Comparing the accuracy of food outlet datasets in an urban environment

A longitudinal assessment of racial and ethnic inequities in food environment exposure and retail market concentration

OBJECTIVE

This paper assesses trends in food environment and market concentration and racial and ethnic inequities in food environment exposure and food retail market concentration at the US census tract level from 2000 to 2019.

DESIGN

Establishment-level data from the National Establishment Time Series were used to measure food environment exposure and food retail market concentration. We linked that dataset to race, ethnicity and social vulnerability information from the American Community Survey and the Agency for Toxic Substances and Disease Registry. A geospatial hot-spot analysis was conducted to identify relatively low and high healthy food access clusters based on the modified Retail Food Environment Index (mRFEI). The associations were assessed using two-way fixed effects regression models.

SETTING

Census tracts spanning all US states.

PARTICIPANTS

69 904 US census tracts.

RESULTS

The geospatial analysis revealed clear patterns of areas with high and low mRFEI values. Our empirical findings point to disparities in food environment exposure and market concentration by race. The analysis shows that Asian Americans are likelier to live in neighbourhoods with a low food environment exposure and low retail market concentration. These adverse effects are more pronounced in metro areas. The robustness analysis for the social vulnerability index confirms these results.

CONCLUSION

US food policies must address disparities in neighbourhood food environments and foster a healthy, profitable, equitable and sustainable food system. Our findings may inform equity-oriented neighbourhood, land use and food systems planning. Identifying priority areas for investment and policy interventions is essential for equity-oriented neighbourhood planning.

National trends and disparities in retail food environments in the USA between 1990 and 2014

OBJECTIVE

To describe national disparities in retail food environments by neighbourhood composition (race/ethnicity and socio-economic status) across time and space.

DESIGN

We examined built food environments (retail outlets) between 1990 and 2014 for census tracts in the contiguous USA (n 71 547). We measured retail food environment as counts of all food stores, all unhealthy food sources (including fast food, convenience stores, bakeries and ice cream) and healthy food stores (including supermarkets, fruit and vegetable markets) from National Establishment Time Series business data. Changes in food environment were mapped to display spatial patterns. Multi-level Poisson models, clustered by tract, estimated time trends in counts of food stores with a land area offset and independent variables population density, racial composition (categorised as predominantly one race/ethnicity (>60 %) or mixed), and inflation-adjusted income tertile.

SETTING

The contiguous USA between 1990 and 2014.

PARTICIPANTS

All census tracts (n 71 547).

RESULTS

All food stores and unhealthy food sources increased, while the subcategory healthy food remained relatively stable. In models adjusting for population density, predominantly non-Hispanic Black, Hispanic, Asian and mixed tracts had significantly more destinations of all food categories than predominantly non-Hispanic White tracts. This disparity increased over time, predominantly driven by larger increases in unhealthy food sources for tracts which were not predominantly non-Hispanic White. Income and food store access were inversely related, although disparities narrowed over time.

CONCLUSIONS

Our findings illustrate a national food landscape with both persistent and shifting spatial patterns in the availability of establishments across neighbourhoods with different racial/ethnic and socio-economic compositions.

When Students Patronize Fast-Food Restaurants near School: The Effects of Identification with the Student Community, Social Activity Spaces and Social Liability Interventions

US schools have fast-food restaurants nearby, encouraging student patronage, unhealthy consumption, and weight gain. Geographers have developed an activity space framework which suggests this nearby location effect will be moderated by whether people perceive the location as their activity space. Therefore, we study whether students perceive a fast-food restaurant near school as their activity space, and whether social marketing messages can change that perception. We conducted six studies: a secondary data analysis with 5986 students, a field experiment with 188 students, and four lab experiments with 188, 251, 178, and 379 students. We find that students who strongly identify with their student community patronize a fast-food restaurant near school (vs. farther away) because they view it as their activity space, while students who weakly identify do not. For example, in our field experiment, 44% vs. 7% of students who strongly identified with the student community patronized the near versus farther restaurant, while only 28% versus 19% of students who weakly identified patronized the near and farther restaurants comparably. We also find that to deter the strong identifiers, messages should convey that patronage is a social liability, e.g., portray student activism against fast food. We show that standard health messages do not change perceptions of restaurants as social activity spaces. Thus, to combat the problem of fast-food restaurants near schools causing unhealthy consumption, policy and educational interventions should focus on students who strongly identify with their student community and find ways to weaken their perceptions that fast-food restaurants near schools are their activity spaces.

Validation of retail food outlet data from a Danish government inspection database

BACKGROUND

Globally, unhealthy diet is one of the leading global risks to health, thus it is central to consider aspects of the food environment that are modifiable and may enable healthy eating. Food retail data can be used to present and facilitate analyses of food environments that in turn may direct strategies towards improving dietary patterns among populations. Though food retail data are available in many countries, their completeness and accuracy differ.

METHODS

We applied a systematically name-based procedure combined with a manual procedure on Danish administrative food retailer data (i.e. the Smiley register) to identify, locate and classify food outlets. Food outlets were classified into the most commonly used classifications (i.e. fast food, restaurants, convenience stores, supermarkets, fruit and vegetable stores and miscellaneous) each divided into three commonly used definitions; narrow, moderate and broad. Classifications were based on branch code, name, and/or information on the internal and external appearance of the food outlet. From ground-truthing we validated the information in the register for its sensitivity and positive predictive value.

RESULTS

In 361 randomly selected areas of the Capital region of Denmark we identified a total of 1887 food outlets compared with 1861 identified in the register. We obtained a sensitivity of 0.75 and a positive predictive value of 0.76. Across classifications, the positive predictive values varied with highest values for the moderate and broad definitions of fast food, convenience stores and supermarkets (ranging from 0.89 to 0.97).

CONCLUSION

Information from the Smiley Register is considered to be representative to the Danish food environment and may be used for future research.

Assessing changes in the food retail environment during the COVID-19 pandemic: opportunities, challenges, and lessons learned

Background

COVID-19 mitigation strategies have had an untold effect on food retail stores and restaurants. Early evidence from New York City (NYC) indicated that these strategies, among decreased travel from China and increased fears of viral transmission and xenophobia, were leading to mass closures of businesses in Manhattan’s Chinatown. The constantly evolving COVID −19 crisis has caused research design and methodology to fundamentally shift, requiring adaptable strategies to address emerging and existing public health problems such as food security that may result from closures of food outlets.

Objective

We describe innovative approaches used to evaluate changes to the food retail environment amidst the constraints of the pandemic in an urban center heavily burdened by COVID-19. Included are challenges faced, lessons learned and future opportunities.

Methods

First, we identified six diverse neighborhoods in NYC: two lower-resourced, two higher-resourced, and two Chinese ethnic enclaves. We then developed a census of food outlets in these six neighborhoods using state and local licensing databases. To ascertain the status (open vs. closed) of outlets pre-pandemic, we employed a manual web-scraping technique. We used a similar method to determine the status of outlets during the pandemic. Two independent online sources were required to confirm the status of outlets. If two sources could not confirm the status, we conducted phone call checks and/or in-person visits.

Results

The final baseline database included 2585 food outlets across six neighborhoods.

Ascertaining the status of food outlets was more difficult in lower-resourced neighborhoods and Chinese ethnic enclaves compared to higher-resourced areas. Higher-resourced neighborhoods required fewer phone call and in-person checks for both restaurants and food retailers than other neighborhoods.

Conclusions

Our multi-step data collection approach maximized safety and efficiency while minimizing cost and resources. Challenges in remote data collection varied by neighborhood and may reflect the different resources or social capital of the communities; understanding neighborhood-specific constraints prior to data collection may streamline the process.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12890-x.

Effect of Neighborhood Food Environment and Socioeconomic Status on Serum Phosphorus Level for Patients on Chronic Dialysis

BACKGROUND

Elevated blood phosphorus levels are common and associated with a greater risk of death for patients receiving chronic dialysis. Phosphorus-rich foods are prevalent in the American diet, and low-phosphorus foods, including fruits and vegetables, are often less available in areas with more poverty. The relative contributions of neighborhood food availability and socioeconomic status to phosphorus control in patients receiving dialysis are unknown.

METHODS

Using longitudinal data from a national dialysis provider, we constructed hierarchical, linear mixed-effects models to evaluate the relationships between neighborhood food environment or socioeconomic status and serum phosphorus level among patients receiving incident dialysis.

RESULTS

Our cohort included 258,510 patients receiving chronic hemodialysis in 2005-2013. Median age at dialysis initiation was 64 years, 45% were female, 32% were Black, and 15% were Hispanic. Within their residential zip code, patients had a median of 25 "less-healthy" food outlets (interquartile range, 11-40) available to them compared with a median of four "healthy" food outlets (interquartile range, 2-6). Living in a neighborhood with better availability of healthy food was not associated with a lower phosphorus level. Neighborhood income also was not associated with differences in phosphorus. Patient age, race, cause of ESKD, and mean monthly dialysis duration were most closely associated with phosphorus level.

CONCLUSIONS

Neither neighborhood availability of healthy food options nor neighborhood income was associated with phosphorus levels in patients receiving chronic dialysis. Modifying factors, such as nutrition literacy, individual-level financial resources, and adherence to diet restrictions and medications, may be more powerful contributors than food environment to elevated phosphorus.

Google-truthing to assess hot spots of food retail change: A repeat cross-sectional Street View of food environments in the Bronx, New York

Google Street View (GSV) images can be used to "ground-truth" current and historical food retail data from approximately 2007 - when GSV was launched in a few US cities - to the present, facilitating analyses of food environments over time. A review of GSV images of all food retailers listed in a government database of licensed establishments in the Bronx, New York enabled records to be verified, businesses classified, and retail change quantified. The data revealed several trends likely to affect food access and health: increasing overall numbers of food retailers; the growth of dollar stores; and numerous openings, closings, and ownership changes across all food retail segments. Hot spot analysis identified statistically significant clusters of new dollar stores and bodegas, purveyors of less healthy processed foods, in lower-income neighborhoods in the South Bronx that face elevated rates of diet-related diseases. This article demonstrates the benefits and limitations of using GSV to conduct "virtual" food environment research.

Association between convenience stores near schools and obesity among school-aged children in Beijing, China

Background

Food environments have rapidly changed over the past years in China and children have more access to unhealthy food in convenience stores near schools. Since the studies on the association between convenience stores near schools and obesity had inconsistent results and no similar study in China, we conducted a study on the association in Beijing of China, which will provide scientific evidence for the intervention of childhood obesity.

Methods

The study included 2201 students at grade 4 of 37 primary schools in Dongcheng or Miyun district of Beijing. The food environment data was acquired from AMAP, the free web-based geospatial service provider. The numbers of convenience stores were captured within the 800-m network buffer near schools using Geographic Information System. The weight and height of each student were measured by trained health professionals. Students’ dietary and physical behaviors and other information associated with obesity were collected with questionnaires for students and their parents. The generalized linear mixed model (GLMM) was used to analyze the data.

Results

The average age of the students was 10.2 years (Standard Deviation (SD) = 0.33). The prevalence of obesity in students was 14.9%. The median number of convenience stores within the 800-m network buffer near schools was 24 in two districts. The number of convenience stores near each school varied from 5 to 67 (median: 25) in Dongcheng district and from 1 to 57 (median: 22) in Miyun district. After adjusting for the confounding factors at the family and individual levels, the association between convenience stores and childhood obesity was statistically significant. Additional ten convenience stores near schools were associated with an increased risk of obesity (Odds Ratio (OR) = 1.13, 95% confidence interval (CI): 1.03,1.24, P = 0.011). Compared with less than 24 convenience stores near schools, the students with more than or equal to 24 convenience stores near schools had an increased risk of obesity (OR = 1.49, 95% CI: 1.09, 2.03, P = 0.013).

Conclusion

The students with more convenience stores near their schools had an increased risk of obesity. The findings provided evidence for developing public health policy to restrict the number of convenience stores near schools to prevent and control childhood obesity.

The neighborhood environment and obesity: Understanding variation by race/ethnicity

Neighborhood characteristics have been associated with obesity, but less is known whether relationships vary by race/ethnicity. This study examined the relationship between soda consumption - a behavior strongly associated with obesity - and weight status with neighborhood sociodemographic, social, and built environments by race/ethnicity. We merged data on adults from the 2011-2013 California Health Interview Survey, U.S. Census data, and InfoUSA (n=62,396). Dependent variables were soda consumption and weight status outcomes (body mass index and obesity status). Main independent variables were measures of three neighborhood environments: social (social cohesion and safety), sociodemographic (neighborhood socioeconomic status, educational attainment, percent Asian, percent Hispanic, and percent black), and built environments (number of grocery stores, convenience stores, fast food restaurants, and gyms in neighborhood). We fit multi-level linear and logistic regression models, stratified by individual race/ethnicity (NH (non-Hispanic) Whites, NH African Americans, Hispanics, and NH Asians) controlling for individual-level characteristics, to estimate neighborhood contextual effects on study outcomes. Lower neighborhood educational attainment was associated with higher odds of obesity and soda consumption in all racial/ethnic groups. We found fewer associations between study outcomes and the neighborhood, especially the built environment, among NH African Americans and NH Asians. While improvements to neighborhood environment may be promising to reduce obesity, null associations among minority subgroups suggest that changes, particularly to the built environment, may alone be insufficient to address obesity in these groups.