Food Deserts Research Articles

Uber to get groceries: Are ride-hail services accessing Chicago’s food deserts?

ABSTRACT Segregation has many negative consequences for marginalized populations, including increased poverty, low-quality housing, and decreased access to quality education, employment, and food stores. This study illuminates how food and transportation infrastructures exacerbate these inequalities and whether ride-hail services like Uber and Lyft help affected populations access food stores. As a descriptive understanding of the intersection between food, transportation, and racial and ethnic residential segregation in Chicago, Illinois, this study analyzes two questions: (1) how often are ride-hail trips crossing food desert census tract boundaries and (2) are ride-hail trips that access food deserts also accessing neighborhoods that contain supermarkets? Using spatial analyses of data from the city of Chicago, the American Community Survey, food store locations, and the USDA food access atlas, this study finds that ride-hail services are accessing food desert neighborhoods at a very low rate, and very few rides access food desert and supermarket-containing neighborhoods in the same trip.

Book review: Urban Food Deserts in Japan

Book review: Urban Food Deserts in Japan

286 Partnering and engaging in Indiana Communities through listening sessions and data sharing: successes of Connection IN Health

OBJECTIVES/GOALS: Participants will be able to identify how partnering with state health departments for a CTSA initiative assists in meeting shared goals by building infrastructure and sharing resources and list key components of a successful county engagement process that can be replicated. METHODS/STUDY POPULATION: Connections IN Health is a collaborative project with the Indiana Clinical and Translational Sciences Institute, Indiana Department of Health, Indiana University Simon Comprehensive Cancer Center, and community partners. We address chronic disease in Indiana with coalition-based engagement at the grassroots level, and partnering to provide technical assistance, resources, connections and evidence-based strategies to address the health challenges. Our methods of county engagement include surveying the broad community, conducting listening sessions with key community stakeholders, compiling, analyzing and sharing data, collaborating with existing local coalitions, assessing community readiness and suggesting evidence-based practices to implement. RESULTS/ANTICIPATED RESULTS: As a result of county engagement, local coalitions have current, local data to drive their efforts in improving local health rankings and outcomes. Community partners in eight counties have selected and implemented evidence-based strategies to manage and/or prevent diabetes, cardiovascular disease and/or stroke. Some examples include: starting a community garden with cooking classes in a food desert to provide fresh produce and nutrition/cooking knowledge, creating a mobile kitchen on hand for organizations to use to provide education and cooking skills, providing a passport for wellness at existing community events with food samples and health screenings and offering evidence-based educational programming such as Dining with Diabetes and Be Heart Smart. DISCUSSION/SIGNIFICANCE: Moving county health coalitions to evidence-based programming that has the greatest likelihood for success is a critical translational sciences challenge. Our rigorous and well defined approach yields significant improvement in local health coalition activities, sustaining their activities through long-term trusted relationships.

Supporting Each Other: Older Adults’ Experiences Empowering Food Security and Social Inclusion in Rural and Food Desert Communities

Older adults vulnerable to food insecurity are at risk of poor psychological and physical health. Poor public infrastructure or proximity to food sources can exacerbate risk of food insecurity. Reduced statutory services for social care has heightened the responsibility on third sector organisations and community-led volunteering, essential to supporting healthy ageing in place and reducing the inequalities of ageing. The aim of this qualitative study was to explore how older adults’ volunteering with a third sector organisation focused on food access supports food security and builds social capital for socially or economically marginalised older adults within rural and food desert communities. The study aims to bridge the knowledge gap of how volunteering in vulnerable geographies affects food insecurity and community. Semi-structured interviews were conducted with seven older (55+) volunteer ‘meal makers’ working with the third sector organisation Food Train and its ‘Meal Makers’ project. Interview recordings were transcribed and thematically analysed. Ecomap methodology was used to illustrate the lived experiences of older adult volunteers as told through the interviews. Two themes were identified by Thematic Analysis: (1) Networks, connectedness, and exposure to social capital, and (2) Supplementarysupport. This study finds that older adult volunteers are well placed within community interventions supporting food insecure older adults in rural or food desert communities. Ecomaps demonstrated that high social capital volunteers can mediate food access barriers and highlighted points of local knowledge and social connection. Volunteer engagement provides opportunities for food secure older adults to share local knowledge and build networks of food support and social inclusion for food insecure older adults. Older age volunteering should be advocated as a multi-faceted intervention promoting mutual health and wellbeing in volunteer and beneficiary.

Association of Food Desert Residency and Preterm Birth in the United States

Introduction: Food deserts are a major public health concern. Inadequate access to healthy food has been associated with poor nutrition and the development of dietary related chronic conditions. Objective: To determine the association between geographic access to nutritious food and preterm birth and whether gestational hypertension mediates this relationship. Methods: Food access data was retrieved from the U.S. Department of Agriculture Food Access Research Atlas (2019) and used to quantify the percentage of Census tracts within each county that were food deserts: low-income tracts with limited access to grocery stores, supermarkets, or other sources of healthy, nutritious foods. These data were merged with US birth records from 2018 to 2019 by using the maternal county of residence (n = 7,533,319). We fit crude and adjusted logistic regression models with generalized estimating equations to determine the association between living in a food desert and the odds of preterm birth. We conducted a secondary within-group analysis by stratifying the fully adjusted model by race for non-Hispanic White and non-Hispanic Black birthing people. Results: In the fully adjusted model, we found a dose–response relationship. As the prevalence of tract-level food deserts within counties increased, so did the likelihood of preterm birth (mid-range: odds ratio (OR) = 1.04, 95% confidence interval (C.I.) 1.01–1.07; high: OR = 1.07, 95% C.I. 1.03–1.11). Similar results were seen in the White–Black stratified models. However, a disparity remained as Black birthing people had the highest odds for preterm birth. Lastly, gestational hypertension appears to mediate the relationship between nutritious food access and preterm birth (natural indirect effect (NIE) = 1.01, 95% CI = 1.00, 1.01). Conclusion: It is salient, particularly for Black birthing people who experience high rates of adverse birth outcomes, that the role of food desert residency be explored within maternal and child health disparities.

Promoting healthful food purchases through in-store interventions: Empirical evidence from rural food deserts

Effective ways to promote healthful food intake in rural areas are understudied. The paper evaluated whether a two-component, in-store intervention designed to encourage healthy food purchases was associated with improved healthfulness scores of food items purchased by shoppers in rural food deserts. One component introduced a point-of-sales label that assigned a single numerical score to each food item facilitating direct comparisons of the product's nutrition with those of other products shelved around it. The other component was a one-day nutrition education workshop promoted within the store. Interventions took place in 2015 at two stores in rural counties in the U.S. Midwest. Four stores in similar communities were selected as the control group. We applied a difference-in-difference model to estimate changes in the healthfulness of food items purchased attributable to the intervention among shoppers at the treatment stores (n = 486) and control stores (n = 10,759) using store transaction data. Healthfulness of food items was measured in terms of food scores published by the Environmental Working Group on a 1–10 scale. Both components had minimal impacts on the scores, although 0.2 and 0.1 points increases in the score per item and score per dollar were statistically significant at the 1% level respectively. A year after the intervention, these small effects of the intervention further diminished compared to the immediately after implementation. Results suggest the average effects of intervention across the study communities had limited practical significance but benefited some rural residents who were exposed to the intervention.

New insights into grocery store visits among east Los Angeles residents using mobility data

In this study, we employed spatially aggregated population mobility data, generated from mobile phone locations in 2021, to investigate patterns of grocery store visits among residents east and northeast of Downtown Los Angeles, in which 60% of the census tracts had previously been designated as “food deserts”. Further, we examined whether the store visits varied with neighborhood sociodemographics and grocery store accessibility. We found that residents averaged 0.4 trips to grocery stores per week, with only 13% of these visits within home census tracts, and 40% within home and neighboring census tracts. The mean distance from home to grocery stores was 2.2 miles. We found that people visited grocery stores more frequently when they lived in neighborhoods with higher percentages of Hispanics/Latinos, renters and foreign-born residents, and a greater number of grocery stores. This research highlights the utility of mobility data in elucidating grocery store use, and factors that may facilitate or be a barrier to store access. The results point to limitations of using geographically constrained metrics of food access like food deserts.

Social inequities in food deserts and food swamps in a northeastern Brazilian capital.

This study identified food deserts and swamps, investigating their associations with socioeconomic and demographic conditions. This ecological study was conducted using data from urban census tracts in the city of Recife, which were considered the unit of analysis. Information on food retail was obtained from government sources in 2019. Census tracts below the 25th percentile in the density of healthy food retail (i.e., those that predominantly sell natural or minimally processed foods, mixed businesses, and super- and hypermarkets) were classified as food deserts. Census tracts above the 25th percentile in the density of unhealthy food retail (i.e., those selling primarily ultra-processed foods) were considered food swamps. The socioeconomic and demographic conditions of the census tracts were evaluated using variables from the 2010 census (per capita income, average income, race, literacy of the head of household, and the availability of essential services) and the Health Vulnerability Index. Census tracts considered food deserts (28.5%) were more vulnerable, characterized by lower income and access to essential services, more illiterate residents and more minorities (Black/Indigenous/mixed race). Food swamps (73.47%) were more prevalent in less vulnerable neighbourhoods characterized by higher percentages of literate residents and Whites, greater purchasing power, and better basic sanitation. The characteristics of Recife's food deserts and swamps demonstrate social inequalities in the food environment. Public facilities could play a vital role in promoting healthy eating within food deserts. Additionally, future implementation of taxes on ultra-processed foods and the provision of tax subsidies to natural or minimally processed food sellers might contribute to fostering healthier dietary choices.

Production planning in an indoor farm: Using time and space requirements to define an efficient production schedule and farm size

Abstract Indoor agriculture is an innovative and environmentally sustainable approach to high-quality food production, utilizing advanced technology to reduce water usage by 95% and achieve a 100-fold increase in production per unit of land compared to conventional farming systems. These enclosed systems provide year-round production of pesticide-free fresh food, even in cities with less favourable climates, addressing food deserts and creating employment opportunities in urban areas. However, the industry faces significant challenges, primarily stemming from substantial investment and operating costs, exacerbated by a limited understanding of the input-output relationship within these systems. This study employs a bioeconomic framework to establish a foundational production function based on growth cycle duration (time) and required growing area (space). Through a partial budget analysis, a 19-day production schedule was identified to provide the highest contribution margin to profits. Results set the minimum size of this hypothetical lettuce indoor farm at 273 m2, rendering it suitable for installation in urban areas. The farm harvests 118 kg per day, within an 800 m2 growing area distributed across four vertically stacked shelves. Estimates of economic output sensitivity to exogenous factors in the US context are also presented, along with a comparison between cost-minimizing and revenue-maximizing strategies.

Innovative Extracurricular Student Engagement: The Community Problem Solving Challenge

The Community Problem Solving Challenge Program is an innovative extracurricular learning program that engages university students with high school students from inner city, economically distressed neighborhoods to develop entrepreneurial solutions for complex socio-economic problems identified by community leaders. Examples of problems addressed by students in the past include drug use among students and members of the community, the transition of incarcerated population to civil society, food deserts, and mobility. This program overcomes the limitations of the outsider-driven top-down model of community development. In this instance, community “insiders”—the high school students—collaborate with “outsiders”—the university students—to develop entrepreneurial solutions to live problems in their communities. The program illustrates how activities designed using entrepreneurship pedagogy theories can provide engaging, enriching, and effective outcomes. The program benefits all stakeholders participating in it. For example, high school students develop an entrepreneurial mindset, learn entrepreneurship principles by application of frameworks to real-world problems, achieve self-efficacy as they discover that they have agency to transform their communities, and by bringing together community leaders, faculty, college, and high school students the program fosters networks, that according to student feedback, increases the likelihood of the high school participants pursuing a college degree. This paper elaborates on the impact for all stakeholders.

Mixed-Method, Multilevel Clustered-Randomized Control Trial for Menstrual Health Disparities.

Menstrual cycle characteristics are largely considered unmodifiable reproductive factors, a framing that prevents exploration of the ways structural factors interfere with menstrual health. Given the role of structural factors like healthy food and healthcare access on reproductive health and the grave need for structural interventions to known reproductive health disparities that disproportionately target cisgender women racialized as Black, it is imperative that science begin to examine how structural factors influence menstrual health. To explore such research, we employ critical race theory and intersectionality to illustrate what a structural intervention to improve menstrual cycle health could look like. Centering those with the greatest need, persons racialized as Black and/or LatinX living in food and healthcare deserts in Northern Manhattan, our illustrative sample includes four groups of persons who menstruate (e.g., cisgender girls and women) that are pre-menarche, pre-parous, postpartum, or perimenopausal. We describe a hypothetical, multilevel clustered-randomized control trial (cRCT) that provides psychoeducation on racism-related trauma and free delivered groceries to both treatment and control groups, while randomizing 30 clusters of housing associations to receive either sexual health clinics at their housing association or free vouchers for healthcare. We embed mixed methods (diaries, interviews, surveys, mobile apps, observation) into the design to evaluate the effectiveness of the 1-year intervention, in addition to determining the impact on participants through their perspectives. Through this illustration, we provide a novel example of how structural interventions can apply mixed methods to evaluate effectiveness while delivering services to populations impacted by multiple structural factors. We demonstrate how qualitative and quantitative approaches can be paired in clustered RCTs and how a living logic model can empirically incorporate the population perspective into more effective interventions. Lastly, we reveal how sensitive menstrual health is to structural factors and how upstream improvements will trickle down to potentially reduce health disparities in reproductive health.

Relationship between food environment, social isolation and diet quality in Brazil

Introduction. The COVID-19 pandemic has impacted diet quality in differentways. In this context, community, organizational and consumer nutrition environments can influence the eating pattern. Objective. The purpose of this study was to identify how quarantine during the COVID-19 pandemic changed the diet in Brazil. Materials and methods. A natural experiment organized into experimental (social-isolated group - SIG) and control groups (non-isolated group - CG) was conducted with data collection from an online survey at the beginning of the pandemic (T0) and in the less restrictive period of 2020 (T1). Pre-post improvements in diet quality (IDQ) were determined for the SIG and CG. Intro-intergroup changes were tested using the Mann–Whitney and Wilcoxon signed rank tests. The intervention effect was estimated using crude and adjusted difference- indifference in multilevel regression analysis accounting for repeated measures. Results. A sample of 565 Brazilian adults answered the questionnaire at T0 and T1. IDQ was favored twice or more by attitudes such as buying food directly from farmers/street markets, reducing requests for food delivery, and increasing time spent on eating activities and the frequency of cooking. The isolated group had no IDQ at T1, whereas the no isolated group, who worsened diet quality (6.1%) at T0, improved it at T1 (4.8%). Conclusions. The restrictive quarantine forced the non-isolated population to have an experience comparable to a food desert, negatively affecting their diet.

Abstract A075: The Association between Food Deserts, Food Swamps, and Postmenopausal Breast Cancer Mortality in the United States

Abstract Purpose: Breast cancer (BRCA) is the 4th leading cause of cancer death in the United States (U.S.) and is one of 13 obesity-related cancers. Healthy food consumption is a protective factor shown to decrease obesity risk and postmenopausal BRCA mortality, respectively. However, residing in geographical areas with no access to healthy food options (food deserts) or unhealthy food options (food swamps) reduces access to healthy foods and has been severely understudied. Recently we found a 77% increased odds of overall obesity-related cancer mortality among U.S. counties with the worst food swamp scored counties/county equivalents. This current study examined the association between residing in food swamps and deserts with postmenopausal BRCA mortality. Methods: We conducted a cross sectional/ecological analysis utilizing 2010 – 2020 Center for Disease Control and Prevention postmenopausal BRCA mortality data (restricted to 45+ years old) and aggregated 2012 – 2020 data from the U.S. Department of Agriculture Food Environment Atlas data. Food swamp score (FS) was calculated as the ratio of fast-food and convenience stores to grocery stores and farmer’s markets. Food desert score (FD) was calculated as the proportion of residents living more than one mile (urban) or 10 miles (rural) from a grocery store and household income ≤ 200% of the federal poverty threshold. We categorized FD and FS to low, moderate, or high; higher scores indicated counties with poorer healthy food resources. Multilevel generalized mixed effects models were used to estimate the mentioned association. Results: 2,280 counties/county equivalents with high postmenopausal BRCA mortality rates had higher percentage of non-Hispanic (NH)-Black population (5.80 vs. 2.08), poverty rates (17.2 vs. 14.2), and high food swamp scored areas (39.0 vs. 24.5) versus counties/county equivalents with low postmenopausal BRCA mortality rates (p-value < 0.0001). After adjusting for age, percentage of NH-Blacks per county, and poverty rate, we found 42% increased odds of having high postmenopausal BRCA mortality rates among U.S. counties/county equivalents with high food swamp scores (adjusted odds ratio [AOR] = 1.42; 95% CI: 1.14 – 1.78). Conclusions: Sampled U.S. counties with the poorest food swamp environment had significantly increased odds of postmenopausal BRCA mortality. We suggest that local policymakers and community stakeholders should employ sustainable approaches at combating obesity and BRCA by increasing healthier accessible food sources (e.g. creating more walkable neighborhoods and community gardens). Citation Format: Malcolm Bevel, Meng-Han Tsai, April Parham, Sydney Andrzejak, Samantha Jones, Justin X Moore. The Association between Food Deserts, Food Swamps, and Postmenopausal Breast Cancer Mortality in the United States [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr A075.

Abstract WP269: Food Desert Residence as a Contributing Risk Factor for Acute Ischemic Stroke Patients

Background: Research suggests that residing in a food desert (FD) area may negatively impact health by increasing cardiovascular risk factors. The USDA defines FD as an area of low income in addition to low access to grocery stores at a 1 (urban) or 10-mile (rural) radius and/or low vehicle access. This study aims to assess sociodemographic profile and stroke risk factors among individuals residing in FDs within the predominantly rural state of South Carolina (SC). Methods: Deidentified administrative discharge data included all individuals admitted to SC hospitals between 2010 and 2019 with ICD-9/10 codes for ischemic stroke. Public USDA census tract data were used to define FDs based on patients’ residential addresses at time of admission, with encrypted linkages provided by SC’s clinical data warehouse. Stroke risk factors were compared between those residing in a FD vs. not via chi-square analyses. Results: Out of the identified 63,330 patients with an index ischemic stroke event, 36.8% were classified as residing within a USDA defined FD. Acute stroke patients residing within a FD were significantly more likely to be younger (age <65), of black race, and without health insurance (all p<.0001). FD residents were significantly more likely to have comorbid hypertension (OR 1.14, 95%CI 1.09, 1.19), type 2 diabetes (OR 1.21, 95%CI 1.17, 1.25), heart failure (OR 1.14, 95%CI 1.09, 1.19), and chronic kidney disease (OR 1.24, 95%CI 1.18, 1.30) associated with acute stroke hospital admission. Also, those residing in FDs were significantly more likely to have a history of obesity (OR 1.17, 95%CI 1.11, 1.23), mental health (OR 1.14, 95%CI 1.10, 1.18), tobacco use (OR 1.28, 95%CI 1.23, 1.33), and substance abuse (OR 1.40, 95%CI 1.35, 1.45). There were no significant differences noted in terms of sex/gender, dyslipidemia, discharge disposition, or case fatality. Conclusion: Stroke patients living within FDs are at heightened risks of comorbidities associated with ischemic stroke. Limitations in access to high quality food and suboptimal nutrition may be a contributing risk factor. Future studies focusing on shopping and eating behaviors among those living within FDs are needed to further reduce health disparities within rural and urban geographic locations nationwide.

Food Swamp Versus Food Desert: Analysis of Geographic Disparities in Obesity and Diabetes in North Carolina Using GIS and Spatial Regression

This study examined how two different types of food environments—food deserts and food swamps—were associated with geographic disparities in obesity and diabetes in North Carolina using geographic information systems and spatial regression. To better identify the association between food swamps and health disparities, this study incorporated socioeconomic dimensions into the food swamp measure and considered dollar stores and gas stations with convenience stores as unhealthy food retailers, which were often overlooked in previous studies. It found that food deserts were concentrated in eastern North Carolina (ENC) and western North Carolina and food swamps in ENC, while obesity and diabetes hot spots were clustered in ENC. The results indicated that obesity and diabetes remained associated with food swamps even after spatial autocorrelation was controlled for, but the associations with food deserts—statistically significant in a nonspatial regression—became no longer significant when food swamps and spatial autocorrelation were controlled for. These results demonstrate that a food swamp might better explain health disparities in North Carolina than a food desert. Identifying ENC as a region containing both food deserts and food swamps illustrates the need for state and local governments to focus their efforts in this region to mitigate food insecurity and health disparities.

A comparison of raster-based point density calculations to vector-based counterparts as applied to the study of food availability

BackgroundProximity to food sources is one of the quantifiable factors measurable across space impacting diet-related health outcomes. Contemporary research has coined the terms ‘food desert’ and ‘food swamp’, sometimes combined with a poverty component, to highlight disproportionate access to healthy and unhealthy food sources. However, there are various ways to measure this proximity—i.e., food availability in this research. Dollar stores such as Dollar General, Family Dollar, and Dollar Tree are one emerging facet of the food environment that provides healthy and unhealthy food options yet have not fully been studied. With more ways to easily measure food availability within the confines of a GIS, this paper proposes a new raster-based Point Density metric to measure the availability of these Dollar stores. In this study, this raster-based metric was calculated for a 6-county region in central North Carolina and compared to six other availability metrics utilized in food security research. A novel Python-based tool to compute the Jaccard Index between these various availability metrics and a matrix to compare these pairwise Jaccard Index calculations was created for this raster-based metric, which is very easy to derive.ResultsUsing a pairwise Jaccard Index summarized and then averaged in a correlation table, the Point Density measure rated the highest (.65) when compared to 6 other popular vector-based techniques. Our results showed the density metric performed statistically better than Euclidean distance, drive-time, density, and point-in-polygon vector metrics when measuring availability for Dollar stores in Central North Carolina.ConclusionsResults reinforce the efficacy of this easy-to-compute metric comparable to vector-based counterparts that require more robust network and/or geoprocessing calculations. Results quantitatively evaluate food availability with an eventual goal of dictating local, regional, and even state-level policy that critically and holistically consider this metric as powerful and convenient metric that can be easily calculated by the lay GIS user and understood by anyone.

Food Access After Disasters

Problem, research strategy, and findings Access after disasters to resources such as food poses planning problems that affect millions of people each year. Understanding how disasters disrupt and alter food access during the initial steps of the recovery process provides new evidence to inform both food system and disaster planning. Our research took a supply-side focus and explored the results from a survey of food retailers after Hurricane Harvey in three Texas counties. The survey collected information on how the disaster affected a store’s property, people, and products and the length of time a store was closed, had reduced hours, and stopped selling fresh food items. We found that a focus only on store closures and property damage would underestimate the number of days residents had limited fresh food access by nearly 2 weeks. Further, stores in lower-income communities with chronically low access to supermarkets (food deserts) were closed longer than other stores, potentially compounding pre-existing inequalities. To plan for a more equitable food supply after a disaster, planners should embrace more dimensions of access, encourage retailer mitigation, and assess the types of retailers and their distribution within their communities. Takeaway for practice Practicing planners aspire to ensure equitable access to resources (e.g., food, education, and health care). In the context of food access, planners should consider that a) common proximity-based measures of accessibility (e.g., food deserts) may underestimate inequality and that the inclusion of multiple dimensions of access may provide a more accurate picture, b) efforts to encourage business resilience can complement food systems planning, and c) targeted engagement with local food retailers, food suppliers, and food aid agencies is important for both day-to-day community needs and for disaster planning.

Decoding Diabetes Nutritional Guidelines for Physicians in Underserved American Populations

Medical (healthcare) deserts and food deserts, either separate or combined, exist in rural areas, globally. The physicians and other healthcare professionals who serve rural and other underserved populations, to some extent, also experience life in these areas. Dietary guidelines, from expert societies, for people with diabetes, have been helpful in guiding healthcare professionals through nutritional interventions. However, these guidelines are not designed for rural areas where healthcare resources are scarce, and access to the built environment for a healthy lifestyle and affordable healthy foods are not available. Therefore, the guidelines were reviewed, with rural physicians and healthcare professionals who work in underserved areas in mind, to assess their appropriateness. Based on the guidelines and other literature, potential solutions to guideline gaps are proposed to aid in providing nutritional therapy for the underserved. The overall goals are to improve the nutritional component of healthcare for underserved people with diabetes, and to begin the conversation around creating specific guidelines for rural physicians and other healthcare professionals, where patients are at a higher risk for diabetes.

Social and spatial inequalities of contemporary food deserts: A compound of store and online access to food in the United Kingdom

This research studies the social and spatial inequalities of contemporary food deserts in England and Wales. Two indices of the Store Food Desert Index and Online Food Desert Index are measured to examine store access and online access to food at the Lower Layer Super Output Areas geographical level. A detailed analysis is conducted to (i) identify “priority areas” where there is relatively lower store access and online access to food, (ii) synthesize population to understand the characteristics of “at-risk communities” that are disproportionately affected by food deserts, and (iii) examine the association between self-reported health conditions and a compound of store and online access to food. Three insights are provided. First, there is a clear urban-rural divide in which urban areas generally benefit from better provision of both store and online access to food. Second, about 23% of the population (13.8 million people) live in priority areas with limited access to both physical stores and online groceries. Within this group, 0.06% (8000 individuals) do not have cars, 2.17% (300,000 individuals) are Black, and 14.5% (2 million individuals) reside in deprived neighborhoods. This is an alarming picture. Third, people residing in areas with high store and online access to food reported better health conditions, and online access is as effective as store access in improving health conditions. The findings highlight the potential of combining online and store access to bridge geographical and economic gaps, thereby providing healthier food options to those in food deserts.

Deserts, Swamps and Food Oases: Mapping around the Schools in Bahia, Brazil and Implications for Ensuring Food and Nutritional Security.

Deserts, swamps and food oases terms have been used to characterize the food environment according to the identified food availability. Food swamps are defined as neighborhoods with a predominance of food establishments selling ultra-processed foods compared to establishments selling healthy options. In contrast, food oases are areas with easy access to healthy and nutritious foods, such as fruits, vegetables, and other fresh foods. Food deserts describe densely populated urban areas where residents face difficulty obtaining healthy food. In this context, this work aimed to map deserts, swamps, and food oases around federal schools in Bahia, Brazil, emphasizing the importance of implementing the Brazilian National School Feeding Program (PNAE) in these schools, to guarantee food security and nutrition. An ecological study was carried out in all 35 federal schools in Bahia, Brazil, using an 800 m buffer analysis, with the school as the centroid. The geographic coordinates of schools and food establishments were initially obtained using Google Maps and later confirmed onsite. To evaluate food deserts and swamps, the methodology proposed by the CDC was used and the Modified Retail Food Environment Index (mRFEI) was calculated; when the result was equal to zero, the surrounding area was considered a food desert and values between 0.01 and 20 determined food swamps; for values above 20, the neighborhood was classified as mixed. Food oases were considered regions containing at least one supermarket within the analyzed buffer. Descriptive analyses were carried out with frequency measurements, measures of central tendency (mean and median) and dispersion (standard deviation). The food environment of schools was compared considering the number of students impacted, the area where the school was located (urban or rural) and the size of the municipalities. The average number of food establishments found was 22.39 (±13.03), with the highest averages for snack bars (7.33 ± 4.43), grocery stores (5.83 ± 4.09) and restaurants (2.94 ± 2.19). Food deserts and mixed environments were identified in 40% of the sample, while swamps represented 20% and oases 65%. An association was observed between food deserts and social vulnerability, making it necessary to emphasize the importance of adequate implementation of the PNAE in these schools to reduce food and nutritional insecurity, guaranteeing the human right to adequate and healthy food and providing better nutrition and health perspectives within the school environment and impact on students' lives through food and nutrition education actions, which are also part of the context of PNAE activities.