Location Of Food Outlets Research Articles

Understanding Food Access in Flint: An Analysis of Racial and Socioeconomic Disparities

The primary objective of this study was to describe the food landscape of Flint, Michigan, and the surrounding townships. We investigated the relationship between the location of food outlets and the racial composition of census tracts. We collected data from multiple sources; however, Data Axle, a repository of information on the U.S. and Canadian businesses, was our primary data source. Data were collected and verified between September 2020 and December 2021. The final fact-checking was completed in June 2022. We used ArcGIS 10.8.1 and SPSS Version 28 to map and analyze the data. We conducted negative binomial regression analyses to identify the difference in the likelihood of finding food retailers in census tracts where the percentage of Black residents was low and those where the percentage of Blacks was high. The article examines 1,137 food retailers in the study area: 407 were in Flint, and the remainder in the surrounding townships. Restaurants—especially fast food and take-out establishments—dominated the food environment. In addition, small groceries and convenience stores proliferated in the grocery store category. The racial composition of the census tracts mattered. Census tracts in which more than 40% of the residents are Black have a mean of 7.6 food outlets. In comparison, census tracts in which 40% or less of the residents are Black have a mean of 11.3 food outlets; the difference is significant. Census tracts with a high percentage of Blacks also had significantly fewer restaurants. The results of this study show Flint’s food landscape to be more complex and robust than described in earlier studies. It underscores the point that researchers should not rely solely on documenting the presence of supermarkets or traditional grocery stores when addressing food insecurity and food access. In the case of Flint, such food outlets comprise only 2.2% of the food landscape. Focusing exclusively on these food retailers misses several important types of food venues that residents rely on to secure food. This siloed approach also ignores the resilience and ingenuity of residents to respond to limited access to traditional food retailers.

Unraveling the Role of Objective Food Environment in Chinese Elderly's Diet-Related Diseases Epidemic: Considering Both Healthy Food Accessibility and Diversity.

The essential role of the objective food environment in achieving healthy aging has been widely recognized worldwide. However, the existing empirical evidence is mostly based on Western cases, and how the objective food environment associates with health outcomes among Chinese elderly remains poorly understood. By merging nationally representative micro survey data with Baidu-based spatial data on the location of food outlets, this study develops accessibility and diversity indicators to explore the relationship between food environment and diet-related diseases among Chinese elderly and investigates how healthy lifestyles moderate this relationship. The results show that improvement in healthy food accessibility and diversity decreases both the probability and the number of diet-related diseases that the elderly suffer. Having more healthy lifestyle factors is associated with a lower risk of suffering from diet-related diseases and strengthens the negative effect of healthy food environment on suffered diet-related diseases. Heterogeneity effect analysis suggests that the relationship between objective food environment and diet-related diseases differs by city scale and income level. The findings of this study shed light on designing tailor-made policies for non-Western countries to promote healthy aging.

The association between the presence of fast-food outlets and BMI: the role of neighbourhood socio-economic status, healthy food outlets, and dietary factors

BackgroundEvidence on the association between the presence of fast-food outlets and Body Mass Index (BMI) is inconsistent. Furthermore, mechanisms underlying the fast-food outlet presence-BMI association are understudied. We investigated the association between the number of fast-food outlets being present and objectively measured BMI. Moreover, we investigated to what extent this association was moderated by neighbourhood socio-economic status (NSES) and healthy food outlets. Additionally, we investigated mediation by frequency of fast-food consumption and amount of fat intake.MethodsIn this cross-sectional study, we used baseline data of adults in Lifelines (N = 149,617). Geo-coded residential addresses were linked to fast-food and healthy food outlet locations. We computed the number of fast-food and healthy food outlets within 1 kilometre (km) of participants’ residential addresses (each categorised into null, one, or at least two). Participants underwent objective BMI measurements. We linked data to Statistics Netherlands to compute NSES. Frequency of fast-food consumption and amount of fat intake were measured through questionnaires in Lifelines. Multivariable multilevel linear regression analyses were performed to investigate associations between fast-food outlet presence and BMI, adjusting for individual and environmental potential confounders. When exposure-moderator interactions had p-value < 0.10 or improved model fit (∆AIC ≥ 2), we conducted stratified analyses. We used causal mediation methods to assess mediation.ResultsParticipants with one fast-food outlet within 1 km had a higher BMI than participants with no fast-food outlet within 1 km (B = 0.11, 95% CI: 0.01, 0.21). Effect sizes for at least two fast-food outlets were larger in low NSES areas (B = 0.29, 95% CI: 0.01, 0.57), and especially in low NSES areas where at least two healthy food outlets within 1 km were available (B = 0.75, 95% CI: 0.19, 1.31). Amount of fat intake, but not frequency of fast-food consumption, explained this association for 3.1%.ConclusionsParticipants living in low SES neighbourhoods with at least two fast-food outlets within 1 km of their residential address had a higher BMI than their peers with no fast-food outlets within 1 km. Among these participants, healthy food outlets did not buffer the potentially unhealthy impact of fast-food outlets. Amount of fat intake partly explained this association. This study highlights neighbourhood socio-economic inequalities regarding fast-food outlets and BMI.

Comparing two analytical approaches to evaluate access to fresh, healthy food: a case of the Indiana Uplands

ABSTRACT In this paper, we develop a new approach to mapping food access in the U.S. We compare the standard USDA approach to a method that examines differences between actual food outlet locations and optimal locations, as defined by a covering model. We find that the new approach places more weight on rural areas, in contrast to the USDA method, which places more weight on urban areas. We contend this covering model approach is superior to the USDA approach in three ways: (1) it explicitly examines what commodities are available a different categories of store, (2) it allows the comparison of real distributions with an idealised surface or set of locations, elucidating where interventions make most sense, (3) it allows flexible inclusion of target populations (i.e. households experiencing economic barriers to food access) by not setting Census Tract-level limits on definitions of low-income, and (4) it provides a flexible analytical tool that can be recalibrated in response to the demands of local policy, politics and changes in the food landscape over time. Provided adequate data and computing power, this new approach can scale to align with a region’s purview and definition of healthy food access.

Do Changes in the Local Food Environment Within New Residential Developments Influence the Diets of Residents? Longitudinal Results from RESIDE.

Background: There is limited longitudinal evidence supporting a link between food outlet locations and dietary outcomes to inform policy and urban planning. This study examined how longitudinal changes in the local food environment within new residential developments influenced changes in adult dietary intake. Methods: Adult participant data (n = 3223 person-observations) were sourced from the RESIDential Environments (RESIDE) project across three time points between 2004 to 2012 in Perth, Western Australia. Fixed effects regression estimated the relationship between change in spatial exposure to the local food environment, individual behaviours and perceptions of the local food environment with dietary outcome variables (healthy diet score, unhealthy diet score, diet quality score and fruit/vegetable intake). Results: An increase over time in the percentage of healthy food outlets around the home was significantly (p ≤ 0.05) associated with an increase in healthy diet scores and an increase in the distance from home to the nearest café restaurant was significantly (p ≤ 0.05) associated with an increase in diet quality scores. Conclusions: Modifying the local food environment by increasing the relative proportion of healthy food outlets around the home may support healthier dietary intake.

The influence of the local food environment on diet following residential relocation: longitudinal results from RESIDential Environments (RESIDE).

To examine the associations of changes in the local food environment, individual behaviours and perceptions with changes in dietary intake, following relocation from an established neighbourhood to a new residential development. Spatial food environment exposure measures were generated relative to each participant's home address using the locations of food outlets at baseline (before moving house) and follow-up (1-2 years after relocation). Self-reported data on socio-demographics, self-selection, usual dietary intake, individual behaviours and perceptions of the local food environment were sourced from the RESIDential Environments (RESIDE) Project. Changes in spatial exposure measures, individual behaviours and perceptions with changes in dietary outcomes were examined using mixed linear models. Perth, Western Australia, 2003-2007. Adults (n 1200) from the RESIDE Project. Moving to a new residential development with more convenience stores and café restaurants around the home was significantly associated with an increase in unhealthy food intake (β = 0·049, 95 % CI 0·010, 0·089; β = 0·020, 95 % CI 0·007, 0·033) and was partially mediated by individual behaviours and perceptions. A greater percentage of healthy food outlets around the home following relocation was significantly associated with an increase in healthy food (β = 0·003, 95 % CI 0·001, 0·005) and fruit/vegetable intake (β = 0·002, 95 % CI 0·001, 0·004). Policy and planning may influence dietary intakes by restricting the number of convenience stores and other unhealthy food outlets and increasing the relative percentage of healthy food outlets.

The evolution of local food environments within established neighbourhoods and new developments in Perth, Western Australia.

Temporal changes in the location of food outlets can result in disparities in the availability and access of food across geographic areas, contributing to health inequalities. This study used mixed linear models to investigate how the location of food outlets around the home evolved over time with respect to area-level socio-economic status (SES) and urban design within established neighbourhoods and new residential developments. Food outlet data (supermarket/greengrocers, convenience stores, café restaurants and takeaway/fast food) were sourced from commercial database listings (SENSIS Pty. Ltd.) in 2004, 2006, 2007, and 2011. Using 2468 addresses from the RESIDential Environments Project (RESIDE), in Perth, Western Australia (WA), a count of each food outlet type and percentage of healthy food outlets within a 1.6 km road network buffer around the home, along with the road network distance to nearest food outlet were generated relative to each address at each time point. Proximity to and count of all food outlets increased over time in both new developments and established neighbourhoods. However, unhealthy food outlets were always in greater numbers and proximity to the home. The percentage of healthy food outlets was significantly greater in established neighbourhoods compared to new developments at all four time points. There were significantly more food outlets, and within closer proximity to the home, in established neighbourhoods compared to new developments at each time point. In established neighbourhoods, there were more convenience stores, takeaway/fast food and café restaurants, a lower percentage of healthy food outlets, and closer proximity to convenience stores in lower compared to high SES areas. In new developments there were significantly less supermarket/greengrocers, a lower percentage of healthy food outlets and greater proximity to takeaway/fast food and café restaurants in low compared to high SES areas. New developments designed according to the WA government's "Liveable Neighbourhoods Community Design Guidelines" policy had significantly more of all food outlets compared to other new developments. As such, people living in new developments, and low SES areas of Perth, may be disadvantaged with poorer access to healthy food outlets and greater exposure to unhealthy food outlets. Future urban planning and policy should focus on providing incentives that support the early development of supermarkets and healthy food outlets within new developments and low SES areas of Perth.

Examining the validity and utility of two secondary sources of food environment data against street audits in England

BackgroundSecondary data containing the locations of food outlets is increasingly used in nutrition and obesity research and policy. However, evidence evaluating these data is limited. This study validates two sources of secondary food environment data: Ordnance Survey Points of Interest data (POI) and food hygiene data from the Food Standards Agency (FSA), against street audits in England and appraises the utility of these data.MethodsAudits were conducted across 52 Lower Super Output Areas in England. All streets within each Lower Super Output Area were covered to identify the name and street address of all food outlets therein. Audit-identified outlets were matched to outlets in the POI and FSA data to identify true positives (TP: outlets in both the audits and the POI/FSA data), false positives (FP: outlets in the POI/FSA data only) and false negatives (FN: outlets in the audits only). Agreement was assessed using positive predictive values (PPV: TP/(TP + FP)) and sensitivities (TP/(TP + FN)). Variations in sensitivities and PPVs across environment and outlet types were assessed using multi-level logistic regression. Proprietary classifications within the POI data were additionally used to classify outlets, and agreement between audit-derived and POI-derived classifications was assessed.ResultsStreet audits identified 1172 outlets, compared to 1100 and 1082 for POI and FSA respectively. PPVs were statistically significantly higher for FSA (0.91, CI: 0.89–0.93) than for POI (0.86, CI: 0.84–0.88). However, sensitivity values were not different between the two datasets. Sensitivity and PPVs varied across outlet types for both datasets. Without accounting for this, POI had statistically significantly better PPVs in rural and affluent areas. After accounting for variability across outlet types, FSA had statistically significantly better sensitivity in rural areas and worse sensitivity in rural middle affluence areas (relative to deprived). Audit-derived and POI-derived classifications exhibited substantial agreement (p < 0.001; Kappa = 0.66, CI: 0.63–0.70).ConclusionsPOI and FSA data have good agreement with street audits; although both datasets had geographic biases which may need to be accounted for in analyses. Use of POI proprietary classifications is an accurate method for classifying outlets, providing time savings compared to manual classification of outlets.

Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?

Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) and adequate vegetable consumption among children living in regional and remote Western Australia (WA). Caregiver-child dyads (n = 256) living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23). A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria (p ≤ 0.20) for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed (p = 0.007), promotion (p = 0.017), location of food outlets (p = 0.027), and price (p = 0.043). Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned) are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing.

Population cardiovascular health and urban environments: the Heart Healthy Hoods exploratory study in Madrid, Spain.

BackgroundOur aim is to conduct an exploratory study to provide an in-depth characterization of a neighborhood’s social and physical environment in relation to cardiovascular health. A mixed-methods approach was used to better understand the food, alcohol, tobacco and physical activity domains of the urban environment.MethodsWe conducted this study in an area of 16,000 residents in Madrid (Spain). We obtained cardiovascular health and risk factors data from all residents aged 45 and above using Electronic Health Records from the Madrid Primary Health Care System. We used several quantitative audit tools to assess: the type and location of food outlets and healthy food availability; tobacco and alcohol points of sale; walkability of all streets and use of parks and public spaces. We also conducted 11 qualitative interviews with key informants to help understanding the relationships between urban environment and cardiovascular behaviors. We integrated quantitative and qualitative data following a mixed-methods merging approach.ResultsElectronic Health Records of the entire population of the area showed similar prevalence of risk factors compared to the rest of Madrid/Spain (prevalence of diabetes: 12 %, hypertension: 34 %, dyslipidemia: 32 %, smoking: 10 %, obesity: 20 %). The food environment was very dense, with many small stores (n = 44) and a large food market with 112 stalls. Residents highlighted the importance of these small stores for buying healthy foods. Alcohol and tobacco environments were also very dense (n = 91 and 64, respectively), dominated by bars and restaurants (n = 53) that also acted as food services. Neighbors emphasized the importance of drinking as a socialization mechanism. Public open spaces were mostly used by seniors that remarked the importance of accessibility to these spaces and the availability of destinations to walk to.ConclusionThis experience allowed testing and refining measurement tools, drawn from epidemiology, geography, sociology and anthropology, to better understand the urban environment in relation to cardiovascular health.Electronic supplementary materialThe online version of this article (doi:10.1186/s12874-016-0213-4) contains supplementary material, which is available to authorized users.

The relationship between unhealthy food sales, socio-economic deprivation and childhood weight status: results of a cross-sectional study in England.

BackgroundRecent increases in obesity prevalence have led to research into the neighbourhood food environment. Research suggests that proximity and density of food outlets around the home is associated with childhood obesity prevalence, however, the evidence is inconclusive, and associations between food outlet locations and diet are less clear. The purpose of this study is to assess area level associations between sales of unhealthy foods in supermarkets and weight status of children.MethodsThis study examined the association between weight status in children (4–5 year olds and 10–11 year olds) measured in the National Child Measurement Programme over three time points (2008/9, 2009/10, 2010/11) and annual sales of unhealthy foods (2012/3), as identified from a large supermarket chain. Geographical analysis was conducted to link store-based food sales for 537 stores with 6517 UK Census Areas. Unadjusted associations were examined with error-bar plots and linear regression was used to examine the relationship between the prevalence of overweight and obesity and sales of unhealthy food, while controlling for covariates known to predict weight status in children.ResultsA statistically significant relationship was identified between the sales of unhealthy foods and the prevalence of overweight and obese children in both age groups (p < 0.01). Of the covariates, area deprivation was positively associated with weight status (p < 0.001). Non-white population (%) was negatively associated (p < 0.001) with overweight and obesity among Reception children, but positively associated with the other weight statuses (p < 0.001). A higher proportion of children in the same age group were associated with statistically significantly lower overweight and obesity prevalence in Reception (p <0.01) but not Year 6 children.ConclusionsThe study provides novel findings linking supermarket food sales with the weight status of children. Food sales in geographically referenced supermarkets are a valuable source of data for research into the factors that influence the weight of the surrounding population. Future research could identify factors that might modify food shopping in supermarkets and use of purchasing data could be an effective way to measure the impact of healthy eating campaigns on the weight status of children over time.

Area Deprivation and the Food Environment Over Time: A Repeated Cross‐Sectional Study on Fast Food Outlet Density and Supermarket Presence in Norfolk, UK, 1990‐2008

Little is known about socioeconomic disparities in UK food environments, including how these may have changed over time, limiting our understanding of current diet and health inequalities. We examined fast food outlet density and supermarket presence by area-level deprivation in the county of Norfolk, UK, 1990-2008. Data on food outlet locations, collected from Yellow Pages telephone directories at six time points from 1990 to 2008, were geocoded and mapped onto 2001 electoral ward boundaries. Wards were assigned to deprivation tertiles using the 2001 Townsend Index. Differences in fast food outlet density by deprivation and over time were compared using a one-way repeated measures analysis of variance. Supermarket presence by deprivation over time was examined with a multiple logistic regression model. All models adjusted for ward population. The odds of supermarket presence were not associated with area deprivation over time (tertile 2 vs 1, p=0.82; tertile 3 vs 1, p=0.58). Mean fast food outlet density increased significantly in all deprivation tertiles (p<0.001). However, fast food outlet density was consistently higher in the most deprived areas (p<0.001) and there was a significant interaction between deprivation and time (p=0.095). Results indicate that the most deprived wards faced the highest density of fast food outlets and were subject to the greatest increase in the number of these outlets over time. These increasing socioeconomic disparities in fast food access may be contributing to social inequalities in diet and health in the UK. Supported by UK Clinical Research Collaboration grant MR/K023187/1

A cross sectional study investigating the association between exposure to food outlets and childhood obesity in Leeds, UK.

BackgroundCurrent UK policy in relation to the influence of the ‘food environment’ on childhood obesity appears to be driven largely on assumptions or speculations because empirical evidence is lacking and findings from studies are inconsistent. The aim of this study was to investigate the number of food outlets and the proximity of food outlets in the same sample of children, without solely focusing on fast food.MethodsCross sectional study over 3 years (n = 13,291 data aggregated). Body mass index (BMI) was calculated for each participant, overweight and obesity were defined as having a BMI >85th (sBMI 1.04) and 95th (sBMI 1.64) percentiles respectively (UK90 growth charts). Home and school neighbourhoods were defined as circular buffers with a 2 km Euclidean radius, centred on these locations. Commuting routes were calculated using the shortest straight line distance, with a 2 km buffer to capture varying routes. Data on food outlet locations was sourced from Leeds City Council covering the study area and mapped against postcode. Food outlets were categorised into three groups, supermarkets, takeaway and retail. Proximity to the nearest food outlet in the home and school environmental domain was also investigated. Age, gender, ethnicity and deprivation (IDACI) were included as covariates in all models.ResultsThere is no evidence of an association between the number of food outlets and childhood obesity in any of these environments; Home Q4 vs. Q1 OR = 1.11 (95% CI = 0.95-1.30); School Q4 vs. Q1 OR = 1.00 (95% CI 0.87 – 1.16); commute Q4 vs. Q1 OR = 0.1.00 (95% CI 0.83 – 1.20). Similarly there is no evidence of an association between the proximity to the nearest food outlet and childhood obesity in the home (OR = 0.77 [95% CI = 0.61 – 0.98]) or the school (OR = 1.01 [95% CI 0.84 – 1.23]) environment.ConclusionsThis study provides little support for the notion that exposure to food outlets in the home, school and commuting neighbourhoods increase the risk of obesity in children. It seems that the evidence is not well placed to support Governmental interventions/recommendations currently being proposed and that policy makers should approach policies designed to limit food outlets with caution.

Food Availability en Route to School and Anthropometric Change in Urban Children

This study examined food availability along children's paths to and from elementary school, and associations with change in body mass index (BMI) and waist circumference over 1year. Secondary data from 319 children aged 8-13years from the "Multiple Opportunities to Reach Excellence" Project was used. Child anthropometry and demographic variables were obtained at baseline (2007) and 1year follow-up. Food outlet locations (n = 1,410) were obtained from the Baltimore City Health Department and validated by ground-truthing. Secondary data on healthy food availability within select food stores in Baltimore City in 2007 were obtained via a validated food environment assessment measure, the Nutrition Environments Measures Study. Multilevel models were used to examine associations between availability of healthy food and number of various food outlets along paths to school and child anthropometric change over 1year. Controlling for individual-, neighborhood-, and school-level characteristics, results indicated that higher healthy food availability within a 100m buffer of paths to school was associated with 0.15kg/m(2) lower BMI gain (p = 0.015) and 0.47cm smaller waist circumference gain (p = 0.037) over 1year. Although prior research has illuminated the importance of healthy food choices within school and home environments, the current study suggests that exposure to the food environment along paths to school should be further explored in relation to child health outcomes.

Characterising food environment exposure at home, at work, and along commuting journeys using data on adults in the UK

BackgroundSocio-ecological models of behaviour suggest that dietary behaviours are potentially shaped by exposure to the food environment (‘foodscape’). Research on associations between the foodscape and diet and health has largely focussed on foodscapes around the home, despite recognition that non-home environments are likely to be important in a more complete assessment of foodscape exposure. This paper characterises and describes foodscape exposure of different types, at home, at work, and along commuting routes for a sample of working adults in Cambridgeshire, UK.MethodsHome and work locations, and transport habits for 2,696 adults aged 29–60 were drawn from the Fenland Study, UK. Food outlet locations were obtained from local councils and classified by type - we focus on convenience stores, restaurants, supermarkets and takeaway food outlets. Density of and proximity to food outlets was characterised at home and work. Commuting routes were modelled based on the shortest street network distance between home and work, with exposure (counts of food outlets) that accounted for travel mode and frequency. We describe these three domains of food environment exposure using descriptive and inferential statistics.ResultsFor all types of food outlet, we found very different foodscapes around homes and workplaces (with overall outlet exposure at work 125% higher), as well as a potentially substantial exposure contribution from commuting routes. On average, work and commuting environments each contributed to foodscape exposure at least equally to residential neighbourhoods, which only accounted for roughly 30% of total exposure. Furthermore, for participants with highest overall exposure to takeaway food outlets, workplaces accounted for most of the exposure. Levels of relative exposure between home, work and commuting environments were poorly correlated.ConclusionsRelying solely on residential neighbourhood characterisation greatly underestimated total foodscape exposure in this sample, with levels of home exposure unrelated to levels of away from home exposure. Such mis-estimation is likely to be expressed in analyses as attenuated parameter estimates, suggesting a minimal ‘environmental’ contribution to outcomes of interest. Future work should aim to assess exposure more completely through characterising environments beyond the residential neighbourhood, where behaviours related to food consumption are likely to occur.

Measuring the food environment in three rural towns in New South Wales, Australia

Food availability affects eating habits, and in the Australian context, refers to the numbers and locations of food retail and food service outlets and the types and range of foods in those outlets. The aim of this study was to assess the community and consumer food environment in three small rural towns in New South Wales, Australia. Geographical analyses were used to measure the diversity, variety and locations of food outlets (community food environment); and checklists were used to assess the availability of selected indicator foods within food outlets (consumer food environment). Supermarkets provided access to the full range of healthy indicator foods, with convenience stores selling a more limited set of healthy food items. There were high numbers of take-away food outlets in each town that had no, or a limited number of, healthy food items. Energy-dense, nutrient-poor foods such as soft drinks and potato crisps were readily available across all food retail outlets in all towns. This study illustrates a valid, reliable and practical way of systematically describing food availability at a local level. The findings emphasise the ubiquity of energy-dense, nutrient-poor foods, and suggest that interventions to promote the availability of healthier food items in take-away food outlets are required. Further research is required to assess other factors which may affect residents' food access, such as cost and transport.

Collecting accurate secondary foodscape data. A reflection on the trials and tribulations

In a special issue of the American Journal of Preventive Medicine (2009, 36(4S)), themed around the measurement of food and physical activity environments, Brownson, Hoehner, Day, Forsyth, and Sallis (2009, 118) made a plea for increased attention to be paid to the difficulties and complexities associated with the gathering of secondary data, and its subsequent refinement for use. Some of the peculiarities involved with the gathering and refining of secondary data, in particular data on the locations of food outlets in North East England are discussed in this paper. ‘Foodscape’ data is often invoked in Geographical Information Systems (GIS) based studies that seek to explore the geography of food availability/access in relation to outcomes such as obesity. However, results from a GIS-based analysis are only as strong as the data utilised. This paper explores the time consuming negotiations, possible expense and probable stress of acquiring foodscape data from a robust source (Local Councils within the North East Government Office Region (GOR), UK), considerations that may unfortunately influence the potential scope of research projects. Furthermore, this paper extends its remit to discuss the clerical issues that plague the ‘tidying up’ of such secondary information. The paper will conclude by discussing how the time intensive sourcing and subsequent ‘cleaning’ of accurate secondary information is likely to be worthwhile, but will note that it is naïve to assume that (a) ‘gatekeepers’ will understand the necessity of your research and will thus cooperate accordingly, and (b) that the use of secondary data exonerates the researcher from ‘getting their hands dirty’. The paper also concludes by highlighting the disconnect between the high quality research that is so frequently called for, and the lack of robust data sets that are available for use in these investigations.

Identifying barriers to promoting healthy nutrition in New Zealand primary schools

Background. Schools are often identified as a site for intervention to improve the diets of students, and help prevent excess weight gain and obesity. Rates of overweight and obesity amongst school children have risen in much of the world, including New Zealand, with unequal distribution by ethnicity and socioeconomic status. Objective. To identify barriers to improving school food environments and promoting healthy nutrition experienced by primary schools in New Zealand. Methods. Five primary schools (ages 5—10 or 5—12 years) were recruited within Wellington, New Zealand. Data included: interviews with school management; school food policy documents; school lunch/food sales; and location of food outlets and outdoor food advertisements surrounding the schools. A case-comparison approach identified barriers to promoting healthy nutrition within primary schools in New Zealand. Results. Common barriers in all schools included the high proportion of food brought to school from home, the crowded curriculum and limited resources to implement changes. Barriers that varied across socioeconomic contexts included the ability of home and community settings to support healthy diets, the degree to which schools relied on fundraising, and engagement of parents and families with the school food environment. Conclusion. New Zealand primary schools face a number of barriers to promoting healthy nutrition related to time and resource constraints, with limited influence on children’s diets in relation to home and community settings. Incremental actions to improve school food environments seem most effective, supported by external agency expertise. The nature of external support should to be tailored to the needs of the individual school.

Examining the interaction between food outlets and outdoor food advertisements with primary school food environments

Schools are commonly seen as a site of intervention to improve children's nutrition, and prevent excess weight gain. Schools may have limited influence over children's diets; however, with home and community environments also exerting an influence within schools. This study considered the environment of food outlets and outdoor food advertisements surrounding four case study primary schools in New Zealand, and the impact of that external environment on within-school food environments. The shortest travel route between school and home addresses, and the number of food outlets and advertisements passed on that route, was calculated for each student. Interviews with school management were conducted. The schools with a higher percentage of students passing food outlets and advertisements considered that their presence impacted on efforts within schools to improve the food environment. Limiting students’ exposure to food outlets and outdoor food adverts through travel route planning, reducing advertising, or limiting the location of food outlets surrounding schools could be explored as intervention options to support schools in promoting nutrition.

The Context for Choice: Health Implications of Targeted Food and Beverage Marketing to African Americans

Targeted marketing of high-calorie foods and beverages to ethnic minority populations, relative to more healthful foods, may contribute to ethnic disparities in obesity and other diet-related chronic conditions. We conducted a systematic review of studies published in June 1992 through 2006 (n = 20) that permitted comparison of food and beverage marketing to African Americans versus Whites and others. Eight studies reported on product promotions, 11 on retail food outlet locations, and 3 on food prices. Although the evidence base has limitations, studies indicated that African Americans are consistently exposed to food promotion and distribution patterns with relatively greater potential adverse health effects than are Whites. The limited evidence on price disparities was inconclusive.