Cargando…

Does exposure to the food environment differ by socioeconomic position? Comparing area-based and person-centred metrics in the Fenland Study, UK

BACKGROUND: Retail food environments (foodscapes) are a recognised determinant of eating behaviours and may contribute to inequalities in diet. However, findings from studies measuring socioeconomic inequality in the foodscape have been mixed, which may be due to methodological differences. The aim...

Descripción completa

Detalles Bibliográficos
Autores principales: Maguire, Eva R., Burgoine, Thomas, Penney, Tarra L., Forouhi, Nita G., Monsivais, Pablo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586029/
https://www.ncbi.nlm.nih.gov/pubmed/28877706
http://dx.doi.org/10.1186/s12942-017-0106-8
_version_ 1783261741343309824
author Maguire, Eva R.
Burgoine, Thomas
Penney, Tarra L.
Forouhi, Nita G.
Monsivais, Pablo
author_facet Maguire, Eva R.
Burgoine, Thomas
Penney, Tarra L.
Forouhi, Nita G.
Monsivais, Pablo
author_sort Maguire, Eva R.
collection PubMed
description BACKGROUND: Retail food environments (foodscapes) are a recognised determinant of eating behaviours and may contribute to inequalities in diet. However, findings from studies measuring socioeconomic inequality in the foodscape have been mixed, which may be due to methodological differences. The aim of this cross-sectional study was to compare exposure to the foodscape by socioeconomic position using different measures, to test whether the presence, direction or amplitude of differences was sensitive to the choice of foodscape metric or socioeconomic indicator. METHODS: A sample of 10,429 adults aged 30–64 years with valid home address data were obtained from the Fenland Study, UK. Of this sample, 7270 participants also had valid work location data. The sample was linked to data on food outlets obtained from local government records. Foodscape metrics included count, density and proximity of takeaway outlets and supermarkets, and the percentage of takeaway outlets relative to all food outlets. Exposure metrics were area-based (lower super output areas), and person-centred (proximity to nearest; Euclidean and Network buffers at 800 m, 1 km, and 1 mile). Person-centred buffers were constructed using home and work locations. Socioeconomic status was measured at the area-level (2010 Index of Multiple Deprivation) and the individual-level (highest educational attainment; equivalised household income). Participants were classified into socioeconomic groups and average exposures estimated. Results were analysed using the statistical and percent differences between the highest and lowest socioeconomic groups. RESULTS: In area-based measures, the most deprived areas contained higher takeaway outlet densities (p < 0.001). However, in person-centred metrics lower socioeconomic status was associated with lower exposure to takeaway outlets and supermarkets (all home-based exposures p < 0.001) and socioeconomic differences were greatest at the smallest buffer sizes. Socioeconomic differences in exposure was similar for home and combined home and work measures. Measuring takeaway exposure as a percentage of all outlets reversed the socioeconomic differences; the lowest socioeconomic groups had a higher percentage of takeaway outlets compared to the middle and highest groups (p < 0.001). CONCLUSIONS: We compared approaches to measuring socioeconomic variation in the foodscape and found that the association was sensitive to the metric used. In particular, the direction of association varied between area- and person-centred measures and between absolute and relative outlet measures. Studies need to consider the most appropriate measure for the research question, and may need to consider multiple measures as a single measure may be context dependent.
format Online
Article
Text
id pubmed-5586029
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-55860292017-09-06 Does exposure to the food environment differ by socioeconomic position? Comparing area-based and person-centred metrics in the Fenland Study, UK Maguire, Eva R. Burgoine, Thomas Penney, Tarra L. Forouhi, Nita G. Monsivais, Pablo Int J Health Geogr Research BACKGROUND: Retail food environments (foodscapes) are a recognised determinant of eating behaviours and may contribute to inequalities in diet. However, findings from studies measuring socioeconomic inequality in the foodscape have been mixed, which may be due to methodological differences. The aim of this cross-sectional study was to compare exposure to the foodscape by socioeconomic position using different measures, to test whether the presence, direction or amplitude of differences was sensitive to the choice of foodscape metric or socioeconomic indicator. METHODS: A sample of 10,429 adults aged 30–64 years with valid home address data were obtained from the Fenland Study, UK. Of this sample, 7270 participants also had valid work location data. The sample was linked to data on food outlets obtained from local government records. Foodscape metrics included count, density and proximity of takeaway outlets and supermarkets, and the percentage of takeaway outlets relative to all food outlets. Exposure metrics were area-based (lower super output areas), and person-centred (proximity to nearest; Euclidean and Network buffers at 800 m, 1 km, and 1 mile). Person-centred buffers were constructed using home and work locations. Socioeconomic status was measured at the area-level (2010 Index of Multiple Deprivation) and the individual-level (highest educational attainment; equivalised household income). Participants were classified into socioeconomic groups and average exposures estimated. Results were analysed using the statistical and percent differences between the highest and lowest socioeconomic groups. RESULTS: In area-based measures, the most deprived areas contained higher takeaway outlet densities (p < 0.001). However, in person-centred metrics lower socioeconomic status was associated with lower exposure to takeaway outlets and supermarkets (all home-based exposures p < 0.001) and socioeconomic differences were greatest at the smallest buffer sizes. Socioeconomic differences in exposure was similar for home and combined home and work measures. Measuring takeaway exposure as a percentage of all outlets reversed the socioeconomic differences; the lowest socioeconomic groups had a higher percentage of takeaway outlets compared to the middle and highest groups (p < 0.001). CONCLUSIONS: We compared approaches to measuring socioeconomic variation in the foodscape and found that the association was sensitive to the metric used. In particular, the direction of association varied between area- and person-centred measures and between absolute and relative outlet measures. Studies need to consider the most appropriate measure for the research question, and may need to consider multiple measures as a single measure may be context dependent. BioMed Central 2017-09-06 /pmc/articles/PMC5586029/ /pubmed/28877706 http://dx.doi.org/10.1186/s12942-017-0106-8 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Maguire, Eva R.
Burgoine, Thomas
Penney, Tarra L.
Forouhi, Nita G.
Monsivais, Pablo
Does exposure to the food environment differ by socioeconomic position? Comparing area-based and person-centred metrics in the Fenland Study, UK
title Does exposure to the food environment differ by socioeconomic position? Comparing area-based and person-centred metrics in the Fenland Study, UK
title_full Does exposure to the food environment differ by socioeconomic position? Comparing area-based and person-centred metrics in the Fenland Study, UK
title_fullStr Does exposure to the food environment differ by socioeconomic position? Comparing area-based and person-centred metrics in the Fenland Study, UK
title_full_unstemmed Does exposure to the food environment differ by socioeconomic position? Comparing area-based and person-centred metrics in the Fenland Study, UK
title_short Does exposure to the food environment differ by socioeconomic position? Comparing area-based and person-centred metrics in the Fenland Study, UK
title_sort does exposure to the food environment differ by socioeconomic position? comparing area-based and person-centred metrics in the fenland study, uk
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586029/
https://www.ncbi.nlm.nih.gov/pubmed/28877706
http://dx.doi.org/10.1186/s12942-017-0106-8
work_keys_str_mv AT maguireevar doesexposuretothefoodenvironmentdifferbysocioeconomicpositioncomparingareabasedandpersoncentredmetricsinthefenlandstudyuk
AT burgoinethomas doesexposuretothefoodenvironmentdifferbysocioeconomicpositioncomparingareabasedandpersoncentredmetricsinthefenlandstudyuk
AT penneytarral doesexposuretothefoodenvironmentdifferbysocioeconomicpositioncomparingareabasedandpersoncentredmetricsinthefenlandstudyuk
AT forouhinitag doesexposuretothefoodenvironmentdifferbysocioeconomicpositioncomparingareabasedandpersoncentredmetricsinthefenlandstudyuk
AT monsivaispablo doesexposuretothefoodenvironmentdifferbysocioeconomicpositioncomparingareabasedandpersoncentredmetricsinthefenlandstudyuk