The Neighborhood Food Environment

Correspondence between participant perceptions of availability of goods and services and healthy

eating options and objective assessments (i.e. VF mapping exercise data + GASI).

By: Rosie Ford

Mentors: Heather Adamus and Kyle Cheung

Outline Define correspondence Method for researching topic Methods of measurement used Characteristics of food stores Results Other influences Challenges Recommendations Conclusions Super Study Questions

A Quick Definition…Just To Be Clear

Correspondence is a close similarity, connection, or equivalent.

Example of Correspondence

Perception (%) Reality (%)

Yes No Yes No

In my neighborhood, it is easy to buy fresh fruits and vegetables.

46 54 36 64

In my neighborhood, it is easy to buy healthy foods.

35 65 36 64

Differences between participants’ perceived access to either fresh fruits and vegetables or healthy foods and the actual availability of these foodstuffs were not statistically significant (4).

Research MethodLiterature Search

PUBMEDKey Terms

Food EnvironmentNutrition EnvironmentPerceptions of Food AccessGISAvailabilityPerceivedObjective

Studies Used 10 articles within 5 years

Only 6 studies actually examined the correspondence between objective measures and perceived measures

2 used objective measures only

2 were reviews of methods used to measure the food environment with recommendations for future research

Methods of Measurement

Objective Measures:GISGround TruthingIn-Store Audits

Perceived Measures:SurveysFocus GroupsInterviews

Characteristics of Food Stores

Major themes in measuring goods and services

AvailabilityCost Quality

Results: AvailabilityCorrespondence of Availability Between Perceived

and Objective Measures

Yes No0

1

2

3

4

5

6

Correspondence

# o

f st

ud

ies

Correspondence of Availability

Respondents with lowest densities of supermarkets (objective), rated the perceived availability of healthy foods 17% lower than those with highest densities (1).

High densities of supermarkets (objective) was associated with better perceived availability (3).

65% of respondents reported it was not easy to buy healthy foods in their neighborhood (perceived), 64% of stores did not sell healthy foods (objective) (4).

Results: Cost

Only one study examined correspondence of cost (5).No correspondence was found between

objective and perceived measures for cost.Objective measures showed healthy foods

cost more than regular foods.Residents perceived healthy foods as the

same price.Perception influenced purchasing behavior

even more so than reality.

Results: Quality

No studies looked at correspondence between objective and perceived measures of quality.

Perceptions: In general, minorities have a lower perception of quality of healthy foods in their stores (1,3,6).

Objective: Supermarkets provide the highest quality of fruits and vegetables (1,2,3,4,5,6,7,10).

Other Factors That Influenced Cost, Quality

and AvailabilityRace/EthnicitySESDistanceTransportation

Race/Ethnicity Minorities have low perceived availability (1).

More convenience stores and less super markets in non-white communities (1).

African Americans have low perceived availability (2,6).

African Americans have low perceived quality (2).

SES Convenience stores have higher prices for

healthy foods and are more common in deprived areas (10).

Residents of low-income neighborhoods have low perceived availability (1).

Low-income neighborhoods have lower densities of super markets (1).

Distance Only distance had a direct association with

satisfaction (6).

Transportation Lack of transportation can influence where

people shop (2).

Challenges

With Objective MeasuresNeed for standardized methodsDefining geographical limitsTypes of food storesAccessibility within storesDefining quality and freshness (8,9)

ChallengesWith Measuring Perceptions

Defining where people shopDefining “quality”Defining “healthy foods”Recruiting participants (8,9)

RecommendationsFor Future Research:

Based on prior formative researchConsider all food sourcesInclude information on access to food within storesConsider seasonal variation in pricing and

availabilityConsider differential acceptance of food assistance

program benefitsInclude perceptions, cultural differences, and

social/cultural patterns (8,9)

Recommendations

For Policy Makers:

Zoning laws to standardize proportion of supermarkets and convenience stores in all neighborhoods

Provide grants/funding for

community gardensRaise taxes on “high fat” unhealthy foods to equal

out higher cost of healthy foods

RecommendationsFor Practitioners:

Educate people on the importance of accessibility to supermarkets when choosing a neighborhood

Educate policy makers on the nutritional effect of the food environment

Build coalitions with policy makers to promote change

Educate people on community gardening

ConclusionsThere needs to be more studies done.

Perceptions seem to mirror reality in most cases.

When perceptions and reality are different, people’s perceptions have a greater impact on purchasing behavior.

Complimentary measures should be used.

My Super StudyI would choose several different sites to study,

varying by rural/urban, geography, SES, ethnicity, and race.

I would use face-to-face interviews to measure perceptions of availability, cost, and quality of food environment.

I would then conduct an assessment of the actual availability, cost, quality, and accessibility of those stores using in-store audits.

I would compare the findings from the perceived and objective measures to look for patterns or correlations.

References1. Moore LV, Diez-Roux AVD, Brines S. Comparing perception-based and

geographic information system (GIS)-based characterizations of the local food environment. Journal of Urban Health: Bulletin of the New York Academy of Medicine. March 2009;85(2):206-16.

2. Kumar S, Quinn SC, Kriska AM, Thomas SB. “Food is directed to the area”: African Americans’ perceptions of the neighborhood nutrition environment in Pittsburgh. Health & Place. January 2011;17(1):370-78.

3. Moore LV, Diez-Roux AV, Nettleton JA, Jacobs DR Jr. 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. The American Journal of Epidemiology . April 2008;167(8):917-24.

4. Freedman DA, Bell BA. Access to healthful foods among an urban food insecure population: perceptions versus reality. Journal of Urban Health: Bulletin of the New York Academy of Medicine. November 2009;86(6):825-38.

5. Giskes K, Van Lenthe FJ, Brug J, Mackenbach JP, Turrell G. Socioeconomic inequalities in food purchasing: the contribution of respondent-perceived and actual (objectively measured) price and availability of foods. Preventive Medicine. July 2007;45(1):41-8.

References (Cont.)6. Zenk SN, Schulz AJ, Lachance LL, et al. Multivlevel correlates of satisfaction with neighborhood availability of fresh fruits and vegetables. Annals of Behavioral Medicine. August 2009;38(1):48-59.

7. Smith DM, Cummins S, Taylor M, et al. Neighbourhood food environment and area deprivation: spatial accessibility to grocery stores selling fresh fruit and vegetables in urban and rural settings. International Journal of Epidemiology. February 2010;39(1):277-284.

8. Glanz K. Measuring food environments: a historical perspective. American Journal of Preventive Medicine. April 2009;36(4S):S93-8.

9. Gittelsohn J, Sharma S. Physical, consumer, and social aspects of measuring the food environment among diverse low-income populations. American Journal of Preventive Medicine. April 2009;36(4S):S161-5.

10. Lee RE, Heinrich KM, Medina AV, et al. A picture of the healthful food environment in two diverse urban cities. Environmental Health Insights. July 21, 2010;4:49-60.

Questions?