Food Access and Its Relationship to Perceived Walkability,Safety,and Social Cohesion

Abstract

Understanding social inequalities in terms of neighborhood characteristics and the context to which individuals belong is important for reducing disparities. This article describes how perceptions of food access are related to three physical and social environmental factors: perceived neighborhood walkability, safety, and social cohesion. A cross-sectional survey was conducted with a random sample of 1,500 households in Springfield, Missouri. The main outcome measures were ease of purchase; availability of a large selection and quality; and affordability of fresh fruits and vegetables (FVs) and low-fat products (LFPs). Overall, 63% of respondents reported consuming <5 servings of FVs daily in the past month. Most agreed it was easy to purchase FVs (70%) and LFPs (76%) in their neighborhood and felt there was a large selection available (70% and 71%, respectively). High walkability (odds ratio [OR]: 1.8), low crime (OR: 1.6), and high social cohesion (OR: 1.7) were significantly associated with having greater selection of FVs. High walkability (OR: 1.6) and low crime (OR: 1.6) were associated with greater access to FVs. Given that healthy food access is an important component to improving health outcomes, understanding how to alter environmental features that influence behaviors like eating is important.

Keywords

chronic disease nutrition surveys program planning and evaluation social determinants of health

Get full access to this article

View all access options for this article.

References

Bell

Mora

Hagan

Rubin

Karpyn

(2013). Access to healthy food and why it matters: A review of the research. Philadelphia, PA: The Food Trust.

Bell

Rubin

(2007). Why place matters: Building a movement for healthy communities. Oakland, CA: PolicyLink. Retrieved from http://www.policylink.org/sites/default/files/WHYPLACEMATTERS_FINAL.PDF

Cannuscio

C. C.

Hillier

Karpyn

Glanz

(2014). The social dynamics of healthy food shopping and store choice in an urban environment. Social Science & Medicine, 122, 13-20. doi:10.1016/j.socscimed.2014.10.005

Carter

Williams

Paterson

Iusitini

(2009). Do perceptions of neighbourhood problems contribute to maternal health? Findings from the Pacific Islands Families study. Health & Place, 15, 622-630. doi:10.1016/j.healthplace.2008.10.005

Chung

W. T.

Gallo

W. T.

Giunta

Canavan

M. E.

Parikh

N. S.

Fahs

M. C.

(2012). Linking neighborhood characteristics to food insecurity in older adults: The role of perceived safety, social cohesion, and walkability. Journal of Urban Health, 89, 407-418. doi:10.1007/s11524-011-9633-y

Clifton

K. J.

(2004). Mobility strategies and food shopping for low-income families: A case study. Journal of Planning Education and Research, 23, 402-413.

Cohen

Davis

Lee

Valdovinos

(2010). Addressing the intersection: Preventing violence and promoting healthy eating and active living. Oakland, CA: Prevention Institute.

Creatore

M. I.

Glazier

R. H.

Moineddin

Fazli

G. S.

Johns

Gozdyra

. . . Booth

G. L.

(2016). Association of neighborhood walkability with change in overweight, obesity, and diabetes. JAMA: Journal of the American Medical Association, 315, 2211-2220. doi:10.1001/jama.2016.5898

Diez Roux

A. V.

(2008). Next steps in understanding the multilevel determinants of health. Journal of Epidemiology & Community Health, 62, 957-959. doi:10.1136/jech.2007.064311

10.

DiSantis

K. I.

Grier

S. A.

Odoms-Young

Baskin

M. L.

Carter-Edwards

Young

D. R.

. . . Kumanyika

S. K.

(2013). What “price” means when buying food: Insights from a multisite qualitative study with Black Americans. American Journal of Public Health, 103, 516-522. doi:10.2105/AJPH.2012.301149

11.

Echeverria

S. E.

Diez-Roux

A. V.

Link

B. G.

(2004). Reliability of self-reported neighborhood characteristics. Journal of Urban Health, 81, 682-701. doi:10.1093/jurban/jth151

12.

Food and Agriculture Organization of the United Nations, UNICEF, International Fund for Agricultural Development, World Food Programme, & World Health Organization. (2017). The state of food security and nutrition in the world 2017: Building resilience for peace and food security. Rome, Italy: FAO. Retrieved from http://www.fao.org/3/a-I7695e.pdf

13.

Food Research and Action Center. (2011). A half-empty plate: Fruit and vegetable affordability and access challenges in America. Washington, DC: Author.

14.

Green

S. H.

Glanz

(2015). Development of the Perceived Nutrition Environment Measures Survey. American Journal of Preventive Medicine, 49, 50-61. doi:10.1016/j.amepre.2015.02.004

15.

Husney

(2014). Springfield-Greene county community health assessment 2014. Springfield, MO: Springfield-Greene County Health Department.

16.

Kirkpatrick

S. I.

Tarasuk

(2011). Housing circumstances are associated with household food access among low-income urban families. Journal of Urban Health, 88, 284-296. doi:10.1007/s11524-010-9535-4

17.

Leal

Bean

Thomas

Chaix

(2012). Multicollinearity in associations between multiple environmental features and body weight and abdominal fat: Using matching techniques to assess whether the associations are separable. American Journal of Epidemiology, 175, 1152-1162. doi:10.1093/aje/kwr434

18.

Lovasi

G. S.

Hutson

M. A.

Guerra

Neckerman

K. M.

(2009). Built environments and obesity in disadvantaged populations. Epidemiologic Reviews, 31, 7-20. doi:10.1093/epirev/mxp005

19.

Martin

K. S.

Rogers

B. L.

Cook

J. T.

Joseph

H. M.

(2004). Social capital is associated with decreased risk of hunger. Social Science & Medicine, 58, 2645-2654. doi:10.1016/j.socscimed.2003.09.026

20.

Mason

K. E.

Pearce

Cummins

(2018). Associations between fast food and physical activity environments and adiposity in mid-life: Cross-sectional, observational evidence from UK Biobank. Lancet Public Health, 3(1), e24-e33. doi:10.1016/S2468-2667(17)30212-8

21.

Matthews

S. A.

Yang

T. C.

(2013). Spatial Polygamy and Contextual Exposures (SPACEs): Promoting activity space approaches in research on place and health. American Behavioral Scientist, 57, 1057-1081. doi:10.1177/0002764213487345

22.

Missouri Census Data Center. (2014). American Community Survey Profile Report 2014 for Springfield City, Missouri. Retrieved from https://census.missouri.edu/acs/profiles/report.php?p=24&g=16000US2970000

23.

Missouri Student Information System Reporting, Missouri Department of Elementary and Secondary Education. (2017). Springfield public schools free and reduced lunch rates: 2016-2017 School year. Retrieved from https://isharesps.org/websitedoc/QIA/Data/FRLunch.pdf

24.

Morland

Wing

Diez Roux

(2002). The contextual effect of the local food environment on residents’ diets: The atherosclerosis risk in communities study. American Journal of Public Health, 92, 1761-1767.

25.

Myers

C. A.

Denstel

K. D.

Broyles

S. T.

(2016). The context of context: Examining the associations between healthy and unhealthy measures of neighborhood food, physical activity, and social environments. Preventive Medicine, 93, 21-26. doi:10.1016/j.ypmed.2016.09.009

26.

Neighborhood Scout. (2015). Springfield, MO, crime rates. Retrieved from https://www.neighborhoodscout.com/mo/springfield/crime

27.

Pearson

Russell

Campbell

M. J.

Barker

M. E.

(2005). Do “food deserts” influence fruit and vegetable consumption? A cross-sectional study. Appetite, 45, 195-197. doi:10.1016/j.appet.2005.04.003

28.

Sadler

R. C.

Gilliland

J. A.

Arku

(2013). A food retail-based intervention on food security and consumption. International Journal of Environmental Research and Public Health, 10, 3325-3346. doi:10.3390/ijerph10083325

29.

Saelens

B. E.

Sallis

J. F.

Black

J. B.

Chen

(2003). Neighborhood-based differences in physical activity: An environment scale evaluation. American Journal of Public Health, 93, 1552-1558.

30.

Sallis

J. F.

Glanz

(2009). Physical activity and food environments: Solutions to the obesity epidemic. Milbank Quarterly, 87, 123-154. doi:10.1111/j.1468-0009.2009.00550.x

31.

Sallis

J. F.

Kerr

Carlson

J. A.

Norman

G. J.

Saelens

B. E.

Durant

Ainsworth

B. E.

(2010). Evaluating a brief self-report measure of neighborhood environments for physical activity research and surveillance: Physical Activity Neighborhood Environment Scale (PANES). Journal of Physical Activity & Health, 7, 533-540.

32.

Sampson

R. J.

Raudenbush

S. W.

Earls

(1997). Neighborhoods and violent crime: A multilevel study of collective efficacy. Science, 277, 918-924.

33.

Sharkey

J. R.

Horel

Dean

W. R.

(2010). Neighborhood deprivation, vehicle ownership, and potential spatial access to a variety of fruits and vegetables in a large rural area in Texas. International Journal of Health Geographics, 9, 26. doi:10.1186/1476-072X-9-26

34.

Smith

K. R.

Brown

B. B.

Yamada

Kowaleski-Jones

Zick

C. D.

Fan

J. X.

(2008). Walkability and body mass index density, design, and new diversity measures. American Journal of Preventive Medicine, 35, 237-244. doi:10.1016/j.amepre.2008.05.028

35.

Story

Kaphingst

K. M.

Robinson-O’Brien

Glanz

(2008). Creating healthy food and eating environments: Policy and environmental approaches. Annual Review of Public Health, 29, 253-272.

36.

U.S. Department of Agriculture. (2009). Access to affordable and nutritious food: Measuring and understanding food deserts and their consequences. A report to Congress. Washington, DC: Author.

37.

U.S. Department of Agriculture, Economic Research Service. (2017). Food security status of U.S. households in 2016. Washington, DC: Author. Retrieved from https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/key-statistics-graphics.aspx

38.

Webber

C. B.

Sobal

Dollahite

J. S.

(2010). Shopping for fruits and vegetables. Food and retail qualities of importance to low-income households at the grocery store. Appetite, 54, 297-303. doi:10.1016/j.appet.2009.11.015

39.

Zick

C. D.

Smith

K. R.

Fan

J. X.

Brown

B. B.

Yamada

Kowaleski-Jones

(2009). Running to the store? The relationship between neighborhood environments and the risk of obesity. Social Science & Medicine, 69, 1493-1500. doi:10.1016/j.socscimed.2009.08.032