Abstract
Modifying the food environment of cities is a promising strategy for improving dietary behaviors, but using traditional empirical methods to test the effectiveness of these strategies remains challenging. We developed an agent-based model to simulate the food environment of Austin, Texas, USA, and to test the impact of different food access policies on vegetable consumption among low-income, predominantly Latino residents. The model was developed and calibrated using empirical data from the FRESH-Austin Study, a natural experiment. We simulated five policy scenarios: (1) business as usual; (2)–(4) expanding geographic and/or economic healthy food access via the Fresh for Less program (i.e., through farm stands, mobile markets, and healthy corner stores); and (5) expanding economic access to vegetables in supermarkets and small grocers. The model predicted that increasing geographic and/or economic access to healthy corner stores will not meaningfully improve vegetable intake, whilst implementing high discounts (>85%) on the cost of vegetables, or jointly increasing geographic and economic access to mobile markets or farm stands, will increase vegetable intake among low-income groups. Implementing discounts at supermarkets and small grocers is also predicted to be an effective policy for increasing vegetable consumption. This work highlights the utility of agent-based modeling for informing food access policies.
Highlights
The multiple health inequalities affecting low-income minority populations in the United States (US) have been extensively described [1–3]
The agent-based model of the business-as-usual scenario was found to adequately reflect the patterns observed in our baseline empirical data of the FRESHAustin Study, as shown by the results of our two model assessment steps
Our findings provide important insights that can help inform policy design and expansion plans in Central Texas for improving vegetable intake in high-need groups, both within and beyond the current scope of the Fresh for some studies have highlighted the promise of healthy corner stores as a potentially effective strategy to improve the access to and consumption of healthy foods among low-income populations [58–60], our modeling results suggest that investing in scaling up this strategy is unlikely to yield meaningful gains in vegetable consumption among low-income, urban residents
Summary
The multiple health inequalities affecting low-income minority populations in the United States (US) have been extensively described [1–3]. Low-income, minority urban residents have a significantly higher risk of developing diet-related outcomes, including obesity, CVD, type II diabetes, and certain types of cancer, than higher-income white populations [4–9]. A large proportion of residents of urban, low-income, predominantly minority communities continues to consume insufficient amounts of fruits and vegetables as part of their habitual diet, in detriment to their health [13,14]. While the prevalence of meeting the recommended levels of fruit intake is higher among Latinos than in the general population, vegetable consumption is a greater concern [15]. In the US, all racial/ethnic minority groups, including Latinos, as well as low-income residents, have lower levels of attainment of vegetable-specific intake recommendations (2–3 cups per day) than their white, high-income counterparts [16,17]
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