Increasing Healthy Food Access for Low-Income Communities: Protocol of the Healthy Community Stores Case Study Project

Improving healthy food access in low-income communities continues to be a public health challenge. One strategy for improving healthy food access has been to introduce community food stores, with the mission of increasing healthy food access; however, no study has explored the experiences of different initiatives and models in opening and sustaining healthy food stores. This study used a case study approach to understand the experiences of healthy food stores in low-income communities. The purpose of this paper is to describe the methodology used and protocol followed. A case study approach was used to describe seven healthy food stores across urban settings in the U.S. Each site individually coded their cases, and meetings were held to discuss emerging and cross-cutting themes. A cross-case analysis approach was used to produce a series of papers detailing the results of each theme. Most case studies were on for-profit, full-service grocery stores, with store sizes ranging from 900 to 65,000 square feet. Healthy Food Availability scores across sites ranged from 11.6 (low) to 26.5 (high). The papers resulting from this study will detail the key findings of the case studies and will focus on the challenges, strategies, and experiences of retail food stores attempting to improve healthy food access for disadvantaged communities. The work presented in this special issue will help to advance research in the area of community food stores, and the recommendations can be used by aspiring, new, and current community food store owners.

Food access, mobility, and transportation: a survey and key informant interviews of users of non-profit food hubs in the City of Vancouver before and during the COVID-19 crisis

Background In the City of Vancouver, Canada, non-profit food hubs such as food banks, neighbourhood houses, community centres, and soup kitchens serve communities that face food insecurity. Food that is available yet inaccessible cannot ensure urban food security. This study seeks to highlight food access challenges, especially in terms of mobility and transportation, faced by users of non-profit food hubs in the City of Vancouver before and during the COVID-19 crisis. Methods This study involved an online survey (n = 84) and semi-structured follow-up key informant interviews (n = 10) with individuals at least 19 years old who accessed food at a non-profit food hub located in the City of Vancouver more than once before and during the COVID-19 crisis. Results 88.5% of survey respondents found food obtained from non-profit food hubs to be either very or somewhat important to their household’s overall diet. In their journey to access food at non-profit food hubs in the City of Vancouver, many survey respondents face barriers such as transportation distance/time, transportation inconveniences/reliability/accessibility, transportation costs, line-ups at non-profit food hubs, and schedules of non-profit food hubs. Comments from interview participants corroborate these barriers. Conclusions Drawing from the findings, this study recommends that non-profit food hubs maintain a food delivery option and that the local transportation authority provides convenient and reliable paratransit service. Furthermore, this study recommends that the provincial government considers subsidizing transit passes for low-income households, that the provincial and/or federal governments consider bolstering existing government assistance programs, and that the federal government considers implementing a universal basic income. This study emphasizes how the current two-tier food system perpetuates stigma and harms the well-being of marginalized populations in the City of Vancouver in their journey to obtain food.

Determine the Food Access among Low-Income Households in Rural Area, Kedah, Malaysia

Objective - This study aims to determine the low-income group in rural areas to food access. This study also determines the main source of choice for this group to get food. Methodology - This study was conducted in Baling, Sik, and Padang Terap districts in Kedah. There is 200 respondent involved in this study. Findings - The results showed that 97.87% of low-income households in Baling, 82.36% in Sik, and 71.43% in Padang Terap had low food access status and were prone to food deserts areas. Low -income households in the area prefer grocery stores for food access over supermarkets. A large number of low-income households access food at the supermarket once a month causing geographical factors. Novelty - In conclusion, policymakers need to determine the measurement and assessment of food deserts in rural areas in Malaysia. Kedai Rakyat 1 Malaysia (KR1M) and the KedaiRuncit Transformation Program (TUKAR) can be re-implemented with the improvement of their implementation structure to improve food access in rural areas. Type of Paper - Empirical. Keywords: Food Access; Low-Income Households; Food Deserts; Rural Area; Kedah

Determining Forms of Expressions of Food Violence in Venezuela

In the present investigation, the existence of various forms of expression of food violence in Venezuela was determined, through the measurement of contextualized variables within the established classification. The existence and aggravation of forms of economic expression of food violence were determined, with a relative improvement in food availability but an increase in the difficulty of access: the basic food basket was located in December 2020 at $180.16, and the minimum wage at $6.35, which covers only 3.5% of the basic food basket. Additionally, a substantial increase in the use of the US dollar was determined, in parallel to the Venezuelan legal tender (Bolívar) as well as the introduction of the electronic currency “Petro”, which distorts the food access market and hinders the accessibility. Likewise, the effectiveness index for the delivery of food subsidies and the ability to satisfy the basic food basket through the food programs was determined. The existence of forms of moral expression of food violence was determined by observing in the respondents, high levels of dissatisfaction in the delivery criteria both in a general and community way and high levels of inappropriate perception of the use of propaganda or political advertising in the delivery of help with the no consulted use of the image of the beneficiaries. Forms of emotional expression of food violence were evidenced, showing high levels of dissatisfaction and uncertainty in the ability to purchase food, as well as high levels of anguish. Forms of cultural expression of food violence were determined, by determining changes in the ancestral and traditional eating pattern of the Venezuelan, as well as high measurements of dissatisfaction in the forced change in said pattern, as well as in the alteration of tastes and preferences expressed by the respondents have experienced. Sanitary forms of expression of food violence were evidenced, by determining considerable percentages in the consumption of basic products such as flour and sugar in bulk with ignorance of the brand and origin of the food and high levels of dissatisfaction with the realization of this type of consumption. No physical forms of expression of Food Violence were evidenced when the queues for food access were apparently stopped, and the use of body markings.

Promoting Healthy Food Access and Nutrition in Primary Care: A Systematic Scoping Review of Food Prescription Programs

Objective To conduct a scoping review to synthesize evidence on food prescription programs. Data Source A systematic search of PubMed, CINAHL, Web of Science, Embase, and the Cochrane Library was conducted using key words related to setting, interventions, and outcomes. Study Inclusion and Exclusion Criteria Publications were eligible if they reported food prescription administered by a health care practitioner (HCP) with the explicit aim of improving healthy food access and consumption, food security (FS), or health. Data Extraction A data charting form was used to extract relevant details on intervention characteristics, study methodology, and key findings. Data Synthesis Study and intervention characteristics were summarized. We undertook a thematic analysis to identify and report on themes. A critical appraisal of study quality was conducted using the Mixed Methods Appraisal Tool (MMAT). Results A total of 6145 abstracts were screened and 23 manuscripts were included in the review. Food prescriptions may improve fruit and vegetable consumption and reduce food insecurity (FI). Evidence for impacts on diet-related health outcomes is limited and mixed. The overall quality of included studies was weak. Addressing barriers such as stigma, transportation, and poor nutrition literacy may increase utilization of food prescriptions. Conclusion Food prescriptions are a promising health care intervention. There is a need for rigorous studies that incorporate larger sample sizes, control groups, and validated assessments of dietary intake, food security, and health.

Policy Implications of the COVID-19 Pandemic on Food Insecurity in Rural America: Evidence from Appalachia

Rural communities are disproportionally affected by food insecurity, making them vulnerable to the consequences of supply disruptions caused by the COVID-19 pandemic. While access to food was initially diminished due to food supply disruptions, little is known about the mechanisms through which federal emergency assistance programs impacted food access in rural populations. Through a series of five focus groups in spring 2021, we examined the impact of the COVID-19 pandemic on food access in a rural Appalachian community in Kentucky. Data were analyzed using a Grounded Theory Approach. Findings revealed the following four primary themes: food scarcity in grocery stores; expanded federal food assistance; expanded community food resources; and expanded home gardening. Participants provided details regarding the way increased federal assistance, especially expanded benefits within the Supplemental Nutrition Assistance Program, allowed them to purchase greater quantities of nutritious food. This study unveils the specific impacts of the COVID-19 pandemic on one rural population, including the influence of some social determinants of health on food insecurity. Policymakers and stakeholders should recognize the layered protection of multiple federal emergency assistance programs against food insecurity and the potential for long-term population health promotion in rural areas.

Indigenous Women’s Worldview in Food Related Research: Rematriating food, bodies and lands.

Western discourses around food (in)security and nutrition often focus on food access primarily through male-driven efforts. In turn, the gendered dimension is missing. Yet Indigenous food systems cannot be fully understood without Indigenous women’s worldview, challenges and labour. Our critique points to the importance of centering Indigenous women’s embodied knowledge systems in our food related research. Novelty: Rematriating food research regenerates the complexities of kinship wellbeing, sustainable economies, and body sovereignty.

Financial Support Program for Small Farmers, and Its Impact on Local Food Security. Evidence from Indonesia

This paper addresses the implementation of the Kawasan Mandiri Pangan (KMP) program, a microfinance program for farmer groups, assessing whether the program affects farmers’ decisions concerning production, marketing, and consumption or not, and its impacts on household food security along three dimensions: food availability, food access, and food utilization. Based on a qualitative and theory of change mixed-methods analysis, which uses interviews and focus group discussions (FGDs), this research sheds light on the program’s success among two groups of farmers. Both groups experienced improved productivity and increased food availability, but only one group sustained the program. The results indicate that the program has not affected the commercialization of any particular crop, where the crop’s best selling price, relationships, and commitments are factors that affect the farmers’ marketing decisions. Other findings show how food access at the household level increased when the crop’s selling price was reasonable, while food utilization was influenced predominantly by local wisdom. Taken together, the research findings highlight the importance of the capability of the management, the commitment of the members, and the supervision of the agricultural extension agents. There is a need for a locally owned enterprise to absorb agricultural products and maintain the selling price of crops, which is the primary driver of food accessibility and utilization at the household level.

Evaluation of the determinants of food security within the COVID-19 pandemic circumstances- a particular case of Shaanxi, China

Background Agricultural food production and distribution industries may play a vital role in determining the current conditions of any country’s food security and sustainable development goals. This paper examined the determinants of food security within three distinct aspects (effective utilization of food, food availability, and food access) within the COVID-19 epidemic situation. Methods The qualitative set-up of the study comprised with the identification of drivers by critical analysis of published papers and discussion held with some practitioners. The quantitative data used in this research were collected from a survey covering the agricultural food supply industry in China (Shaanxi Province). The survey was conducted from November to December 2020 and we mainly focus on three aspects of food security (effective utilization of food, food availability, and food access). The core analytical assumptions were made by employing exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equation modeling (SEM). Results After analyzing the data collected from 257 agricultural food productions and distribution personnel along with the hypothesis testing, it found that the determinants of the effective utilization of food were positively related to the determinants of food access (β = 0.291, p = 0.029) and food availability (β = 0.298, p = 0.011), and the determinants of food availability were positively related to the food access determinants (β = 0.128, p = 0.002). The association and variance values between food availability and food access were 0.659 and 0.407; the association and variance values between for effective utilization of food and food availability aspects were 0.465 and 0.298, and between effective utilization of food and economy were 0.508 and 0.475. Conclusion The study critically evaluated the interconnection among the crucial determinants within the banner of three dimensions, which will act as a major contribution to existing literature. This research will help the government and industry to develop policies and strategies for the successful implementation of all the associated determinants of food security in terms of the epidemic situation.