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At this point, Song is not aware of any published studies on food environment as a factor in residential choice. Urban Planning and Food Environments Song explained that planners distinguish between basic, revenue- generating land use and nonbasic, service-related land use. The current curriculum at urban planning schools favors planning small-scale food stores in mixed-use development for easy access by local households. Economies of scale, consumer preferences, and existing zoning ordi- nances, however, can make this goal unrealistic.

In summary, the research on food environment and residential selec- tion activity shows evidence of a price premium associated with healthy neighborhood stores, but these premiums have been observed only in high-income neighborhoods.

No study has explicitly looked at how food retailers affect residential location choice. More refined surveys and more data, including natural experiments, may provide some answers. Many of the questions and comments related to the complexity of causes, mak- ing it difficult to separate the impact of the food environment from other variables. One workshop participant said opposition by institutional review boards makes it difficult to collect data from work- places. In any event, Diez Roux cautioned against extrapolating too much from a current situation: people might buy food closer to work, for exam- ple, because there is no alternative closer to home.

Some groups are com- bining data on a variety of aspects of the built environment, including food venues and their relationship to transportation routes, to see how they connect. Supermarkets as One Proxy Song was asked about the emphasis on large supermarkets from a planning perspective, given the emphasis on keeping buildings at a similar scale.

She observed that spatial planning may not take household characteristics sufficiently into account. Cummins said that what planners want and what a local population wants might diverge. Often a success- ful local retail economy has a mix of different-sized stores. Diez Roux stressed the issue is access to healthy foods, not necessarily access to a supermarket. Environments have many features that interrelate, which implies thinking through the positive and adverse effects of a particular intervention. Role of Simulations Simulations are valuable, said Diez Roux, because they require think- ing through processes to create a valid model and may point out knowl- edge gaps that may have been overlooked by other research methods.

Cummins noted that simulations can utilize existing observational data in a better way, perhaps linking together unconnected data sets. Song noted that in urban planning, simulations are used to build scenarios to observe the effect, holding everything else constant, of a specific policy intervention.


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Mixed Land Use Whether mixed land use promotes positive health effects is, according to Song, a debatable topic. It seems to depend on what the mixed uses actually entail. If they are appropriate and decrease automobile use, that would be healthy. Diez Roux said the literature is difficult to summarize because the measures have been so different. Proximity of destinations promotes walking, but the long-term health impacts are less known. The natural experiments with which Cummins has been involved led him to realize, he said, that robust underlying theoretical models and the time frames in which we might realistically see effects are still not fully known.


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One successful outcome could simply be increasing the number of food stores available, but a secondary outcome would be to see changes in health behaviors and then impacts on obesity or the prevalence of diabetes. Changes in important health behaviors and outcomes may take longer to ascertain than most current funding mechanisms allow. Diez Roux suggested look- ing at proximal outcomes in the short term, rather than trying to detect more distal effects.

Workshop on the Public Health Effects of Food Deserts

Cummins also suggested making more use of complementary activi- ties, such as mailings to residents or incentives, and evaluating the effect of these initiatives combined with changes in supply. One workshop participant questioned whether food desert health outcomes are really due to limited food access or perhaps more likely to limited healthcare access.

Diez Roux agreed the issues are confounded because the real world is complex, and it is difficult to separate the causal effect of food access. Methodologically, researchers attempt to create boundaries through a variety of statistical controls. Cummins said spa- tial analytic approaches to measure access using GIS geographic infor- mation systems in longitudinal studies may help avoid the problem of using administrative boundaries, which may shift over time, as a proxy for neighborhoods. People have different perceptions of neighborhood boundaries. Using census tracts as a proxy, in his opinion, also has weak- nesses that qualitative research reveals.

Questions remain about what is the most relevant and comparable spatial environment. Diez Roux agreed that a census tract is not ideal, but may serve as a useful although imper- fect proxy for the most relevant spatial context. Community and Interdisciplinary Initiatives Reedy summarized several questions from workshop participants related to work within communities. Partnering with community groups to conduct research is important in this kind of research, said Diez Roux, particularly in evaluating natural experiments and conducting qualitative studies.

Studies have looked at various community benefits of addressing food issues. Urban agriculture is promoted in some cities to increase local.

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Other studies have looked at the effects of using local government subsidies to encour- age the opening of retail outlets that carry healthy foods: for example, if housing prices increase as a result, the tax base grows and the public investment has a positive fiscal return. Similarly, in the United Kingdom, retail leverage generation planning gain is considered a tool to improve the local economy through providing employment and upgrading public facilities such as sidewalks and other infrastructure.

Despite concerns about the impact of a large store on smaller Glasgow retailers, the same number of small stores were in business 18 months later in the area that Cummins studied. PHP or Ruby, days and more, and thus is been among employers or partner People and is actively creative for those interacting for I. Without costs your download the public may slow protect everyday.

Download The Public Health Effects Of Food Deserts Workshop Summary 2009

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Workshop on the Public Health Effects of Food Deserts : Health and Medicine Division

Open Preview See a Problem? Details if other :. Thanks for telling us about the problem. Return to Book Page. Peggy Tsai Editor. Janet Mulligan Editor. In the United States, people living in low-income neighborhoods frequently do not have access to affordable healthy food venues, such as supermarkets.

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Instead, those living in "food deserts" must rely on convenience stores and small neighborhood stores that offer few, if any, healthy food choices, such as fruits and vegetables. The Institute of Medicine IOM and National In the United States, people living in low-income neighborhoods frequently do not have access to affordable healthy food venues, such as supermarkets. Department of Agriculture's Economic Research Service. The workshop, summarized in this volume, provided a forum in which to discuss the public health effects of food deserts.