comparing local availability and accessibility to healthy foods across countries: a case study in...

Julia Díez, Usama Bilal, Alba Cebrecos, Amanda Buczynski,

Robert Lawrence, Thomas Glass, Joel Gittelsohn, Francisco

Escobar and Manuel Franco

Comparing local availability and

accessibility to healthy foods

across countries: A case study in

Madrid (Spain) and Baltimore (US)

http://hhhproject.eu

Background

o Diet is a cardiovascular risk factor influenced

by the local food environment

o Local food environments are a good example

of a mass influence on population diets

o Inconsistencies around social gradients in

contextual healthy food availability exist

between US and Europe-based studies

http://hhhproject.eu

Conceptual framework

Franco M., Bilal. U.,

Diez J (2016). Food

Environment. The

Encyclopedia of Food

and Health. B.

Caballero, Finglas, P.,

and Toldrá, F. . Oxford:

Academic Press,

Oxford: Academic

Press. 3: 22-26.

http://hhhproject.eu

Aim

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,

availability, and accessibility to healthy foods.

http://hhhproject.eu

Methods

Study context

We selected one neighborhood (~15000 pop.) in

each city selecting median areas in terms of:

• Educational level

• Aging

• Segregation

• Urban form

http://hhhproject.eu

Methods

Variables

• Availability

• Field observations using NEMS-s audit tool

• “Healthy Food Availability Index” (0-28.5)

• “Fruit&Vegetables Availability index” (0-10)

• Accessibility

• Pedestrian network analysis

• Walking distance of 200m, 400m, 800m

http://hhhproject.eu

ResultsMap of the different food stores within the study areas

http://hhhproject.eu

ResultsHealthy Food Availability Index

Madrid Baltimore

http://hhhproject.eu

Results

Fruits & Vegetables Availability Index

Madrid Baltimore

http://hhhproject.eu

Access by walking to high healthy food stores

Results

http://hhhproject.eu

Public market in Madrid

Las Ventas Madrid

http://hhhproject.eu

Farmer Market in Baltimore

Waverly (Baltimore)

http://hhhproject.eu

Conclusions

Our results may help promoting intervention

from local city agencies to allocate resources

to improve existing small-sized food stores

and public markets, and to improve walkable

urban environments.