Address Inequity in Food Accessibility through a Multi-phase Collaborative Study

Hui Cai Ph.D., Associate Professor, Department of Architecture, Director of Research, Institute of Health and Wellness Design, The University of Kansas
Renee Bryant Community Wellness Coordinator, Department of Health and Environment, Johnson County
Lingling Li Ph.D., lecturer, Researcher at the Chongqin Architectural and Planning Institute
Robin Liston MPH, Preventive Medicine and Public Health, University of Kansas Medical Center
Kim Kimminau Ph.D., Associate Professor, Preventive Medicine and Public Health, Department of Family Medicine, University of Kansas Medical Center

Most existing research on health disparity and equity in healthy food access focuses on underserved areas with clear racial and economic stratification. Relatively fewer attention has been paid to people who live in highly populated and more affluent counties. These communities are surrounded by resource-rich neighborhoods and have unclear geographically delimited concentrations of poverty, which tend to be overlooked regarding access to healthy food. This presentation will report a multi-phase collaborative project that addresses equity in healthy food access in Johnson County, KS, a relatively more affluent area.

The project was developed in three phases. Phase I identified "micro-food deserts" using ArcGIS mapping and analysis. Secondary data from several sources were compiled and analyzed. Various food outlets distribution (grocery stores, farmers' markets, cultural food stores, convenience stores, food pantries, soup kitchens, and community gardens) were correlated with demographics and neighborhood socioeconomic status at the census tract level. County public transportation system and road network (using 0.5-mile circular buffer and 5-minute driving distance thresholds) overlaid these maps.

Phase III applied the participatory strategies at various scales. The community, including the Johnson County Department of Health and Environment Food Policy Council (FPC), used the interactive web map app to facilitate identification of targeted areas and policy options to improve healthy food access. The research team also engaged three targeted communities using focus groups and Photovoice collected by community members. Researchers worked closely with FPC members, community and faith-based organizations, schools, and residents in the micro-food deserts to further understand food shopping behaviors, barriers in accessing healthy food resources, and potential grassroots solutions to address the issue. Crystallization immersion was used to distill key themes to aid in shaping policy recommendations.

Phase III conducted statistical analysis of a large scale (1250 respondents) convenient sample survey of food shopping and consumption behaviors of local residents conducted in 2012 in JoCo.

An expanded set of measures including geographical food accessibility, measures from space syntax theory, and land use in urban planning were used to link the physical environment with individual travel behaviors for food shopping (travel frequency, time, and mode).

The Phase I interactive maps assisted communities, public health organizations and the research team to pinpoint the neighborhoods with barriers to access healthy food. These data plus the results of Phase II Photovoice informed the FPC and county leaders on community-driven policy food access recommendations. The Phase III survey further identified the variety of healthy food stores as a strong predictor for food travel behavior. In addition, high accessibility of street patterns, establishment of mixed-use zoning, and connect the trails network with residential areas with healthy food sources are proposed as design and planning strategies that can enhance healthy food access in these areas.

This project is a result of close collaborations among public health, planning, design, and community stakeholders. The community engagement and participatory approach allows the multi-disciplinary team to identify areas in need of public health-informed programming and provide tailored recommendations for food access improvement.

Learning objectives:

1. The audience will learn the collaborative approach that combine knowledge from architecture, urban planning, public health, and public policy in addressing the inequity of access to healthy food;
   
2. Discuss the multi-phase study in using ArcGIS to identifying targeted area, using the participatory approach to work with community stakeholders to develop catered strategies, and using survey data and advanced statistical analysis to inform future policies;
   
3. Introduce theories and measures from urban planning, transportation, and space syntax in analyzing food accessibility;
   
4. Share the results of the three-phase study and discuss the potential implications on urban planning strategies and policy-making.