This study was conducted to evaluate disparities in access to healthy food in Montreal, focusing on the availability of fresh fruits and vegetables (F/V) as an indicator.
F/V selling area was measured in all food retail stores and public markets offering more than 75 square feet of fresh fruits and vegetables. An accessibility index was elaborated, taking into account motorization rates and the total surface of these fresh foods for sale within an easily accessible zone. The extent of that zone was determined differently for motorized (3 km) and non-motorized (500 m) consumers. Measures were calculated and georeferenced at the level of "Dissemination Areas" according to the 2001 Census.
In general, access to healthy foods is quite good for consumers who shop by car. But 40% of the population have poor access to fruits and vegetables within a walkable distance from home. No relationship is observed between median income in dissemination areas and food supply.
Improved access to healthy food by non-motorized consumers is needed in many areas of Montreal. Implications of differential access to fresh fruits and vegetables for health and environmental sustainability are discussed.
The paper describes dietary changes and related nutrition policies and interventions in Finland since the 1960s. Dietary changes are interpreted from the lifestyle perspective, in which food consumption patterns are assumed to be formed by the interplay of individual choices and structural chances, such as socioeconomic and cultural conditions. Finland can demonstrate a success story when it comes to decreased use of dairy fats and increased use of vegetables and fruit. However, the prevalence of overweight has increased. Nutrition policies and interventions together with sociocultural factors have supported the shift towards healthy nutrition. The same factors have promoted overweight, as well.
Physical access to stores selling groceries, fresh fruit and vegetables (FV) is essential for urban dwellers. In Canadian cities where low-density development practices are common, social and material deprivation may be compounded by poor geographic access to healthy food. This case study examines access to food stores selling fresh FV in Gatineau, Quebec, to identify areas where poor access is coincident with high deprivation.
Food retailers were identified using two secondary sources and each store was visited to establish the total surface area devoted to the sale of fresh FV. Four population-weighted accessibility measures were then calculated for each dissemination area (DA) using road network distances. A deprivation index was created using variables from the 2006 Statistics Canada census, also at the scale of the DA. Finally, six classes of accessibility to a healthy diet were constructed using a k-means classification procedure. These were mapped and superimposed over high deprivation areas.
Overall, deprivation is positively correlated with better accessibility. However, more than 18,000 residents (7.5% of the population) live in high deprivation areas characterized by large distances to the nearest retail food store (means of 1.4 km or greater) and virtually no access to fresh FV within walking distance (radius of 1 km).
In this research, we identified areas where poor geographic access may introduce an additional constraint for residents already dealing with the challenges of limited financial and social resources. Our results may help guide local food security policies and initiatives.
Food habits and their socio-economic differences in Russia have rarely been compared to those in western countries. Our aim was to determine socio-economic differences and their changes in the consumption of vegetables, fruit and berries in two neighbouring areas: the district of Pitkäranta in the Republic of Karelia, Russia, and North Karelia, Finland.
Cross-sectional risk factor surveys in Pitkäranta, in 1992, 1997, 2002 and 2007 (1144 men, 1528 women) and in North Karelia, in 1992, 1997 and 2002 (2049 men, 2316 women), were carried out. Data collected with a self-administered questionnaire were analysed with logistic regression.
The consumption of fruit and vegetables was more common in North Karelia than in Pitkäranta, but increased markedly in Pitkäranta from 1992 to 2007. In Pitkäranta, women, and in North Karelia both men and women with higher education ate fresh vegetables more often than those with a lower education. In both areas, daily consumption of fruit tended to be more common among subjects with a higher education. In Pitkäranta, there were virtually no differences by employment status. In North Karelia, vegetable consumption was less common among the unemployed than the employed subjects. Only minor socio-economic differences in berry consumption were observed. The educational differences in vegetable consumption seemed to widen in Pitkäranta and narrow in North Karelia.
A converging trend was observed, with the Russian consumption levels and socio-economic differences starting to approach those observed in Finland. This may be partly explained by the improvements in availability and affordability of fruit and vegetables in Pitkäranta.
To examine the cost of fruits and vegetables (FV) with respect to different food store types, urbanization level and material deprivation for various urban areas of greater Quebec City.
A sample of 85 food stores was selected. They represented five store types (small, conventional, and large grocery stores; greengrocers; convenience stores) in four geographic areas reflecting three different socio-economic levels. We identified three FV baskets (grocery, fresh FV, convenience) by drawing on data on household food spending and consumption, and food supply in the five store types. Four investigators were trained to conduct a survey of prices for the week of September 17-23, 2007. Analysis of variance and t tests were conducted to examine variations in food baskets with regard to the variables defined in this study. A chi-square test was used to measure the frequency distribution of stores throughout the greater Quebec City.
Only food store type had a significant influence on FV cost: cost was much lower in large grocery stores and greengrocers. Convenience stores, where prices are higher, outnumbered all others in deprived urban areas, supporting the contention that there are inequities in economic access.
Economic access to FV may differ by area in the greater Quebec City, putting rural inhabitants and less privileged urban dwellers at the greatest disadvantage; this may, in turn, contribute to health disparities. The results point to the need to improve our understanding of the way components of the food environment at the regional level affect social inequality.
This study tested whether socio-economic status (SES) moderated the association between the psychosocial constructs included in the attitude-social influence-self-efficacy (ASE) model and fruit intake in Norwegian schoolchildren. The sample consisted of 962 Norwegian sixth graders, mean age 11.3 years. They were split into three SES groups, and multi-group structural equation modeling (MSEM) was used. Children in the highest SES group reported eating fruit more frequently and reported more positive ASE variables than children in the lower SES groups. This was particularly true for social environmental factors, home availability of fruit and intention to eat fruit. MSEM showed that the relationships specified in the adapted ASE model were moderated by SES, as we did not find support for equal model structure across the three samples. Model modification for each SES group separately showed that the relation between home availability and fruit intake was not significant for the medium and low SES groups, and the relation between self-efficacy and intention to eat fruit was not significant for the medium SES group. Future interventions aiming at increasing fruit intake in children need to be sensitive to such SES-related differences and should in particular affect factors that may impede fruit intake in the lower SES groups.
Access to fruit and vegetables (FV) is associated with adolescents' FV consumption. However, little is known about implementation of strategies to increase access to FV at schools. We examined the implementation of two environmental components designed to increase access to FV at Danish schools.
We used data from 20 intervention schools involved in the school-based multicomponent Boost trial targeting 13-year-olds' FV consumption. The environmental components at school included daily provision of free FV and promotion of a pleasant eating environment. Questionnaire data was collected by the end of the nine-month intervention period among 1,121 pupils (95%), from all school principals (n?=?20) and half way through the intervention period and by the end of the intervention among 114 teachers (44%). The implementation of the components was examined descriptively using the following process evaluation measures; fidelity, dose delivered, dose received and reach. Schools with stable high implementation levels over time were characterised by context, intervention appreciation and implementation of other components.
For all process evaluation measures, the level of implementation varied by schools, classes and over time. Dose received: 45% of pupils (school range: 13-72%, class range: 7-77%) ate the provided FV daily; 68% of pupils (school range: 40-93%, class range: 24-100%) reported that time was allocated to eating FV in class. Reach: The intake of FV provided did not differ by SEP nor gender, but more girls and low SEP pupils enjoyed eating FV together. Dose delivered: The proportion of teachers offering FV at a daily basis decreased over time, while the proportion of teachers cutting up FV increased over time. Schools in which high proportions of teachers offered FV daily throughout the intervention period were characterized by being: small; having a low proportion of low SEP pupils; having a school food policy; high teacher- and pupil intervention appreciation; having fewer teachers who cut up FV; and having high implementation of educational components.
The appliance of different approaches and levels of analyses to describe data provided comprehension and knowledge of the implementation process. This knowledge is crucial for the interpretation of intervention effect.
Current Controlled Trials ISRCTN11666034.
Cites: Health Educ Behav. 2000 Apr;27(2):157-6610768797
The present study explores the spatial distribution and in-store availability of fresh fruits and vegetables from a socio-environmental perspective in terms of the type of food store, level of deprivation and the setting (urban/rural) where the food outlets are located.
Seven types of fresh fruit and vegetable stores (FVS) were identified then visited in six districts (urban setting) and seven communities (rural setting). The quantity and diversity of fresh fruits and vegetables (F&V) were also assessed.
Québec City, Canada.
The FVS spatial distribution showed differences between the two settings, with accessibility to supermarkets being more limited in rural settings. The quantity and diversity of fresh F&V in-store availability were associated with the type of FVS, but not with setting or its level of deprivation. Greengrocers and supermarkets offered a greater quantity and diversity of fresh F&V than the other FVS.
The results suggest that inequalities in physical access to fresh F&V across the region could have an impact on public health planning considering that supermarkets, which are one of the excellent sources of F&V, are less prevalent in rural settings.
OBJECTIVE: The aim of the present study was to: 1) describe the patterns of fruit and vegetable (f&v) intake in Canadian elderly and 2) identify socio-demographic factors that were associated with the low consumption. METHODS: Data from the Canadian Community Health Survey cycle 2.1 (2003), Public Use File, were used. Statistical analysis was conducted using SPSS 11.5 for Windows. Total f&v intake of Canadian elderly (65 years and older) was cross-tabulated between four age groups, by gender, level of household education, total household income, ethnicity, marital status, and geographical locations. RESULTS: Our data revealed that 47% of Canadian elderly sample consume f&v equal to or greater than five times daily. A strong positive association was found between f&v consumption and total household income and highest household education. Gender and marital status were other important contributing factors for f&v intake among elderly. Ethnicity did not influence f&v intake. Younger males reported to consume less f&v than older males did, but consumption of f&v was comparable among all four age groups of females. Elderly living in the Maritime Provinces and the Yukon/Northwest Territories/Nunavut had a lower level of f&v consumption, as compared to elderly living in other provinces. CONCLUSIONS: These results indicate that >50% of Canadian elderly do not consume f&v five or more times per day. Gender and several socio-demographic factors significantly influence f&v intake in Canadian elderly. Further studies warrant identifying at risk elderly groups and implementing programs to encourage adequate f&v intake by Canadian elderly.