ArticlePDF Available

Green Carts (Mobile Produce Vendors) in the Bronx-Optimally Positioned to Meet Neighborhood Fruit-and-Vegetable Needs?

Authors:
  • City University of New York City - Lehman College; City University of New York School of Public Health
Article

Green Carts (Mobile Produce Vendors) in the Bronx-Optimally Positioned to Meet Neighborhood Fruit-and-Vegetable Needs?

Abstract and Figures

Poor access to fresh produce likely contributes to disparities in obesity and diet-related diseases in the Bronx. New York City's Green Cart program is a partial response to the problem. We evaluated this program (permitting street vendors to sell fresh produce) by canvassing the Bronx for carts, interviewing vendors, and analyzing their locations and food offerings. Green Carts were clustered in areas of probable high pedestrian traffic, covering only about 57% of needy areas by liberal estimates. Some carts sold outside allowed boundaries; a few sold sugary snacks. Vendor locations and their food offerings suggest possible areas for program improvement.
Content may be subject to copyright.
Journal of Urban Health: Bulletin of the New York Academy of Medicine
doi:10.1007/s11524-011-9593-2
*2011 The New York Academy of Medicine
Green Carts (Mobile Produce Vendors)
in the BronxOptimally Positioned to Meet
Neighborhood Fruit-and-Vegetable Needs?
Sean C. Lucan, Andrew Maroko, Renee Shanker,
and William B. Jordan
ABSTRACT Poor access to fresh produce likely contributes to disparities in obesity and
diet-related diseases in the Bronx. New York Citys Green Cart program is a partial
response to the problem. We evaluated this program (permitting street vendors to sell
fresh produce) by canvassing the Bronx for carts, interviewing vendors, and analyzing
their locations and food offerings. Green Carts were clustered in areas of probable high
pedestrian traffic, covering only about 57% of needy areas by liberal estimates. Some
carts sold outside allowed boundaries; a few sold sugary snacks. Vendor locations and
their food offerings suggest possible areas for program improvement.
INTRODUCTION
Obesity and diet-related diseases disproportionately affect urban, low-income,
minority communities.
1
The BronxNew York City (NYC)s poorest borough with
large Hispanic/Latino (52%) and Black (34%) populations
2
provides a clear
example. The Bronx has alarming rates of obesity, diabetes, heart disease, and
cancer, and the worst health outcomes in New York State, particularly among its
racial and ethnic minorities.
3,4
Reasons for disproportionate disease are likely multifactorial, but unfavorable
diet almost certainly contributes. For instance, diets low in fruits and vegetables are
thought to contribute to obesity, chronic disease, and early mortality,
5,6
and the
Bronx has the highest percentage of NYC residents reporting no fruits or vegetables
consumed the previous day (18.2% vs. 9.1% in Manhattan, for example).
4
A substantial and growing body of evidence relates low fruit-and-vegetable
intake with having limited nearby sources of fresh produce.
7,8
In the Bronx, 35% of
residents report having to walk more than 10 minutes to buy fresh produce,
4
and
most households have no car.
9
Recognizing poor health outcomes likely exacerbated by limited access to fresh
produce, NYCs Department of Health and Mental Hygiene (DOHMH) has
pursued several strategies to increase access. A prime example is the Green Cart
program.
10
The program, started in 2008, aims to increase fresh fruit-and-vegetable
availability in the citys most underserved areas by way of street carts (which up
until 2008, did not deal appreciably in produce vending in poor neighborhoods).
Street carts selling whole fresh produce (i.e., Green Carts) are granted permits to
Lucan, Shanker, and Jordan are with the Department of Family and Social Medicine, Monteore Medical
Center/Albert Einstein College of Medicine, Bronx, NY, USA; Maroko is with the Department of Health
Sciences, Lehman College, City University of New York, Bronx, NY, USA.
Correspondence: Sean C. Lucan, Department of Family and Social Medicine, Monteore Medical
Center/Albert Einstein College of Medicine, Bronx, NY, USA. (E-mail: slucan@yahoo.com)
sell in specied areas (designated by DOHMH based on the reported low-produce
consumption of area residents).
10
The specied area in the Bronx is the most
extensive of any NYC borough.
10
While DOHMH is currently conducting its own assessment of Green Carts,
there have been no published Green Cart evaluations to date. Our team sought to
determine where Green Carts are located and what they sell in the Bronx in order to
understand potential implications for program viability and community nutrition
and health.
METHODS
Two pairs of researchers, working separately on distinct projects, canvassed the
Bronx in search of Green Carts. One pair rode all city bus routes in the specied
Green Cart area, looking down side streets en route. The other pair used a personal
vehicle to drive Bronx streets. Togetherdespite missed side streets by the public-
transportation pair, and missed southwestern neighborhoods by the personal-vehicle
FIGURE 1. There were 61 Green Carts identied. There were 8 signicant Green Cart clusters
(minimum of 3 Green Carts with maximum span of 0.5 miles per cluster). Notable adjacent
landmarks by cluster were as follows: A. Monteore Medical Center - Moses Division, Childrens
Hospital at Monteore, North Central Bronx Hospital, Mosholu Monteore Community Center,
Jerome-Gun Hill Business Improvement District, B. New York Presbyterian Hospital - Allen Hospital
(Manhattan), River Plaza Shopping Center (Bronx), C. James J Peters VA Medical Center, Monroe
College, Fordham University, Monteore Medical Center - Fordham Plaza, New York Public Library,
Fordham Road Business Improvement District, 4 / D Subway Lines, 12 Select Bus Line, Metro-North
Railroad Station, D. Bronx Zoo, E. East Tremont Medical Center, F. Urban Horizons Family Health,
Essen Medical Associates, New York Public Library, G. Hunts Point Library, Point Community Center,
Hunts Point Recreation Center, Sustainable South Bronx, H. Hostos Community College, Lincoln
Hospital, St. Barnabas Hospital, College of New Rochelle, 2 / 4 / 5 Subway Lines
LUCAN ET AL.
pairthe two pairs covered the entire geographic area of the Bronx, with signicant
overlap for most neighborhoods.
Both pairs of researchers canvassed during business hours on weekdays from
JuneAugust 2010, recording the location and permit number for each identied
Green Cart. One pair recorded items being sold, and asked vendors about when the
cart usually sells or if it ever sells in another location.
We determined spatial coordinates for all Green Cart addresses and plotted
locations using ArcGIS.
11
To test for spatial clustering, we used ArcGISaverage
nearest neighbor analysis. To identify specic clusters, we used Crimestat III
12
for
nearest neighbor hierarchical spatial clustering, setting a minimum of three Green
Carts at a maximum distance of 0.5 miles per cluster. Finally, we used ArcGIS for
kernel density estimations, to generate Green Cart hotspotsusing a 0.5-mile
bandwidth (a likely more liberal accessibility thresholdthan in other studies
using, for example, 5-min walk to fruit-and-vegetable markets).
13
RESULTS
Cumulatively, we identied 61 unique Green Carts. Figure 1shows that identied
Green Carts were not evenly distributed. The average-nearest-neighbor-analysis
ratio of observed-to-expected distances between Green Carts was 0.54 (G1=
clustered, 1=random, and 91=dispersed), pG0.0001. Nearest neighbor hierarchical
spatial clustering identied eight clusters; these were around medical, academic,
transportation, retail, and recreation centers (see footnotes to Figure 1). Nearly 43%
of the specied Green Cart area was not within the generous 0.5-mile accessibility
threshold around identied carts.
Researchers observed 3 of the 61 Green Carts selling outside the specied area, with
other vendors admitting to sometimes doing likewise. Of 21 Green Carts for which we
recorded specic foods, three sold cookies and/or sugar-sweetened beverages.
DISCUSSION
In this rst-ever study of NYC Green Carts, we identied 61 carts that tended to
cluster near centers of probable high pedestrian trafc. While such centers might
offer large numbers of potential customers, competition for business and space in
these areas could also constrain vendor prots,
14
thereby threatening program
success.
Vendor clustering might also limit the provision of fresh produce to commun-
ities most in need. While Green Carts were generally located in disadvantaged
neighborhoods, there were often miles of Green Cart desertsbetween hotspots.
Green Carts were absent from some of the neediest Bronx neighborhoods. Vendor
concerns for the volume of foot trafc may have contributed to this absence, as well
as to the small number of vendors locating unlawfully in neighborhoods less
challenged by access to fresh produce.
4
We witnessed at least a small number of Green Carts selling expressly
disallowed sugary drinks and cookies. These products run counter to the programs
intent of improving community nutrition and health.
Our ndings highlight opportunities for future research to improve NYCs
important Green Cart program. For instance, researchers could explore differences
in prots between vendors clustered in high trafc areas and/or selling sugary treats
GREEN CARTS IN THE BRONXOPTIMALLY POSITIONED TO MEET NEEDS?
versus those selling produce only in areas of minimal competition but perhaps less
foot trafc.
Opportunities for additional research suggest some of the limitations of our own
work. First, we are unable to comment on vendor sales, protability, or exact customer
base (e.g., it is possible that residents of disadvantaged neighborhoods have access to
Green Carts around where they work even if there are no Green Carts near their
homes). Also, our ndings are only a composite snapshot, representing the combination
of two separate but corroborating cross-sectional samples. If carts were in locations at
different times than either of our two research teams, they would have been missed.
While DOHMH has granted more than twice as many permits as the number of Green
Carts we identied (113 granted as of June 21; 145 as of August 19) it is unclear how
many permitees ever started (or continue) to vend.
15,16
Reassuringly, our nal
composite list of carts was consistent with a list compiled by the citys consulting
rm providing technical assistance to Green Cart vendors.
16
In spite of limitations, our work points to potential strategies to enhance
Green Cart implementation. For instance, to move Green Carts into disadvan-
taged neighborhoods where carts are absent: (1) the city might expand
community partnerships to create local demand, (2) community groups might
enlist residents of disadvantaged neighborhoods to become Green Cart vendors,
and (3) vendors might explore establishing electronic benettransferfor
potential Supplemental Nutrition Assistance Program customers. NYC could
also consider increasing efforts to attract more potential vendors to the Green
Cart program: e.g., expanding advertising and informational sessions at
community centers, modifying credit-history requirements for microloans for
cart purchases, or having a leasing option for carts. Indeed, with less than half
of the Bronxs allotted permits having already been granted, issues of
geographic maldistribution could self-correct if future vendors take to the
streets. Finally, support for Green Cart vendors (often immigrants with limited
English prociency, lower education, and little business experience)
2
might
come through community groups, to help vendors spread out, sell within the
limits of the law, and still generate sufcient revenue to provide fresh produce
where needed.
ACKNOWLEDGEMENTS
The authors would like to thank Cassandra Flechsig from Karp Resources for
providing data and reviewing this manuscript; Hope M. Spano from the Hispanic
Center of Excellence at the Albert Einstein College of Medicine and Mary Huynh
from the Bronx Careers in Health and Mentoring Program of Lehman College for
nancial support and intern coordination; the Laurie M. Tisch Illumination Fund
for a grant to Monteore Medical Center and the Street Vendor Project of the Urban
Justice Center to support street outreach; Gustavo Hernandez, Monica Varona,
Gillian Saunders, and Sushant Bhalla for performing data collection; Nandini Deb,
MA of Monteore Medical Center and Mahbooba Akhter Kabita of Westchester
Square Partnership for translation of the vendor questionnaire into Bengali.
This publication was made possible by the CTSA Grant UL1 RR025750 and KL2
RR025749 and TL1 RR025748 from the National Center for Research Resources
(NCRR), a component of the National Institutes of Health (NIH), and NIH
Roadmap for Medical Research. Its contents are solely the responsibility of the
authors and do not necessarily represent the ofcial view of the NCRR or NIH.
LUCAN ET AL.
REFERENCES
1. Jeffery RW. Population perspectives on the prevention and treatment of obesity in
minority populations. Am J Clin Nutr. 1991; 53(6 Suppl): 1621S1624S.
2. U.S. Census Bureau. 20062008 American Cummunity Survey. http://fastfacts.census.gov/
servlet/ACSCWSFacts?_event=&geo_id=05000US36005&_geoContext=01000US|
04000US36|05000US36005&_street=&_county=05000US36005&_cd=&_city Town=&_sta-
te=&_zip=10461&_lang=en&_sse=on&ActiveGeoDiv=&_useEV=&pctxt=fph&pgsl=050&_-
content=&_keyword=&_industry.AccessedNovember30,2010.
3. County Health RankingsMobilizing Action Toward Community Health. Snapshot
2010: Bronx. http://www.countyhealthrankings.org/new-york/bronx. Accessed June 2,
2010.
4. New York City Department of Health and Mental Hygiene. EpiQuery: Community
Health Survey, 20022009. https://a816-healthpsi.nyc.gov/epiquery/EpiQuery/CHS/
index2009.html. Accessed March 7, 2011.
5. Crowe FL, Roddam AW, Key TJ, et al. Fruit and vegetable intake and mortality from
ischaemic heart disease: results from the European Prospective Investigation into Cancer
and Nutrition (EPIC)-Heart study. Eur Heart J. 2011 (in press).
6. Tonstad S, Butler T, Yan R, Fraser GE. Type of vegetarian diet, body weight, and
prevalence of type 2 diabetes. Diabetes Care. 2009; 32(5): 791796.
7. Kamphuis CB, Giskes K, de Bruijn GJ, Wendel-Vos W, Brug J, van Lenthe FJ.
Environmental determinants of fruit and vegetable consumption among adults: a
systematic review. Br J Nutr. 2006; 96(4): 620635.
8. Larson NI, Story MT, Nelson MC. Neighborhood environments: disparities in access to
healthy foods in the U.S. Am J Prev Med. 2009; 36(1): 7481.
9. U.S. Census Bureau. American FactFinder: Vehicles available and Household Income in
1999:2000. http://factnder.census.gov/servlet/QTTable?_bm=y&-geo_ id=05000US36005&-
qr_name=DEC_2000_SF4_U_QTH11&-ds_name=D&-_lang=en&-redoLog=false.Accessed
November 30, 2010.
10. New York City Department of Health and Mental Hygiene. NYC Green Carts. http://
www.nyc.gov/html/doh/html/cdp/cdp_pan_green_carts.shtml. Accessed September 18,
2010.
11. ArcGIS [computer program]. Version 9.3.1. Redlands, CA: ESRI. http://www.esri.com/
software/arcgis/whats-new/index.html. Accessed December 10, 2010.
12. Crimestat III [computer program]. Version 3.3. Houston, TX and Washington, DC: Ned
Levine & Associates and The National Institute of Justice. http://www.icpsr.umich.edu/
CrimeStat/. Accessed December 10, 2010.
13. Raja S, Ma C, Yadav P. Beyond food deserts: measuring and mapping racial disparities in
neighborhood food environments. J Plann Educ Res. 2008; 27: 469482.
14. Baroni BN Spatial Stratification of Street Vendors in Downtown Mexico City [master's
thesis.] Cambridge, MA: Department of Urban Studies and Planning, Massachusetts
Institute or Technology; 2007. http://dspace.mit.edu/bitstream/handle/1721.1/39932/
182760220.pdf?sequence=1. Accessed December 10, 2010.
15. New York City Department of Health and Mental Hygienes Physical Activity and
Nutrition Program. Email communications to Sean Lucan from Deputy Director, Sabrina
Baronberg on November 17, 2010, and from Director, Cathy Nonas on March 4, 2011,
as well as phone conversations on other dates
16. Karp Resources. Email communication to William Jordan from Project Coordinator,
Cassandra Flechsig, on November 8, 2010
GREEN CARTS IN THE BRONXOPTIMALLY POSITIONED TO MEET NEEDS?
... Seulement, au moins à court terme, l'effet de ces politiques apparaît faible ou incertain. L'impact des politiques de renforcement de l'accès aux produits frais est limité par la réticence des promoteurs et commerçants à participer aux programmes, le manque d'espaces vacants et des incitations trop faibles (Cohen 2018), ou encore l'évitement des secteurs les plus défavorisés (Lucan et al. 2011;Li et al. 2014). L'efficacité des politiques de régulation de fastfoods n'est pas non plus démontrée (Keeble et al. 2019), tant sur la prévalence de l'obésité que sur l'amélioration de l'environnement alimentaire (Sturm et Hattori 2015;Brown et al. 2021). ...
Thesis
Full-text available
Cette thèse propose d’analyser l’organisation spatiale de l’offre alimentaire et ses effets sur les comportements de consommation, dans la perspective de construire une géographie des paysages alimentaires urbains. Elle mobilise pour cela le concept émergeant de foodscapes permettant de spatialiser l’offre alimentaire. L’objectif est de caractériser d’abord la diversité des foodscapes, leurs dynamiques d’évolution, afin de pouvoir ensuite évaluer l’impact de l’environnement alimentaire local sur les comportements alimentaires. Au niveau scientifique, ce sujet se positionne sur un front de recherche à la croisée de deux courants en plein essor : l’urban food planning et la géographie urbaine de la santé. Au niveau opérationnel, ce projet de thèse permettra d’élaborer des diagnostics territoriaux de l’offre alimentaire et pourra déboucher sur des recommandations aux politiques publiques en termes de design urbain, d'urbanisme commercial et de gouvernance locale des foodscapes. Il éclairera les questions de durabilité liées à la réduction des inégalités sociales dans les systèmes alimentaires urbains.
... As a starting point for data collection, investigators drafted a rough data-collection tool based on tools from prior foodenvironment research [32][33][34][35][36][37]. The tool was then refined nyc.gov/epiqu ery/CHS/CHSXI ndex.html. ...
Article
Full-text available
The overall nutritional quality of foods/drinks available at urban food pantries is not well established. In a study of 50 pantries listed as operating in the Bronx, NY, data on food/drink type (fresh, shelf-stable, refrigerated/frozen) came from direct observation. Data on food/drink sourcing (food bank or other) and distribution (prefilled bag vs. client choice for a given client’s position in line) came from semi-structured interviews with pantry workers. Overall nutritional quality was determined using NuVal® scores (range 1–100; higher score indicates higher nutritional quality). Twenty-nine pantries offered zero nutrition at listed times (actually being closed or having no food/drinks in stock). Of the 21 pantries that were open as listed and had foods/drinks to offer, 12 distributed items in prefilled bags (traditional pantries), 9 allowed for client choice. Mean NuVal® scores were higher for foods/drinks available from client-choice pantries than traditional pantries (69.3 vs. 57.4), driven mostly by sourcing fresh items (at 28.3% of client-choice pantries vs. 4.8% of traditional pantries). For a hypothetical ‘balanced basket’ of one of each fruit, vegetable, grain, dairy and protein item, highest-NuVal® items had a mean score of 98.8 across client-choice pantries versus 96.6 across traditional pantries; lowest-NuVal® items had mean scores of 16.4 and 35.4 respectively. Pantry workers reported lower-scoring items (e.g., white rice) were more popular—appeared in early bags or were selected first—leaving higher-scoring items (e.g., brown rice) for clients later in line. Fewer than 50% of sampled pantries were open and had food/drink to offer at listed times. Nutritional quality varied by item type and sourcing and could also vary by distribution method and client position in line. Findings suggest opportunities for pantry operation, client and staff education, and additional research.
Article
Full-text available
Past research on food-environment change has been limited in key ways: (1) considering only select storefront businesses; (2) presuming items sold based only on businesses category; (3) describing only ecological changes; (4) considering only multi-year intervals. The current study addressed past limitations by: (1) considering a full range of both storefront and non-storefront businesses; (2) focusing on items actually offered (both healthful and less-healthful varieties); (3) describing individual-business-level changes (openings, closings, changes in offerings); (4) evaluating changes within a single year. Using a longitudinal, matched-pair comparison of 119 street segments in the Bronx, NY (October 2016-August 2017), investigators assessed all businesses—food stores, restaurants, other storefront businesses (OSBs), street vendors—for healthful and less-healthful food/drink offerings. Changes were described for individual businesses, individual street segments, and for the area overall. Overall, the number (and percentage) of businesses offering any food/drink increased from 45 (41.7%) in 2016 to 49 (45.8%) in 2017; businesses newly opening or newly offering food/drink cumulatively exceeded those shutting down or ceasing food/drink sales. In 2016, OSBs (gyms, barber shops, laundromats, etc.) together with street vendors represented 20.0% and 27.3% of businesses offering healthful and less-healthful items, respectively; in 2017, the percentages were 31.0% and 37.0%. While the number of businesses offering healthful items increased, the number offering less-healthful items likewise increased and remained greater. If change in a full range of food/drink availability is not appreciated: food-environment studies may generate erroneous conclusions; communities may misdirect resources to address food-access disparities; and community residents may have increasing, but unrecognized, opportunities for unhealthful consumption.
Article
Full-text available
Objective Conceptualisations of ‘food deserts’ (areas lacking healthful food/drink) and ‘food swamps’ (areas overwhelm by less-healthful fare) may be both inaccurate and incomplete. Our objective was to more accurately and completely characterise food/drink availability in urban areas. Design Cross-sectional assessment of select healthful and less-healthful food/drink offerings from storefront businesses (stores, restaurants) and non-storefront businesses (street vendors). Setting Two areas of New York City: the Bronx (higher-poverty, mostly minority) and the Upper East Side (UES; wealthier, predominantly white). Participants All businesses on 63 street segments in the Bronx ( n 662) and on 46 street segments in the UES ( n 330). Results Greater percentages of businesses offered any , any healthful, and only less-healthful food/drink in the Bronx (42·0 %, 37·5 %, 4·4 %, respectively) than in the UES (30 %, 27·9 %, 2·1 %, respectively). Differences were driven mostly by businesses (e.g. newsstands, gyms, laundromats) not primarily focused on selling food/drink – ‘other storefront businesses’ (OSBs). OSBs accounted for 36·0 % of all food/drink-offering businesses in the Bronx (more numerous than restaurants or so-called ‘food stores’) and 18·2 % in the UES (more numerous than ‘food stores’). Differences also related to street vendors in both the Bronx and the UES. If street vendors and OSBs were not captured, the missed percentages of street segments offering food/drink would be 14·5 % in the Bronx and 21·9 % in the UES. Conclusions Of businesses offering food/drink in communities, OSBs and street vendors can represent substantial percentages. Focusing on only ‘food stores’ and restaurants may miss or mischaracterise ‘food deserts’, ‘food swamps’, and food/drink-source disparities between communities.
Article
Full-text available
Objective: To assess the accuracy of government inspection records, relative to ground observation, for identifying businesses offering foods/drinks. Design: Agreement between city and state inspection records v. ground observations at two levels: businesses and street segments. Agreement could be 'strict' (by business name, e.g. 'Rizzo's') or 'lenient' (by business type, e.g. 'pizzeria'); using sensitivity and positive predictive value (PPV) for businesses and using sensitivity, PPV, specificity and negative predictive value (NPV) for street segments. Setting: The Bronx and the Upper East Side (UES), New York City, USA. Participants: All food/drink-offering businesses on sampled street segments (n 154 in the Bronx, n 51 in the UES). Results: By 'strict' criteria, sensitivity and PPV of government records for food/drink-offering businesses were 0·37 and 0·57 in the Bronx; 0·58 and 0·60 in the UES. 'Lenient' values were 0·40 and 0·62 in the Bronx; 0·60 and 0·62 in the UES. Sensitivity, PPV, specificity and NPV of government records for street segments having food/drink-offering businesses were 0·66, 0·73, 0·84 and 0·79 in the Bronx; 0·79, 0·92, 0·67, and 0·40 in the UES. In both areas, agreement varied by business category: restaurants; 'food stores'; and government-recognized other storefront businesses ('gov. OSB', i.e. dollar stores, gas stations, pharmacies). Additional business categories - 'other OSB' (barbers, laundromats, newsstands, etc.) and street vendors - were absent from government records; together, they represented 28·4 % of all food/drink-offering businesses in the Bronx, 22·2 % in the UES ('other OSB' and street vendors were sources of both healthful and less-healthful foods/drinks in both areas). Conclusions: Government records frequently miss or misrepresent businesses offering foods/drinks, suggesting caveats for food-environment assessments using such records.
Article
Full-text available
... Improvements in community nutrition and health may follow from healthier food access. Strategies to support healthier food access might focus on a wide array of local food sellers. Strategies focused on placing “food stores” and restaurants could be valuable, but might be costly and complicated and lack precision with regard to healthfulness. Strategies focused on OSBs and their offerings may be logistically simpler and more precise, although--like other storefront approaches--not entirely flexible from a geographic standpoint. Farmers’ markets offer greater geographic flexibility, but may fall short in several dimensions of access for many community residents. By comparison, mobile food vending holds promise as a flexible, adaptable, and dynamic strategy to optimize healthier food access more broadly ... https://www.sciencedirect.com/science/article/pii/S2212267218302582
Article
Background Street foods vary with respect to their nutritional value and safety characteristics and contribute to a sizable proportion of food intake in many populations worldwide. Therefore, the present study aimed to describe the coverage in the scientific literature of different health‐related and socio‐economic aspects of street food consumption and trading. Methods Three electronic databases (searched from inception to 16 October 2017), a hand‐search of relevant journals and backward citation tracking were used to identify eligible scientific articles with a main objective of investigating or reporting specific results on health‐related or socio‐economic aspects of street food. Papers published in English, Portuguese, French, Spanish or Italian, as well as English abstracts of papers published in other languages, were assessed. The selected articles were evaluated by two independent researchers and described according to year of publication, geographical distribution, definition of street food, main topics addressed and target population. Results In total, 441 papers were selected. The number of publications has increased in recent years, almost half of them being published after 2012. Almost three‐quarter of the articles were from Africa or Asia. Most studies addressed food safety (85.5%), whereas street food availability and consumption were much less frequently investigated (30.3%). The focus of the studies was usually the food (mostly its microbiological contamination) and the vendors (mostly their food handling), whereas consumers and vending sites were seldom evaluated. More than half of the studies did not specify a definition for street food. Conclusions Efforts are needed for a more widespread and comprehensive assessment of different issues related to street food availability and consumption in different settings, especially regarding street food offer, nutritional composition, and patterns of purchase and consumption by the population.
Article
Full-text available
Background: Local food environments include ‘food stores’ (e.g. supermarkets, grocery stores, bakeries) and restaurants. But the extent to which other storefront businesses offer food/drink is not well described, nor is the extent to which food/drink availability through a full range of storefront businesses might change over time. Objective: This study aimed to assess food/drink availability from a full range of storefront businesses and change over time, and consider implications for food-environment research. Design: Investigators compared direct observations from 2010 and 2015. Participants/Setting: Included were all storefront businesses offering foods/drinks on 153 street segments in the Bronx, NY. Main outcome measures: The main outcome was change between 2010 and 2015 as determined by matches between businesses. Matches could be ‘strict’ (businesses with the same name on the same street segment in both years) or ‘lenient ’ (similar businesses on the same street segment in both years). Investigators categorized businesses as general grocers, specialty food stores, restaurants, or ‘other storefront businesses’ (e.g., barber shops/beauty salons, clothing outlets, hardware stores, laundromats, and newsstands). Statistical analyses performed: Investigators quantified change, specifically calculating how often businesses in 2015 were present in 2010, and vice versa. Results: ‘Strict’ matches for businesses in 2015 present in 2010 ranged 29-52% depending on business category; lenient matches ranged 43-72%. ‘Strict’ matches for businesses in 2010 present in 2015 ranged 34-63%; ‘lenient’ matches ranged 72-83%. In 2015 vs. 2010, on 22% more of the sampled street segments, there were 30% more businesses offering food/drink: 66 vs. 46 general grocers, 22 vs. 19 specialty food stores, 99 vs. 99 restaurants, 98 vs. 56 ‘other storefront businesses.’ Conclusions: Over five years, an urban food environment changed substantially, even by lenient standards, particularly among ‘other storefront businesses’ and in the direction of markedly greater food availability (more businesses offering food on more streets). Failing to consider a full range of food/drink sources, and change in food/drink sources, could result in erroneous food-environment conclusions.
Article
Full-text available
For individuals who are food insecure, food pantries can be a vital resource to improve access to adequate food. Access to adequate food may be conceptualized within five dimensions: availability (item variety), accessibility (e.g., hours of operation), accommodation (e.g., cultural sensitivity), affordability (costs, monetary or otherwise), and acceptability (e.g., as related to quality). This study examined the five dimensions of access in a convenience sample of 50 food pantries in the Bronx, NY. The design was cross-sectional. Qualitative data included researcher observations and field notes from unstructured interviews with pantry workers. Quantitative data included frequencies for aspects of food access, organized by the five access dimensions. Inductive analysis of quantitative and qualitative data revealed three main inter-related findings: (1) Pantries were not reliably open: only 50% of pantries were open during hours listed in an online directory (several had had prolonged or indefinite closures); (2) Even when pantries were open, all 5 access dimensions showed deficiencies (e.g., limited inventory, few hours, pre-selected handouts without consideration of preferences, opportunity costs, and inferior-quality items); (3) Open pantries frequently had insufficient food supply to meet client demand. To deal with mismatch between supply and demand, pantries developed rules for food provision. Rules could break down in cases of pantries receiving food deliveries, leading to workarounds, and in cases of compelling client need, leading to exceptions. Adherence to rules, versus implementation of workarounds and/or exceptions, was worker- and situation-dependent and, thus, unpredictable. Overall, pantry food provision was unreliable. Future research should explore clients’ perception of pantry access considering multiple access dimensions. Future research should also investigate drivers of mismatched supply and demand to create more predictable, reliable, and adequate food provision. Full paper: https://rdcu.be/287G
Article
Full-text available
Introduction: Studies of neighborhood food environments typically focus on select stores (especially supermarkets) and/or restaurants (especially fast-food outlets), make presumptions about healthfulness without assessing actual items for sale, and ignore other kinds of businesses offering foods/drinks. The current study assessed availability of select healthful and less-healthful foods/drinks from all storefront businesses in an urban environment and considered implications for food-environment research and community health. Methods: Cross-sectional assessment in 2013 of all storefront businesses (n=852) on all street segments (n=1,253) in 32 census tracts of the Bronx, New York. Investigators assessed for healthful items (produce, whole grains, nuts, water, milk) and less-healthful items (refined sweets, salty/fatty fare, sugar-added drinks, and alcohol), noting whether items were from food businesses (e.g., supermarkets and restaurants) or other storefront businesses (OSB, e.g., barber shops, gyms, hardware stores, laundromats). Data were analyzed in 2017. Results: Half of all businesses offered food/drink items. More than one seventh of all street segments (more than one third in higher-poverty census tracts) had businesses selling food/drink. OSB accounted for almost one third of all businesses offering food/drink items (about one quarter of businesses offering any healthful items and more than two thirds of businesses offering only less-healthful options). Conclusions: Food environments include many businesses not primarily focused on selling foods/drinks. Studies that do not consider OSB may miss important food/drink sources, be incomplete and inaccurate, and potentially misguide interventions. OSB hold promise for improving food environments and community health by offering healthful items; some already do.
Article
Full-text available
Given the emerging focus on improving food environments and food systems through planning, this article investigates racial disparities in neighborhood food environments. An empirical case of Erie County, New York tests the hypothesis that people belonging to different racial groups have access to different neighborhood food destinations. Using multiple methods—Gini coefficients and Poisson regression—we show that contrary to studies elsewhere in the country there are no food deserts in Erie County. However, like other studies, we find an absence of supermarkets in neighborhoods of color when compared to white neighborhoods. Nonetheless, our study reveals an extensive network of small grocery stores in neighborhoods of color. Rather than soliciting supermarkets, supporting small, high-quality grocery stores may be a more efficient strategy for ensuring access to healthful foods in minority neighborhoods.
Article
Full-text available
The current ecological approach in health behaviour research recognises that health behaviour needs to be understood in a broad environmental context. This has led to an exponential increase in the number of studies on this topic. It is the aim of this systematic review to summarise the existing empirical evidence pertaining to environmental influences on fruit and vegetable (FV) consumption. The environment was defined as ‘all factors external to the individual’. Scientific databases and reference lists of selected papers were systematically searched for observational studies among adults (18–60 years old), published in English between 1 January 1980 and 31 December 2004, with environmental factor(s) as independent factor(s), and fruit intake, vegetable intake or FV intake combined as one outcome measure as dependent factor(s). Findings showed there was a great diversity in the environmental factors studied, but that the number of replicated studies for each determinant was limited. Most evidence was found for household income, as people with lower household incomes consistently had a lower FV consumption. Married people had higher intakes than those who were single, whereas having children showed mixed results. Good local availability (e.g. access to one's own vegetable garden, having low food insecurity) seemed to exert a positive influence on intake. Regarding the development of interventions, improved opportunities for sufficient FV consumption among low-income households are likely to lead to improved intakes. For all other environmental factors, more replicated studies are required to examine their influence on FV intake.
Article
Full-text available
A higher intake of fruits and vegetables has been associated with a lower risk of ischaemic heart disease (IHD), but there is some uncertainty about the interpretation of this association. The objective was to assess the relation between fruit and vegetable intake and risk of mortality from IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study. After an average of 8.4 years of follow-up, there were 1636 deaths from IHD among 313 074 men and women without previous myocardial infarction or stroke from eight European countries. Participants consuming at least eight portions (80 g each) of fruits and vegetables a day had a 22% lower risk of fatal IHD [relative risk (RR) = 0.78, 95% confidence interval (CI): 0.65-0.95] compared with those consuming fewer than three portions a day. After calibration of fruit and vegetable intake to account for differences in dietary assessment between the participating centres, a one portion (80 g) increment in fruit and vegetable intake was associated with a 4% lower risk of fatal IHD (RR = 0.96, 95% CI: 0.92-1.00, P for trend = 0.033). Results from this large observational study suggest that a higher intake of fruits and vegetables is associated with a reduced risk of IHD mortality. Whether this association is causal and, if so, the biological mechanism(s) by which fruits and vegetables operate to lower IHD risks remains unclear.
Article
Full-text available
The current ecological approach in health behaviour research recognises that health behaviour needs to be understood in a broad environmental context. This has led to an exponential increase in the number of studies on this topic. It is the aim of this systematic review to summarise the existing empirical evidence pertaining to environmental influences on fruit and vegetable (FV) consumption. The environment was defined as 'all factors external to the individual'. Scientific databases and reference lists of selected papers were systematically searched for observational studies among adults (18-60 years old), published in English between 1 January 1980 and 31 December 2004, with environmental factor(s) as independent factor(s), and fruit intake, vegetable intake or FV intake combined as one outcome measure as dependent factor(s). Findings showed there was a great diversity in the environmental factors studied, but that the number of replicated studies for each determinant was limited. Most evidence was found for household income, as people with lower household incomes consistently had a lower FV consumption. Married people had higher intakes than those who were single, whereas having children showed mixed results. Good local availability (e.g. access to one's own vegetable garden, having low food insecurity) seemed to exert a positive influence on intake. Regarding the development of interventions, improved opportunities for sufficient FV consumption among low-income households are likely to lead to improved intakes. For all other environmental factors, more replicated studies are required to examine their influence on FV intake.
Article
Background Poor dietary patterns and obesity, established risk factors for chronic disease, have been linked to neighborhood deprivation, neighborhood minority composition, and low area population density. Neighborhood differences in access to food may have an important influence on these relationships and health disparities in the U.S. This article reviews research relating to the presence, nature, and implications of neighborhood differences in access to food. Methods A snowball strategy was used to identify relevant research studies (n=54) completed in the U.S. and published between 1985 and April 2008. Results Research suggests that neighborhood residents who have better access to supermarkets and limited access to convenience stores tend to have healthier diets and lower levels of obesity. Results from studies examining the accessibility of restaurants are less consistent, but there is some evidence to suggest that residents with limited access to fast-food restaurants have healthier diets and lower levels of obesity. National and local studies across the U.S. suggest that residents of low-income, minority, and rural neighborhoods are most often affected by poor access to supermarkets and healthful food. In contrast, the availability of fast-food restaurants and energy-dense foods has been found to be greater in lower-income and minority neighborhoods. Conclusions Neighborhood disparities in access to food are of great concern because of their potential to influence dietary intake and obesity. Additional research is needed to address various limitations of current studies, identify effective policy actions, and evaluate intervention strategies designed to promote more equitable access to healthy foods.
Article
We assessed the prevalence of type 2 diabetes in people following different types of vegetarian diets compared with that in nonvegetarians. The study population comprised 22,434 men and 38,469 women who participated in the Adventist Health Study-2 conducted in 2002-2006. We collected self-reported demographic, anthropometric, medical history, and lifestyle data from Seventh-Day Adventist church members across North America. The type of vegetarian diet was categorized based on a food-frequency questionnaire. We calculated odds ratios (ORs) and 95% CIs using multivariate-adjusted logistic regression. Mean BMI was lowest in vegans (23.6 kg/m(2)) and incrementally higher in lacto-ovo vegetarians (25.7 kg/m(2)), pesco-vegetarians (26.3 kg/m(2)), semi-vegetarians (27.3 kg/m(2)), and nonvegetarians (28.8 kg/m(2)). Prevalence of type 2 diabetes increased from 2.9% in vegans to 7.6% in nonvegetarians; the prevalence was intermediate in participants consuming lacto-ovo (3.2%), pesco (4.8%), or semi-vegetarian (6.1%) diets. After adjustment for age, sex, ethnicity, education, income, physical activity, television watching, sleep habits, alcohol use, and BMI, vegans (OR 0.51 [95% CI 0.40-0.66]), lacto-ovo vegetarians (0.54 [0.49-0.60]), pesco-vegetarians (0.70 [0.61-0.80]), and semi-vegetarians (0.76 [0.65-0.90]) had a lower risk of type 2 diabetes than nonvegetarians. The 5-unit BMI difference between vegans and nonvegetarians indicates a substantial potential of vegetarianism to protect against obesity. Increased conformity to vegetarian diets protected against risk of type 2 diabetes after lifestyle characteristics and BMI were taken into account. Pesco- and semi-vegetarian diets afforded intermediate protection.
Article
Poor dietary patterns and obesity, established risk factors for chronic disease, have been linked to neighborhood deprivation, neighborhood minority composition, and low area population density. Neighborhood differences in access to food may have an important influence on these relationships and health disparities in the U.S. This article reviews research relating to the presence, nature, and implications of neighborhood differences in access to food. A snowball strategy was used to identify relevant research studies (n=54) completed in the U.S. and published between 1985 and April 2008. Research suggests that neighborhood residents who have better access to supermarkets and limited access to convenience stores tend to have healthier diets and lower levels of obesity. Results from studies examining the accessibility of restaurants are less consistent, but there is some evidence to suggest that residents with limited access to fast-food restaurants have healthier diets and lower levels of obesity. National and local studies across the U.S. suggest that residents of low-income, minority, and rural neighborhoods are most often affected by poor access to supermarkets and healthful food. In contrast, the availability of fast-food restaurants and energy-dense foods has been found to be greater in lower-income and minority neighborhoods. Neighborhood disparities in access to food are of great concern because of their potential to influence dietary intake and obesity. Additional research is needed to address various limitations of current studies, identify effective policy actions, and evaluate intervention strategies designed to promote more equitable access to healthy foods.
Article
Possible causes of population differences in obesity prevalence are discussed: biologic susceptibility, treatment availability or effectiveness, and shared behavior patterns leading to caloric imbalance. It is argued that obesity in minority groups in the United States is best understood as a variation on a larger cultural theme, the creation of an environment in which highly palatable foods are accessible to all at low cost and physical activity is not required. Inequities in access to health education, treatment services, and environmental opportunities are probably responsible for the exacerbation of obesity and its attendant health conditions in some minority groups. Programs for the prevention of obesity in minority populations need to address these inequities and also to consider ways to counteract the historical trends in the United States toward nutritional excess in the population as a whole.
Email communications to Sean Lucan from Deputy Director, Sabrina Baronberg on November 17, 2010, and from Director
  • Green Carts In The Bronx—optimally Positioned
  • To
  • Needs
New York City Department of Health and Mental Hygiene's Physical Activity and Nutrition Program. Email communications to Sean Lucan from Deputy Director, Sabrina Baronberg on November 17, 2010, and from Director, Cathy Nonas on March 4, 2011, as well as phone conversations on other dates 16. Karp Resources. Email communication to William Jordan from Project Coordinator, Cassandra Flechsig, on November 8, 2010 GREEN CARTS IN THE BRONX—OPTIMALLY POSITIONED TO MEET NEEDS?
DC: Ned Levine & Associates and The National Institute of Justice
  • Houston
  • Tx
  • Washington
Houston, TX and Washington, DC: Ned Levine & Associates and The National Institute of Justice. http://www.icpsr.umich.edu/ CrimeStat/. Accessed December 10, 2010.