Physical access to healthy food in context : adapting current conceptualizations to a Latin American city

Abstract

The retail food environment is increasingly recognized as a key determinant of eating behavior and health outcomes. The present work aimed at conceptualizing adequate physical access to food in Montevideo, the capital city of a Latin American country. The conceptualization was developed following three key steps: i) analysis of observational data on food purchasing behavior from primary and secondary data sources, ii) development of an initial definition, iii) validation and refinement of the definition in a workshop with key local stakeholders. Primary data was obtained from a telephone survey with 505 residents of Montevideo to explore food purchasing patterns of two food groups recommended by the Uruguayan dietary guidelines. Secondary data corresponded to surveys previously conducted in the country, one on household income and expenditure and another on mobility. Primary and secondary data highlighted the diversity of food outlets where residents of Montevideo purchase their food. Small neighborhood stores were identified as key sources of healthy foods, especially for residents of low socio-economic status. Regarding food shopping trips, walking was identified as the main transportation mode. The median travel time was estimated to be 10 minutes or lower, regardless of the socio-economic status of the household. Areas with adequate physical access to healthy food in Montevideo were defined as those where residents have access within 600 meters to outlets selling all the following food groups: fruits and vegetables, meat, eggs, milk, or culinary ingredients. The methodological approach presented in the current study can be used by other authors to adapt current conceptualizations of physical access to healthy food to their local context.