Abstract
OBJECTIVES: Food insecurity in an important public health issue and affects 13% of Canadian households. It is associated with poor accessibility to fresh, diverse and affordable food products. However, measurement of the food environment is challenging in rural settings since the proximity of food supply sources is unevenly distributed. The objective of this study was to develop a methodology to identify food deserts in rural environments.
METHODS: In-store evaluations of 25 food products were performed for all food stores located in four contiguous rural counties in Quebec. The quality of food products was estimated using four indices: freshness, affordability, diversity and the relative availability. Road network distance between all residences to the closest food store with a favourable score on the four dimensions was mapped to identify residential clusters located in deprived communities without reasonable access to a “good” food source. The result was compared with the food desert parameters proposed by the US Department of Agriculture (USDA), as well as with the perceptions of a group of regional stakeholders.
RESULTS: When food quality was considered, food deserts appeared more prevalent than when only the USDA definition was used. Objective measurements of the food environment matched stakeholders’ perceptions.
CONCLUSION: Food stores’ characteristics are different in rural areas and require an in-store estimation to identify potential rural food deserts. The objective measurements of the food environment combined with the field knowledge of stakeholders may help to shape stronger arguments to gain the support of decision-makers to develop relevant interventions.
KEY WORDS: Social environment, geography, food supply, food insecurity
Résumé
OBJECTIFS : L’insécurité alimentaire est une problématique de santé publique qui atteint près de 13 % des ménages canadiens. Elle est associée à une faible accessibilité à des produits alimentaires frais, diversifiés et abordables. Cependant, la mesure de l’environnement alimentaire demeure un défi important en milieu rural puisque les sources d’approvisionnement alimentaire sont distribuées de façon inégale sur le territoire. L’objectif de cette étude était de développer une méthodologie pour identifier les déserts alimentaires potentiels en milieu rural.
MÉTHODES : L’évaluation de 25 produits alimentaires a été réalisée pour tous les magasins d’alimentation de quatre municipalités régionales de comté rurales québécoises. La qualité des produits alimentaires fut estimée par quatre indices: la fraîcheur, l’abordabilité, la diversité et la disponibilité relative. La distance réticulaire entre toutes les résidences et le magasin d’alimentation le plus proche ayant un indice favorable pour les quatre indices fut cartographiée pour localiser les regroupements de résidences localisés dans une communauté défavorisée n’ayant pas un accès à une « bonne » source d’approvisionnement alimentaire. Le résultat fut comparé aux paramètres d’identification d’un désert alimentaire proposés par le USDA, ainsi qu’à la perception d’un groupe d’acteurs régionaux.
RÉSULTATS : Lorsque la qualité de l’alimentation était considérée, la présence de déserts alimentaires potentiels était beaucoup plus importante qu’avec la définition proposée par le USDA. La mesure objective de l’environnement alimentaire concordait avec la perception des acteurs régionaux.
CONCLUSION : Les caractéristiques des magasins d’alimentation sont différentes en milieu rural et nécessitent une évaluation directe pour identifier les déserts alimentaires potentiels. Les mesures objectives de l’environnement alimentaire conjuguées avec les connaissances des acteurs régionaux pourraient contribuer à développer des arguments plus solides pour obtenir le support des décideurs afin d’élaborer des interventions adaptées au milieu.
MOTS CLÉS: environnement social, géographie, approvisionnement alimentaire, insécurité alimentaire
Footnotes
Acknowledgements: This research was partly funded by the Fonds de recherche du Québec-Santé, the Graduate School of Land management and Regional Planning of the Laval University, the Evaluation Platform on Obesity Prevention of the Quebec’s Heart and Lung Institute, and the Regional Public Health Authority, Chaudière-Appalaches. The authors would like to acknowledge members of the Regional Food Security Committee of Chaudière-Appalaches for sharing their knowledge.
Conflict of Interest: None to declare.
References
- 1.Mozaffarian D, Ludwig DS. The 2015 US dietary guidelines: Lifting the ban on total dietary fat. JAMA. 2015;313(24):2421–22. doi: 10.1001/jama.2015.5941. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Kiefte-de Jong JC, de Vries JH, Bleeker SE, Jaddoe VW, Hofman A, Raat H, et al. Socio-demographic and lifestyle determinants of ‘Western-like’ and ‘Health conscious’ dietary patterns in toddlers. Br J Nutr. 2013;109(1):137–47. doi: 10.1017/S0007114512000682. [DOI] [PubMed] [Google Scholar]
- 3.USDA, D.G.A.C. Dietary Guidelines Advisory Committee. Washington, DC: USDA and US Department of Health and Human Services; 2015. Scientific Report of the 2015. [Google Scholar]
- 4.Coleman-Jensen A, Rabbitt MP, Gregory C, Singh A. Household Food Security in the United States in 2014, 194) Washington, DC: US Department of Agriculture, Economic Research Service; 2015. [Google Scholar]
- 5.Tarasuk V, Mitchell A, Dachner N. Household Food Insecurity in Canada, 2012. Toronto, ON: Research to Identify Policy Options to Reduce Food Insecurity (PROOF); 2014. [Google Scholar]
- 6.Egger G, Swinburn B. An “ecological” approach to the obesity pandemic. Br Med J. 1997;315(7106):477–80. doi: 10.1136/bmj.315.7106.477. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Townsend N, Foster C. Developing and applying a socio-ecological model to the promotion of healthy eating in the school. Public Health Nutr. 2013;16(6):1101–8. doi: 10.1017/S1368980011002655. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Golden SD, Earp JAL. Social ecological approaches to individuals and their contexts: Twenty years of Health Education & Behavior health promotion interventions. Health Educ Behav. 2012;39(3):364–72. doi: 10.1177/1090198111418634. [DOI] [PubMed] [Google Scholar]
- 9.Giskes K, Kamphuis CB, van Lenthe FJ, Kremers S, Droomers M, Brug J. 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. 2007;10(10):1005–17. doi: 10.1017/S1368980007665525. [DOI] [PubMed] [Google Scholar]
- 10.McEntee J, Agyeman J. Towards the development of a GIS method for identifying rural food deserts: Geographic access in Vermont, USA. Appl Geogr. 2010;30(1):165–76. doi: 10.1016/j.apgeog.2009.05.004. [DOI] [Google Scholar]
- 11.Barrett CB. Measuring food insecurity. Science. 2010;327(5967):825–28. doi: 10.1126/science.1182768. [DOI] [PubMed] [Google Scholar]
- 12.Radimer K, Olson C. Understanding hunger and developing indicators to assess it in women and children. J Nutr Educ. 1992;24(1):36S–44S. doi: 10.1016/S0022-3182(12)80137-3. [DOI] [Google Scholar]
- 13.HR-CA. L’identification des déserts alimentaires en milieu rural. Sainte Marie de Beauce: Direction de santé publique de Chaudière-Appalaches; 2015. p. 10. [Google Scholar]
- 14.HR-CA. Plan d’action régional en sécurité alimentaire de Chaudière-Appalaches 2013-2018. In: D.d.s. publique (Ed.): Gouvernement du Québec, 2013; 15.
- 15.Charreire H, Casey R, Salze P, Simon C, Chaix B, Banos A, et al. Measuring the food environment using geographical information systems: A methodological review. Public Health Nutr. 2010;13(11):1773–85. doi: 10.1017/S1368980010000753. [DOI] [PubMed] [Google Scholar]
- 16.Glanz K, Sallis JF, Saelens BE, Frank LD. Healthy nutrition environments: Concepts and measures. Am J Health Promot. 2005;19(5):330–33. doi: 10.4278/0890-1171-19.5.330. [DOI] [PubMed] [Google Scholar]
- 17.Caspi CE, Sorensen G, Subramanian SV, Kawachi I. The local food environment and diet: A systematic review. Health Place. 2012;18(5):1172–87. doi: 10.1016/j.healthplace.2012.05.006. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Walker RE, Keane CR, Burke JG. Disparities and access to healthy food in the United States: A review of food deserts literature. Health Place. 2010;16(5):876–84. doi: 10.1016/j.healthplace.2010.04.013. [DOI] [PubMed] [Google Scholar]
- 19.Lytle LA. Measuring the food environment: State of the science. Am J Prev Med. 2009;36(4):S134–44. doi: 10.1016/j.amepre.2009.01.018. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Beaulac J, Kristjansson E, Cummins S. Peer reviewed: A systematic review of food deserts, 1966-2007. Prev Chronic Dis. 2009;6(3):A105. [PMC free article] [PubMed] [Google Scholar]
- 21.Apparicio P, Abdelmajid M, Riva M, Shearmur R. Comparing alternative approaches to measuring the geographical accessibility of urban health services: Distance types and aggregation-error issues. Int J Health Geogr. 2008;7(1):7. doi: 10.1186/1476-072X-7-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Morland KB. Local Food Environments: Food Access in America. xxiv, 323, 8 pages de planches non numérotées.
- 23.Cummins S, Macintyre S. A systematic study of an urban foodscape: The price and availability of food in greater Glasgow. Urban Stud. 2002;39(11):2115–30. doi: 10.1080/0042098022000011399. [DOI] [Google Scholar]
- 24.Ver Ploeg M, Breneman V, Dutko P, Williams R, Snyder S, Dicken C, Kaufman P. Access to affordable and nutritious food: Updated estimates of distance to supermarkets using 2010 data, ERR-143. Washington, DC: U.S. Department of Agriculture, Economic Research Service; 2012. [Google Scholar]
- 25.Bitler M, Haider SJ. An economic view of food deserts in the United States. J Policy Anal Manage. 2011;30(1):153–76. doi: 10.1002/pam.20550. [DOI] [Google Scholar]
- 26.Smith C, Morton LW. Rural food deserts: Low-income perspectives on food access in Minnesota and Iowa. J Nutr Educ Behav. 2009;41(3):176–87. doi: 10.1016/j.jneb.2008.06.008. [DOI] [PubMed] [Google Scholar]
- 27.Hartley D, Anderson N, Fox K, Lenardson J. How does the rural food environment affect rural childhood obesity? Child Obes. 2011;7(6):450–61. doi: 10.1089/chi.2011.0086. [DOI] [Google Scholar]
- 28.Lucan SC, Gustafson A, Jilcott Pitts SB. The concept of “rural food deserts” is still meaningful. Child Obes. 2012;8(5):484–85. doi: 10.1089/chi.2012.0063. [DOI] [PubMed] [Google Scholar]
- 29.Black J. Local food environments outside of the United States—a look to the north: Examining food environments in Canada. In: Morland KB, editor. Local Food Environments: Food Access in America. Boca Raton, FL: Taylor and Francis Group; 2015. pp. 231–69. [Google Scholar]
- 30.Sadler RC, Gilliland JA, Arku G. An application of the edge effect in measuring accessibility to multiple food retailer types in Southwestern Ontario, Canada. Int J Health Geogr. 2011;10:34. doi: 10.1186/1476-072X-10-34. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31.Usda E. Food Access Research Atlas. 2012. [Google Scholar]
- 32.Mader E, Busse H. Hungry in the heartland: Using community food systems as a strategy to reduce rural food deserts. J Hunger Environ Nutr. 2011;6(1):45–53. doi: 10.1080/19320248.2011.549377. [DOI] [Google Scholar]
- 33.Cummins S. Food Deserts. Illness, Behavior, and Society: The Wiley Blackwell Encyclopedia of Health; 2014. [Google Scholar]
- 34.Berque A. Écoumène: introduction à l’étude des milieux humains. Paris: Belin; 2000. p. 271. [Google Scholar]
- 35.Liu QA, Ryan V, Aurbach H, Besser T. The influence of local church participation on rural community attachment. Rural Sociol. 1998;63(3):432. [Google Scholar]
- 36.Pampalon R, Raymond G. A deprivation index for health and welfare planning in Quebec. Chronic Dis Can. 2000;21(3):104–13. [PubMed] [Google Scholar]
- 37.Frank LD, Andresen MA, Schmid TL. Obesity relationships with community design, physical activity, and time spent in cars. Am J Prev Med. 2004;27(2):87–96. doi: 10.1016/j.amepre.2004.04.011. [DOI] [PubMed] [Google Scholar]
- 38.Pouliot N, Hamelin A-M. Disparities in fruit and vegetable supply: A potential health concern in the greater Quebec City area. Public Health Nutr. 2009;12(11):2051–59. doi: 10.1017/S1368980009005369. [DOI] [PubMed] [Google Scholar]
- 39.Buck-McFadyen EV. Rural food insecurity: When cooking skills, homegrown food, and perseverance aren’t enough to feed a family. Can J Public Health. 2015;106(3):e140–46. doi: 10.17269/CJPH.106.4837. [DOI] [PMC free article] [PubMed] [Google Scholar]