Public Directory Data Sources Do Not Accurately Characterize the Food Environment in Two Predominantly Rural States

doi:10.1016/j.jada.2011.01.008

Journal of the American Dietetic Association

Volume 111, Issue 4, April 2011, Pages 577-582

https://doi.org/10.1016/j.jada.2011.01.008 Get rights and content

Abstract

Communities are being encouraged to develop locally based interventions to address environmental risk factors for obesity. Online public directories represent an affordable and easily accessible mechanism for mapping community food environments, but may have limited utility in rural areas. The primary aim of this study was to evaluate the efficacy of public directories vs rigorous onsite field verification to characterize the community food environment in 32 geographically dispersed towns from two rural states covering 1,237.6 square miles. Eight types of food outlets were assessed in 2007, including food markets and eating establishments, first using two publically available online directories followed by onsite field verification by trained coders. χ² and univariate binomial regression were used to determine whether the proportion of outlets accurately listed varied by food outlet type or town population. Among 1,340 identified outlets, only 36.9% were accurately listed through public directories; 29.6% were not listed but were located during field observation. Accuracy varied by outlet type, being most accurate for big box stores and least accurate for farm/produce stands. Overall, public directories accurately identified fewer than half of the food outlets. Accuracy was significantly lower for rural and small towns compared to mid-size and urban towns (P<0.001). In this geographic sample, public directories seriously misrepresented the actual distribution of food outlets, particularly for rural and small towns. To inform local obesity-prevention efforts, communities should strongly consider using field verification to characterize the food environment in low-population areas.

Section snippets

Methods

Data for the current study were collected as part of a larger study of individual, family, and environmental influences on adolescent obesity in primarily rural and small town geographic areas of Northern New England. The study, titled “Environmental and Family Influences on Adolescent Overweight,” was approved by the Committee for the Protection of Human Subjects at Dartmouth College.

Results and Discussion

The sampling area covered 1,237.6 square miles, encompassing 7% of the total combined land area in New Hampshire and Vermont. Towns were well-distributed by population size: rural, n=11; small town, n=7; mid-sized town, n=8; and urban, n=6. Nine hundred and forty-three food outlets were identified through public directory listings and 960 through field observations. After accounting for overlap, this provided a sample of 1,340 unique food outlets. Twenty-seven percent were food markets and 73%

Conclusions

This study represents one of the largest samples of food outlets to date validated through field verification methods, identifying nearly 1,000 outlets in the primarily low-population sampling area. The sample included four distinct population patterns within a relatively small geographic area, and assessed eight types of food outlets, providing a comprehensive description of the regional food environment. The efficacy of using public directories to identify community food outlets in

M. R. Longacre is an instructor, Community Health Research Program, Hood Center for Children and Families, Department of Pediatrics, Dartmouth Medical School, Lebanon, NH.

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Cited by (23)

Local retail food environment exposure and diet quality in rural and urban adults: A longitudinal analysis of the ORISCAV-LUX cohort study
2024, Health and Place
Despite growing interest in understanding how food environments shape dietary behaviors, European longitudinal evidence is scarce. We aimed to investigate the associations of 9-year average and change in exposure to local retail food environments with the diet quality of residents in Luxembourg. We used data from 566 adults enrolled in both waves of the nationwide ORISCAV-LUX study (2007–2017). Dietary quality was assessed by the Diet Quality Index-International (DQI-I). Exposure to “healthy” and “less healthy” food outlets was assessed by both absolute and relative GIS-based measurements. The results showed a 56.3% increase in less healthy food outlets over the period. In adjusted linear mixed models, high (vs. low) 9-year average exposure to less healthy food outlets was associated with lower DQI-I, when examining spatial access (β = −1.25, 95% CI: −2.29, −0.22) and proportions (β = −1.24, 95% CI: −2.15, −0.33). Stratified analyses showed these associations to be significant only among urban residents. There was no association between change in exposure to less healthy food outlets and DQI-I. Increased exposure to healthy outlets in rural areas, using absolute measurements, was associated with worsened DQI-I. Neighborhood socioeconomic status did not moderate the above associations. Findings suggest that the proliferation of less healthy food outlets may have contributed to the deterioration of the diet quality of urban residents, and support the use of relative measurements to fully capture the healthiness of food environments.
Food in my life: How Australian adolescents perceive and experience their foodscape
2023, Appetite
Food choice has long been recognized as an interaction between psychological, social, cultural, economic, and biological forces through life course events and experiences. Adolescence is a particularly sensitive life stage during which personal and external environments influence food decisions and attitudes that can have long-term implications. Young people represent future households, yet little is understood about their perspectives on, and experiences of, their foodscape. To address this, a photovoice study with thirty-two students was undertaken at three state high schools with differing foodscapes in South East Queensland (Australia). Adolescent perspectives on foodscapes highlighted the food in front of them (either common or favourite foods), food routines, their emotional relationship with food, and the important role that family has in shaping their relationship with food (in particular mothers). Adolescents demonstrated an astute awareness of healthy/good and unhealthy/bad foods in relation to ingredients, ways of eating and different types of foods. Yet they expressed noticeable confusion on this matter, referring to some foods as “healthy-ish”, or describing a "balanced" diet as consuming something healthy followed by something unhealthy. We found that adolescents are inundated by discretionary foods on a daily basis, however, are not particularly cognisant of them. These findings have direct implications for preventative health messages targeting adolescents.
Neighborhood socioeconomic status and food environment: A 20-year longitudinal latent class analysis among CARDIA participants
2014, Health and Place
Citation Excerpt :
Powell׳s larger study (Powell et al., 2011) included non-urban tracts compared to the latter two studies that were set in urban areas. Other studies also suggest validity may be poor in rural compared to urban areas (Kravets and Hadden, 2007; Boone et al., 2008; Longacre et al., 2011; McGuirt et al., 2011; Fleischhacker and Rodriguez et al., 2012; Han et al., 2012). Nonetheless, CARDIA participants were recruited from four major U.S. cities and after 20 years, over 90% of them were still living either in or less than a mile away from an urban area.
Cross-sectional studies suggest that neighborhood socioeconomic (SES) disadvantage is associated with obesogenic food environments. Yet, it is unknown how exposure to neighborhood SES patterning through adulthood corresponds to food environments that also change over time. We used latent class analysis (LCA) to classify participants in the U.S.-based Coronary Artery Risk Development in Young Adults study [n=5,114 at baseline 1985–1986 to 2005–2006] according to their longitudinal neighborhood SES residency patterns (upward, downward, stable high and stable low). For most classes of residents, the availability of fast food and non-fast food restaurants and supermarkets and convenience stores increased (p<0.001). Yet, socioeconomically disadvantaged neighborhood residents had fewer fast food and non-fast food restaurants, more convenience stores, and the same number of supermarkets in their neighborhoods than the advantaged residents. In addition to targeting the pervasive fast food restaurant and convenient store retail growth, improving neighborhood restaurant options for disadvantaged residents may reduce food environment disparities.
Food availability/convenience and obesity
2014, Advances in Nutrition
Neighborhood environments have received considerable attention in recent local, state, and national obesity prevention initiatives, with a particular focus on food deserts, or areas with poor access to healthy foods. Yet, there are inconsistencies in the evidence base, suggesting a nuanced association between neighborhood environment, food availability, diet behaviors, and obesity. There is heterogeneity in associations between environmental exposures and health outcomes across race/ethnicity, gender, region, and urbanicity, which results in complexity in the interpretation of findings. There are several limitations in the literature, including a predominance of cross-sectional studies, reliance on commercial business listings, lack of attention to the process by which diet resources are established and expanded within neighborhoods and the potential for individuals to selectively migrate to locate near such facilities, a predominant focus on residential neighborhoods, and lack of information about the decision-making process underlying purchasing patterns. More research is needed to address the complexity of individual-level residential decision making as well as the purposeful placement of food environment resources across social and geographic space using longitudinal data and complex statistical approaches. In addition, improvements in data quality and depth related to food access and availability are needed, including behavioral data on purchase patterns and interactions with the food environment, and greater attention to heterogeneity across subpopulations. As policy changes to the food environment move forward, it is critical that there is rigorous and scientific evaluation of environmental changes and their impact on individual-level diet choices and behaviors, and their further influence on body weight.
Validity of secondary retail food outlet data: A systematic review
2013, American Journal of Preventive Medicine
Citation Excerpt :
Farmers’ markets were specifically examined by four predominantly rural studies.18–20,30 To define and classify the retail food outlets examined, most studies created their own definitions or classification schemes17,20–24,27,31,32 or used the North America Industry Classification System12–14,18,19,25,26,28,30 (Table 4 and Appendix B, available online at www.ajpmonline.org). Only three studies18,19,35 reported percentage agreement between independent coders for classifying food outlets.
Improving access to healthy foods is a promising strategy to prevent nutrition-related chronic diseases. To characterize retail food environments and identify areas with limited retail access, researchers, government programs, and community advocates have primarily used secondary retail food outlet data sources (e.g., InfoUSA or government food registries). To advance the state of the science on measuring retail food environments, this systematic review examined the evidence for validity reported for secondary retail food outlet data sources for characterizing retail food environments.
A literature search was conducted through December 31, 2012, to identify peer-reviewed published literature that compared secondary retail food outlet data sources to primary data sources (i.e., field observations) for accuracy of identifying the type and location of retail food outlets. Data were analyzed in 2013.
Nineteen studies met the inclusion criteria. The evidence for validity reported varied by secondary data sources examined, primary data–gathering approaches, retail food outlets examined, and geographic and sociodemographic characteristics. More than half of the studies (53%) did not report evidence for validity by type of food outlet examined and by a particular secondary data source.
Researchers should strive to gather primary data but if relying on secondary data sources, InfoUSA and government food registries had higher levels of agreement than reported by other secondary data sources and may provide sufficient accuracy for exploring these associations in large study areas.
Fast-food environments and family fast-food intake in nonmetropolitan areas
2012, American Journal of Preventive Medicine
Little is known about the influence of in-town fast-food availability on family-level fast-food intake in nonmetropolitan areas.
The purpose of the current study was to determine whether the presence of chain fast-food outlets was associated with fast-food intake among adolescents and parents, and to assess whether this relationship was moderated by family access to motor vehicles.
Telephone surveys were conducted with 1547 adolescent–parent dyads in 32 New Hampshire and Vermont communities between 2007 and 2008. Fast-food intake in the past week was measured through self-report. In-town fast-food outlets were located and enumerated using an onsite audit. Family motor vehicle access was categorized based on the number of vehicles per licensed drivers in the household. Poisson regression was used to determine unadjusted and adjusted risk ratios (RRs). Analyses were conducted in 2011.
About half (52.1%) of adolescents and 34.7% of parents consumed fast food at least once in the past week. Adolescents and parents who lived in towns with five or more fast-food outlets were about 30% more likely to eat fast food compared to those in towns with no fast-food outlets, even after adjusting for individual, family, and town characteristics (RR=1.29, 95% CI= 1.10, 1.51; RR=1.32, 95% CI=1.07, 1.62, respectively). Interaction models demonstrated that the influence of in-town fast-food outlets on fast-food intake was strongest among families with low motor vehicle access.
In nonmetropolitan areas, household transportation should be considered as an important moderator of the relationship between in-town fast-food outlets and family intake.

View all citing articles on Scopus

M. R. Longacre is an instructor, Community Health Research Program, Hood Center for Children and Families, Department of Pediatrics, Dartmouth Medical School, Lebanon, NH.

B. A. Primack is an assistant professor, Divisions of General Internal Medicine and Adolescent Medicine, Departments of Medicine and Pediatrics, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA.

P. M. Owens is an urban planner, Smart Mobility, Inc, Norwich, VT.

L. Gibson is principal, Smart Mobility, Inc, Norwich, VT.

S. Beauregard is an engineer, Smart Mobility, Inc, Norwich, VT.

T. A. Mackenzie is an associate professor, Community Health Research Program, Hood Center for Children and Families, Departments of Community and Family Medicine and Medicine, Dartmouth Medical School, Lebanon, NH.

M. A. Dalton is a professor, Community Health Research Program, Hood Center for Children and Families, Departments of Pediatrics and Community and Family Medicine, Dartmouth Medical School, Lebanon, NH.

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ResearchResearch and Professional BriefPublic Directory Data Sources Do Not Accurately Characterize the Food Environment in Two Predominantly Rural States

Abstract

Section snippets

Methods

Results and Discussion

Conclusions

A national study of obesity prevalence and trends by type of rural county

J Rural Health

Is rural residency a risk factor for overweight and obesity for US children?

Obesity

Creating healthy food and eating environments: Policy and environmental approaches

Annu Rev Public Health

Recommended community strategies and measurements to prevent obesity in the United States

MMWR Recomm Rep

Creating healthy food and eating environments: Policy and environmental approaches

Annu Rev Public Health

White House Task Force on Childhood Obesity Report to the PresidentSolving the problem of childhood obesity within a generation

Public Health Law and PolicyHealthy corner stores: The state of the movement

Strategic Alliance for Healthy Food and Activity EnvironmentsENACT neighborhood environment: Fast food

Healthy Eating Active Living Convergence PartnershipHealthy people, healthy places

Neighborhood environments: Disparities in access to healthy foods in the US

Am J Prev Med

Measuring potential access to food stores and food-service places in rural areas in the US

Am J Prev Med

Measures of the food environment: A compilation of the literature, 1990-2007

Am J Prev Med

The neighborhood food environment: Sources of historical data on retail food stores

Int J Behav Nutr Phys Act

The foodscape: Classification and field validation of secondary data sources

Health Place

Research
Research and Professional Brief
Public Directory Data Sources Do Not Accurately Characterize the Food Environment in Two Predominantly Rural States