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J Public Health (2012) 20:375385 DOI 10.1007/s10389-011-0470-y
ORIGINAL ARTICLE
The food environment and dietary intake: demonstrating a method for GIS-mapping and policy-relevant research
Sean C. Lucan & Nandita Mitra
Received: 14 July 2011 /Accepted: 14 November 2011 /Published online: 4 December 2011 # Springer-Verlag 2011
AbstractAims The aims of this paper are (1) to assess if perceptions of the food environment are associated with select dietary intake by neighborhood, and (2) to map neighborhood-specific findings, demonstrating a method for policy-relevant research.
Methods Using pre-collected data from a Philadelphia, PA community health survey, we aggregated individual-level data (n04,434 respondents) to neighborhoods (n0381 census tracts), adjusting for conceptually-relevant socio-demographic factors. We estimated Spearman correlations between multivariable adjusted food-environment perceptions (perceived produce availability, supermarket accessibility, grocery quality) and select dietary intake (reported fruit-and-vegetable and fast-food consumption), and mapped variables by neighborhood using geographic information systems (GIS).
Results Difficulty finding fruits and vegetables, having to travel outside of ones neighborhood to get to a supermarket, and poor grocery quality were each directly correlated with fast-food intake (rho00.21, 0.34, 0.64 respectively; p values <0.001); and inversely correlated with fruit-and-vegetable intake (rho00.35, 0.54, 0.56 respectively; p values <0.001). Maps identified neighborhoods
within the city with the worst food-environment perceptions and poorest dietary intakes.
Conclusion Negative perceptions of the food environment were strongly correlated with less-healthy eating in neighborhoods. Maps showed the geographic areas of greatest concern. Our findings demonstrate a method that might be used prospectively in public health for policy planning (e.g. to identify neighborhoods most in need), or retrospectively for policy assessment (e.g. to identify changes in neighborhoods after policy implementation).
Keywords Policy research . Public health . Fruits and vegetables . Fast food . Food environment . Geographic information systems (GIS) mapping . Neighborhoods
Introduction
Diet-related diseasesincluding cardiovascular disease and cancer, and contributing conditions like obesity and diabetesare leading causes of morbidity and premature mortality in the developed world, particularly the United States (American Heart Association/American Stroke Association, http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/HealthyLivingAfterStroke/UnderstandingRiskyConditions/Converging-Risk-Factors_UCM_310319_Article.jsp#.TsXJzGCI0iQ
Web End =http://www.strokeassociation.org/STROKEORG/ http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/HealthyLivingAfterStroke/UnderstandingRiskyConditions/Converging-Risk-Factors_UCM_310319_Article.jsp#.TsXJzGCI0iQ
Web End =LifeAfterStroke/HealthyLivingAfterStroke/Understanding http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/HealthyLivingAfterStroke/UnderstandingRiskyConditions/Converging-Risk-Factors_UCM_310319_Article.jsp#.TsXJzGCI0iQ
Web End =RiskyConditions/Converging-Risk-Factors_UCM_310319_ http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/HealthyLivingAfterStroke/UnderstandingRiskyConditions/Converging-Risk-Factors_UCM_310319_Article.jsp#.TsXJzGCI0iQ
Web End =Article.jsp#.TsXJzGCI0iQ ; Michaud et al. 2001; Mokdad et al. 2004; National Cancer Institute, http://www.cancer.gov/cancertopics/factsheet/risk/obesity
Web End =http://www.cancer.gov/ http://www.cancer.gov/cancertopics/factsheet/risk/obesity
Web End =cancertopics/factsheet/risk/obesity ). Cumulatively, these conditions account for a huge proportion of healthcare spending, and are...