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Do food deserts exist A multi-level geog

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  Confidential Pre-Publication Draft – Not to be copied or quoted without permission Do ‘food deserts’ exist? A multi-level, geographical analysis of the relationship between retail food access, socio-economic position and dietary intake Final Report to the Food Standards Agency February 2004 Dr Martin White, Dr Jane Bunting, Dr Liz Williams, Dr Simon Raybould, Dr Ashley Adamson, Prof John Mathers Project No. N09010 Lead Contractor: Dr Martin White  Confidential Pre-Publication Draft – Not to be copied or quoted without permission Do food deserts exist? Page ii   20/02/04 Do ‘food deserts’ exist? A multi-level, geographical analysis of the relationship between retail food access, socio-economic position and dietary intake Final Report to the Food Standards Agency, February 2004 Project No. N09010 Lead Contractor: Dr Martin White © University of Newcastle upon Tyne, 2004  Authors (all based at the University of Newcastle upon Tyne): Dr Martin White, Senior Lecturer in Public Health and Dr Jane Bunting, Research  Associate, Public Health Research Group, School of Population & Health Sciences Prof John Mathers, Professor of Human Nutrition, Dr Liz Williams, Lecturer in Human Nutrition and Dr Ashley Adamson, Lecturer in Human Nutrition, Human Nutrition Research Centre, School of Clinical Medical Sciences Dr Simon Raybould, Senior Research Associate, Centre for Urban and Regional Development Studies  All correspondence relating to this report should be directed to: Dr Martin White Senior Lecturer in Public Health Public Health Research Group, School of Population & Health Sciences The Medical School Framlington Place, University of Newcastle upon Tyne NE2 4HH E-mail: martin.white@ncl.ac.uk Telephone: +44 (0)191 222 6275 Fax: +44 (0)191 222 8211  Confidential Pre-Publication Draft – Not to be copied or quoted without permission Do food deserts exist? Page iii   20/02/04  Acknowledgements We are indebted to many people who have contributed to this research. In particular we would like to thank: •   Emma Hutchinson, Astrid Macintyre, Terry Lisle, Angela Jones and Pauline Winship for secretarial support •   Fraser Chalmers and Juliet Schick for technical support •   Ruth Wood for technical support and database advice •    Vicky Ryan for statistical advice and critical appraisal of analytical methods •   Jean Adams for critical comments, proof reading and technical help with the report •   Thomas Clavel, Kelly Guthrie, Laura Hoban, Hannah Mathers, Shamini Nair, Jeanette Rabe, Joanne Rothwell, Debbie Summerson, Katja Weiner and Petra Wigand, who helped with various aspects of the fieldwork. •   Martin Charlton, Barrie Margetts, Daniel Warm, Tim Pearson and Neil Wrigley for helpful advice on study design and research methods •   Jenny Woolfe and Louis Levy of the Food Standards Agency for advice and support throughout •   Micheal Crilly, of Newcastle City Council Planning Department, for facilitating access to their retail planning database. •   NEXUS for providing digitised public transport data and Consignia for providing access to the Postcode address file via Edinburgh University •   Colleagues and friends, too many to mention, who have provided critical comments and helpful suggestions on the methods and results The research was hosted by the School of Population & Health Sciences, which we thank, together with the Human Nutrition Research Centre, School of Clinical Medical Sciences and the Centre for Urban and Regional Development Studies at the University of Newcastle upon Tyne The research was funded by the Food Standards Agency  Confidential Pre-Publication Draft – Not to be copied or quoted without permission Do food deserts exist? Page iv   20/02/04 Contents  ACKNOWLEDGEMENTS III   LIST OF TABLES IX    LIST OF FIGURES XIV    LIST OF FIGURES XIV     ABBREVIATIONS USED IN THIS REPORT XVI    ABBREVIATIONS USED IN THIS REPORT XVI   GLOSSARY OF TERMS XVII   EXECUTIVE SUMMARY 1   Introduction 1   Objectives 1   Methods 1   Results 2   Food shopping   2 Dietary behaviour   3 Obesity and physical activity   3 Shops in Newcastle   4  Availability of food in shops   4 Cost of food   5 Quality of fresh produce   5 Geographical proximity to shops   5 Integrated analyses   6 Conclusions 6   1. INTRODUCTION 8   2. BACKGROUND 9   3. AIMS AND OBJECTIVES 12   4.   METHODS 13   4.1   Study design 13   4.2   Research Governance 14   4.3   Setting 14   4.4   Sample size 18   4.5   Individual and Household surveys 18   4.5.1 Development of Household and Individual Questionnaires  18 4.5.1.1 Household Questionnaire 19 4.5.1.2 Individual Questionnaire 19  Confidential Pre-Publication Draft – Not to be copied or quoted without permission Do food deserts exist? Page v   20/02/04 Dietary assessment   19 Nutritional knowledge   20  Attitudes to diet   21 4.5.2 Pre-testing the questionnaires  21 4.5.3 Pilot studies  21 4.5.3.1 Pilot study 1 21 Procedure   22 Response rates   22 Interviews with non-respondents   23 4.5.3.2 Pilot study 2 24 Procedure   24 Response rates   25 4.5.4 Main questionnaire survey  25 4.5.4.1 Sample selection 25 4.5.4.2 Survey procedure 25 4.5.4.3 Data preparation and management 26 4.5.4.4 Derivation of nutrient values and portion sizes from the FFQ 26 4.5.4.5 Development of dietary indices 28 4.5.4.6 Validation of the FFQ 31 4.5.4.7 Development of composite and recoded variables 31  Adult equivalence   32 Household composition   32 Density within households   32 Income   32 Proportion of income spent on food   33 Standard of Living Index   34 Socio-Economic Index   34 Body Mass Index   35  Alcohol consumption   35 Physical activity   35 Dietary knowledge   36 4.6   Retail Survey 37   4.6.1 Development of the data collection sheet  37 4.6.1.1 Development of the shopping basket 37 4.6.1.2 Categorisation of shops selling food 39 4.6.2 Retail survey procedure  41
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