The food environment and dietary intake: demonstrating a method for GIS-mapping and policy-relevant research
The aims of this paper are (1) to assess if perceptions of the food environment are associated with select dietary intake by neighborhood, and (2) to map neighborhood-specific findings, demonstrating a method for policy-relevant research.
Using pre-collected data from a Philadelphia, PA community health survey, we aggregated individual-level data (n = 4,434 respondents) to neighborhoods (n = 381 census tracts), adjusting for conceptually-relevant socio-demographic factors. We estimated Spearman correlations between multivariable adjusted food-environment perceptions (perceived produce availability, supermarket accessibility, grocery quality) and select dietary intake (reported fruit-and-vegetable and fast-food consumption), and mapped variables by neighborhood using geographic information systems (GIS).
Difficulty finding fruits and vegetables, having to travel outside of one’s neighborhood to get to a supermarket, and poor grocery quality were each directly correlated with fast-food intake (rho = 0.21, 0.34, 0.64 respectively; p values <0.001); and inversely correlated with fruit-and-vegetable intake (rho = –0.35, –0.54, –0.56 respectively; p values <0.001). Maps identified neighborhoods within the city with the worst food-environment perceptions and poorest dietary intakes.
Negative perceptions of the food environment were strongly correlated with less-healthy eating in neighborhoods. Maps showed the geographic areas of greatest concern. Our findings demonstrate a method that might be used prospectively in public health for policy planning (e.g. to identify neighborhoods most in need), or retrospectively for policy assessment (e.g. to identify changes in neighborhoods after policy implementation).
KeywordsPolicy research Public health Fruits and vegetables Fast food Food environment Geographic information systems (GIS) mapping Neighborhoods
For reviewing early drafts of this manuscript: A. Hillier. and C. Branas, University of Pennsylvania; for statistical help, C. Schechter, Albert Einstein College of Medicine; for help with mapping: A. Wagner, University of Pennsylvania School of Design, J. Fletcher and V. Huang, Albert Einstein College of Medicine, and A. Maroko, Lehman College, City University of New York; for mentorship: J. A. Long, Veterans Affairs Center for Health Equity Research and Promotion (CHERP); for contributing to lead author’s training: the Pisacano Leadership Foundation and the Robert Wood Johnson Clinical Scholars Program; for providing access to the dataset: the Robert Wood Johnson Clinical Scholars Program at the University of Pennsylvania and the Public Health Management Corporation.
Statement of conflict of interests
The authors declare that they have no conflicts of interest.
- Franco M, et al. (2009) Availability of healthy foods and dietary patterns: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr doi: ajcn.2008.26434
- Freedman DA, Bell BA (2009) Access to healthful foods among an urban food insecure population: perceptions versus reality. J Urban Health. doi: 10.1007/s11524-009-9408-x
- Giang T, Karpyn A, Laurison HB, Hillier A, Perry RD (2008) Closing the grocery gap in underserved communities: the creation of the Pennsylvania Fresh Food Financing Initiative. J Public Health Manage Pract 14(3):272–279Google Scholar
- GIS Center of the Bureau of Epidemiology Services in the New York City Department of Health and Mental Hygiene (2009) New York City Community Health Survey Atlas 2009. In: http://www.nyc.gov/html/doh/downloads/pdf/epi/nyc_commhealth_atlas09.pdf. Cited November 30, 2010
- Giskes K, Kamphuis CB, van Lenthe FJ, Kremers S, Droomers M, Brug J (2007) A systematic review of associations between environmental factors, energy and fat intakes among adults: Is there evidence for environments that encourage obesogenic dietary intakes? Public Health Nutr 10(10):1005–1017PubMedCrossRefGoogle Scholar
- Giskes K, van Lenthe FJ, Kamphuis CB, Huisman M, Brug J, Mackenbach JP (2009) Household and food shopping environments: Do they play a role in socioeconomic inequalities in fruit and vegetable consumption? A multilevel study among Dutch adults. J Epidemiol Community Health 63(2):113–120PubMedCrossRefGoogle Scholar
- Health Canada (2010) Canadian Community Health Survey. In: http://www.hc-sc.gc.ca/fn-an/surveill/nutrition/commun/index-eng.php. Cited November 4, 2011
- Los Angeles County Department of Public Health (2007) LA County Health Survey. In: http://publichealth.lacounty.gov/ha/hasurveyintro.htm. Cited December 16, 2010
- Lucan S, Mitra N (2011) Perceptions of the food environment are associated with fast-food (not fruit-and-vegetable) consumption—findings from multi-level models. Int J Public Health. doi: 10.1007/s00038-011-0276-2
- Moore LV, Diez Roux AV, Nettleton JA, Jacobs DR Jr (2008b) Associations of the local food environment with diet quality: a comparison of assessments based on surveys and geographic information systems—the multi-ethnic study of atherosclerosis. Am J Epidemiol 167(8):917–924PubMedCrossRefGoogle Scholar
- Moore LV, Diez Roux AV, Nettleton JA, Jacobs DR, Franco M (2009) Fast-food consumption, diet quality, and neighborhood exposure to fast food: the multi-ethnic study of atherosclerosis. Am J EpidemiolGoogle Scholar
- National Institute for Health Research (NIHR) Biomedical Research Centre (2010) South East London Community Health (SELCoH) Study. In: http://www.slam.nhs.uk/research/biomedical-research-centre/about-the-brc/core-facilities/south-east-london-community-health-(selcoh)-survey.aspx. Cited November 4, 2011
- New York City Department of Health and Mental Hygiene (2008) Community health survey. In: http://www.nyc.gov/html/doh/html/survey/survey.shtml Cited December 16, 2010
- Philadelphia City Planning Commission (2004) The Political and Community Service Boundaries of Philadelphia. In: http://www.philaplanning.org/data/boundaries.pdf. Cited September 3, 2009
- Philadelphia Health Management Corporation (2004) Community Health Data Base: Southeastern Pennsylvania Household Health Survey. In: http://www.phmc.org/site/index.php?option=com_content&view=article&id=66&Itemid=20. November 10, 2011
- US Census Bureau, Geography Division (2000) Census tracts and block numbering areas. In: http://www.census.gov/geo/www/cen_tract.html. Cited October 29, 2009
- US Department of Health and Human Services (2010) Obama administration details healthy food financing initiative. In: http://www.hhs.gov/news/press/2010pres/02/20100219a.html. Cited March 27, 2011
- Westenhoefer J (2005) Age and gender dependent profile of food choice. Forum nutr (57):44-51Google Scholar