Beyond physical access to healthy food: A mixed-methods exploration of the food retail environment in two low-income neighborhoods in a Latin American city

Abstract

Achieving sustainable urban food systems requires ensuring access to healthy foods for all. In this context, the aim of the present work was to characterize the retail food environment in two low-income neighborhoods in Montevideo (Bella Italia and Punta Rieles), the capital city of Uruguay, a Latin American country. The study was informed by the Retail Food Environment and Customer Interaction Model and relied on a mixed-methods approach. A survey of food retail outlets was conducted using field observation in the area (10.76 km²). Information about the availability of specific food groups (fruits and vegetables, meats, fish, milk, eggs, culinary ingredients, processed foods, ultra-processed products, and ready to eat dishes) was collected. All the outlets were geocoded, and service areas were created considering street network distances and a 600 meters threshold. Quantitative information on the availability and physical accessibility of food outlets was supplemented with qualitative information from semi-structured interviews with residents and grocery store owners. A total of 415 outlets selling variety of foods were identified. Adequate physical access to the foods recommended by the Uruguayan dietary guidelines was found in most of the residential areas of the two neighborhoods. Small behind-the-counter grocery stores were identified as the key source of healthy foods in the area. However, the accounts of local residents highlighted problems related to the price, variety, and quality of the foods sold by the local grocery stores. Therefore, strategies to ensure access to healthy food in the neighborhoods should go beyond physical access and tackle food affordability, variety and quality. The promotion of short food supply chains in the neighborhoods should be a key element of the strategies to achieve sustainable urban food systems in Montevideo given the difficulties to access foods directly from producers expressed by store owners.