2385 - Incorporating Community Voices on Infrastructure Barriers to a Spatial Analysis of Accessibility to Food Outlets: A Mixed-Method Approach

Abstract

Background Providing adequate access to healthy and affordable food is one critical criterion for planning healthy communities. One of the main approaches to assessing accessibility to food in a community is mapping out the availability of food outlets (supermarkets, corner stores, fast food etc.) based on density and proximity to these outlets. However, common spatial analyses of access to food outlets often fall short of accounting for infrastructure barriers related to the journey to reach them. Our study employed a mixed-method approach, incorporating qualitative accounts by community members about the challenges in travelling to food outlets, and examined how spatial distribution of these challenges reveal a more realistic understanding of existing accessibility. Methods We first assessed population coverage by nearest grocery stores and bus stops within a walking distance in an urban community in Nova Scotia, Canada. A network analysis function within a Geographic Information System was used to estimate population coverage. Second, from a previously conducted photo voice study, we extracted some of the most frequently voiced challenges in traveling to food outlets: 1) steepness of the road; 2) lack of side walks; and 3) inadequate snow clearance in winter. Then, we mapped these factors using elevation and municipal service data and evaluated how they reduce the estimate of the population initially identified as having good access to a food outlet. Results About 60% of the community population was covered by at least one grocery store and about 90% had a bus stop within a 500 m distance from their residence. However, once roads with steep slope, side walks and priority rankings of snow clearance services by road are overlaid with the coverage map, the proportion the population coverage was reduced to 50%. About 37% of the populations in the area identified as not having adequate accessibility were found to be living in low income neighbourhoods. Conclusions Seemingly innocuous factors for those who have cars—i.e., hilliness of the roads, absence of sidewalks, and road maintenance—can significantly hinder some residents from obtaining sufficient and nutritious food even if the distance to food and public transit services may suggest a higher degree of accessibility. Our study demonstrates a benefit in incorporating the voices of community members who are likely most vulnerable to the barriers in traveling to food, which will allow planners to better understand the needs to improve the infrastructure of transportation from health and equity perspectives.