4.4 Article

Small Improvements in an Urban Food Environment Resulted in No Changes in Diet Among Residents

Journal

JOURNAL OF COMMUNITY HEALTH
Volume 46, Issue 1, Pages 1-12

Publisher

SPRINGER
DOI: 10.1007/s10900-020-00805-z

Keywords

Food environment; Natural experiment; Diet; Food desert

Funding

  1. National Institute of Diabetes and Digestive and Kidney Diseases [R01DK108184]
  2. Centers for Disease Control and Prevention [1U48DP005030]
  3. National Center for Advancing Translational Sciences [UL1TR002548]

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The study found that the low-dose implementation of a food hub led to small improvements in the availability of healthy foods, but did not significantly impact residents' dietary patterns. Implementing a food hub in low-income neighborhoods with low access to healthy food retailers presents challenges, including the full implementation of components and reaching a broader impact.
Living in a low-income neighborhood with low access to healthy food retailers is associated with increased risk for chronic disease. The U.S. Healthy Food Financing Initiative (HFFI) provides resources to support the development of infrastructure to improve neighborhood food environments. This natural experiment examined a HFFI funded food hub that was designed to be implemented by a community development corporation in an urban neighborhood in Cleveland, Ohio. It was intended to increase access to affordable, local, and healthy foods; establish programs to increase social connections and support for healthy eating; and create job opportunities for residents. We used a quasi-experimental, longitudinal design to externally evaluate food hub implementation and its impact on changes to the built and social environment and dietary patterns among residents living in the intervention neighborhood (n = 179) versus those in a comparison (n = 150) neighborhood. Overall, many of the food hub components were not implemented fully, and dose and reach of the executed food hub components was low. There were statistically significant improvements in observed availability of healthy foods in the intervention neighborhood versus the comparison neighborhood. There were no changes over time in diet quality scores, total caloric intake, or fruit and vegetable intake in the intervention neighborhood. In conclusion, low dose implementation of a food hub led to small improvements in availability of healthy foods but not in dietary patterns. Findings highlight challenges to implementing a food hub in neighborhoods with low access to healthy food retailers.

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