Abstract
OBJECTIVES: We examined whether access to retail sources of healthy and unhealthy food varies according to level of neighbourhood material deprivation in three Ontario regions and whether urban form characteristics help to explain any such variations.
METHODS: Food retail (FR) outlets were identified from a commercial database for 804 urban neighbourhoods in Toronto, Brampton/Mississauga and Hamilton, Ontario. The median number of healthy and unhealthy FR outlets and percentage of outlets that were unhealthy were derived using 720-metre network buffers based on dissemination blocks and aggregated up to neighbourhood level (census tract). The 2006 Canadian Census was used to derive a composite index of material deprivation and three urban form measures related to zoning and urbanization. Multivariate regression models assessed the association between material deprivation, urban form and each measure of FR access.
RESULTS: Compared with the least deprived areas, the most materially deprived neighbourhoods had 2 to 4 times more healthy and unhealthy FR outlets within 720 metres (≈ a 10-minute walk) of where most people lived, with the exception of Toronto, where unhealthy FR was more plentiful in less deprived areas. Urban form measures attenuated these associations for Brampton/Mississauga and Hamilton more so than for Toronto. The percentage of unhealthy outlets was generally unrelated to level of neighbourhood deprivation or urban form characteristics.
CONCLUSION: More deprived neighbourhoods had greater access to both healthy and unhealthy FR outlets, with some variation across study regions. Plentiful access to local retail sources of unhealthy food suggests a possible point of intervention for healthy public policy.
Keywords: Food, socioeconomic factors, residential characteristics, geographic information systems
Résumé
OBJECTIFS : Nous avons voulu déterminer si l’accès aux sources de détail d’aliments sains et malsains varie selon le niveau de défavorisation matérielle du quartier dans trois régions de l’Ontario et si les caractéristiques de la forme urbaine contribuent à expliquer de tels écarts.
MÉTHODE : Les points de vente au détail (PVD) d’aliments ont été identifiés à partir d’une base de données commerciale pour 804 quartiers urbains de Toronto, de Brampton/Mississauga et de Hamilton en Ontario. Le nombre médian de PVD d’aliments sains et malsains et le pourcentage de points de vente d’aliments malsains ont été dérivés à l’aide de zones tampon de 720 mètres fondées sur les îlots de diffusion et regroupées au niveau du quartier (secteur de recensement). Le Recensement de 2006 du Canada a servi à dériver un indice composite de la défavorisation matérielle et trois indicateurs de la forme urbaine liés au zonage et à l’urbanisation. Des modèles de régression multivariée ont évalué l’association entre la défavorisation matérielle, la forme urbaine et chaque indicateur d’accès aux PVD d’aliments.
RÉSULTATS : Comparativement aux zones les moins défavorisées, les quartiers les plus défavorisés sur le plan matériel avaient de deux à quatre fois plus de PVD d’aliments sains et malsains dans un rayon de 720 mètres (≈ 10 minutes de marche) du lieu d’habitation des gens, sauf à Toronto, où les PVD d’aliments malsains étaient plus nombreux dans les zones moins défavorisées. Les indicateurs de la forme urbaine ont atténué ces associations pour Brampton/Mississauga et pour Hamilton davantage que pour Toronto. Le pourcentage de points de vente d’aliments malsains était généralement sans lien avec le niveau de défavorisation du quartier ou les caractéristiques de la forme urbaine.
CONCLUSION : Les quartiers plus défavorisés avaient davantage accès aux PVDA sains et malsains, avec certains écarts selon les régions à l’étude. L’accès facile à des sources de détail locales d’aliments malsains pourrait être un point d’intervention pour l’élaboration de politiques publiques saines.
Motsclés: aliments, facteurs socioéconomiques, caractéristiques résidentielles, systèmes d’information géographique
Footnotes
Acknowledgements: All analyses were conducted at the Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute of St. Michael’s Hospital. During the tenure of this study, Jane Polsky was supported by a Doctoral Research Award from the Canadian Institutes of Health Research. Richard Glazier is funded as a Clinician Scientist in the Department of Family and Community Medicine at the University of Toronto and St. Michael’s Hospital. Gillian Booth holds Mid-Career Investigator Awards from the Heart and Stroke Foundation of Ontario and the Department of Medicine at the University of Toronto. The authors thank Jonathan T. Weyman for creating all GIS-based measures for this work. All views expressed in this paper are those of the authors and do not necessarily reflect the views of any affiliated organization.
Conflict of Interest: None to declare.
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