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Access in the Food Environment: A Health Equity Approach Reveals Unequal Opportunity

Equity Focus

This study targets distributed access to affordable healthy food in Denver, Colorado, which varies according to social advantage and disadvantage, as a possible explanation for health inequalities. This is a promising approach for understanding the relationship between food environment and health.

Case Summary

This project looked at systematic differences in access to healthy, affordable food for a disadvantaged group and compared it to an advantaged group. We found that the disadvantaged social group lived closer to food stores and had more food stores (including grocery stores) in their food environment than the advantaged group. The average cost of a Staple Food Basket for the disadvantaged group was significantly less expensive at the closest food store, but more expensive at the closest grocery store,as compared to the advantaged group. Although there was no difference in the number of available Healthy Food Basket items at the closest store for the disadvantaged group compared to the advantaged group, the disadvantaged group had significantly fewer items available at the closest grocery store.

Lessons Learned

• Of particular interest is that when we consider the preferred food store of the disadvantaged group compared to the advantaged group, access to a healthy food environment looks more equal. The disadvantaged group is not significantly farther from their preferred store, the percentage
  living within 1 mile of their preferred store is not significantly different, and the number of available healthy food items is not significantly different from the advantaged group. Cost, however, is significantly higher for a Staple Food Basket at the preferred store of the disadvantaged group as compared to the advantaged group. Given the health disparity between the advantaged and disadvantaged social groups, findings suggest a gap in opportunity to access to healthy food in an environment that appears equal.

LINK TO CASE STUDY