scholarly journals Neighborhood Food Environment Associated with Cardiometabolic Health among Predominately Low-income, Urban, Black Women

2021 ◽  
Vol 31 (4) ◽  
pp. 537-546
Author(s):  
Gabrielle Corona ◽  
Tamara Dubowitz ◽  
Wendy M. Troxel ◽  
Madhumita Ghosh-Dastidar ◽  
Bonny Rockette-Wagner ◽  
...  
Keyword(s):  
Low Income ◽  
Food Environment ◽  
Cardiometabolic Health ◽  
Grocery Stores ◽  
Healthy Foods ◽  
Fruit And Vegetable ◽  
Cross Sectional ◽  
Lower Odds ◽  
Food Shopping ◽  
Access To Healthy Foods

Objectives: This study sought to: 1) under­stand how the perceived food environment (availability, accessibility, and affordability) is associated with cardiometabolic health outcomes in predominately low-income Black residents in urban neighborhoods with limited healthy food access; and 2) examine the association of shopping at specific store types with cardiometabolic health outcomes.Methods: We report on cross-sectional data from 459 individuals participating in the Pittsburgh, PA Hill/Homewood Research on Neighborhoods and Health (PHRESH) study. Mean participant age was 60.7 (SD=13.9); 81.7% were female. We used logistic regression to examine associations between three factors (perceived fruit and vegetable availability, quality, and price; primary food shopping store characteristics; and frequency of shopping at stores with low or high access to healthy foods) and cardiometabolic and self-rated health.Results: Adjusting for sociodemographic characteristics, participants with higher perceived fruit and vegetable accessibility (AOR:.47, 95%CI: .28-.79, P=.004) and affordability (AOR:.59, 95%CI: .36-.96, P=.034) had lower odds of high blood pres­sure. Shopping often (vs rarely) at stores with low access to healthy foods was associated with higher odds of high total cholesterol (AOR:3.52, 95%CI: 1.09-11.40, P=.035). Finally, primary food shopping at a discount grocery (vs full-service supermarket) was as­sociated with lower odds of overweight/obe­sity (AOR:.51, 95%CI: .26-.99, P=.049).Conclusions: These results suggest that both perceived accessibility and affordability of healthy foods are associated with reduced cardiometabolic risk factors in this urban, low-income predominantly Black population. Additionally, discount grocery stores may be particularly valuable by providing access and affordability of healthy foods in this population. Ethn Dis. 2021;31(4):537-546; doi:10.18865/ed.31.4.537

scholarly journals Perceived Produce Availability and Child Fruit and Vegetable Intake: The Healthy Communities Study

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3681
Author(s):  
Laurel F. Moffat ◽  
Lorrene D. Ritchie ◽  
Wendi Gosliner ◽  
Kaela R. Plank ◽  
Lauren E. Au
Keyword(s):  
Low Income ◽  
Food Environment ◽  
Vegetable Intake ◽  
Household Food Security ◽  
Linear Regression Models ◽  
Fruit And Vegetable ◽  
Cross Sectional ◽  
Healthy Communities ◽  
Weight Outcomes ◽  
Low Income Households

Children eat more fruits and vegetables when more are available at home, but less is known about how the neighborhood food environment relates to children’s diet and weight outcomes. The goal of this study was to determine whether parental perception of the food environment (neighborhood and home) is associated with children’s fruit and vegetable (F&V) intake and weight outcomes, and to assess differences by household food security status and household income. Cross-sectional data from the 2013–2015 U.S. Healthy Communities Study included 5138 children, aged 4 to 15 years old, from 130 U.S. communities. Neighborhood and home food environments were assessed with parent-reported, perceived F&V availability scores. Associations were tested with multi-level linear regression models. Parents’ perception of produce availability was associated with household F&V availability ratings (β = 0.09 points, p < 0.001). Household F&V availability was associated with child F&V intake (β = 0.32 cups/day or 25.6 g/day, p < 0.001). A higher child F&V intake was associated with a lower child BMI z-score (β = −0.05, p = 0.002). Weaker relationships were seen for children living in food insecure or low-income households. Optimizing neighborhood and home access to F&V may help children improve diet quality, but may not be as effective for children living in food insecure or low-income households.

Availability and affordability of healthy and less healthy food in Nova Scotia: where you shop may affect the availability and price of healthy food

2020 ◽  
pp. 1-9 ◽  
Author(s):  
Manfred Egbe ◽  
Amy Grant ◽  
Madeleine Waddington ◽  
Mikiko Terashima ◽  
Rita MacAulay ◽  
...  
Keyword(s):  
Nova Scotia ◽  
Food Environment ◽  
Urban Areas ◽  
Healthy Food ◽  
Grocery Stores ◽  
Healthy Foods ◽  
Policy Action ◽  
Type Representation ◽  
Cross Sectional ◽  
Convenience Stores

Abstract Objective: The present study aimed to examine the availability and price of healthier compared with less healthy foods by geography, store category and store type for convenience stores, and by store size for grocery stores in Nova Scotia. Design: A cross-sectional study that examined differences in the overall availability and price of healthier compared to less healthy foods in grocery and convenience stores in Nova Scotia. The Nova Scotia Consumer Food Environment project was part of a larger initiative of the Nova Scotia government (Department of Health and Wellness) to assess the food and beverage environment in Nova Scotia in 2015/16. Setting: Four geographic zones (Nova Scotia Health Authority Management Zones) in Nova Scotia, Canada. Participants: A sample of forty-seven grocery stores and fifty-nine convenience stores were selected from a list of 210 grocery stores and 758 convenience stores in Nova Scotia to ensure geographic and store type representation in our sample. Results: Findings indicate that rurality had a significant effect on food availability as measured by the Nutrition Environment Measures Surveys (NEMS) score (P < 0·01); there was a higher availability of healthy foods in rural compared to urban areas for convenience stores but not grocery stores. Healthier foods were also more available in chain stores compared to independent stores (P < 0·01) and in large stores compared to small and medium stores (P < 0·001 and P < 0·01, respectively). Conclusions: The availability of and accessibility to less healthy foods in Nova Scotia food environment suggests that there is a need for government policy action to support a food environment that contributes to healthier diets.

Abstract P283: Where You Shop and Neighborhood Access to Fruit and Vegetables are Associated With Self-rated and Cardiometabolic Health

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Gabrielle Corona ◽  
Wendy M Troxel ◽  
Tamara Dubowitz ◽  
Tiffany Gary-Webb
Keyword(s):  
Blood Pressure ◽  
Health Outcomes ◽  
Food Environment ◽  
Fruits And Vegetables ◽  
Grocery Store ◽  
Cardiometabolic Health ◽  
Lower Odds ◽  
Self Rated Health ◽  
Food Shopping

Introduction: The food environment, including food retail venues, has been shown to be associated with diet, and many disadvantaged neighborhoods lack access to high quality and affordable healthy foods. Research has sought to understand whether and how the food retail environment influences diet, and it is possible that shopping at different types of stores (e.g. full-service vs discount grocery store) influences diet and self-reported health outcomes. There is limited understanding of whether factors of the food environment and primary shopping location impact cardiometabolic health (blood pressure, HbA1c, cholesterol) and self-rated health. Methods: We report on 459 individuals who participated in a blood draw in 2018 as part of the Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health, a longitudinal natural-experiment study among African American adults from two socioeconomically similar neighborhoods. Participants reported their perceived access to fruit and vegetables within their neighborhood and where they did their primary food shopping. Outcomes include measured height, weight, blood pressure, cholesterol (HDL, Total), HbA1c, and participant’s self-rated health. We employed logistic regression to examine associations between 1) perceived fruit and vegetable availability, quality, and price and 2) primary food shopping store type and reason for shopping there, with cardiometabolic and self-rated health outcomes. Covariates were neighborhood, years lived in neighborhood, age, race, income, education, and marital status. Results: Participants were on average, 60.7 years old (SD=13.9); 81.7% (375 of 459) female; 80.4% (369 of 459) overweight/obese. After covariate adjustment, both more perceived accessibility of purchasing (OR: 0.47, 95% CI: 0.28, 0.79) and pricing of fruits and vegetables (OR: 0.59, 95% CI: 0.36, 0.96) within one’s neighborhood were associated with lower odds of high blood pressure. More accessible purchasing (OR: 0.59, 95% CI: 0.39, 0.90), pricing (OR: 0.62, 95% CI: 0.41, 0.94), and higher quality of fruits and vegetables (OR: 0.64, 95% CI: 0.42, 0.97) within one’s neighborhood were associated with lower odds of poor self-rated health. Doing one’s primary food shopping at a discount grocery store compared to a full-service grocery store was associated with lower odds of being overweight (OR: 0.51, 95% CI: 0.26, 0.99). Choosing a primary food store based on price rather than quality of food was associated with increased odds of high cholesterol (OR: 2.02, 95% CI: 1.19, 3.45). Conclusion: These results suggest that higher perceptions of access to fruits and vegetables in one’s neighborhood and choice of primary food shopping store are important correlates of cardiometabolic health. Further research should look towards understanding how direct food choices made at stores impact cardiometabolic outcomes within this population.

scholarly journals Shaping Physical, Economic, and Policy Components of the Food Environment to Create Sustainable Healthy Diets

2020 ◽  
Vol 41 (2_suppl) ◽  
pp. 74S-86S
Author(s):  
Adam Drewnowski ◽  
Eva C. Monterrosa ◽  
Saskia de Pee ◽  
Edward A. Frongillo ◽  
Stefanie Vandevijvere
Keyword(s):  
Low Income ◽  
Food Environment ◽  
Food System ◽  
Well Being ◽  
Food Environments ◽  
Healthy Foods ◽  
Equitable Access ◽  
Nutrition Labels ◽  
Healthy Diets ◽  
Physical Spaces

Background: Sustainable healthy diets are those dietary patterns that promote all dimensions of individuals’ health and well-being; have low environmental pressure and impact; are accessible, affordable, safe, and equitable; and are culturally acceptable. The food environment, defined as the interface between the wider food system and consumer’s food acquisition and consumption, is critical for ensuring equitable access to foods that are healthy, safe, affordable, and appealing. Discussion: Current food environments are creating inequities, and sustainable healthy foods are generally more accessible for those of higher socioeconomic status. The physical, economic, and policy components of the food environment can all be acted on to promote sustainable healthy diets. Physical spaces can be modified to improve relative availability (ie, proximity) of food outlets that carry nutritious foods in low-income communities; to address economic access certain actions may improve affordability, such as fortification, preventing food loss through supply chain improvements; and commodity specific vouchers for fruits, vegetables, and legumes. Other policy actions that address accessibility to sustainable healthy foods are comprehensive marketing restrictions and easy-to-understand front-of-pack nutrition labels. While shaping food environments will require concerted action from all stakeholders, governments and private sector bear significant responsibility for ensuring equitable access to sustainable healthy diets.

scholarly journals Healthy eating: a matter of prioritisation by households or policymakers?

2021 ◽  
pp. 1-3
Author(s):  
Joreintje Dingena Mackenbach
Keyword(s):  
Decision Making ◽  
Healthy Eating ◽  
Low Income ◽  
Fruits And Vegetables ◽  
Food System ◽  
Vegetable Consumption ◽  
Fruit And Vegetable Consumption ◽  
Healthy Foods ◽  
Fruit And Vegetable ◽  
Decision Making Processes

Abstract I reflect upon the potential reasons why American low-income households do not spend an optimal proportion of their food budgets on fruits and vegetables, even though this would allow them to meet the recommended levels of fruit and vegetable consumption. Other priorities than health, automatic decision-making processes and access to healthy foods play a role, but solutions for the persistent socio-economic inequalities in diet should be sought in the wider food system which promotes cheap, mass-produced foods. I argue that, ultimately, healthy eating is not a matter of prioritisation by individual households but by policymakers.

scholarly journals Where do food desert residents buy most of their junk food? Supermarkets

2016 ◽  
Vol 20 (14) ◽  
pp. 2608-2616 ◽  
Author(s):  
Christine A Vaughan ◽  
Deborah A Cohen ◽  
Madhumita Ghosh-Dastidar ◽  
Gerald P Hunter ◽  
Tamara Dubowitz
Keyword(s):  
Low Income ◽  
Food Desert ◽  
Healthy Foods ◽  
Food Retail ◽  
Limited Access ◽  
Food Purchases ◽  
Convenience Stores ◽  
Food And Beverage ◽  
Predominantly Female ◽  
Access To Healthy Foods

Abstract Objective To examine where residents in an area with limited access to healthy foods (an urban food desert) purchased healthier and less healthy foods. Design Food shopping receipts were collected over a one-week period in 2013. These were analysed to describe where residents shopped for food and what types of food they bought. Setting Two low-income, predominantly African-American neighbourhoods with limited access to healthy foods in Pittsburgh, PA, USA. Subjects Two hundred and ninety-three households in which the primary food shoppers were predominantly female (77·8 %) and non-Hispanic black (91·1 %) adults. Results Full-service supermarkets were by far the most common food retail outlet from which food receipts were returned and accounted for a much larger proportion (57·4 %) of food and beverage expenditures, both healthy and unhealthy, than other food retail outlets. Although patronized less frequently, convenience stores were notable purveyors of unhealthy foods. Conclusions Findings highlight the need to implement policies that can help to decrease unhealthy food purchases in full-service supermarkets and convenience stores and increase healthy food purchases in convenience stores.

scholarly journals Setting the table, not running it: An inclusive approach to access to healthy foods

2021 ◽  
pp. 47-50
Author(s):  
Karen Emmerman
Keyword(s):  
Child Labor ◽  
Low Income ◽  
Food System ◽  
Food Justice ◽  
Healthy Foods ◽  
Species Barrier ◽  
Sustainable Food ◽  
Living Wages ◽  
Inclusive Approach ◽  
Access To Healthy Foods

Food Empowerment Project (F.E.P.) is a vegan food justice nonprofit in northern California. We focus on making a more just and sustainable food system for everyone involved. Since injustice in the food system crosses the species barrier, we work to connect the dots between the exploitation of human and nonhuman animals. We focus our efforts on four main areas: ending the use of animals in the food system, improving access to healthy foods in Black, Brown, and low-income communities, exposing the worst forms of child labor (including slavery) in the chocolate industry, and advocating for farmworker rights. These seemingly disparate areas have much in common: they are interlocking forms of oppres­sion, marginalization, and domination in the food system. We recognize that the intersecting nature of oppression necessitates a nuanced response. For example, as an organization working on both farm­worker justice and food apartheid, we cannot advocate for lowering the price of food as this would negatively impact produce workers who already suffer grave systemic injustice. Instead, we advocate for equality of access and living wages for everyone.[1] In this piece, we focus on our approach to the lack of access to healthy foods, and specifically our community-based efforts in Vallejo, California.

WIC Cash Value Voucher Redemption Behavior in Jefferson County, Alabama, and Its Association With Fruit and Vegetable Consumption

2017 ◽  
Vol 32 (2) ◽  
pp. 325-333 ◽  
Author(s):  
Chelsea R. Singleton ◽  
William Opoku-Agyeman ◽  
Ermanno Affuso ◽  
Monica L. Baskin ◽  
Emily B. Levitan ◽  
...  
Keyword(s):  
Vegetable Intake ◽  
Vegetable Consumption ◽  
Farmers Markets ◽  
Grocery Stores ◽  
Jefferson County ◽  
Fruit And Vegetable ◽  
Cross Sectional ◽  
Supplemental Nutrition Program ◽  
Study Participants ◽  
Cash Value Voucher

Purpose: To examine cash value voucher (CVV) redemption behavior and its association with fruit and vegetable (FV) consumption among women who participate in the Supplemental Nutrition Program for Women, Infants, and Children (WIC). Design: Cross-sectional. Setting: Jefferson County, Alabama. Participants: Between October 2014 and January 2015, 300 women (mean age: 27.6 years; 66.8% non-Hispanic black; 45.1% obese) who participated in the Birmingham WIC program were surveyed. Measures: Self-reported information on demographics, produce shopping behaviors, and residential access to fresh produce retailers (eg, supermarkets and farmers markets) was examined. Fruit and vegetable intake was collected via the Block Fruit–Vegetable–Fiber screener. Participants who self-reported redeeming the WIC CVV in each of the 3 prior months were classified as regular redeemers. Analysis: Multivariable-adjusted regression models were used to examine associations between variables of interest and regular WIC CVV redemption. Results: There were 189 (63.0%) study participants classified as regular WIC CVV redeemers. Regular redeemers and other participants (ie, irregular redeemers and nonredeemers) were similar with respect to demographics. Regular redeemers were more likely to use grocery stores to purchase FVs ( P = .003) and consumed significantly more servings of FVs per day (β = .67; standard error = 0.24; P = .007). Conclusion: Regular WIC CVV redemption was associated with some produce shopping behaviors and increased FV consumption and among WIC participants in Jefferson County, Alabama.

scholarly journals A modified choice experiment to examine willingness to participate in a Community Supported Agriculture (CSA) program among low-income parents

2018 ◽  
Vol 35 (2) ◽  
pp. 140-157 ◽  
Author(s):  
Jared T. McGuirt ◽  
Stephanie B. Jilcott Pitts ◽  
Karla L. Hanson ◽  
Molly DeMarco ◽  
Rebecca A. Seguin ◽  
...  
Keyword(s):  
New York ◽  
Low Income ◽  
Rural Areas ◽  
Choice Experiment ◽  
Limited Resource ◽  
Community Supported Agriculture ◽  
Willingness To Participate ◽  
Healthy Foods ◽  
Food Quantity ◽  
Access To Healthy Foods

AbstractThere is a need to improve geographical and financial access to healthy foods for limited resource populations in rural areas. Community Supported Agriculture (CSA) programs can improve access to healthy foods in rural and limited-resource populations. However, research is needed to discern the most appealing conditions for a CSA (e.g. price, frequency, food quantity) among rural, low-income customers. The goal of this study was to understand low-income consumers' preferences related to participation in a CSA program, considering price, frequency, food quantity and accessibility (e.g. distance) conditions. A modified exploratory choice experiment exercise was embedded within in-depth interviews to examine willingness to participate in CSA under a variety of conditions among 42 low-income adults with at least one child in the household in North Carolina, New York, Vermont and Washington. Willingness to participate in a CSA under each condition was summed and compared across conditions. Results were stratified by race, number of children and household members and McNemar's test and Student's t-test were used to examine differences in willingness between conditions. Salient quotes were extracted to support themes related to each condition. Our analysis suggests that the ideal CSA would be a full-sized share of eight to nine items of mixed variety, distributed every other week, priced at less than US$15, no more than 10 min further than the supermarket (SM) from their home and preferably less expensive but no more than 20% more expensive than SM prices. CSAs interested in reaching rural low-income populations may benefit from considering these consumer-level preferences.

scholarly journals Comparing food desert residents with non-food desert residents on grocery shopping behaviours, diet and BMI: results from a propensity score analysis

2020 ◽  
Vol 23 (5) ◽  
pp. 806-811
Author(s):  
Rebecca C Woodruff ◽  
Regine Haardörfer ◽  
Ilana G Raskind ◽  
April Hermstad ◽  
Michelle C Kegler
Keyword(s):  
Propensity Score Analysis ◽  
Grocery Store ◽  
Food Desert ◽  
Dietary Behaviour ◽  
Grocery Shopping ◽  
Healthy Foods ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Perceived Access ◽  
Access To Healthy Foods

AbstractObjective:To determine whether residence in a US Department of Agriculture-designated food desert is associated with perceived access to healthy foods, grocery shopping behaviours, diet and BMI among a national sample of primary food shoppers.Design:Data for the present study came from a self-administered cross-sectional survey administered in 2015. Residential addresses of respondents were geocoded to determine whether their census tract of residence was a designated food desert or not. Inverse probability of treatment-weighted regression was used to assess whether residence in a food desert was associated with dependent variables of interest.Setting:USA.Participants:Of 4942 adult survey respondents, residential addresses of 75·0 % (n 3705) primary food shoppers were included in the analysis.Results:Residence in a food desert (11·1 %, n 411) was not significantly associated with perceived access to healthy foods, most grocery shopping behaviours or dietary behaviour, but was significantly associated with primarily shopping at a superstore or supercentre v. a large grocery store (OR = 1·32; 95 % CI 1·02, 1·71; P = 0·03) and higher BMI (b = 1·14; 95 % CI 0·36, 1·93; P = 0·004).Conclusions:Results suggest that food desert residents shop at different food stores and have higher BMI than non-food desert residents.

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