Abstract
OBJECTIVES: This exploratory study aimed to shed light on the role of the food environment in shaping food access among immigrants living in the Region of Waterloo, Ontario.
METHODS: In this qualitative case study, in-depth interviews aided by photovoice were conducted with nine immigrants, and key informant (KI) interviews were conducted with nine community stakeholders (e.g., settlement workers, planners) who held expert knowledge of the local context with respect to both the food system and experiences of immigrants in interacting with this system. In this paper, we focus specifically on insights related to the food environment, applying the Analysis Grid for Environments Linked to Obesity Framework to assess economic, physical, socio-cultural and political aspects.
RESULTS: Economic features of the food environment, including food prices and differential costs of different types of food, emerged as factors related to food access. However, interactions with the food environment were shaped by broader economic factors, such as limited employment opportunities and low income. Most immigrants felt that they had good geographic access to food, though KIs expressed concerns about the types of outlet and food that were most accessible. Immigrants discussed social networks and cultural food practices, whereas KIs discussed political issues related to supporting food security in the Region.
CONCLUSION: This exploratory case study is consistent with prior research in highlighting the economic constraints within which food access exists but suggests that there may be a need to further dissect food environments.
Key Words: Food supply, emigrants and immigrants, food intake, environment, refugees, immigrant
Résumé
OBJECTIFS : Cette étude préliminaire visait à faire la lumière sur le rôle de l’environnement alimentaire dans l’accès aux aliments des immigrants vivant dans la Région de Waterloo, Ontario.
MÉTHODE : Dans cette étude de cas qualitative, des entretiens en profondeur aidés par Photovoice ont été menés auprès de neuf immigrants; des entretiens avec des informateurs ont aussi été menés auprès de neuf acteurs communautaires (p. ex., travailleurs en services d’établissement, planificateurs) possédant une connaissance approfondie du contexte local en ce qui a trait à la fois au système alimentaire et aux expériences des immigrants par rapport à ce système. Dans cet article, nous traitons spécifiquement des idées liées à l’environnement alimentaire en appliquant le cadre ANGELO (Analysis Grid for Environments Linked to Obesity) pour évaluer les aspects économiques, physiques, socioculturels et politiques.
RÉSULTATS : Les caractéristiques économiques de l’environnement alimentaire, dont le prix des aliments et les coûts différentiels de divers types d’aliments, se sont avérés être des facteurs liés à l’accès aux aliments. Toutefois, les interactions avec l’environnement alimentaire étaient influencées par des facteurs économiques plus généraux, comme les occasions d’emploi limitées et les faibles revenus. La plupart des immigrants considéraient qu’ils avaient un bon accès géographique aux aliments, mais les informateurs ont exprimé des préoccupations quant aux types d’établissements et aux aliments qui étaient les plus accessibles. Les immigrants ont discuté de réseaux sociaux et de pratiques alimentaires culturelles, tandis que les informateurs ont discuté des enjeux politiques liés au soutien de la sécurité alimentaire dans la Région.
CONCLUSION : Comme la recherche antérieure, cette étude de cas exploratoire souligne les contraintes économiques dans lesquelles l’accès aux aliments existe, mais elle suggère aussi qu’il pourrait être nécessaire de disséquer davantage les environnements alimentaires.
Mots Clés: approvisionnement en nourriture, émigrants et immigrants, ration alimentaire, environnement, réfugiés, immigrant
Footnotes
Acknowledgements: This study was made possible through financial contributions from a SEED Grant through the University of Waterloo’s Chronic Disease Prevention Initiative at the Propel Centre for Population Health Impact. We also thank the participants who kindly contributed their time and insights to this study.
Conflict of Interest: None to declare.
References
- 1.Canadian Demographics at a Glance. Ottawa, ON: Statistics Canada. 2008. Available at: http://www.statcan.gc.ca/pub/91-003-x/2007001/4129907-eng. htm (Accessed August 21, 2015).
- 2.Newbold KB. Chronic conditions and the healthy immigrant effect: Evidence from Canadian immigrants. JEthn Migr Stud. 2006;32(5):765–84. doi: 10.1080/13691830600704149. [DOI] [Google Scholar]
- 3.Ng E, Russell W, François G, Berthelot J. Healthy Today, Healthy Tomorrow? Findings From the National Population Health Survey (82-618-MWE) Ottawa, ON: Statistics Canada; 2005. Dynamics of immigrants’ health in Canada: Evidence from the National Population Health Survey; pp. 1–11. [Google Scholar]
- 4.Ali J. Mental health of Canada’s immigrants. Ottawa, ON: Statistics Canada; 2015. [Google Scholar]
- 5.Dean JA, Wilson K. “My health has improved because I always have everything I need here…”: A qualitative exploration of health improvement and decline among immigrants. Soc Sci Med. 2010;70(8):1219–28. doi: 10.1016/j.socscimed.2010.01.009. [DOI] [PubMed] [Google Scholar]
- 6.Newbold B. The short-term health of Canada’s new immigrant arrivals: Evidence from LSIC. Ethn Health. 2009;14(3):315–36. doi: 10.1080/13557850802609956. [DOI] [PubMed] [Google Scholar]
- 7.Sanou D, O’Reilly E, Ngnie-Teta I, Batal M, Mondain N, Andrew C, et al. Acculturation and nutritional health of immigrants in Canada: A scoping review. J Immigr Minor Health. 2014;16(1):24–34. doi: 10.1007/s10903-013-9823-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Tarasuk V, Dachner N. Household Food Insecurity in Canada. Toronto, ON: Research to Identify Policy Options to Reduce Food Insecurity (PROOF); 2012. [Google Scholar]
- 9.Kirkpatrick SI, Dodd KW, Parsons R, Ng C, Garriguet D. Household food insecurity is a stronger marker of adequacy of nutrient intakes among Canadian compared to American youth and adults. JNutr. 2015;145(7):1596–603. doi: 10.3945/jn.114.208579. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Tarasuk V, Cheng J, de Oliveira C, Dachner N, Gundersen C, Kurdyak P. Association between household food insecurity and annual health care costs. CMJA. 2005;187(14):E429–36. doi: 10.1503/cmaj.150234. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Lindsay AC, Sussner KM, Greaney ML, Peterson KE. Influence of social context on eating, physical activity, and sedentary behaviors of Latina mothers and their preschool-age children. Health Educ Behav. 2009;36(1):81–96. doi: 10.1177/1090198107308375. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Chaufan C, Davis M, Constantino S. The twin epidemics of poverty and diabetes: Understanding diabetes disparities in a low-income Latino and immigrant neighborhood. J Community Health. 2011;36(6):1032–43. doi: 10.1007/s10900-011-9406-2. [DOI] [PubMed] [Google Scholar]
- 13.Hamelin A-M, Beaudry M, Habicht J-P. Characterization of household food insecurity in Quebec: Food and feelings. Soc Sci Med. 2002;54(1):119–32. doi: 10.1016/S0277-9536(01)00013-2. [DOI] [PubMed] [Google Scholar]
- 14.Special Rapporteur on the Right to Food. United Nations Human Rights, Geneva, Switzerland. 2015. [Google Scholar]
- 15.Food Security. Ottawa, ON: Public Health Agency of Canada, 2014). Available at: http://cbpp-pcpe.phac-aspc.gc.ca/public-health-topics/food-security/ (Accessed September 25, 2015).
- 16.Curbing Childhood Obesity. Ottawa, ON: Public Health Agency of Canada, 2010). Available at: http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/framework-cadre/pdf/ccofw-eng.pdf (Accessed March 10, 2015).
- 17.Measuring the Food Environment in Canada. Ottawa, ON: Health Canada, 2013), p. 7. Available at: http://www.foodsecuritynews.com/resource-documents/MeasureFoodEnvironm_EN.pdf (Accessed April 21, 2015).
- 18.Kirkpatrick SI, Tarasuk V. Assessing the relevance of neighbourhood characteristics to the household food security of low-income Toronto families. Public Health Nutr. 2010;13(7):1139–48. doi: 10.1017/S1368980010000339. [DOI] [PubMed] [Google Scholar]
- 19.Park Y, Quinn J, Florez K, Jacobson J, Rundle A. Hispanic immigrant women’s perspective on healthy foods and the New York City retail food environment: A mixed-method study. Soc Sci Med. 2011;73(1):13–21. doi: 10.1016/j.socscimed.2011.04.012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Lake A, Townshend T. Obesogenic environments: Exploring the built and food environments. J R Soc Promot Health. 2006;126(6):262–67. doi: 10.1177/1466424006070487. [DOI] [PubMed] [Google Scholar]
- 21.Raine K, Church J, Boulé N, Slater L, Marko J, Gibbons K, et al. State of the Evidence Review on Urban Health and Healthy Weights. Ottawa, ON: Canadian Institute for Health Information; 2008. [Google Scholar]
- 22.Dean JA, Elliot SJ. Prioritizing obesity in the city. J Urban Health. 2011;89(1):196–213. doi: 10.1007/s11524-011-9620-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Greder K, De Slowing FR, Doudna K. Latina immigrant mothers: Negotiating new food environments to preserve cultural food practices and healthy child eating. Fam Consum Sci Res J. 2012;41(2):145–60. doi: 10.1111/fcsr.12004. [DOI] [Google Scholar]
- 24.Region of Waterloo Public Health. Waterloo Region Immigration Fact Sheet. 2015. [Google Scholar]
- 25.Johnson BH, Hayes SC, Ekundayo OT, Wheeler P, Ford DM. Health literacy of an urban business community. J Health Care Poor Underserved. 2012;23(1):242–53. doi: 10.1353/hpu.2012.0028. [DOI] [PubMed] [Google Scholar]
- 26.Heidelberger L, Smith C. The food environment through the camera lenses of 9- to 13-year-olds living in urban, low-income, midwestern households: A photovoice project. J Nutr Educ Behav. 2015;47(5):437–45. doi: 10.1016/j.jneb.2015.05.005. [DOI] [PubMed] [Google Scholar]
- 27.Wang CC, Yi WK, Tao ZW, Carovano K. Photovoice as a participatory health promotion strategy. Health Promot Int. 1998;13(1):75–86. doi: 10.1093/heapro/13.1.75. [DOI] [Google Scholar]
- 28.Wang C, Burris MA. Photovoice: Concept, methodology, and use for participatory needs assessment. Health Educ Behav. 1997;24(3):369–87. doi: 10.1177/109019819702400309. [DOI] [PubMed] [Google Scholar]
- 29.Patton MQ. Qualitative Research and Evaluation Methods. Thousand Oaks, CA: Sage Publications; 2002. [Google Scholar]
- 30.Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101. doi: 10.1191/1478088706qp063oa. [DOI] [Google Scholar]
- 31.Swinburn B, Egger G, Raza F. Dissecting obesogenic environments: The development and application of a framework for indentifying and prioritizing environmental interventions for obesity. Prev Med. 1999;29:563–70. doi: 10.1006/pmed.1999.0585. [DOI] [PubMed] [Google Scholar]
- 32.Dachner N, Ricciuto L, Kirkpatrick SI, Tarasuk V. Food purchasing and food insecurity among low-income families in Toronto. Can J Diet Pract Res. 2010;71(3):e50–56. doi: 10.3148/71.3.2010.127. [DOI] [PubMed] [Google Scholar]
- 33.Vahabi M, Damba C. Perceived barriers in accessing food among recent Latin American immigrants in Toronto. Int J Equity Health. 2013;12(1):1. doi: 10.1186/1475-9276-12-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 34.Minaker LM, Raine KD, Wild TC, Nykiforuk CIJ, Thompson ME, Frank LD. Objective food environments and health outcomes. Am J Prev Med. 2013;45(3):289–96. doi: 10.1016/j.amepre.2013.05.008. [DOI] [PubMed] [Google Scholar]