Local Food Environment Research Articles

Exploring the multiple dimensions of perceived food access in the local food environment

Abstract Persons in socioeconomically disadvantaged situations (PSEDs) are more susceptible and disproportionally exposed to unhealthy food environments, resulting in poorer dietary outcomes. Food access plays an important role within the wider food environment. This qualitative paper explores the context-specific relationships between the dimensions of perceived food access within the local food environment among PSEDS. 23 participants were recruited through purposeful convenience sampling until data saturation was achieved in two municipalities in Flanders, Belgium. Utilizing the photovoice and photo-elicitation method, participants expressed their perceptions of food access within their local food environment and its role in their eating behaviour, both individually (n = 16) and in group (n = 7). Applying the access framework to our analysis, the dimensions of perceived food access among PSEDS were divided into the personal (acceptability and convenience), perceived external (accommodation and desirability) or both personal and perceived external (awareness, availability, accessibility and affordability) domain. Our results suggest that awareness (e.g. of local opportunities available) precedes the other dimensions and that affordability is related to all dimensions among PSEDs. This study underscores the importance of perceived food access in healthy eating among PSEDS. The identified food access dimensions can inform policy, urban planning and community-based interventions to promote equitable access to healthy food. Key messages • Understanding perceived food access is essential to identify ways in which inequalities in food access can be addressed. • Perceived food access interacts between external and personal domains.

Consumer knowledge of and engagement with traditional takeaway and dark kitchen food outlets

Background Dark kitchens – delivery-only food outlets operating through digital technology platforms – are a contemporary addition to the food environment. Some concerns have been raised the ability for local authorities to identify and regulate these businesses, with growing concern around the nutritional quality of foods, food safety practices and the impact on the local food environment. The present work explores consumer understanding of and engagement with dark kitchen establishments. Methods Healthy adults living in the United Kingdom completed an online survey comprising of questions measuring participant demographics, engagement with takeaways and dark kitchens, purchasing behaviours and decision making, and knowledge and understanding around dark kitchens. Questions were primarily closed-ended and quantitative. Data were analysed using descriptive statistics. Results In total, 2,023 participants (46.3 ± 16.7 years) completed the survey. Forty percent purchased a takeaway at least weekly, often through aggregator applications (e.g., Just Eat, Deliveroo). Food was mainly purchased as a treat (79.3%), for enjoyment of the food or taste (60.8%) and for convenience (58.2%). When ordering, consumers considered the taste (88.1%), quality (83.5%), value for money (77.8%), and familiarity with (68.1%) and reputation of the business (60.0%). Only 24.7% of participants had heard of dark kitchens and 9.1% had knowingly purchased from one. After reading a working definition, 54.9% of consumers said they would purchase from a dark kitchen but most would want to know explicitly that they were ordering from these businesses. A major concern was trust in the food safety and hygiene standards. Conclusion Consumers are unfamiliar with dark kitchens and are not aware of or confident in identifying these businesses. This confusion and concerns around food safety means dark kitchens are often viewed negatively. Consumers would prefer more transparency in where their foods are being prepared to allow for more informed decision-making.

Systems thinking for local food environments: a participatory approach identifying leverage points and actions for healthy and sustainable transformations

BackgroundCurrent local food environments encourage poor diets, posing a significant threat to public and planetary health. Acknowledging and addressing its inherent complexity is vital to making meaningful improvements to the food environment. Using a participatory approach with local stakeholders, this study aims to gain insight into the factors and mechanisms underlying the local food environment and to identify leverage points and system-based actions to foster healthy and sustainable local food environments.MethodsA systems-thinking approach was used in a Dutch municipality in 2022. Two group model building (GMB) workshops were held with community stakeholders (e.g. local policymakers, retailers and residents). During the first workshop (June 2022), factors and mechanisms influencing the local food environment were identified and visualized through a causal loop diagram (CLD). During the second workshop, leverage points and system-based actions to improve food environments were identified by the stakeholders. Four months after (October 2022), an action-implementation meeting was organized to stimulate the implementation of selected actions. Progress was monitored through brief telephone interviews 6 and 12 months after the second workshop.ResultsThe CLD visualises the factors and mechanisms influencing the local food environment from the point of view of the community stakeholders. The CLD consists of 46 factors shaping the local food environment, which were categorized into four identified subsystems: societal factors, individual, socio-economic factors, commercial factors and political factors. Eight leverage points were identified within the CLD, for example, ‘lobby from food industry’, ‘governmental food policies’ and ‘e-commerce and platform economy’. Stakeholders formulated 20 actions targeting the identified leverage points. During the action-implementation meeting, long-term plans were created for five actions. After 1 year, only one participant (policy advisory role) remained actively engaged in three of these actions.ConclusionsThis study yields insight into the numerous factors and mechanisms underlying the local food environment and identified system-based actions as perceived by local stakeholders to improve this food environment locally. The CLD offers stakeholders valuable insights on employing a systems approach when enhancing food environments. More research is necessary, especially into the long-term processes and effects of implementing system-oriented actions to improve local food environments.

Factors and Perceptions Associated with Post-Pandemic Food Sourcing and Dietary Patterns among Urban Corner Store Customers in Baltimore, Maryland.

Diet-related disease is rising, disproportionately affecting minority communities in which small food retail stores swamp supermarkets. Barriers to healthy food access were exacerbated by the pandemic. We examined the following: (1) individual- and household-level factors in a sample of Baltimore community members who regularly shop at corner stores and (2) how these factors are associated with indicators of dietary quality. Cross-sectional data were collected using an online survey to capture sociodemographics, anthropometrics, and food sourcing, spending, and consumption patterns. Concurrent quantitative and qualitative analyses were conducted in Stata 18 and ATLAS.ti. This study was set in Baltimore, Maryland, USA. The participants included adults (n = 127) living or working in Baltimore who identified as regular customers of their neighborhood corner store. The respondents were majority Black and low-income, with a high prevalence of food insecurity (62.2%) and overweight/obesity (66.9%). Most (82.76%) shopped in their neighborhood corner store weekly. One-third (33.4%) of beverage calories were attributed to sugar-sweetened beverages, and few met the recommended servings for fruits and vegetables or fiber (27.2% and 10.4%, respectively). Being Black and not owning a home were associated with lower beverage and fiber intake, and not owning a home was also associated with lower fruit and vegetable intake. Food insecurity was associated with higher beverage intake, while WIC enrollment was associated with higher fruit and vegetable and fiber intakes. Open-ended responses contextualized post-pandemic food sourcing and consumption in this setting. This paper helps characterize the consumers of a complex urban food system. The findings will inform future strategies for consumer-engaged improvement of local food environments.

Spatial Disparity of Neighborhood Food Environment by Socioeconomic Status: Application of Urban Network Analysis

There is a large amount of academic research to date on food environments that has been widely conducted in Western countries. This is due to the high population density of Asian megacities, the advancement of public transportation systems, and the relatively low dependence on private vehicles, which has led to a lack of attention, relatively, to the surrounding food environments. Thus, this study aimed to analyze food environments at the neighborhood level by considering demographics, households, land use, and physical environmental factors in Seoul, South Korea. We employed urban network analysis methods to assess food access and availability in various neighborhoods. The primary findings indicate that Seoul’s food environment is significantly related to the elderly population, aging infrastructure, and proximity to public transportation. In particular, a higher concentration of elderly residents negatively affects food availability and access, irrespective of income level, potentially exacerbating social inequality based on income. Our findings identify various factors that contribute to spatial disparities in local food environments and provide policy implications to mitigate inequalities in neighborhood food environments.

Toward Sustainable Diets-Interventions and Perceptions Among Adolescents: A Scoping Review.

Adolescence is an important life stage during which shifts toward more healthy and sustainable diets can be promoted. Adolescents have increasing influence over their food choices, informed by their developing personal knowledge and values, affecting long-term dietary behaviors into adulthood. The recent literature regarding adolescents' (1) perceptions of environmentally sustainable diets and (2) interventions to support adolescents to eat sustainably was reviewed in this study. We reviewed published literature that focused on adolescent participants and their perceptions of, or interventions to support, sustainable dietary habits. Five electronic databases were searched to include studies published since 2012 that met the inclusion criteria, including reporting of participants aged between 11 and 18 years, reporting on adolescents' perceptions of sustainable diets or interventions implemented to improve the sustainability of adolescents' diets, and framed in the context of sustainability. Data were extracted, including study and participant characteristics, methodology, and results in relation to each of the 2 research focus areas. Twenty-eight articles were included in the review. Findings suggest that adolescents' understanding of what constitutes sustainable eating is poor. Adolescents who had previously received education regarding sustainable diets valued nature and health, or were from a rural or indigenous community, were more likely to value environmentally sustainable-food choices. Interventions which target adolescents' understanding of and aspiration to make sustainable-food choices appears to improve their attitudes toward sustainable food, whereas interventions to increase the availability of sustainable foods improved the environmental sustainability of adolescents' dietary intake. Multicomponent, tailored, and community-based interventions were most effective; however, the long-term effect of these interventions remains unclear. More research is needed in low- and middle-income countries, with consideration of adolescents' level of autonomy in food choice in local food environments and the long-term effectiveness of interventions. Systematic Review Registration: Open Science Framework identifier osf.io/h3jz6.

Developing the DIGIFOOD Dashboard to Monitor the Digitalization of Local Food Environments: Interdisciplinary Approach.

Online food delivery services (OFDS) enable individuals to conveniently access foods from any deliverable location. The increased accessibility to foods may have implications on the consumption of healthful or unhealthful foods. Concerningly, previous research suggests that OFDS offer an abundance of energy-dense and nutrient-poor foods, which are heavily promoted through deals or discounts. In this paper, we describe the development of the DIGIFOOD dashboard to monitor the digitalization of local food environments in New South Wales, Australia, resulting from the proliferation of OFDS. Together with a team of data scientists, we designed a purpose-built dashboard using Microsoft Power BI. The development process involved three main stages: (1) data acquisition of food outlets via web scraping, (2) data cleaning and processing, and (3) visualization of food outlets on the dashboard. We also describe the categorization process of food outlets to characterize the healthfulness of local, online, and hybrid food environments. These categories included takeaway franchises, independent takeaways, independent restaurants and cafes, supermarkets or groceries, bakeries, alcohol retailers, convenience stores, and sandwich or salad shops. To date, the DIGIFOOD dashboard has mapped 36,967 unique local food outlets (locally accessible and scraped from Google Maps) and 16,158 unique online food outlets (accessible online and scraped from Uber Eats) across New South Wales, Australia. In 2023, the market-leading OFDS operated in 1061 unique suburbs or localities in New South Wales. The Sydney-Parramatta region, a major urban area in New South Wales accounting for 28 postcodes, recorded the highest number of online food outlets (n=4221). In contrast, the Far West and Orana region, a rural area in New South Wales with only 2 postcodes, recorded the lowest number of food outlets accessible online (n=7). Urban areas appeared to have the greatest increase in total food outlets accessible via online food delivery. In both local and online food environments, it was evident that independent restaurants and cafes comprised the largest proportion of food outlets at 47.2% (17,437/36,967) and 51.8% (8369/16,158), respectively. However, compared to local food environments, the online food environment has relatively more takeaway franchises (2734/16,158, 16.9% compared to 3273/36,967, 8.9%) and independent takeaway outlets (2416/16,158, 14.9% compared to 4026/36,967, 10.9%). The DIGIFOOD dashboard leverages the current rich data landscape to display and contrast the availability and healthfulness of food outlets that are locally accessible versus accessible online. The DIGIFOOD dashboard can be a useful monitoring tool for the evolving digital food environment at a regional scale and has the potential to be scaled up at a national level. Future iterations of the dashboard, including data from additional prominent OFDS, can be used by policy makers to identify high-priority areas with limited access to healthful foods both online and locally.

'Acceleration' of the food delivery marketplace: Perspectives of local authority professionals in the North-East of England on temporary COVID regulations.

In January 2021, we assessed the implications of temporary regulations in the United Kingdom allowing pubs and restaurants to operate on a takeaway basis without instigating a change of use. Local authorities (LAs) across the North-East of England were unaware of any data regarding the take-up of these regulations, partially due to ongoing capacity issues; participants also raised health concerns around takeaway use increasing significantly. One year on, we repeated the study aiming to understand the impact of these regulations on the policy and practice of key professional groups. Specifically, we wanted to understand if LAs were still struggling with staff capacity to address the regulations, whether professionals still had public health trepidations, and if any unexpected changes had occurred across the local food environment because of the pandemic. We conversed with 16 public health professionals, planners and environmental health officers across seven LAs throughout the North-East of England via focus groups and interviews. Data collated were analysed via an inductive and semantic, reflexive-thematic approach. Through analysis of the data, three themes were generated and are discussed throughout: popular online delivery services as a mediator to increased takeaway usage; potential long-term health implications and challenges; continued uncertainty regarding the temporary regulations. This paper highlights important changes to local food environments, which public health professionals should be aware of, so they are better equipped to tackle health inequalities across urban and sub-urban areas.

Relationship between local food environment and reliance on food pantries: insights from a statewide client survey in Minnesota

Relationship between local food environment and reliance on food pantries: insights from a statewide client survey in Minnesota

Examining the nutrition and packaging of foods promoted as ‘Back to School’ products for children’s school lunchboxes

The local food environment plays an important role in food purchasing behaviours, and it is important to understand the how this context shapes the highly complex drivers of food choice for children and families. In Australia, children consume more than one-third of their total energy intake whilst at school(1), thus making the content of school lunchboxes an important target for nutrition promotion efforts. Supermarkets invest heavily in promoting food for inclusion in school lunchboxes, particularly in the ‘Back to School’ period, but little is known about the nutrition content or the packaging of the foods included in these promotions. This study aimed to examine the types and packaging of foods that are promoted by supermarkets as school lunchbox foods. Catalogues for six supermarket chains in Adelaide, South Australia were collected during the four weeks of January 2023, the window often described as the ‘Back to School’ period. An audit of the contents was conducted and items promoted specifically as ‘Back to School’ items were coded according to the type of food (fruits, vegetables, dairy, grains/cereals, protein or drinks), whether the items was packaged or unpackaged and the processing classification according to the NOVA criteria(2). Descriptive statistics were calculated. In the ‘Back to School’ period, each of the six supermarket chains produced 4 catalogues and items relating specifically to foods promoted for inclusion in school lunchboxes appeared in 18 of the 24 catalogues. A total of 151 food or drink items appeared in the ‘Back to School’ promotions in these catalogues, and 100% of these items were packaged; 29% were packaged in single-use plastic packaging, 25% were packaged in recyclable packaging and 46% were packaged in a combination of single-use plastic and recyclable packaging. In terms of foods, snack foods, including sweet (n = 32, 21%) and savoury (n = 21, 14%) snacks were highly represented (35% overall). Dairy products (n = 23, 15%), grains/cereal products (n = 23, 15%) and drinks (n = 20, 13%) were also featured, and spreads (e.g. vegemite, Nutella) appeared in 13% of catalogues (n = 12). Fruits (n = 8, 5%), vegetables (n = 3, 2%) and proteins (n = 5, 3%) did not appear in many catalogues. Seventeen (11%) foods were unprocessed, with 111 (74%) classified as ultra-processed foods. Supermarket catalogues promote ‘Back to School’ lunchbox foods that are overwhelmingly packaged and ultra-processed. Working with supermarkets to adapt the promotion of foods that are less packaged and less processed is an important step to improving the local food environment.

Measuring the Potential and Realized (or Revealed) Spatial Access from Places of Residence and Work to Food Outlets in Rural Communities of Québec, Canada

This study aims to bridge the gap between the potential and realized spatial access to food outlets in rural areas of Québec, Canada. By assessing both aspects, this research aims to provide a comprehensive understanding of the challenges faced by rural communities in accessing food resources and the effectiveness of existing interventions in addressing these challenges. A mixed methods approach was adopted to collect and analyze data, combining GIS-based spatial analysis with community-based surveys. The spatial analysis allowed for the quantification of the potential access metrics, while the community surveys provided valuable information on travel behaviors, preferences, and barriers experienced by residents when accessing food outlets. The results of the distance measurement calculations showed that for both the potential and realized distance measurements, convenience stores are more easily accessible than grocery stores and supermarkets. Thus, workers seem to have a strategy for minimizing the impact of long distances by combining work and grocery shopping. These results are measured for the realized accessibility to grocery stores and supermarkets and the principal retailer used. Finally, the results of the analyses show that there is a socio-economic gradient in the potential geographical accessibility from home to the food outlets. The importance of developing and strengthening the local food environment to make it favourable to healthy eating and supportive of food security is discussed.

A participatory approach to model the neighbourhood food environment.

Inequalities in exposure to a health-promoting local food environment have been implicated in the generation of inequalities in diet-related behaviours and outcomes, including obesity and diabetes. Increasingly, poor diet and diet-related disease have been characterised as an emergent property of a complex system and, as such, the drivers of poor diet may be better understood by using a complex system perspective. In this study, we describe a participatory approach for understanding the system drivers of unhealthy food consumption. System dynamics (SD) was used to identify, understand, and visualise the elements of the neighbourhood food retail system that influence individuals' eating behaviour. Group Model Building (GMB), undertaken online with stakeholders (n = 11), was used to funnel existing knowledge and evidence on urban food environments and to build a conceptual system map of the local food retail environment inclusive of the drivers that influence the decision to purchase and consume meals that are high in fat, salt, and sugar (HFSS), and calories. The GMB was organised as a knowledge elicitation process involving a questionnaire, a workbook, and a structured workshop. The GMB generated a comprehensive causal loop diagram (CLD) of the retail environment inclusive of the drivers that influence the decision to purchase and consume unhealthy meals. The CLD was designed around two main variables (i) exposure to food outlets and (ii) food consumption. The system map built during the Group Model Building session linked exposure to food outlets with the possibility to purchase and consume unhealthy meals. The effectiveness of this link will be tested in an Agent-Based model. The conceptual model illustrates the complexity of the factors responsible for inequalities in unhealthy eating. The GMB approach provides a basis for building an agent-based model for local authorities to characterise their food retail environment, uncover potential leverage points for interventions and test them 'in silico' in a virtual environment.

Using participatory geographic information systems (PGIS) mapping to describe household food access in Buffalo, New York

ABSTRACT Despite existing only blocks apart, neighborhoods in Buffalo, NY can have very different levels of food availability and access due to their local food environment. This study uses participatory geographic information systems (PGIS) mapping and qualitative interviewing to describe these food environments based on the lived experiences of Buffalo residents. PGIS mapping interviews were conducted with residents of the city who regularly used food pantries and focused on access to and availability of both free food resources (such as soup kitchens and food pantries) and purchased food resources (such as grocery stores). Participants were also asked about food access in their own neighborhood, their perceptions of food access in the city, and what develops they thought would contribute to greater food security for their neighborhoods. Results show cost of living and transportation were important barriers to food access for many participants. Findings suggest that residents of historically marginalized neighborhoods in Buffalo continue to have lower access to affordable healthy foods.

ADVANCING FOOD EQUITY AMONG OLDER ADULTS AND ADULTS WITH DISABILITIES IN THE US

Abstract Older adults and adults with disabilities face challenges related to food insecurity, defined as limited or uncertain access to adequate food due to economic and social conditions. Adults with disabilities have triple the risk of food insecurity than their peers and rates of food insecurity have been rising over the past two decades among older adults and food insecurity is known to be a risk factor for numerous adverse health outcomes. Despite knowledge of disparities, research is needed to identify and test strategies for addressing food insecurity disparities. This symposium will examine mechanisms that may contribute to food insecurity, including local food environments, vision impairment and access to the Supplemental Nutrition Assistance Program, which is the largest food assistance program in the U.S.. National data is used in all three studies to allow population-based inferences to be drawn from study findings. Results have potential to inform our understanding of food equity and advance data-driven policy and programmatic decisions.

GIS-Based Assessments of Neighborhood Food Environments and Chronic Conditions: An Overview of Methodologies.

The industrial revolution and urbanization fundamentally restructured populations' living circumstances, often with poor impacts on health. As an example, unhealthy food establishments may concentrate in some neighborhoods and, mediated by social and commercial drivers, increase local health risks. To understand the connections between neighborhood food environments and public health, researchers often use geographic information systems (GIS) and spatial statistics to analyze place-based evidence, but such tools require careful application and interpretation. In this article, we summarize the factors shaping neighborhood health in relation to local food environments and outline the use of GIS methodologies to assess associations between the two. We provide an overview of available data sources, analytical approaches, and their strengths and weaknesses. We postulate next steps in GIS integration with forecasting, prediction, and simulation measures to frame implications for local health policies.

Diet-Related Disease Prevention in a Rural Australian Setting: Understanding Barriers, Enablers, and the Role of Rural Health Services in Supporting Changes in Local Rural Food Environments

Bold and comprehensive action is needed to prevent diet-related diseases in rural areas, which includes improving food environments to enable healthier dietary practices. Rural health services are integral to the health of rural populations, yet their role in community disease prevention is not swell understood. This study sought to understand health service, local government, and food outlet stakeholders’ perspectives on (1) the drivers of unhealthy retail environments in a rural setting; (2) the role of rural health services in supporting changes in local food environments; and to (3) identify characteristics of potential interventions. Two Group Model Building workshops were held with health service and local government leaders (n = 9), and interviews were conducted with local food outlet participants (n = 13). Key themes included ‘enablers to healthier food environments’, ‘barriers to healthier food environments’, ‘Rural health services are a leading broker of knowledge for healthy food environments’, and ‘characteristics of desirable healthy food environment interventions.’. Rural health services can play a key role in addressing the current barriers to healthy food environments in rural areas. Effective promotion of healthier diets in rural populations will require consideration of key stakeholder perspectives and the development of further evidence on the role that rural health services can play in improving the healthiness of food environments.

Evaluating the availability, accessibility, and affordability of fresh food in informal food environments in five Mexican cities

ABSTRACT This study sheds light on the role of informal street markets in local Mexican food environments. Less is known about the availability, accessibility, and affordability of fresh food offered in these markets and their contribution to urban health in cities of the Global South in which high degrees of informality exist. We examined the impacts of informal markets on food environments in Mexico City, Guadalajara, Monterrey, Queretaro, and San Luis Potosí. We conclude that informal markets significantly improve availability, access, and affordability of fresh food, especially in the central region of Mexico and for vulnerable low-income groups on the urban periphery. However, they play a very limited role in car-centric cities of the industrial north such as Monterrey. This study aims to support planning decisions that target the improvement of access to a healthy diet in informal settings.

Systems dynamics for healthy and sustainable local food environments

Abstract Background Current food environments steer unhealthy food choices, increasing the risk for diet-related non-communicable diseases. Changing food environments is complex and underlying system dynamics of local food environments are relatively unclear. This study aimed to identify factors and leverage points that shape local food environments and to develop systemic actions with local stakeholders to improve food environments. Methods Two workshops (in 2022) were held in a Dutch municipality using a community-based system dynamics approach in which a variety of stakeholders (n = 13) participated (e.g., policy maker, retailers, health coach, citizens). Group model building exercises were used to identify factors shaping the local food environment and to develop a causal loop diagram. Subsequently, leverage points and actions to improve food environments were identified by the stakeholders. Results Based on the first workshop, a total of 46 factors influencing the local food environment were identified and categorized into four subsystems including commercial-, political-, global- and societal factors. The leverage points included the anti-lobby from food industry, food industry's willingness to change, Government/consumer priority on healthy food, food policy, e-commerce and platform economy, demand for healthy food, time to prepare/consume meals. In correspondence, 20 actions to improve the local food environment were identified during the second workshop. Moreover, the exercises initiated dialogues and collaborations between the participating stakeholders to adapt their local food environment. Conclusions This research yielded one of the first causal loop diagrams showing the multiple and varied factors influencing the local food environment. It underlines the importance of using a systems approach to adapt and improve food environments. More work is needed to implement the developed actions and to translate the system dynamics approach for use by non-academics. Key messages • Food environments are complex adaptive systems, which require a systems dynamic approach to generate change. • Food environments need to be adapted at multiple levels requiring multiple pathways and stakeholders to succeed, and thus move away from single component interventions.

Harnessing community expertise in understanding food insecurity to inform responses in a local government area in Victoria, Australia: a mixed methods photovoice study

BackgroundLocal food systems which support affordable, equitable, accessible, and sustainable food are important to enhance food access and reduce food insecurity. Cardinia Shire Council, a local government in Victoria, Australia has developed and endorsed a ‘Community Food Strategy’ to support their local food system and food security. This study aimed to explore local government community member perspectives regarding food access within their local food environment, and suggested areas to be addressed to better support access.MethodsA sequential mixed methods photovoice methodology was implemented. Participants aged over 18 years, who resided in Cardinia Shire, completed an online quantitative survey to explore demographics, food access and food security status and severity (18-item USDA Household Food Security Survey Module). The qualitative photovoice method was used, whereby participants were asked to take photographs that represent their experiences of food access. These photographs were used as prompts in a semi-structured interview Interview data were thematically analysed.ResultsSeventeen participants completed the study, of which five participants experienced varied severity levels of food insecurity. From the photovoice interviews four themes were developed: 1) Food: a connector to self, people and place, 2) Influencers of food access and triggers for food insecurity, 3) Savvy food literacy skills to support access to food, 4) Consequences of and struggles with food insecurity. Participants suggested recommendations for action to support future food access in their community.ConclusionsWhile food choice is influenced by a range of determinants, the local food environment greatly impacts both food access and food choice. A supportive local food system which promotes inclusion of a community voice, community connectedness, food literacy and physical and economic access to local produce is crucial to support food security.

SynthEco - A multi-layered digital ecosystem for analysing complex human behaviour in context

Introduction & BackgroundHuman behaviour is multi-faceted and complex, with different dimensions interacting and impacting each other and individuals operating in an environmental context. In order to understand this behaviour better, the combination of data from different sources is useful to uncover some of those interactions and complexities. We present a multi-layered digital ecosystem based on a data platform providing statistically representative synthetic population derived from census data at different geo-spatial granularity, which we call SynthEco. This platform is enriched with individual data stemming from cohorts and cross-sectional surveys and geo-scanning of different layers of socio-environmental actors and conditions to create a complex digital ecosystem.
 Objectives & ApproachThe objective of SynthEco is to allow for the analysis of behaviour, as well as health and wellbeing outcomes, through the integration of cohort and cross-sectional data into a geospatially anchored synthetic population embedded into environmental data which is forming the backdrop. We demonstrate the use of this platform on the example of Montreal, Canada. The synthetic population is first generated from census data using iterative proportional fitting, which allows for the creation of a population data set that is artificial yet statistically representative for a given geospatial granularity, such as a city. Each individual household is assigned a geospatial location, which allows for the consideration of their surrounding environment including enterprises or institutions such as schools, hospitals and the local food environment. Through fuzzy matching and statistical extrapolation, different cohort and cross-sectional survey data are then merged to individual records, in order to describe them in more detail. This includes health, as well as financial wellbeing or social environment descriptors.
 Relevance to Digital FootprintsThere are two important points made through the presented work in relation to Digital Footprints data: the first is the technical approach to merging multiple datasets describing different dimensions of interacting human characteristics and behaviour by anchoring them into a synthetic population through fuzzy record matching. The second is the consideration of a spatial dimension when describing human behaviour. This is especially important when describing behaviour within local environments, such as the interaction with local food outlets.
 ResultsRecent work in this context includes an analysis of the food environment in Montreal, Canada. It introduces a way of utilising the synthetic population to predict the healthfulness of their local environment in terms of healthy food outlets, as well as providing a platform for the analysis of food environment surveillance and intervention simulations. For this purpose, the healthfulness of different census tract regions in Montreal is calculated to identify food deserts, food swamps, as well as healthy areas as defined through the Modified Retail Food Environment Index. We test different machine learning approaches to then predict these healthfulness scores using census variables from the synthetic population in their respective census tract, achieving accuracy scores of around 0.53 to 0.60. This demonstrates that census data has some limited predictive power in explaining the healthiness of the local food environment, which could be especially relevant for situations in which no information on the retailers is available to local policy makers. Future work can extend this approach to also include further data describing the population, stemming from the integrated cohorts and survey data, which could improve the prediction accuracy or help in identifying areas of concern.
 Conclusions & ImplicationsThe presented SynthEco platform views individuals as agents nested within modular systems of systems, trying to capture both internal systems and processes as well as environmental ones within which individuals are operating. The platform thus enables the application of computational systems modelling for the analysis of individual human behaviour in contexts. As demonstrated through the example of using SynthEco in the context of healthier food environments, the approach is especially relevant to practitioners and policy makers interested in local intervention strategies and identifying areas for targeted policy related to different dimensions of health and wellbeing.