Comparing local availability and accessibility to healthy foods across countries: A case study in Madrid (Spain) and Baltimore (US)

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This study compared the local availability and accessibility of healthy foods in neighborhoods in Madrid, Spain and Baltimore, US. Researchers used audits and GIS mapping to examine food store types, availability of healthy foods using indexes, and pedestrian access within 200m, 400m, and 800m of each neighborhood. The results showed Madrid had higher healthy food availability and fruit/vegetable indexes in stores, but Baltimore residents had greater access to stores within walking distance. The researchers concluded local agencies should promote interventions to improve small stores and markets and walkable environments.

Health & Medicine

Julia Díez, Usama Bilal, Alba Cebrecos, Amanda Buczynski,
Robert Lawrence, Thomas Glass, Joel Gittelsohn, Francisco
Escobar and Manuel Franco
Comparing local availability and
accessibility to healthy foods
across countries: A case study in
Madrid (Spain) and Baltimore (US)

http://hhhproject.eu
Background
o Diet is a cardiovascular risk factor influenced
by the local food environment
o Local food environments are a good example
of a mass influence on population diets
o Inconsistencies around social gradients in
contextual healthy food availability exist
between US and Europe-based studies

http://hhhproject.eu
Conceptual framework
Franco M., Bilal. U.,
Diez J (2016). Food
Environment. The
Encyclopedia of Food
and Health. B.
Caballero, Finglas, P.,
and Toldrá, F. . Oxford:
Academic Press,
Oxford: Academic
Press. 3: 22-26.

http://hhhproject.eu
Aim
 To understand cross-national differences in the
local food environment between Madrid and
Baltimore by comparing an average neighborhood
in each city in terms of food store types,
availability, and accessibility to healthy foods.

http://hhhproject.eu
Methods
Study context
We selected one neighborhood (~15000 pop.) in
each city selecting median areas in terms of:
• Educational level
• Aging
• Segregation
• Urban form

http://hhhproject.eu
Methods
Variables
• Availability
• Field observations using NEMS-s audit tool
• “Healthy Food Availability Index” (0-28.5)
• “Fruit&Vegetables Availability index” (0-10)
• Accessibility
• Pedestrian network analysis
• Walking distance of 200m, 400m, 800m

http://hhhproject.eu
Results
Map of the different food stores within the study areas

http://hhhproject.eu
Results
Healthy Food Availability Index
Madrid Baltimore

http://hhhproject.eu
Results
Fruits & Vegetables Availability Index
Madrid Baltimore

http://hhhproject.eu
Access by walking to high healthy food stores
Results

http://hhhproject.eu
Public market in Madrid
Las Ventas Madrid

http://hhhproject.eu
Farmer Market in Baltimore
Waverly (Baltimore)

http://hhhproject.eu
Conclusions
Our results may help promoting intervention
from local city agencies to allocate resources
to improve existing small-sized food stores
and public markets, and to improve walkable
urban environments.

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1. Julia Díez, Usama Bilal, Alba Cebrecos, Amanda Buczynski, Robert Lawrence, Thomas Glass, Joel Gittelsohn, Francisco Escobar and Manuel Franco Comparing local availability and accessibility to healthy foods across countries: A case study in Madrid (Spain) and Baltimore (US)

2. http://hhhproject.eu Background o Diet is a cardiovascular risk factor influenced by the local food environment o Local food environments are a good example of a mass influence on population diets o Inconsistencies around social gradients in contextual healthy food availability exist between US and Europe-based studies

3. http://hhhproject.eu Conceptual framework Franco M., Bilal. U., Diez J (2016). Food Environment. The Encyclopedia of Food and Health. B. Caballero, Finglas, P., and Toldrá, F. . Oxford: Academic Press, Oxford: Academic Press. 3: 22-26.

4. http://hhhproject.eu Aim  To understand cross-national differences in the local food environment between Madrid and Baltimore by comparing an average neighborhood in each city in terms of food store types, availability, and accessibility to healthy foods.

5. http://hhhproject.eu Methods Study context We selected one neighborhood (~15000 pop.) in each city selecting median areas in terms of: • Educational level • Aging • Segregation • Urban form

6. http://hhhproject.eu Methods Variables • Availability • Field observations using NEMS-s audit tool • “Healthy Food Availability Index” (0-28.5) • “Fruit&Vegetables Availability index” (0-10) • Accessibility • Pedestrian network analysis • Walking distance of 200m, 400m, 800m

7. http://hhhproject.eu Results Map of the different food stores within the study areas

8. http://hhhproject.eu Results Healthy Food Availability Index Madrid Baltimore

9. http://hhhproject.eu Results Fruits & Vegetables Availability Index Madrid Baltimore

10. http://hhhproject.eu Access by walking to high healthy food stores Results

11. http://hhhproject.eu Public market in Madrid Las Ventas Madrid

12. http://hhhproject.eu Farmer Market in Baltimore Waverly (Baltimore)

13. http://hhhproject.eu Conclusions Our results may help promoting intervention from local city agencies to allocate resources to improve existing small-sized food stores and public markets, and to improve walkable urban environments.

Comparing local availability and accessibility to healthy foods across countries: A case study in Madrid (Spain) and Baltimore (US)

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