abstract: Background: Stores authorized by the Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been shown to improve the community food environments of lower-income areas by stocking healthy food items in accordance with the program’s food package guidelines. Whether greater access to WIC-authorized stores is associated with improvements in diet among children from WIC and non-WIC households is not well understood. Methods: Secondary analysis of cross-sectional data collected in 2009-2010 and 2014 for the New Jersey Child Health Study (NJCHS). Surveys from 2,211 urban households with 3-18-year-old children. Counts of WIC stores near children’s homes determined through geo-coding of store and household addresses using roadway network distances of 0.5 and 1.0 mile. Children’s consumption was categorized in age-specific deciles of quantities consumed for each food category examined: fruits, vegetables, sugar from sugar-sweetened beverages, total added sugars. Associations between counts of WIC stores and children’s consumption were examined, first for the full sample, then by household WIC participation. Results: No significant associations between WIC store counts near children’s homes and consumption were observed in the overall sample at any distance. A small, but significant inverse relationship was seen in total added sugar consumption among children residing in WIC households only, with each additional WIC store within a 0.5 mile roadway network associated with a 0.24-decile lower consumption (p = .047). In age-stratified exploratory analysis, higher vegetable (p = .024) and combined fruits and vegetables (p = .006) consumption were seen in the under 5 age group only. Conclusions: Living close to more WIC-authorized stores was associated with healthier consumption, but only for a subset of children and only for a few food categories examined. Lack of a consistent pattern of healthier consumption among children suggests that access to WIC stores may have a positive, albeit limited impact on children’s diets. / Dissertation/Thesis / Masters Thesis Nutrition 2021

Increasing the number of farmers’ markets and implementing Electronic Benefit Transfer (EBT) systems for the Supplemental Nutrition Assistance Program (SNAP) at more farmers’ markets have been suggested as strategies to overcome food access issues, but little is known about their availability in the rural South. This study examines differences in availability of farmers’ markets and SNAP/EBT at markets by county-level rural/urban classification, percentage poverty, percentage racial/ethnic minority, and percentage obese residents in North Carolina counties. Data were collected using a cross-sectional survey. Though results related to rurality and economic status are mixed, regression analyses indicate that the percentage of African American residents is inversely associated with the number of markets and number of markets that accept EBT. Results suggest that access to farmers’ markets varies in North Carolina, and additional research is needed to determine whether this impacts obesity.

No description available.

No description available.

This project takes a look at the impacts of our built environment on obesity in children living in racial and ethnic communities in relation to city planning. The results of this project results in a comprehensive report to provide an in-depth look into understanding the important relationships between children’s health and the built environment and understanding the best practices and recommendations for improving health in Guadalupe. Located in the Santa Barbara County, the City of Guadalupe is mainly an agricultural town with over 85 percent of its residents who are of Hispanic Origin. With almost half of its Latino population under 17 years of age, Guadalupe is an ideal location to examine the number of complex social, economic, and environmental matters that can contribute to higher overweight and obesity rates among Latino children. The food environments and physical environments were examined using Community Assessments and outreach efforts with school children and the residents of Guadalupe. Current professional and academic literature on childhood obesity, the built environments, food environments, and schools were reviewed for this project. Responses from a multitude of methods were analyzed and compared to create a list of recommendations for improving children’s health in Guadalupe. These methods included Community of Excellence (CX3) field surveys, walkability surveys, and a Photovoice project with school children.

No description available.

Doctor of Philosophy / Department of Human Nutrition / David A. Dzewaltowski / The prevalence of obesity within the U.S. has risen dramatically in the past thirty years. Recent changes in food and physical activity environments may contribute to increased obesity prevalence, suggesting that disparities in these environments may be linked to the increased risk of obesity observed in low-income, and racial/ethnic minority women. This dissertation characterizes the local food environment experienced by low-income women who participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Kansas, evaluates whether characteristics of the local food environment contribute to obesity risk, and examines how these relationships vary across the urban-rural continuum. Chapter One reviews the relevant literature examining the association between obesity and local food environments, and identifies three testable hypotheses that serve as the framework for later chapters. Chapter Two characterizes the local food environment and examines geographic, racial, ethnic, and socioeconomic disparities in the availability of small grocery stores and supermarkets. Chapter Three examines the association between store availability and obesity risk at an individual level among participants in the WIC Program, while Chapter Four utilizes multi-level modeling to examine the relationships between tract deprivation, tract store availability and body mass index (BMI). Significant geographic disparities were observed in the availability of small grocery and supermarkets. Racial and ethnic disparities observed within tracts were not observed when examining store availability in a 1-mile radius around the residence of WIC mothers. The majority of women participating in the WIC program resided within a 1-mile radius of a small grocery store, and micropolitan and metropolitan WIC mothers had a multiplicity of food stores available within a 3-mile radius of residence. Food store availability was associated with increased obesity risk only in micropolitan areas. The availability of food stores did not mediate the association between tract deprivation and BMI, which varied across the urban-rural continuum. Overall, these results suggest that the relationship between local food environments and eating behaviors is complex, that limited store availability does not contribute to increased obesity risk in vulnerable populations, and that the association between local food environments and obesity risk varies across the urban-rural continuum.

Research has shown that the suburbanization of supermarkets has created `food deserts', defined as areas where socially disadvantaged individuals lack access to nutritious food outlets. Additionally, the growing presence of fast-food restaurants has created `food swamps', or areas where socially disadvantaged individuals encounter an overabundance of unhealthy food outlets. While previous studies have analyzed either `food deserts' or `food swamps' using conventional statistical techniques, a more comprehensive approach that includes samples of both healthy and unhealthy entities and considers the variety of available food options is necessary to improve our understanding of the local food environment and related disparities. This thesis addresses several limitations associated with previous geographic research on the built food environment through a case study that examines socio-demographic inequities in access to supermarkets and fast-food restaurants in Hillsborough County, Florida-- an urban area that has been severely affected by the obesity and food crisis plaguing the nation. An important goal is to examine the spatial and statistical association between socioeconomic deprivation and potential access to all supermarkets, healthiest supermarkets, all fast-food restaurants, and unhealthiest fast-food restaurants, respectively. This study utilizes precise locations of food retailers based on government codes, U.S. Census data, GIS-based network analysis, and a combination of conventional statistical measures and exploratory spatial analytical techniques. Specifically, local indicators of spatial association (LISA) are used to visualize how the relationship between socioeconomic deprivation and accessibility to food outlets varies geographically within the county, and identify the locations of food deserts and food swamps based on the statistical significance of spatial correlations. Conventional statistical measures indicate that socioeconomically deprived neighborhoods are significantly less accessible to the healthiest supermarkets and more accessible to all fast-food restaurants. LISA significance maps reveal that food deserts are located in suburban and rural regions, food swamps are located closer to the urban center, and both are found along major highways in Hillsborough County. Logistic regression results show that race and ethnicity play an undeniably pervasive role in explaining the presence and location of both food deserts and food swamps. This research demonstrates the need to explore local variations in statistical relationships relevant to the study of the built food environment, and highlights the need to consider both healthy and unhealthy food outlets in geographic research and public policy initiatives that aim to address the obesity crisis.

abstract: Food deserts are the collection of deprived food environments and limit local residents from accessing healthy and affordable food. This dissertation research in San Lorenzo, Paraguay tests if the assumptions about food deserts in the Global North are also relevant to the Global South. In the Global South, the recent growth of supermarkets is transforming local food environments and may worsen residential food access, such as through emerging more food deserts globally. This dissertation research blends the tools, theories, and frameworks from clinical nutrition, public health, and anthropology to identify the form and impact of food deserts in the market city of San Lorenzo, Paraguay. The downtown food retail district and the neighborhood food environment in San Lorenzo were mapped to assess what stores and markets are used by residents. The food stores include a variety of formal (supermarkets) and informal (local corner stores and market vendors) market sources. Food stores were characterized using an adapted version of the Nutrition Environment Measures Survey for Stores (NEMS-S) to measure store food availability, affordability, and quality. A major goal in this dissertation was to identify how and why residents select a type of food store source over another using various ethnographic interviewing techniques. Residential store selection was linked to the NEMS-S measures to establish a connection between the objective quality of the local food environment, residential behaviors in the local food environment, and nutritional health status. Using a sample of 68 households in one neighborhood, modeling suggested the quality of local food environment does effect weight (measure as body mass index), especially for those who have lived longer in poorer food environments. More generally, I find that San Lorenzo is a city-wide food desert, suggesting that research needs to establish more nuanced categories of poor food environments to address how food environments emerge health concerns in the Global South. / Dissertation/Thesis / Ph.D. Social Science and Health 2012

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-05-11T13:35:02Z No. of bitstreams: 1 mariaalvimleite.pdf: 4859167 bytes, checksum: 142fc39fa9cb7da06ba1766afd1170c0 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-05-17T15:10:58Z (GMT) No. of bitstreams: 1 mariaalvimleite.pdf: 4859167 bytes, checksum: 142fc39fa9cb7da06ba1766afd1170c0 (MD5) / Made available in DSpace on 2017-05-17T15:10:58Z (GMT). No. of bitstreams: 1 mariaalvimleite.pdf: 4859167 bytes, checksum: 142fc39fa9cb7da06ba1766afd1170c0 (MD5) Previous issue date: 2017-02-21 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Discussões recentes sobre a epidemia da obesidade têm considerado o papel do ambiente no aumento do consumo de alimentos não saudáveis e na diminuição dos gastos energéticos. A distribuição espacial dos estabelecimentos de venda de alimentos e fatores socioeconômicos ambientais influenciam no ganho de peso. A disposição dos comércios de alimentos ao redor das escolas influencia no ganho de peso de crianças e adolescentes. O estudo teve como objetivo examinar espacialmente o ambiente alimentar e as características socioeconômicas nas Regiões Urbanas (RU) e no entorno das escolas de Juiz de Fora, Minas Gerais. Foi feito um estudo ecológico que investigou o ambiente alimentar do município, considerando regiões de diferentes níveis de privação social. Mapas temáticos e clusters de bairros foram desenvolvidos. Foram estudados buffers de 500 m ao redor das escolas e uma auditoria em supermercados foi realizada. As funções K uni e bivariada foram utilizadas para testar a significância das aglomerações de estabelecimentos. Em relação à privação social, 25 bairros (30,86%) apresentaram alta ou muito alta vulnerabilidade. Estabelecimentos alimentares não saudáveis apresentaram maiores frequências (52,73%) em relação às demais categorias. O centro do município apresentou maiores aglomerações de estabelecimentos. Regiões de maior vulnerabilidade se assemelharam a desertos alimentares. Notou-se maior estímulo à compra e ao consumo de alimentos saudáveis por supermercados localizados em regiões de menor privação social. Buffers ao redor das escolas revelaram padrão de baixas densidades de todos estabelecimentos em regiões de maior vulnerabilidade. Maiores densidades de estabelecimentos não saudáveis em relação aos demais foram encontradas ao redor de todas as escolas. A função K bivariada demonstrou o potencial das escolas em atraírem a instalação de comércios de alimentos. A baixa qualidade do ambiente alimentar ao redor das escolas indica uma urgência de regulamentação. Iniquidades ambientais reforçam a necessidade da implantação de políticas que promovam um ambiente alimentar saudável por todo o espaço urbano das cidades. / Recent approaches to the obesity epidemic have considered the role of the environment in increasing consumption of unhealthy foods and reducing physical activity. The aim of this study has been to examine how the distribution of food stores and other environmental and socioeconomic factors may affect obesogenicity, with special attention to the distribution of food traders around schools. The study examined the food environment and socioeconomic characteristics in the urban regions and the areas surrounding schools in Juiz de Fora, Minas Gerais, Brazil. An ecological study was used to investigate the city’s food environment. Thematic maps and neighborhood clusters were developed. An audit of supermarkets and hypermarkets mas made. 500 meters surrounding schools areas buffers were examined. Univariate and bivariate K functions were used to evaluate the food stores’ distribution. In 25 (30.86%) socio-economically deprived neighborhoods unhealthy establishments were much more common. The centre of the city was most concentrated in all types of establishment, whereas the most deprived areas resembled food deserts. There was more opportunity to buy and consume healthy foods in supermarkets and hypermarkets located in regions of higher socio-economic status. Examination of the areas around schools showed a pattern of low densities of all types of food establishments in regions of low socio-economic status and high densities in regions of high socio-economic status, but, higher densities of establishments selling unhealthy food were found around all schools. This indicates that schools attract food stores in their surroundings. The low quality of food environments around schools in Juiz de Fora shows an urgent need to regulate these spaces, to enable and encourage stores selling healthy food. Socio-economic and environmental inequities reinforce the need to implement public policies that promote a healthy food environment throughout the city and its urban areas.