Abstract
Introduction: Neighborhood environments pose an adequate policy target for the development of interventions aimed at improving the cardiovascular health of their residents. Our objective was to assess the Food Stores, Food Markets and Healthy Food Availability in two comparable neighborhoods in a European (Madrid) and an American city (Baltimore), to shed light into possible food system interventions that would improve resident’s nutritional profile. Methods: We selected one neighborhood (~15000 pop) in each city based on the Median Neighborhood Index, a method that selects contiguous areas within a city that are less extreme in terms of education, aging, segregation and urban form. This method looks for clusters of non-extreme neighborhoods using the SaTSCAN statistic. For each neighborhood we directly collected information on the types of food stores present and the availability of healthy foods carried in side the stores. We classified stores into Public Markets, Supermarkets, Grocery Stores, Specialty Stores and Corner/Convenience/Gas Stations. We measured healthy food availability using a brief and modified version of the Nutrition Environment Measurement Survey in Stores (NEMS-S) developed by the Center for a Livable Future (Johns Hopkins Bloomberg School of Public Health). This score ranges from 0 to 27. We performed a descriptive analysis of stores and public markets, mapping the amount of stores by categories and their healthy food availability. Results: The number of stores located in the neighborhood selected in Madrid was 41, with around 25 stores per 10000 residents. The number of stores in Baltimore was 19, with around 17 stores per 10000 residents. The main difference in terms of types of stores was between Madrid’s 12 Specialty Stores (mostly devoted to fruit/vegetable retailing) vs. 0 in the Baltimore area; and Baltimore’s 8 Convenience Stores, vs. Madrid’s 1. In terms of healthy food availability, this was similar across types of stores except for the Corner/Convenience/Gas Station category where Madrid had a mean healthy food availability of 13.2 vs. 9.3 in Baltimore. In terms of public markets, both areas had one market present, with very different characteristics. The Madrid’s market of “Las Ventas” is a three storied indoors market with 112 stands, mostly devoted to fruit/vegetable (n= (n=34), meat/dairy (n=38), and fish retailing (n=19), open all year-round 6 days a week. Only three stands served prepared food. Baltimore’s 32nd Street Farmers Market is a smaller market (50 stands total), open all year-wide once a week (Saturday mornings), mostly devoted to fruit/vegetable retailing (n=20), meat/dairy (n=9) and prepared food (n=10). Conclusions: This study compared two neighborhoods in Madrid and Baltimore portraying two different food systems highlighting major differences in the distribution of food stores and food availability.
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