSTRACT: This paper examines the role of urban agriculture (UA) projects in relieving food insecurity in lowerincome neighborhoods of post-industrial U.S. cities, using Philadelphia as a case study. Based on food justice literature and mixed-methods such as GIS, survey, field observations, and interviews, we discuss how neighborhoods, nearby residents, and the local food economy interact with UA projects. Our findings suggest that, although UA projects occupy a vital place in the fight against community food insecurity in disadvantaged inner-city neighborhoods, there are debates and concerns associated with the movement. These concerns include geographic, economic, and informational accessibility of UA projects; social exclusion in the movement; spatial mismatch between UA participants and neighborhood socioeconomic and racial profiles; distribution of fresh produce to populations under poverty and hunger; and UA’s economic contributions in underprivileged neighborhoods. Finally, we outline future research directions that are significant to understanding the practice of UA.
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