Understanding differences in the local food environment across countries: A case study in Madrid (Spain) and Baltimore (USA).
Places where we buy food influence dietary patterns, making local food environments a good example of a mass influence on population diets. Cross-cultural studies, using reliable methods, may help understanding the relationship between food environments and diet-related health outcomes. We aimed to understand cross-national differences in the local food environment between Madrid and Baltimore by comparing an average neighborhood in each city in terms of food store types, healthy food availability, and residents' pedestrian access. During 2012-2013, we assessed one neighborhood (~15,000 residents) in each city selecting median areas in terms of socio-demographic characteristics (segregation, education, aging, and population density). We collected on-field data on (a) number and types of all food stores, (b) overall healthy food availability and (c) specific availability of fruits & vegetables. Throughout a street network analysis (200m, 400m and 800m) of food stores with high healthy food availability, we estimated residents' pedestrian accessibility. We found 40 stores in Madrid and 14 in Baltimore. Small food stores carrying fresh foods in Madrid contrasted with the high presence of corner and chain convenience stores in Baltimore. In Madrid, 77% of the residents lived within less than 200m from a food store with high healthy food availability. In contrast, 95% of Baltimore's residents lived further than 400m from these stores. Our results may help promoting interventions from local city agencies to allocate resources to existing small-sized food stores, and to improve walkable urban environments. These actions may influence food choices, especially for those residents lacking access to private vehicles.
Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain.
Julia
J
Díez
Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Usama
U
Bilal
Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain.
Alba
A
Cebrecos
Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Amanda
A
Buczynski
Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Robert S
RS
Lawrence
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Thomas
T
Glass
Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain.
Francisco
F
Escobar
Global Obesity Prevention Center at Johns Hopkins, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Joel
J
Gittelsohn
Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States. Electronic address: manuel.franco@uah.es.
Manuel
M
Franco
D015142:Baltimore; D003132:Commerce; D003431:Cross-Cultural Comparison; D004032:Diet; D004777:Environment; D005523:Food Supply; D005638:Fruit; D006293:Health Promotion / Q000379:methods; D006801:Humans; D019982:Organizational Case Studies; D011156:Population Density; D011203:Poverty; D012111:Residence Characteristics; D013030:Spain; D014505:Urban Population; D014675:Vegetables
Food environment; GIS; Healthy food availability; International comparison; Obesity; Urban environment