Linking the Flint Food Store Survey: Is Objective or Perceived Access to Healthy Foods Associated with Glycemic Control in Patients with Type 2 Diabetes?

Type 2 diabetes mellitus (DM-2) remains a significant public health concern, particularly in low-income neighborhoods where healthy foods may be scarcer. Despite the well-known relationship between diet and diabetes, little evidence exists on the connections among the objectively measured community and consumer food environment, perception of food access, and diabetes management or outcomes. This cross-sectional, ecological study represents the first example of combining a GIS-based, objectively measured food store audit considering quality, variety, and price of foods in stores with a clinical survey of patients with DM-2 (n = 126). In this way, we offer evidence on the relationship between healthy food access—measured more robustly than proximity to or density of certain store types—and diabetes management knowledge, medication adherence, and glycemic control. Better glycemic control was not correlated with better overall food store score, meaning that people in neighborhoods with better access to healthy foods are not necessarily more likely to manage their diabetes. While perceived healthy food access was not correlated with glycemic control, it was strongly correlated with objective healthy food access at shorter distances from home. These results have great importance both for clinical understanding of the persistence of poor diabetes management outcomes and for the understanding of the influence of the food environment on health behaviors.

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A method for assessing links between objectively measured food store scores and store & neighborhood favorability

International Journal of Health Geographics ◽

10.1186/s12942-019-0195-7 ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

Richard C. Sadler ◽

Ashley N. Sanders-Jackson ◽

Josh Introne ◽

Robyn Adams

Keyword(s):

Food Environment ◽

Food Access ◽

Healthy Lifestyle ◽

Local Level ◽

Objective Measure ◽

Small Sample ◽

Healthy Food ◽

Grocery Store ◽

Food Store ◽

Objectively Measured

AbstractWorldwide, interest in research on methods to define access to healthy food at the local level has grown, given its central connection to carrying out a healthy lifestyle. Within this research domain, papers have examined the spatial element of food access, or individual perceptions about the food environment. To date, however, no studies have provided a method for linking a validated, objective measure of the food environment with qualitative data on how people access healthy food in their community. In this study, we present a methodology for linking scores from a modified Nutrition Environment Measures Survey in Stores (conducted at every store in our study site of Flint, Michigan) with perceptions of the acceptability of food stores and shopping locations drawn from seven focus groups (n = 53). Spatial analysis revealed distinct patterns in visiting and avoidance of certain store types. Chain stores tended to be rated more highly, while stores in neighborhoods with more African-American or poor residents were rated less favorably and avoided more frequently. Notably, many people avoided shopping in their own neighborhoods; participants traveled an average of 3.38 miles to shop for groceries, and 60% bypassed their nearest grocery store when shopping. The utility of our work is threefold. First, we provide a methodology for linking perceived and objective definitions of food access among a small sample that could be replicated in cities across the globe. Second, we show links between perceptions of food access and objectively measured food store scores to uncover inequalities in access in our sample to illustrate potential connections. Third, we advocate for the use of such data in informing the development of a platforms that aim to make the process of accessing healthy food easier via non-food retail based interventions. Future work can replicate our methods to both uncover patterns in distinct food environments and aid in advocacy around how to best intervene in the food environment in various locales.

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Influence of the Local Food Environment on Hispanics’ Perceptions of Healthy Food Access in New York City

Hispanic Health Care International ◽

10.1177/1540415318788068 ◽

2018 ◽

Vol 16 (2) ◽

pp. 76-84 ◽

Cited By ~ 2

Author(s):

Manuel C. Co ◽

Suzanne Bakken

Keyword(s):

New York ◽

Food Environment ◽

Food Access ◽

Fruits And Vegetables ◽

Local Food ◽

Healthy Food ◽

Food Environments ◽

Large Size ◽

Healthy Food Access

Introduction: Studies have characterized food environments and documented its impact on access and consumption of healthy foods as well as diet-related health conditions. This study aims to characterize the local food environment in New York City’s Washington Heights and Inwood community and to examine its influence on Hispanics’ perceptions of healthy food access. Methods: Person-level local food environments were created by spatially modeling food retailers selling fresh fruits and vegetables or low-fat products within a participant’s 400- and 800-m residential radius buffers. Data were analyzed using multivariate binary logistic regression. Results: Fruit/vegetable markets significantly increased participants’ odds of perceiving the availability of a large selection as well as the high quality of fresh fruits and vegetables in their neighborhood. Medium-/large-size supermarkets/groceries within 400-m radius significantly increased participants’ odds of perceiving the high quality of fresh fruits and vegetables in their neighborhood, whereas meat markets significantly lowered the odds. Fruit/vegetable markets and medium-/large-size supermarkets/groceries significantly increased participants’ odds of perceiving the availability of a large selection of low-fat products in their neighborhood. Conclusion: Study findings advance our understanding of the relationships between local food environment and perceived healthy food access among urban Hispanics.

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Tracking Double-up Food Bucks (DUFB) Program Use Among Supplemental Nutrition Assistant Program (SNAP) Recipients and the Implications for Healthy Food Access

10.20944/preprints202011.0324.v1 ◽

2020 ◽

Author(s):

Abiodun Atoloye ◽

Carrie Durward

Keyword(s):

Food Access ◽

Single Market ◽

Healthy Food ◽

Healthy Foods ◽

Total Revenue ◽

Supplemental Nutrition ◽

Frequent Users ◽

Healthy Food Access ◽

Access To Healthy Foods

Acceptance of SNAP benefits has increased in farmers’ markets (FM) over the years. However, getting SNAP recipients to take up the opportunity of extra dollars for healthy food options remains a challenge. Thus, we tracked the use of the Double-up Food Buck (DUFB) program among SNAP recipients who visit participating FMs in Utah to understand the unique characteristics of the program users. Our results identified varying types of program users (multiple and single market shoppers, more frequent and less frequent shoppers). While our findings indicate a higher DUFB transaction in token value among frequent users, larger markets are more likely to have higher DUFB transactions with a higher number of market visits compared to smaller ones. In conclusion, while all types of users may add to the total revenue generated by participating FM, additional initiatives are required to encourage frequent visits and uptake of the program for better access to healthy foods.

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A community-based system dynamics approach suggests solutions for improving healthy food access in a low-income urban environment

PLoS ONE ◽

10.1371/journal.pone.0216985 ◽

2019 ◽

Vol 14 (5) ◽

pp. e0216985 ◽

Cited By ~ 8

Author(s):

Yeeli Mui ◽

Ellis Ballard ◽

Eli Lopatin ◽

Rachel L. J. Thornton ◽

Keshia M. Pollack Porter ◽

...

Keyword(s):

System Dynamics ◽

Urban Environment ◽

Low Income ◽

Food Access ◽

Healthy Food ◽

Community Based ◽

Healthy Food Access

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Evaluating Community Measures of Healthy Food Access

Journal of Community Health ◽

10.1007/s10900-017-0346-3 ◽

2017 ◽

Vol 42 (5) ◽

pp. 991-997 ◽

Cited By ~ 6

Author(s):

Melissa L. Santorelli ◽

Janice O. Okeke

Keyword(s):

Food Access ◽

Healthy Food ◽

Healthy Food Access

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Associations between Food Policy Councils and Policies That Support Healthy Food Access: A National Survey of Community Policy Supports

Nutrients ◽

10.3390/nu13020683 ◽

2021 ◽

Vol 13 (2) ◽

pp. 683

Author(s):

Samantha J. Lange ◽

Larissa Calancie ◽

Stephen J. Onufrak ◽

Katherine T. Reddy ◽

Anne Palmer ◽

...

Keyword(s):

National Survey ◽

Food Access ◽

Food Systems ◽

Food Policy ◽

Healthy Food ◽

Farmers Markets ◽

Cross Sectional ◽

Food Policy Councils ◽

Nationally Representative ◽

Healthy Food Access

Food policy councils (FPCs) are one form of community coalition that aims to address challenges to local food systems and enhance availability, accessibility, and affordability of healthy foods for local residents. We used data from the 2014 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living, a nationally representative survey of US municipalities (n = 2029), to examine the prevalence of FPCs and cross-sectional associations between FPCs and four types of supports for healthy food access (approaches to help food stores, practices to support farmers markets, transportation-related supports, and community planning documents). Overall, 7.7% of municipalities reported having a local or regional FPC. FPCs were more commonly reported among larger municipalities with ≥50,000 people (29.2%, 95% Confidence Interval (CI): 21.6, 36.8) and western region municipalities (13.2%, 95% CI: 9.6, 16.8). After multivariable adjustment, municipalities with FPCs had significantly higher odds of having all four types of supports, compared to those without FPCs (adjusted odds ratio (aOR) range: 2.4–3.4). Among municipalities with FPCs (n = 156), 41% reported having a local government employee or elected official as a member, and 46% had a designated health or public health representative. Although FPCs were uncommon, municipalities that reported having a local or regional FPC were more likely to report having supports for healthy food access for their residents.

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The Ontario Food and Nutrition Strategy: identifying indicators of food access and food literacy for early monitoring of the food environment

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.37.9.06 ◽

2017 ◽

Vol 37 (9) ◽

pp. 313-319 ◽

Cited By ~ 4

Author(s):

Beatrice A. Boucher ◽

Elizabeth Manafò ◽

Meaghan R. Boddy ◽

Lynn Roblin ◽

Rebecca Truscott

Keyword(s):

Food Environment ◽

Selection Criteria ◽

Food Access ◽

Healthy Food ◽

System Level ◽

Level Indicator ◽

Individual Level ◽

Food Literacy ◽

Food And Nutrition ◽

Nutrition Strategy

Introduction To address challenges Canadians face within their food environments, a comprehensive, multistakeholder, intergovernmental approach to policy development is essential. Food environment indicators are needed to assess population status and change. The Ontario Food and Nutrition Strategy (OFNS) integrates the food, agriculture and nutrition sectors, and aims to improve the health of Ontarians through actions that promote healthy food systems and environments. This report describes the process of identifying indicators for 11 OFNS action areas in two strategic directions (SDs): Healthy Food Access, and Food Literacy and Skills. Methods The OFNS Indicators Advisory Group used a five-step process to select indicators: (1) potential indicators from national and provincial data sources were identified; (2) indicators were organized by SD, action area and data type; (3) selection criteria were identified, pilot tested and finalized; (4) final criteria were applied to refine the indicator list; and (5) indicators were prioritized after reapplication of selection criteria. Results Sixty-nine potential indicators were initially identified; however, many were individual-level rather than system-level measures. After final application of the selection criteria, one individual-level indicator and six system-level indicators were prioritized in five action areas; for six of the action areas, no indicators were available. Conclusion Data limitations suggest that available data may not measure important aspects of the food environment, highlighting the need for action and resources to improve system-level indicators and support monitoring of the food environment and health in Ontario and across Canada.

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