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Ares G, Girona A, Brunet G, Alcaire F, Fajardo G, Paroli C, Amado M, Santín V, Vidal L. A mixed-methods exploration of the food retail environment of a low-income area of Montevideo, Uruguay. Health Promot Int 2025; 40:daae201. [PMID: 39907529 DOI: 10.1093/heapro/daae201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2025] Open
Abstract
Creating supportive food environments has been identified as one of the most effective strategies to promote healthy diets. In this context, the present work aimed to characterize the retail food environment in a low-income area of the city of Montevideo (Uruguay). The study relied on a mixed-methods approach. A survey of food retail outlets was conducted. All the outlets were geocoded, and service areas were created considering a 600 m threshold. Quantitative information was supplemented with qualitative information from semi-structured interviews with residents and grocery store owners. A total of 415 outlets selling a variety of foods were identified. Adequate physical access to the foods recommended by the Uruguayan dietary guidelines was found in most of the residential areas. Small behind-the-counter grocery stores were identified as the key source of healthy foods in the area. However, the accounts of residents highlighted problems related to the price, variety and quality of the foods sold by the local grocery stores. Therefore, strategies to ensure access to healthy food in the study area should go beyond physical access and tackle food affordability, variety and quality. The promotion of short food supply chains in the area should be a key element of the strategies to achieve sustainable urban food systems in Montevideo.
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Affiliation(s)
- Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000 Pando, Uruguay
| | - Alejandra Girona
- Escuela de Nutrición, Universidad de la República, Av. Ricaldoni S/N, CP 11600 Montevideo, Uruguay
| | - Gerónimo Brunet
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP 11200 Montevideo, Uruguay
| | - Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000 Pando, Uruguay
| | - Gabriela Fajardo
- Escuela de Nutrición, Universidad de la República, Av. Ricaldoni S/N, CP 11600 Montevideo, Uruguay
| | - Carolina Paroli
- Intendencia de Montevideo, 18 de Julio 1360, CP 11200 Montevideo, Uruguay
| | - Marcelo Amado
- Intendencia de Montevideo, 18 de Julio 1360, CP 11200 Montevideo, Uruguay
| | - Viviana Santín
- Intendencia de Montevideo, 18 de Julio 1360, CP 11200 Montevideo, Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000 Pando, Uruguay
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Poole MK, Tucker K, Adams K, Rimm EB, Emmons KM, Gortmaker SL, Norris J, Kenney EL. Prevalence and Implementation Characteristics of Weekend Food Assistance Programs in U.S. Schools. Am J Prev Med 2024; 67:503-511. [PMID: 38880305 PMCID: PMC11416307 DOI: 10.1016/j.amepre.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/31/2024] [Accepted: 06/02/2024] [Indexed: 06/18/2024]
Abstract
INTRODUCTION Amid national efforts to align priorities for nutrition and food assistance programs, little is known about the implementation of community-led efforts for children. This study aimed to estimate U.S. public school participation in weekend backpack programs (WBPs), to document program structure, and to consider characteristics of programs with more nutritious food offerings. METHODS The prevalence of WBP participation in 2022 was estimated using a state-stratified, random sample of n=413 public schools. Administrators from WBPs at 49 schools completed measures of implementation characteristics and nutritional quality of foods offered. In 2022-2023, using a multivariable-adjusted linear regression model, the authors explored the association between hypothesized implementation characteristics and Healthy Eating Index-2015 scores of foods provided. RESULTS Half of public schools (53.7%, 95% CI: 46.8%, 60.7%) in the national sample reported participating in WBPs. Many WBPs in the subsample were affiliated with anti-hunger organizations (41%), led by school counselors and volunteers (55%), and funded by grants (51%). WBPs spent an average of $0.56 (sd=$0.36) per item. Foods provided averaged a Healthy Eating Index-2015 score of 58.4 (sd=12.3), similar to children's average diets. About half of WBPs (41%) reported accessing nutrition resources. CONCLUSIONS Despite the decentralized structure and absence of dedicated funding mechanisms, WBPs were common in our national sample of schools, suggesting widespread perceptions of unmet food needs and extensive efforts from community members to mitigate weekend hunger. Further research on food procurement methods and program impacts on child nutrition outcomes is needed to advance national priorities for nutrition and food security.
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Affiliation(s)
- Mary Kathryn Poole
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Kyla Tucker
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Office of Student Wellbeing, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Kate Adams
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; The Greater Boston Food Bank, Boston, Massachusetts
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Karen M Emmons
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Steven L Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jasmine Norris
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Erica L Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Titis E. Quantifying the Impact of Supermarket Distance on Childhood Obesity in Greater London, United Kingdom: Exploring Different Access Measures and Modification Effects of Transportation. Child Obes 2023; 19:479-488. [PMID: 36322899 DOI: 10.1089/chi.2022.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Healthy food access may be relevant for predicting trends in childhood obesity. The goal was to determine associations between childhood overweight (including obesity) and distance to three nearest supermarkets stratified by transportation modes (walking, cycling, driving). Methods: Bivariate and multivariate linear regressions examine the relationship with obesity, including interacting active and inactive modes. Results: Proximity to at least three supermarkets shows small but significant positive association with obesity. Walking mode showed higher obesity rates than driving, and distance was not related to the mode of travel. Conclusions: Disparities in healthy food access may not contribute meaningfully to childhood obesity, as other individual factors may be largely at play.
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Affiliation(s)
- Elzbieta Titis
- Warwick Institute for the Science of Cities, Department of Computer Science, University of Warwick, Coventry, United Kingdom
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Kim C, Goodwyn B, Albukhaytan S, Nartea T, Ndegwa E, Dhakal R. Microbiological Survey and Antimicrobial Resistance of Foodborne Bacteria in Select Meat Products and Ethnic Food Products Procured from Food Desert Retail Outlets in Central Virginia, USA. Pathogens 2023; 12:965. [PMID: 37513812 PMCID: PMC10385447 DOI: 10.3390/pathogens12070965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/12/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
In food desert areas, low-income households without convenient transportation often shop at small, independently owned corner markets and convenience stores (SIOMs). Studies indicate a higher potential for reduced product quality and safety of foods sold at SIOMs, with more critical and non-critical code violations in the region. This study aimed to assess the difference in market scale on the microbiological quality in select food products procured from food deserts in Central Virginia. A total of 326 samples consisting of meat products (i.e., ground beef, chicken, and sausage), ethnic food products (i.e., ox tail, stock fish bite, egusi ground, and saffron powder), and food packaging surfaces procured from ten registered SIOMs and nine large chain supermarkets (LCSMs) between August 2018 and March 2020 were evaluated. Higher levels of aerobic mesophile and coliform counts were found in SIOMs-acquired samples than in LCSMs-acquired samples, as demonstrated by the lower food safety compliance rate of SIOMs. Regardless of SIOMs or LCSMs, Campylobacter, E. coli, Listeria, and Salmonella were detected in 3.6%, 20.9%, 5.5%, and 2.7% of samples, respectively. The majorities of Campylobacter (75%, 6/8) and Salmonella (83.3%, 5/6) detected were from SIOMs-acquired samples including ethnic food products. Among the tested antimicrobials, AMP (100%) and TOB (100%) showed the highest frequency of resistance among Campylobacter, TCY (69.9%) among E. coli, NAL (100%) among Listeria, and TCY (50%) among Salmonella, respectively. The prevalence of multi-drug resistance (MDR) and non-susceptibility in Campylobacter and non-susceptibility in Listeria isolated from SIOMs-acquired food products were lower than those isolated from LCSMs-acquired samples. A higher price of the same brand name commodity sold at SIOMs than those sold at LCSMs was also observed, indicating an increased financial burden to economically challenged residents in food desert areas, in addition to food safety concerns. Elaborated and in-depth research on a larger-scale sample size with a greater diversity of products is needed to determine and intervene in the cause(s) of the observed differences in the prevalence of the pathogens and AMR profiles.
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Affiliation(s)
- Chyer Kim
- Agricultural Research Station, Virginia State University, 1 Hayden Drive, Petersburg, VA 23806, USA
| | - Brian Goodwyn
- Department of Agriculture, Food, and Resource Sciences, University of Maryland Eastern Shore, Princess Anne, MD 21853, USA
| | - Sakinah Albukhaytan
- AlAhsa Health Cluster, Ministry of Health, Hofuf 36421, AlAhsa, Saudi Arabia
| | - Theresa Nartea
- Cooperative Extension, Virginia State University, 1 Hayden Drive, Petersburg, VA 23806, USA
| | - Eunice Ndegwa
- Agricultural Research Station, Virginia State University, 1 Hayden Drive, Petersburg, VA 23806, USA
| | - Ramesh Dhakal
- Agricultural Research Station, Virginia State University, 1 Hayden Drive, Petersburg, VA 23806, USA
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Taylor NG, Luongo G, Jago E, Mah CL. Observational study of population level disparities in food costs in 2021 in Canada: A digital national nutritious food basket (dNNFB). Prev Med Rep 2023; 32:102162. [PMID: 36910505 PMCID: PMC9995921 DOI: 10.1016/j.pmedr.2023.102162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/24/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
The aim of this work was to assess the feasibility and effect of applying a nationally representative and highly disaggregated food costing measure across Canada, through the novel application of web-scraping technology to the methods of the National Nutritious Food Basket (NNFB). Further, this study tested the hypothesis that a product-matched digital NNFB (dNNFB) correlates with existing market basket measures and quantified any differences in costs. This was an observational cross-sectional study using web scraped food price data collected in November 2021. Food price data was collected from the majority of Loblaw's banners across Canada, resulting in a final store sample of 751 stores sourced from 11 retail banners. Stores were located across all five Statistics Canada regions, including all provinces and territories with the exception of Nunavut. Store-level dNNFB costs were computed, adjusted by age-sex group, and summarized by geographic region and banner. dNNFB costs were then compared with existing national statistics office estimates (Market Basket Measure thresholds for reference families). dNNFB costs varied widely across the country, with notable differences by regional, store-level, and age-sex group characteristics. When compared to reported national statistics, our estimates exceeded the national market basket measure in every comparison in corresponding sub-national geography across the country, with correlation varying from 0.49 to 0.78 dependent on summary comparator. Digital collection of food price data was a feasible strategy for market basket costing. Our findings suggest we may be routinely underestimating the impact of food inflation for consumers, particularly those restricted to certain food environments.
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Affiliation(s)
- Nathan G.A. Taylor
- School of Health Administration, Faculty of Health, Sir Charles Tupper Medical Building, 2nd Floor 5850 College Street, PO Box 15000, Halifax, NS B3H 4R2, Canada
| | - Gabriella Luongo
- School of Health Administration, Faculty of Health, Sir Charles Tupper Medical Building, 2nd Floor 5850 College Street, PO Box 15000, Halifax, NS B3H 4R2, Canada
| | - Emily Jago
- School of Health Administration, Faculty of Health, Sir Charles Tupper Medical Building, 2nd Floor 5850 College Street, PO Box 15000, Halifax, NS B3H 4R2, Canada
| | - Catherine L. Mah
- School of Health Administration, Faculty of Health, Sir Charles Tupper Medical Building, 2nd Floor 5850 College Street, PO Box 15000, Halifax, NS B3H 4R2, Canada
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Glanz K, Fultz AK, Sallis JF, Clawson M, McLaughlin KC, Green S, Saelens BE. Use of the Nutrition Environment Measures Survey: A Systematic Review. Am J Prev Med 2023:S0749-3797(23)00068-5. [PMID: 36990939 DOI: 10.1016/j.amepre.2023.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION The Nutrition Environment Measurement Survey (NEMS) measures were developed to assess the consumer food environment in stores and restaurants. NEMS tools have been widely used in research and adapted for diverse settings and populations in the 15 years since they were created. This systematic review examines the use and adaptations of these measures and what can be learned from published studies using NEMS tools. METHODS A comprehensive search of bibliographic databases was conducted from 2007 to September 2021, supplemented by backward searches and communications with authors, to identify research articles using NEMS tools. Data on purpose, key findings, sample characteristics, NEMS characteristics, and modifications were abstracted. Articles were categorized on the basis of study goals, NEMS tool(s) used, variables measured, and common themes. RESULTS A total of 190 articles from 18 countries were identified. Most studies (69.5%, n=123) used a modified version of NEMS tools. There were 23 intervention studies that used measures from NEMS tools or adaptations as outcomes, moderators, or process assessments. A total of 41% (n=78) of the articles evaluated inter-rater reliability, and 17% (n=33) evaluated test-retest reliability. DISCUSSION NEMS measures have played an important role in the growth of research on food environments and have helped researchers to explore the relationships among healthy food availability, demographic variables, eating behaviors, health outcomes, and intervention-driven changes in food environments. The food environment is constantly changing, so NEMS measures should continue to evolve. Researchers should document data quality of modifications and use in new settings.
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Affiliation(s)
- Karen Glanz
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Amanda K Fultz
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, California
| | - Margaret Clawson
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kelly C McLaughlin
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Sarah Green
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Brian E Saelens
- Department of Pediatrics, University of Washington, Seattle, Washington; Seattle Children's Research Institute, Seattle, Washington
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7
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Berry KM, Drew JAR, Brady PJ, Widome R. Impact of smoking cessation on household food security. Ann Epidemiol 2023; 79:49-55.e3. [PMID: 36657695 PMCID: PMC9957954 DOI: 10.1016/j.annepidem.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/30/2022] [Accepted: 01/08/2023] [Indexed: 01/18/2023]
Abstract
PURPOSE Smokers can spend a substantial amount on cigarettes, potentially constraining their ability to purchase food. We tested the association of smoking cessation and household food security. METHODS Using the Current Population Survey (2001-2019), we longitudinally linked the Tobacco Use Supplement and the Food Security Supplement (n = 71,278). Among adult smokers (n = 13,144), we used modified Poisson regression to model household food insecurity as a function of quit status (continuing smokers vs. recent quitters), adjusting for sex, age, household size, children in the household, and other household smokers. We also used multinomial logistic regression to examine more detailed food security status (high, marginal, low, very low). RESULTS The adjusted probability of household food insecurity at follow-up was 11% (95% CI: 8.7%-13%) for recent quitters and 20% (95% CI: 19%-21%) for continuing smokers. Continuing smokers had a lower adjusted probability of high food security (69% vs. 80%) and a higher adjusted probability of marginal (11% vs. 9.8%), low (12% vs. 7%), and very low food security (7.8% vs. 3.6%) compared to recent quitters. CONCLUSIONS Cigarette cessation is associated with a lower risk of household food insecurity. Therefore, promoting tobacco cessation alongside food assistance and poverty reduction policies may help alleviate food insecurity.
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Affiliation(s)
- Kaitlyn M Berry
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
| | - Julia A Rivera Drew
- Institute on Social Research and Data Innovation, University of Minnesota, Minneapolis, MN
| | - Patrick J Brady
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Rachel Widome
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN
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Carr JK, Fontanella SA, Kaiser ML. Uncertainty in Thrifty Food Plan Cost Estimates for Community Food Security Assessments. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2023. [DOI: 10.1080/19320248.2023.2179447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Jake K. Carr
- Commercial Real Estate Analytics, Moody’s Analytics, San Francisco, CA, USA
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Mahfuza R, Islam N, Toyeb M, Emon MAF, Chowdhury SA, Alam MGR. LRFMV: An efficient customer segmentation model for superstores. PLoS One 2022; 17:e0279262. [PMID: 36538513 PMCID: PMC9767363 DOI: 10.1371/journal.pone.0279262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/04/2022] [Indexed: 12/24/2022] Open
Abstract
The Recency, Frequency, and Monetary model, also known as the RFM model, is a popular and widely used business model for determining beneficial client segments and analyzing profit. It is also recommended and frequently used in superstores to identify customer segments and increase profit margins. Later, the Length, Recency, Frequency, and Monetary model, also known as the LRFM model, was introduced as an improved version of the RFM model to identify more relevant and exact consumer groups for profit maximization. Superstores have a varying number of different products. In RFM and LRFM models, the relationship between profit and purchased quantity has never been investigated. Therefore, this paper proposed an efficient customer segmentation model, namely LRFMV (Length, Recency, Frequency, Monetary and Volume) and studied the profit-quantity relationship. A new dimension V (volume) has been added to the existing LRFM model to show a direct profit-quantity relationship in customer segmentation. The V stands for volume, which is derived by calculating the average number of products purchased by a frequent superstore client in a single day. The data obtained from feature extraction of the LRMFV model is then clustered by using conventional K-means, K-Medoids, and Mini Batch K-means methods. The results obtained from the three algorithms are compared, and the K-means algorithm is chosen for the superstore dataset of the proposed LRFMV model. All clusters created using these three algorithms are evaluated in the LRFMV model, and a close relationship between profit and volume is observed. A clear profit-quantity relationship of items has yet not been seen in any prior study on the RFM and LRFM models. Grouping customers aiming at profit maximization existed previously, but there was no clear and direct depiction of profit and quantity of sold items. This study applied unsupervised machine learning to investigate the patterns, trends, and correlations between volume and profit. The traits of all the clusters are analyzed by the Customer-Classification Matrix. The LRFMV values, larger or less than the overall average for each cluster, are identified as their traits. The performance of the proposed LRFMV model is compared with the legacy RFM and LRFM customer segmentation models. The outcome shows that the LRFMV model creates precise customer segments with the same number of customers while maintaining a greater profit.
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Affiliation(s)
- Rezwana Mahfuza
- Dept. of Computer Science and Engineering, Brac University, Dhaka, Bangladesh
| | - Nafisa Islam
- Dept. of Computer Science and Engineering, Brac University, Dhaka, Bangladesh
| | - Md. Toyeb
- Dept. of Computer Science and Engineering, Brac University, Dhaka, Bangladesh
| | | | - Shahnur Azad Chowdhury
- Dept. of Business Administration, International Islamic University Chittagong, Sonaichhari, Bangladesh
| | - Md. Golam Rabiul Alam
- Dept. of Computer Science and Engineering, Brac University, Dhaka, Bangladesh
- * E-mail:
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Massengale KE, Jones MA, Liao J, Park C, Old M. Priority Areas for Child Diaper Access: Low-Income Neighborhoods with Limited Retail Access to the Basic Need of Diapers. Health Equity 2022; 6:767-776. [PMID: 36225666 PMCID: PMC9536341 DOI: 10.1089/heq.2021.0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction: Although a requirement for the health and hygiene of young children, millions of US families with low-incomes have unmet needs for diapers. The present study explored retail options in Durham County, NC for purchasing diapers in low-income neighborhoods in effort to increase our understanding of the overall context of diaper need. Methods: During June 2018, we visited 63 retailers selling 2460 child diaper products in 29 census tracts with a median household income ≤200% of the federal poverty guideline. Corner stores were the only retailers to sell products without original packaging, including one corner store selling loose diapers for $1.49 each. Next, we calculated bus routes to determine accessibility of the retailer with the lowest prices and greatest selection. One-way bus travel from all other census tracts to a big-box store required taking two buses combined with an average of 11 min walking for an average travel time of 43 min. We deemed census tracts as “priority areas for diaper access” when they were characterized as: (1) low income and (2) low access with no retailer selling all of the 10 most common child diaper sizes. Results: Nearly half (n=13) of the census tracts in our sample met our criteria for priority areas. We compared neighborhood characteristics of priority areas with all other county census tracts. Families living in priority areas were statistically significantly more likely to: identify as Black or African American, face challenges affording housing costs, have homes or automobiles in need of repair, experience neighborhood violence, and have less educational attainment.
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Affiliation(s)
| | - Melissa A. Jones
- Department of Informatics and Analytics, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Juncheng Liao
- Department of Statistical Science, Duke University, Durham, North Carolina, USA
| | - Christine Park
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Michelle Old
- Diaper Bank of North Carolina, Durham, North Carolina, USA
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Shier V, Miller S, Datar A. Heterogeneity in grocery shopping patterns among low-income minority women in public housing. BMC Public Health 2022; 22:1612. [PMID: 36002848 PMCID: PMC9404610 DOI: 10.1186/s12889-022-14003-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Public housing residents, who tend to be predominantly female and racial/ethnic minorities, are at a particularly high risk for chronic health conditions. Prior studies have suggested that a lack of access to healthy and affordable food may be an important barrier in public housing communities, but evidence is mixed on the association between the neighborhood food environment and dietary quality, suggesting the need to examine food access patterns in low-income, minority communities more deeply. The purpose of this study was to examine the variability in grocery shopping patterns, and the factors that predict them, among low-income minority women in public housing. METHODS Interviewer-administered surveys and body composition measurements were collected in the Watts Neighborhood Health Study, an ongoing longitudinal cohort study of low-income urban public housing residents located in South Los Angeles. Descriptive analyses were conducted to understand the variation in grocery shopping patterns among women. Logistic and ordered logistic regression models were estimated to examine the association between resident characteristics and grocery shopping patterns. RESULTS There was considerable variability in grocery shopping patterns, including the types of grocery stores accessed, distance travelled, frequency of shopping, and reasons behind grocery store choice. Grocery shopping patterns were associated with several participant characteristics, including race/ethnicity, working status, access to a car, income, and education. Hispanic participants were less likely to shop at a supermarket, travel further distances to shop, shop more frequently, and were more likely to prioritize price in their choice of primary grocery store than non-Hispanic Black women participants. CONCLUSIONS There was considerable variability in grocery shopping patterns, even within this low-income, minority community despite access to the same neighborhood food environment. Convenience and quality, in addition to price, were priorities for choice of primary grocery store, and differences by race/ethnicity suggest that initiatives to improve the neighborhood food environment should consider quality of food, cultural factors, and availability of foods desired by the surrounding community, in addition to price and proximity of grocery stores.
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Affiliation(s)
- Victoria Shier
- Price School of Public Policy, Schaeffer Center for Health Policy and Economics, University of Southern California, 635 Downey Way, Los Angeles, CA 90089 USA
| | - Sydney Miller
- Department of Population and Public Health Sciences, University of Southern California, 2001 N Soto St, Los Angeles, CA 90033 USA
| | - Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA 90089 USA
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John S, Winkler MR, Kaur R, DeAngelo J, Hill AB, Sundermeir SM, Colon-Ramos U, Leone LA, Dombrowski RD, Lewis EC, Gittelsohn J. Balancing Mission and Margins: What Makes Healthy Community Food Stores Successful. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8470. [PMID: 35886315 PMCID: PMC9315622 DOI: 10.3390/ijerph19148470] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/02/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022]
Abstract
Mission-driven, independently-owned community food stores have been identified as a potential solution to improve access to healthy foods, yet to date there is limited information on what factors contribute to these stores' success and failure. Using a multiple case study approach, this study examined what makes a healthy community food store successful and identified strategies for success in seven community stores in urban areas across the United States. We used Stake's multiple case study analysis approach to identify the following key aims that contributed to community store success across all cases: (1) making healthy food available, (2) offering healthy foods at affordable prices, and (3) reaching community members with limited economic resources. However, stores differed in terms of their intention, action, and achievement of these aims. Key strategies identified that enabled success included: (1) having a store champion, (2) using nontraditional business strategies, (3) obtaining innovative external funding, (4) using a dynamic sourcing model, (5) implementing healthy food marketing, and (6) engaging the community. Stores did not need to implement all strategies to be successful, however certain strategies, such as having a store champion, emerged as critical for all stores. Retailers, researchers, philanthropy, and policymakers can utilize this definition of success and the identified strategies to improve healthy food access in their communities.
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Affiliation(s)
- Sara John
- Center for Science in the Public Interest, Washington, DC 20005, USA
| | - Megan R. Winkler
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
| | - Ravneet Kaur
- Division of Health Research and Evaluation, Department of Family and Community Medicine, University of Illinois College of Medicine, Rockford, IL 61107, USA;
| | - Julia DeAngelo
- Departments of Health Policy Management & Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA;
| | - Alex B. Hill
- Urban Studies and Planning and Detroit Food Map Initiative, Wayne State University, Detroit, MI 48202, USA;
| | - Samantha M. Sundermeir
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (S.M.S.); (E.C.L.); (J.G.)
| | - Uriyoan Colon-Ramos
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC 20052, USA;
| | - Lucia A. Leone
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY 14260, USA;
| | - Rachael D. Dombrowski
- Division of Kinesiology, Health and Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA;
| | - Emma C. Lewis
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (S.M.S.); (E.C.L.); (J.G.)
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (S.M.S.); (E.C.L.); (J.G.)
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13
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Scaciota LL, Jaime PC, Borges CA. Development and validation of a guide to support public managers and retailers in promoting a healthy food environment. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01669-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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14
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Residents' Insights on Their Local Food Environment and Dietary Behaviors: A Cross-City Comparison Using Photovoice in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910134. [PMID: 34639435 PMCID: PMC8507815 DOI: 10.3390/ijerph181910134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 12/26/2022]
Abstract
Perceptions of local food environments and the ability of citizens to engage in participatory research may vary, even if participants share similar cultural and socioeconomic contexts. In this study, we aimed to describe participants’ narratives about their local food environment in two cities in Spain. We used the participatory methodology of Photovoice to engage participants in Madrid (n = 24) and Bilbao (n = 17) who took and discussed photographs about their local food environment (Madrid; n = 163 and Bilbao; n = 70). Common themes emerged across both cities (food insecurity, poverty, use of public spaces for eating and social gathering, cultural diversity and overconsumption of unhealthy foods); however, in Bilbao citizens perceived that there was sufficient availability of healthy foods despite that living in impoverished communities. Photovoice was a useful tool to engage participating citizens to improve their local food environments in both cities. This new approach allowed for a photovoice cross-city comparison that could be useful to fully understand the complexity and diversity of residents’ perceptions regardless of their place of residence.
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Vergeer L, Franco-Arellano B, Tjong GB, Bernstein JT, L’Abbé MR. The Level of Processing, Nutritional Composition and Prices of Canadian Packaged Foods and Beverages with and without Gluten-Free Claims. Nutrients 2021; 13:nu13041183. [PMID: 33918418 PMCID: PMC8066194 DOI: 10.3390/nu13041183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 12/27/2022] Open
Abstract
Little is known about the healthfulness and cost of gluten-free (GF) foods, relative to non-GF alternatives, in Canada. This study compared the extent of processing, nutritional composition and prices of Canadian products with and without GF claims. Data were sourced from the University of Toronto Food Label Information Program (FLIP) 2013 (n = 15,285) and 2017 (n = 17,337) databases. Logistic regression models examined the association of NOVA processing category with GF claims. Calorie/nutrient contents per 100 g (or mL) were compared between GF and non-GF products. Generalized linear models compared adjusted mean prices per 100 g (or mL) of products with and without GF claims. The prevalence of GF claims increased from 7.1% in 2013 to 15.0% in 2017. GF claims appeared on 17.0% of ultra-processed foods, which were more likely to bear GF claims products than less-processed categories. Median calories and sodium were significantly higher in GF products; no significant differences were observed for saturated fat or sugars. Compared to non-GF products, adjusted mean prices of GF products were higher for 10 food categories, lower for six categories and not significantly different for six categories. Overall, GF claims are becoming increasingly prevalent in Canada; however, they are often less healthful and more expensive than non-GF alternatives, disadvantaging consumers following GF diets.
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Affiliation(s)
- Laura Vergeer
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (B.F.-A.); (G.B.T.); (J.T.B.)
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (B.F.-A.); (G.B.T.); (J.T.B.)
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON L1G 0C5, Canada
| | - Gabriel B. Tjong
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (B.F.-A.); (G.B.T.); (J.T.B.)
| | - Jodi T. Bernstein
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (B.F.-A.); (G.B.T.); (J.T.B.)
| | - Mary R. L’Abbé
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.V.); (B.F.-A.); (G.B.T.); (J.T.B.)
- Correspondence: ; Tel.: +1-416-946-7545
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16
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Caspi CE, Winkler MR, Lenk KM, Harnack LJ, Erickson DJ, Laska MN. Store and neighborhood differences in retailer compliance with a local staple foods ordinance. BMC Public Health 2020; 20:172. [PMID: 32019508 PMCID: PMC7001202 DOI: 10.1186/s12889-020-8174-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 01/07/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Policies to improve healthy food retail have been recognized as a potential means of reducing diet-related health disparities. The revised 2014 Minneapolis Staple Foods Ordinance instituted minimum stocking standards for healthy, staple foods. The objective of this study was to examine retailer compliance with the policy, and whether compliance varied by neighborhood and store characteristics. METHODS In this natural experiment, audits were conducted annually pre- and post-ordinance (2014-2017) in 155 small/nontraditional stores in Minneapolis, MN and a comparison city (St. Paul, MN). Compliance measures for 10 product categories included: (1) met requirements for ≥8 categories; (2) 10-point scale (one point for each requirement met); and (3) carried any item in each category. Store characteristics included store size and ownership status. Neighborhood characteristics included census-tract socioeconomic status and low-income/low-access status. Analyses were conducted in 2018. RESULTS All compliance measures increased in both Minneapolis and St. Paul from pre- to post-policy; Minneapolis increases were greater only for carrying any item in each category (p < 0.01). In Minneapolis, corporate (vs. independent) stores were generally more compliant. No differences were found by neighborhood characteristics. CONCLUSIONS Overall trends suggest broad movement among Minneapolis stores towards providing a minimum level of staple foods. Increases were greater in corporate stores. Trends do not suggest neighborhood-level disparities in compliance. STUDY REGISTRATION ClinicalTrials.gov NCT02774330, retrospectively registered May 17, 2016.
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Affiliation(s)
- Caitlin E Caspi
- Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, USA.
| | - Megan R Winkler
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, USA
| | - Kathleen M Lenk
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, USA
| | - Lisa J Harnack
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, USA
| | - Darin J Erickson
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, USA
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17
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Gravina L, Jauregi A, Estebanez A, Fernández-Aedo I, Guenaga N, Ballesteros-Peña S, Díez J, Franco M. Residents' perceptions of their local food environment in socioeconomically diverse neighborhoods: A photovoice study. Appetite 2019; 147:104543. [PMID: 31794819 DOI: 10.1016/j.appet.2019.104543] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 12/15/2022]
Abstract
The influence of unhealthy food environments on residents' eating behaviors has been previously documented. Yet, socioeconomic differences across areas are less studied. Participatory studies provide relevant knowledge to better inform future nutrition interventions. We conducted a participatory Photovoice project in which residents interpreted the influence of the local food environment on eating behaviors across three neighborhoods of contrasting area-level socioeconomic status (SES) in Bilbao, Spain. From April to July 2017, a total of 23 residents participated in the three Photovoice groups. Each group critically discussed their photographs (N = 110) in groups of 6-9 participants along six group sessions. Through a consensus-building process, participants identified 27 emerging categories choosing finally 39 related photographs, which followed six conceptual main themes characterizing their local food environment: 1) unhealthy eating behaviors, 2) cultural diversity, 3) retail transformation, 4) social relationships, 5) precariousness, and 6) healthy eating. Although high food quality and fresh products may portray a general healthy food environment in all three neighborhoods, participants discussed why some residents still adopt unhealthy eating behaviors characterized by an excessive consumption of alcohol (high-SES area), sugar loaded foods (high- and middle-SES) and fast food (middle and low-SES). This photovoice participatory methodology helps highlighting important similarities and differences regarding food environment perceptions in the whole socioeconomic spectrum of any given city. This type of participatory approach helps guiding local policies and interventions promoting healthier local food environments.
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Affiliation(s)
- Leyre Gravina
- Department of Nursing, University of the Basque Country (UPV/EHU), 48940, Leioa, Spain.
| | - Amets Jauregi
- Department of Nursing, University of the Basque Country (UPV/EHU), 48940, Leioa, Spain.
| | - Ainhoa Estebanez
- Department of Nursing, University of the Basque Country (UPV/EHU), 48940, Leioa, Spain.
| | | | - Nahia Guenaga
- Department of Nursing, University of the Basque Country (UPV/EHU), 48940, Leioa, Spain.
| | - Sendoa Ballesteros-Peña
- Department of Nursing, University of the Basque Country (UPV/EHU), 48940, Leioa, Spain; Bibao-Basurto Integrated Healthcare Organisation, Bilbao, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.
| | - Julia Díez
- Public Health and Epidemiology Research Group, Universidad de Alcalá, Alcalá de Henares, 28805, Madrid, Spain.
| | - Manuel Franco
- Public Health and Epidemiology Research Group, Universidad de Alcalá, Alcalá de Henares, 28805, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
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18
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BeLue R, NDao F, McClure S, Alexander S, Walker R. The Role of Social Issues on Food Procurement among Corner Store Owners and Shoppers. Ecol Food Nutr 2019; 59:35-46. [PMID: 31475574 DOI: 10.1080/03670244.2019.1659789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE We assessed corner store shopper and owner perceptions, barriers, and enablers related to food procurement in a sample of neighborhood corner stores where over 50% of families are SNAP eligible. DESIGN We conducted semi-structured interviews to identify inventory stocking, shopping and marketing approaches, and perspectives on healthy eating. PARTICIPANTS Five corner store owners and 20 corner store shoppers. RESULTS Corner store owners: 1) did not feel as though they belonged to the community where their corner store was located; 2) had difficulty in becoming authorized WIC retailers because of the perceived complexity of the process, and 3) stated tobacco products and hot food items are their best-selling items; fruits and vegetables were perceived as unmarketable. Corner store shoppers preferred shopping at local corner stores because: 1) lack of transportation made corner stores easier to access than full-service grocery stores; 2) hot foods are readily available and inexpensive; 3) some home kitchens lacked an oven or stovetop for meal preparation; 4) they need to shop daily for children or other family members. CONCLUSIONS Social issues such as housing quality, corner store owner sense of community, and acculturation should be addressed when considering food environment in limited resource communities.
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Affiliation(s)
- Rhonda BeLue
- Department of Health Management and Policy, Saint Louis University College of Public Health and Social Justice, Saint Louis, MO, USA
| | - Fatou NDao
- Penn State University College of Medicine, Hershey, PA, USA
| | - Stephanie McClure
- Department of Health Management and Policy, Saint Louis University College of Public Health and Social Justice, Saint Louis, MO, USA
| | - Suzanne Alexander
- Department of Health Management and Policy, Saint Louis University College of Public Health and Social Justice, Saint Louis, MO, USA
| | - Renee Walker
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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19
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Variation in the food environment of small and non-traditional stores across racial segregation and corporate status. Public Health Nutr 2019; 22:1624-1634. [PMID: 30846012 DOI: 10.1017/s1368980019000132] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We examined differences in consumer-level characteristics and structural resources and capabilities of small and non-traditional food retailers (i.e. corner stores, gas-marts, pharmacies, dollar stores) by racial segregation of store neighbourhood and corporate status (corporate/franchise- v. independently owned). DESIGN Observational store assessments and manager surveys were used to examine availability-, affordability- and marketing-related characteristics experienced by consumers as well as store resources (e.g. access to distributors) and perceived capabilities for healthful changes (e.g. reduce pricing on healthy foods). Cross-sectional regression analyses of store and manager data based on neighbourhood segregation and store corporate status were conducted. SETTING Small and non-traditional food stores in Minneapolis and St. Paul, MN, USA.ParticipantsOne hundred and thirty-nine stores; seventy-eight managers. RESULTS Several consumer- and structural-level differences occurred by corporate status, independent of residential segregation. Compared with independently owned stores, corporate/franchise-owned stores were more likely to: not offer fresh produce; when offered, receive produce via direct delivery and charge higher prices; promote unhealthier consumer purchases; and have managers that perceived greater difficulty in making healthful changes (P≤0·05). Only two significant differences were identified by residential racial segregation. Stores in predominantly people of colour communities (<30 % non-Hispanic White) had less availability of fresh fruit and less promotion of unhealthy impulse buys relative to stores in predominantly White communities (P≤0·05). CONCLUSIONS Corporate status appears to be a relevant determinant of the consumer-level food environment of small and non-traditional stores. Policies and interventions aimed at making these settings healthier may need to consider multiple social determinants to enable successful implementation.
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Jewell MP, Lai ES, Thompson J, Fox M, Kuo T. Higher pricing of fresh produce is more likely in SNAP-Ed eligible neighborhoods when adjacent non-program eligible neighborhoods are mixed income. Prev Med Rep 2019; 14:100817. [PMID: 30828538 PMCID: PMC6383328 DOI: 10.1016/j.pmedr.2019.01.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/23/2019] [Accepted: 01/27/2019] [Indexed: 02/03/2023] Open
Abstract
This analysis describes the socioeconomic attributes of neighborhoods adjacent to low-income neighborhoods with ≥50% of households that are Supplemental Nutrition Assistance Program Education (SNAP-Ed) eligible. It compares the pricing, availability, and quality of fresh produce between these neighborhoods in Los Angeles County. The Los Angeles County Department of Public Health utilized 2013–2014 community-level data from the Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention (CX3) Project to examine the geographic patterns of fresh produce purchases and accessibility in SNAP-Ed eligible census tracts. Community indicators collected by CX3 included information on pricing, availability, and quality of fruits and vegetables from grocery stores (n = 108) in these eligible neighborhoods (n = 21). Correlation statistics were generated to explore the effects of adjacent neighborhoods' socioeconomic status on fruit and vegetable pricing, availability, and quality in the selected neighborhoods (“CX3 neighborhoods”). Poverty data were obtained from the United States Census' American Community Survey. Residents of CX3 neighborhoods that were surrounded by mixed income neighborhoods paid 43% more for fresh produce than CX3 neighborhoods surrounded by other similarly low-income neighborhoods (median produce price, $1.50 versus $1.05). Study results suggest that while quality of produce remains an issue, it is the higher pricing of fresh produce in CX3 neighborhoods – i.e., in the presence of other surrounding mixed income neighborhoods (those with relatively higher income) – that appeared to potentiate food access barriers. Future SNAP-Ed efforts should take this pricing pattern under consideration when designing, planning, and/or implementing nutrition-related programs in these neighborhoods. CX3 assessments provide environmental context to the delivery of SNAP-Ed services. Produce quality remains an issue in Los Angeles County's low-income neighborhoods. Low-income neighborhoods near mixed-income neighborhoods have higher priced produce.
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Affiliation(s)
- Mirna Ponce Jewell
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA 90010, USA
| | - Elaine S Lai
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA 90010, USA
| | - Jack Thompson
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA 90010, USA
| | - Michael Fox
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA 90010, USA
| | - Tony Kuo
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA 90095, USA.,Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.,Population Health Program, UCLA Clinical and Translational Science Institute, Los Angeles, CA 90095, USA
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21
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Caldwell AE, Sayer RD. Evolutionary considerations on social status, eating behavior, and obesity. Appetite 2019; 132:238-248. [PMID: 30078673 PMCID: PMC7039671 DOI: 10.1016/j.appet.2018.07.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/16/2018] [Accepted: 07/26/2018] [Indexed: 12/31/2022]
Abstract
Lower socioeconomic status (SES) is consistently related to higher obesity risk, especially in women living in developed countries such as the United States and Western Europe. Prevailing theories to describe this relationship have focused primarily on proximate level factors such as the generally poorer food environment (e.g. relative lack of healthy food options and higher concentrations of fast food restaurants) found in lower vs. higher SES neighborhoods and the higher financial costs associated with purchasing healthy, nutrient-dense foods compared to unhealthy, energy-dense foods. These factors are hypothesized to preclude the purchase of these foods by lower SES individuals. Unfortunately, public health interventions aimed at improving the food environment of lower SES communities and to provide financial resources for purchasing healthy foods have had limited success in reducing overall energy intake and body weight. Some evidence suggests these interventions may even exacerbate obesity. More recent hypotheses have shifted the focus to ultimate (or adaptive) factors that view increased energy intake and accrual of body fat among individuals of lower social status as adaptive strategies to protect against potential prolonged food scarcity. The purpose of this review is integrate past research at the proximate and ultimate levels with a consideration of how social status and SES during development (in utero through adolescence) may moderate the relationships between social status, eating behavior, and obesity. Utilizing an evolutionary framework that incorporates life history theory can lead to more integrative and thorough interpretations of past research and allow researchers to better elucidate the complex set of environmental, physiological, psychological, and behavioral factors that influence obesity risk among individuals of lower social status.
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Affiliation(s)
- Ann E Caldwell
- University of Colorado Anschutz Medical Campus, University of Colorado, Anschutz Health and Wellness Center, USA; University of Colorado Anschutz Medical Campus, Division of Endocrinology, Metabolism, and Diabetes, USA.
| | - R Drew Sayer
- University of Colorado Anschutz Medical Campus, University of Colorado, Anschutz Health and Wellness Center, USA; University of Colorado Anschutz Medical Campus, Division of Endocrinology, Metabolism, and Diabetes, USA
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Chrisinger BW, Ramos A, Shaykis F, Martinez T, Banchoff AW, Winter SJ, King AC. Leveraging Citizen Science for Healthier Food Environments: A Pilot Study to Evaluate Corner Stores in Camden, New Jersey. Front Public Health 2018; 6:89. [PMID: 29632857 PMCID: PMC5879453 DOI: 10.3389/fpubh.2018.00089] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 03/07/2018] [Indexed: 11/23/2022] Open
Abstract
Over the last 6 years, a coordinated “healthy corner store” network has helped an increasing number of local storeowners stock healthy, affordable foods in Camden, New Jersey, a city with high rates of poverty and unemployment, and where most residents have little or no access to large food retailers. The initiative’s funders and stakeholders wanted to directly engage Camden residents in evaluating this effort to increase healthy food access. In a departure from traditional survey- or focus group-based evaluations, we used an evidence-based community-engaged citizen science research model (called Our Voice) that has been deployed in a variety of neighborhood settings to assess how different features of the built environment both affect community health and wellbeing, and empower participants to create change. Employing the Our Voice model, participants documented neighborhood features in and around Camden corner stores through geo-located photos and audio narratives. Eight adult participants who lived and/or worked in a predefined neighborhood of Camden were recruited by convenience sample and visited two corner stores participating in the healthy corner store initiative (one highly-engaged in the initiative and the other less-engaged), as well as an optional third corner store of their choosing. Facilitators then helped participants use their collected data (in total, 134 images and 96 audio recordings) to identify and prioritize issues as a group, and brainstorm and advocate for potential solutions. Three priority themes were selected by participants from the full theme list (n = 9) based on perceived importance and feasibility: healthy product selection and display, store environment, and store outdoor appearance and cleanliness. Participants devised and presented a set of action steps to community leaders, and stakeholders have begun to incorporate these ideas into plans for the future of the healthy corner store network. Key elements of healthy corner stores were identified as positive, and other priorities, such as improvements to safety, exterior facades, and physical accessibility, may find common ground with other community development initiatives in Camden. Ultimately, this pilot study demonstrated the potential of citizen science to provide a systematic and data-driven process for public health stakeholders to authentically engage community residents in program evaluation.
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Affiliation(s)
- Benjamin W Chrisinger
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Ana Ramos
- The Food Trust, Philadelphia, PA, United States
| | | | | | - Ann W Banchoff
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Sandra J Winter
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Abby C King
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, United States.,Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, United States
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Ross A, Krishnan N, Ruggiero C, Kerrigan D, Gittelsohn J. A mixed methods assessment of the barriers and readiness for meeting the SNAP depth of stock requirements in Baltimore's small food stores. Ecol Food Nutr 2017; 57:94-108. [PMID: 29283673 DOI: 10.1080/03670244.2017.1416362] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We sought to understand Baltimore corner store owners' awareness of and readiness for the then-approved Supplemental Nutrition Assistance Program depth of stock requirements and assess potential barriers and solutions. In-depth interviews and stocking observations were conducted in 17 corner stores in low-income food deserts of Baltimore City. Corner store owners conveyed little to no awareness of the pending depth of stock changes. Only two stores were currently ready for the requirements. Low customer demand, high amounts of potential spoilage, and unfair pricing at the wholesaler were identified by store owners as barriers to stocking required foods.
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Affiliation(s)
- Alexandra Ross
- a Global Obesity Prevention Center , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA.,b Department of Health, Behavior, and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA
| | - Nandita Krishnan
- a Global Obesity Prevention Center , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA
| | - Cara Ruggiero
- a Global Obesity Prevention Center , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA
| | - Deanna Kerrigan
- b Department of Health, Behavior, and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA
| | - Joel Gittelsohn
- a Global Obesity Prevention Center , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD, USA
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