Wanted: Food Environment Measurement Tools

Above: Farmer's Market, Hawaii. Credit: Brock Roseberry

The food environment is a major influence on what we eat, and what we eat directly influences our nutrition, health, and well-being. However, despite these recognized links, there is a shortcoming on how we measure the food environment.
 

To address this shortcoming and to develop a community of practice around food environment research, a workshop – “Building a Food Environment Community of Practice” - recently took place at the University of Hawa’ii at Manoa. As a starting point, discussion at the workshop defined the food environment as the types of food available, affordable, convenient, and desirable in a given place.1 That is, the external influences on an individual’s food choice rather than personal preferences and individual resources, such as income and time. Whilst defining and understanding the food environment is one thing, measuring it is a next step.

Different approaches to measuring food environments

Over 500 research tools exist for measuring the food environment that use geographic analysis and geospatial data. Geographic analysis measures availability, accessibility and convenience of foods in a food environment, primarily through distance and density based metrics. The workshop presented new tools that are being pilot tested to measure additional aspects of the food environment in diverse contexts globally.
 
The workshop keynote, led by Dr. Anna Herforth, highlighted that it is possible to scale up promising measurement tools internationally. The IANDA (Indicators of Affordability of Nutritious Diets in Africa) project – funded through UK Aid’s IMMANA programme - is collaborating with government agencies in Ghana and Tanzania to collect food price data for nutritious foods that are missing in existing food price monitoring systems. In so doing, it transforms an existing system into a powerful source of information about food environments, by monitoring the availability and affordability of a wide range of foods.
 
Further presenters emphasized the need for tools that are cross-culturally valid and reliable. Workshop presentations showed that the scales of some metrics could lead to vastly different conclusions in different places. For example, one presentation concluded that distance to grocery stores had little impact on food acquisition and quality. This study was carried out on the Island of Oahu where the greatest distance to a store is approximately two miles. In contrast, another presentation showed that distance to stores significantly impacts food access and quality on American Indian Reservations of Montana, where distance to the nearest grocery store with fresh food can be 20 to 60 miles. Those distances, or analogous travel times, are similar to many rural locations in low-income countries. Findings emphasize that scale of measurement is important and that common metrics with common scales are helpful to compare research across contexts2,3.
 
While most food environment measures are objective, workshop discussion highlighted the value of subjective assessment. Previous research has shown that people’s perceptions of availability, affordability, and convenience of food items can be more important, and even more real to the individual, than objective measures. This can be particularly important for indigenous, displaced or marginalized communities, where imperfect information and social barriers can affect food access unpredictably. The Food and Health Lab at Montana State University presented two subjective consumer measures, including a sensory analysis of fruit and vegetable desirability and household perceptions of the food environment.
 

Rapid food environment measurement: demonstration of simple tools

While comprehensively measuring the food environment can be daunting, the workshop highlighted that valuable data can be gathered relatively simply, cost-effectively, and rapidly. The Food and Health Lab group took advantage of the unique food environment of Hawai’i to carry out food environment research on the spot. Dr. Selena Ahmed and Dr. Carmen Byker Shanks applied their validated Produce Color Diversity Tool to rapidly assess the diversity of fruits and vegetables in markets across a rural to urban continuum. This food environment tool has been pilot tested in Yunnan, China and Mexico, and is currently being submitted for publication for use by other researchers.
Above: A collage of photos taken in the Hawaii food environment.
Credit: Carmen Byker Shanks
 

Key points and priorities highlighted through the workshop

  1. Measurement is necessary to understand and to manage food environments to support healthy food choices.
  2. Scale up use of relatively simple measures of food availability and prices in food markets and use them for monitoring within and across countries.
  3. Because the food environment is a multifaceted concept, multiple tools that complement each other are needed to comprehensively capture it. Both objective measures and subjective measures are needed. In some contexts, wild and cultivated food environments play a notable role in addition to the built environment and should be taken into account in food environment research.
  4. As the concept of food environments is increasingly applied globally, metrics are needed with common scales and interpretability across diverse contexts.
 

By Anna Herforth1, Selena Ahmed2, and Carmen Byker Shanks2

1 Columbia University
2 The Food and Health Lab at Montana State University
 
Anna Herforth is a member of the ANH Academy Food Environments Working Group (FEWG). For more information about their ongoing work, visit the FEWG page
 
This blog follows the workshop “Building a Food Environment Community of Practice”, held Nov 16-17 at the University of Hawa’ii at Manoa. Further information can be found here: http://www.montana.edu/food-health-lab/workshops/
 
The Building a Food Environment Community of Practice workshop was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number P20GM103474. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health
 

References

  1. Byker Shanks, C.; Ahmed, S.; Smith, T.; Houghtaling, B.; Jenkins, M.; Margetts, M.; Schultz, D.; Stephen, L. 2015. Quality of Fruits and Vegetables using the Nutrition Environment Measurement Survey (NEMS) is Lower in More Rural Counties of Montana. Preventing Chronic Disease 12:150158
  2. Byker Shanks, C.; Jilcott Pitts, S.; Gustafson, A. 2015. Development and Validation of a Farmers’ Market Audit Tool in Rural and Urban Communities. Health Promotion Practice. 16:85

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