Measuring and mapping disparities in access to fresh fruits and vegetables in Montréal.

OBJECTIVE This study was conducted to evaluate disparities in access to healthy food in Montreal, focusing on the availability of fresh fruits and vegetables (F/V) as an indicator. METHOD F/V selling area was measured in all food retail stores and public markets offering more than 75 square feet of fresh fruits and vegetables. An accessibility index was elaborated, taking into account motorization rates and the total surface of these fresh foods for sale within an easily accessible zone. The extent of that zone was determined differently for motorized (3 km) and non-motorized (500 m) consumers. Measures were calculated and georeferenced at the level of "Dissemination Areas" according to the 2001 Census. RESULTS In general, access to healthy foods is quite good for consumers who shop by car. But 40% of the population have poor access to fruits and vegetables within a walkable distance from home. No relationship is observed between median income in dissemination areas and food supply. CONCLUSION Improved access to healthy food by non-motorized consumers is needed in many areas of Montreal. Implications of differential access to fresh fruits and vegetables for health and environmental sustainability are discussed.

[1]  M. Nelson,et al.  Socioeconomic determinants of health: The contribution of nutrition to inequalities in health , 1997 .

[2]  Steve Wing,et al.  The contextual effect of the local food environment on residents' diets: the atherosclerosis risk in communities study. , 2002, American journal of public health.

[3]  Claudio E Pérez,et al.  Fruit and vegetable consumption. , 2002, Health reports.

[4]  E. Rimm,et al.  Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. , 1996, JAMA.

[5]  C. Strugnell,et al.  An investigation into the availability and economic accessibility of food items in rural and urban areas of Northern Ireland , 2002 .

[6]  Andrew Fisher,et al.  Homeward Bound: Food-Related Transportation Strategies in Low Income and Transit Dependent Communities , 1996 .

[7]  N. Wrigley,et al.  Assessing the Impact of Improved Retail Access on Diet in a 'Food Desert': A Preliminary Report , 2002 .

[8]  Kameshwari Pothukuchi,et al.  Placing the food system on the urban agenda: The role of municipal institutions in food systems planning , 1999 .

[9]  A. Anderson,et al.  Scotland's health--a more difficult challenge for some? The price and availability of healthy foods in socially contrasting localities in the west of Scotland. , 1993, Health bulletin.

[10]  A. D. Diez Roux,et al.  Neighborhood characteristics associated with the location of food stores and food service places. , 2002, American journal of preventive medicine.

[11]  Allen Dearry,et al.  Creating healthy communities, healthy homes, healthy people: initiating a research agenda on the built environment and public health. , 2003, American journal of public health.

[12]  An Analysis of Local Market Concentration Levels and Trends in the U.S. Grocery Retailing Industry , 1993 .

[13]  C. Guy,et al.  Deriving Indicators of Access to Food Retail Provision in British Cities: Studies of Cardiff, Leeds and Bradford , 2002 .

[14]  C. Strugnell,et al.  An investigation of the potential existence of ``food deserts'' in rural and urban areas of Northern Ireland , 2001 .

[15]  S. Cummins,et al.  A Systematic Study of an Urban Foodscape: The Price and Availability of Food in Greater Glasgow , 2002 .

[16]  H. Shaw The ecology of food deserts , 2003 .

[17]  E. Dowler,et al.  Mapping access to food in a deprived area: the development of price and availability indices , 2000, Public Health Nutrition.

[18]  A. Ericson,et al.  Maternal smoking in pregnancy: does it increase the risk of childhood cancer? , 1992, International journal of epidemiology.

[19]  Richard G. Wilkinson,et al.  Social Determinants of Health: The Solid Facts , 1998 .

[20]  T. Richards,et al.  Geographic information systems and public health: mapping the future. , 1999, Public health reports.

[21]  S. Cummins,et al.  “Food deserts”—evidence and assumption in health policy making , 2002, BMJ : British Medical Journal.

[22]  J. Potter,et al.  Vegetables, fruit, and cancer prevention: a review. , 1996, Journal of the American Dietetic Association.

[23]  Harvey G Lehtman,et al.  Working together , 1988 .

[24]  C. Mooney Cost and availability of healthy food choices in a London health district , 1990 .

[25]  P. van’t Veer,et al.  Fruits and vegetables in the prevention of cancer and cardiovascular disease† , 2000, Public Health Nutrition.

[26]  J. Powles,et al.  Fruit and vegetables, and cardiovascular disease: a review. , 1997, International journal of epidemiology.

[27]  Marion J. C. de Lepper,et al.  The benefits of the application of geographical information systems in public and environmental health. , 1991, World health statistics quarterly. Rapport trimestriel de statistiques sanitaires mondiales.

[28]  E. Eisenhauer In poor health: Supermarket redlining and urban nutrition , 2001 .

[29]  T. Moffat,et al.  Determinants of variation in food cost and availability in two socioeconomically contrasting neighbourhoods of Hamilton, Ontario, Canada. , 2007, Health & place.

[30]  N. Wrigley,et al.  Deprivation, Diet, and Food-Retail Access: Findings from the Leeds ‘Food Deserts' Study , 2003 .

[31]  S. Cummins,et al.  REVIEW environments and obesity— neighbourhood or nation? , 2006 .

[32]  A. Prevost,et al.  Seasonal consumption of salad vegetables and fresh fruit in relation to the development of cardiovascular disease and cancer , 2000, Public Health Nutrition.

[33]  J. Pearce,et al.  Neighbourhoods and health: a GIS approach to measuring community resource accessibility , 2006, Journal of Epidemiology and Community Health.

[34]  L. F. Alwitt,et al.  Retail Stores in Poor Urban Neighborhoods , 1997 .

[35]  Neil Wrigley,et al.  'Food Deserts' in British Cities: Policy Context and Research Priorities , 2002 .