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An analysis of fruit and vegetable access in Saskatoon’s grocery stores
Sugandhi del Canto1, Rachel Engler-Stringer,1, 2 Nazeem Muhajarine1,2 and Smart Cities, Healthy Kids research team
1 Department of Community Health and Epidemiology, University of Saskatchewan; 2 Saskatchewan Population Health and Evaluation Research Unit
Background
Saskatoon is a mid-sized, Canadian city in the Prairies that
has seen significant population growth over the last few
years. While the body of Canadian food environment
literature is growing, little has been documented, thus far,
about the Prairie-specific context. This study, the first of
its kind in the city, aims to measure in-store food offerings
and assess relationships with neighbourhood-level socioeconomic status (SES). The quantitative findings
presented here are part of a mixed methods dissertation
that incorporates qualitative assessments of food
environment perceptions among mothers in Saskatoon.
Objectives
Using an ecological, cross-sectional design, this study aims
to enumerate access to healthy food options in the city’s
grocery and convenience stores. The purpose of this
phase of the study is to evaluate the relationship between
the price and availability of fruits and vegetables (F/V) in
grocery stores with neighbourhood-level SES and
demographic characteristics in Saskatoon.
Figure 2: Distance to Nearest Supermarket in Saskatoon (4)
All photographs used were taken by mothers participating in the photo-voice project
in the qualitative phase of this study.
What is the food environment?
The food environment is any opportunity to obtain food.
This can include physical, socio-cultural, economic and
policy factors at both micro- and macro-levels (1). Food
environments include the accessibility and availability of
food, as well as the marketing and advertising of food
and food products (2).
The Community Nutrition Environments Model (Figure
1) is useful for conceptualizing the relationship between
food and health outcomes (3). Aspects of each of these
environments influence both individual- and populationlevel health (4). The study presented here focuses on
the built community and consumer food environments,
which can be thought of as the choice and access
between different food retail outlets, as well as the
choice and access within food retail outlets.
Figure 1: Model of Community Nutrition Environments (3)
Conclusions
Table 1: Distribution of grocery and convenience stores by
neighbourhood-level SES
The disproportionately high distribution of convenience
stores in lower SES neighbourhoods provides evidence of
food swamps, areas in which there are an overrepresentation of unhealthy food stores (5). Combined
with the higher prices of F/V in these neighbourhoods, as
well as in neighbourhoods that have a higher proportion
of Aboriginal residents, these finding are worrisome.
Previous research (6) has indicated that residents of
Saskatoon's poorest neighbourhoods experience worse
health outcomes compared to the rest of the city. People
with lower incomes and reduced options for
transportation are more affected by their built food
environment, and this study indicates that, in Saskatoon,
they have lower access to a healthy and affordable diet.
Neighbourhoods
No. of food
stores†
No. of grocery stores (% of No. of convenience stores (%
total food stores)
of total food stores)
All
131
24 (20.9)
92 (80)
High SES
35
10 (28.6)*
21 (60.0)
Mid SES
41
5 (12.19)
31 (75.6)
Low SES
55
9 (16.4)
40 (72.7) **
†Includes all grocery, convenience and specialty food stores. As such, percentages in the last two columns
will not equal 100%
*p=0.007
**p=0.052
Chi-square tests were used to assess differences in
grocery and convenience store distribution. While
each neighbourhood had at least one convenience
store, only 18 neighbourhoods had grocery stores.
• High SES neighbourhoods have a higher proportion of grocery
stores (of all 3 store types).
• Low SES neighbourhoods have a higher proportion of
convenience stores.
ANOVAs and correlation tests among grocery stores
indicated that:
Methods
The Nutrition Environment Measurement Survey for
Stores (NEMS-S) was used to assess a census of 131 food
stores in Saskatoon’s 60 residential neighbourhoods.
(NEMS-S) measures 10 food categories for price,
availability and quality, generating a composite “score” for
each store (3).
Residential neighbourhoods were grouped into high, mid
and low SES based on the Material and Social Deprivation
Index (using variables derived from Statistic Canada’s
2006 Census and projected data from the City of
Saskatoon up to 2010)
–
Material: income, education, unemployment
–
Social: marital status, lone parent status and living alone status
131 food stores in Saskatoon were measured
–
–
–
Created by Peter Downing – Educational Media Access and Production © 2011
Results and Discussion
Objectives and Methods
24 grocery stores
92 convenience stores
15 specialty stores
• Overall NEMS-S scores did not vary by SES, but did vary by
proportion of Aboriginal residents.
• Availability of F/V did not differ by SES nor with proportion of
Aboriginal residents
• Price of F/V was higher in low SES neighbourhoods and in
those with a higher proportion of Aboriginal residents
Table 2: Fruit and vegetable access in Saskatoon's grocery
stores
Price (F/V)
SES
High
Mid
Low
Availability (F/V)
Total NEMS-S
F
r2
F
r2
F
r2
1.225
0.09
0.345
0.077
6.244*
0.343**
2.681
0.054
5.673
0.089
1.840
0.064
2.762
0.006
1.554
0.015
1.233
0.032
T
r2
6.708***
0.201****
4.002
0.091
3.785*****
0.391
Aboriginal
*p=0.035
**p=0.023
***p=0.02
****p=0.037
*****p=0.001
Study Strengths and Limitations
Strengths
This is the first study in Saskatoon to measure in-store
offerings of all grocery stores and to enumerate the built
consumer food environment. These results provide a
strong base upon which to compare Saskatoon with other
Canadian cities, and lays the groundwork for further
analysis.
Limitations
As a cross-sectional study, changes in F/V availability over
time are not captured. NEMS-S did not capture the F/V
offerings of ethnic grocery stores (eg. guava), and these
stores were not included in the analysis. The sample size
for F/V analysis (n=24 grocery stores) is small, and results
must be interpreted with caution. However, consistent
with other research findings in Saskatoon (6) this study
further indicates that significant health inequities exist in
the city’s poorest neighbourhoods and among the city’s
Aboriginal population.
References
1. Townshend T, Lake A (2009). Obesogenic urban form: Theory, policy and
practice. Health Place, 15(4):909-16.
2. Lytle LA. Measuring the food environment: state of the science. Am J Prev
Med. 2009;36(4S):S134–S144.
3. Glanz K, Sallis JF, Saelens BE, Frank LD. Healthy nutrition environments:
concepts and measures. Am J health Promot 2005; 19(5): 330-333
4. Kershaw T, Creighton T, Markham T, Marko J. Food access in Saskatoon.
2010: Saskatoon Health Region.
5. Health Canada. (2013). Measuring the Food Environment in Canada.
Health Canada; Ottawa, ON
6. Lemstra M, Neudorf C, Beaudin G. Health disparity knowledge and
support for intervention in Saskatoon. CJPH November 2007 (98)6

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