Obesogenic retail food environments around more and less socioeconomically deprived schools in New Zealand: a national study

Transcription

1 Obesogenic retail food environments around more and less socioeconomically deprived schools in New Zealand: a national study Dr. Stefanie Vandevijvere WPHNA Conference, Capetown, 01/09/2016

2 POPULATIONS OUTCOMES FOOD ENVIRONMENTS IMPACTS ORGANISATIONS PROCESSES INFORMAS monitoring framework Public sector policies and actions Private sector policies and actions How much progress have (international, national, state and local) governments made towards good practice in improving food environments and implementing obesity/ncds prevention policies and actions? (University of Auckland) How are private sector organisations affecting food environments and influencing obesity/ncds prevention efforts? (Deakin University & City University) Food composition Food labelling Food marketing Food provision Food retail Food prices Food trade & investment What is the nutrient composition (particularly fat, saturated fat, sugar and salt content) of common packaged foods? (The George Institute) What labelling (including nutrition info & claims) is present on packaged foods and on menus in quick-service restaurants? (University of Oxford) What is the level of exposure (of different population groups) to the marketing of unhealthy foods and beverages? (University of Wollongong) What foods are provided in different settings (eg. schools, hospitals, workplaces)? (University of Toronto) What foods are available in different settings (eg. supermarkets, communities)? (University of Auckland) What is the relative price and affordability of current vs healthy diets, meals & foods? (Queensland University of Technology & University of Auckland) What are the risks and benefits to healthy food environments and diets from trade agreements? (Australian National University) Population diet Physiological & metabolic risk factors Health outcomes What is the quality and quantity of (different population s) diet? (University of Sao Paulo) What are obesity and other risk factor burdens? (WHO) What are NCD morbidity and mortality burdens? (WHO)

3 INFORMAS Food retail module In-store measures (main focus currently on supermarkets): Junk food free check-outs Junk food free end-of-aisle ends Junk food free promotions on windows & entrance & in flyer Cumulative shelf length for healthy versus unhealthy foods Simple indicator developed and validated for supermarkets: fresh and frozen fruit and vegetables versus soft drinks, crisps and snacks, sweet biscuits and confectionary Measures for fast food and takeaway outlets being tested Testing and validation in LMIC needed!!

4 INFORMAS Food retail module Community measures (main focus on school food zones): Number of convenience stores per 100 square meters within a zone of 250m/500m/800m around schools Number of fast food outlets per 100 square meters within a zone of 250m/500m/800m around schools Number of areas identified as potential food swamps Number of areas identified as potential food deserts Definition of school food zone: Common walking distance(s) Radial, Network and/or Polygon buffers Correcting for differences in area size under investigation Definition of types of outlets and availability of outlet lists Testing and validation for LMIC needed!!

5 INFORMAS Equity indicators: examples FOOD-EPI Reducing diet-related inequalities is a government priority Progress towards reducing diet-related health inequalities & societal & economic determinants of health are monitored FOOD PROVISION Percentage of foods in schools meeting nutrition standards in the most versus the least deprived schools FOOD RETAIL Density of fast food outlets/convenience stores in a zone of 250m/500m/800m around the most versus the least deprived schools Ratio of shelf space devoted to healthy versus unhealthy foods in supermarkets in the most versus the least deprived areas Percentage of junk-food free check-outs and end-of-aisle ends in FOOD PRICES FOOD PROMOTION supermarkets in the most versus the least deprived areas Cost and affordability of healthy versus current, less healthy diets (as derived from nutrition survey data) for different population groups Percentage of outdoor advertisements for unhealthy foods in a zone of 250m/500m/800m around the most versus the least deprived schools

6 Methods national study NZ Total of 2531 NZ schools (Ed. counts 2014) Schools located off shore, special schools, teen parent units, and correspondence schools excluded (n=58) Measure of deprivation used: School Deciles 1-10 Rural/urban schools Food outlet lists sourced from the 66 NZ City and District Councils In total about outlets

7 Methods national study NZ Food outlet classification tool tested and validated 14 food outlet categories Only convenience stores and fast food/takeaway outlets included in this study Convenience stores included bakeries, dairies, petrol stations, confectionary outlets

8 Methods national study NZ Land parcel information (schools) & road centerlines network from Land Information New Zealand For 36 schools no land parcel could be assigned and they were excluded 3 common walking distances: 250m 500m 800m 3 different buffer zones used: radial buffers, network buffers, polygon buffers Geocoding and (spatial) validation performed

9 Results: Retail environments around NZ schools Median road distance to the closest convenience store from urban New Zealand schools (n=1777) was 535 ( ) m and to the closest fast food outlet or takeaway 634 ( ) m and was significantly higher for the least compared to the most deprived schools. On average 2.4 unhealthy outlets per km 2 with a maximum of 85 per km 2 (polygon buffers) Vandevijvere et al, AJPM 2016

10 Results: Community neighbourhoods NZ Mean density (SE) of different types of food outlets per people in census area neighbourhoods stratified by NZDep2013 NZDep2013 Convenience stores Fast-food/takeaways (n=4087) (n=4316) Quintile Mean SE Mean SE Least Deprived Quintile Quintile Quintile Most Deprived

11 Results: Food swamps in NZ 21 areas of differing size and shape identified as food swamps

12 Strengths and limitations Strengths Nation-wide study Spatial validation Data to be used for citizen engagement project and by Councils/District Health Boards update of food outlet lists Limitations Type and location only validated for 1% of outlets Individual children s journeys from home to school and back not considered Spatial access only. Thoughts of communities/parents/children on the issue lacking

13 Media uptake It doesn t matter how much you educate kids, they will give in and buy junk food

14 Policy and Action New Zealand Local Government Act (2002) does not include provisions for Councils to enact zoning policies for this purpose A revision of the Resource Management Act (1991) to include provisions to allow for limiting the establishment of new outlets in school neighbourhoods Councils Health Promotors and communities to work with food retailers Public pressure you can smell it from the classrooms and see it from the windows

15 Policy and Action International + Green school food zones South Korea

16 Conclusions Higher access to unhealthy foods around more than less deprived urban schools in New Zealand Councils currently do not have sufficient power to regulate One Council exploring how to regulate this matter in the future Action around the world very limited in this area Potential to involve communities (increase public pressure) and create snow ball effect Improving in-store environments important as well

17 Contact Dr Stefanie Vandevijvere #INFORMAS