Availability and affordability of healthy and less healthy food in Nova Scotia: where you shop may affect the availability and price of healthy food

Abstract

Objective: The present study aimed to examine the availability and price of healthier compared with less healthy foods by geography, store category and store type for convenience stores, and by store size for grocery stores in Nova Scotia. Design: A cross-sectional study that examined differences in the overall availability and price of healthier compared to less healthy foods in grocery and convenience stores in Nova Scotia. The Nova Scotia Consumer Food Environment project was part of a larger initiative of the Nova Scotia government (Department of Health and Wellness) to assess the food and beverage environment in Nova Scotia in 2015/16. Setting: Four geographic zones (Nova Scotia Health Authority Management Zones) in Nova Scotia, Canada. Participants: A sample of forty-seven grocery stores and fifty-nine convenience stores were selected from a list of 210 grocery stores and 758 convenience stores in Nova Scotia to ensure geographic and store type representation in our sample. Results: Findings indicate that rurality had a significant effect on food availability as measured by the Nutrition Environment Measures Surveys (NEMS) score (P < 0·01); there was a higher availability of healthy foods in rural compared to urban areas for convenience stores but not grocery stores. Healthier foods were also more available in chain stores compared to independent stores (P < 0·01) and in large stores compared to small and medium stores (P < 0·001 and P < 0·01, respectively). Conclusions: The availability of and accessibility to less healthy foods in Nova Scotia food environment suggests that there is a need for government policy action to support a food environment that contributes to healthier diets.

The Cost of a Nutritious Diet for Households Including People Living with HIV/AIDS in Nova Scotia: Findings and Lessons Learned by FoodNOW 2020 to 2022

“…Prior to the pandemic, researchers in Nova Scotia had found disparities in food availability for people across the province, particularly for people living in rural communities [44]. Specifically, there is a greater availability of nutritious food options in chain stores commonly located in urban areas [44].…”

Assessment of Doubly Disadvantaged Neighborhoods by Healthy Living Environment Exposure

“…We acknowledge that there are some limitations to our study due to data availability. First of all, we only consider spatial access to healthy food in this study when food affordability is also an important factor for many low-income residents (Egbe et al, 2021 ; Ward et al, 2013 ). Second, besides the spatial dimension (e.g., travel distance), the temporal dimension of accessibility (e.g., opening hours of urban parks and grocery stores) can also affect people’s accessibility to greenspace and healthy food (Chen & Clark, 2016 ; Xing et al, 2018 ).…”

Development and Application of Healthiness Indicators for Commercial Establishments that Sell Foods for Immediate Consumption

“…Among the few studies that present summary measures, the complete or adapted tool of the Nutritional Environment Measures Survey (NEMS) has been the most widely used in studies to assess the consumer food environment [ 22 , 25 , 41 , 42 , 43 ]. NEMS uses a composite indicator that assesses the availability of healthy food choices, prices, and quality of foods, attributing points to the healthy food options based on a combination of the three dimensions analyzed.…”

“…There are versions of the instrument both for the assessment of the retail food trade and the assessment of establishments that sell foods for immediate consumption. The complexity of the tool’s implementation, the subjectivity of the quality assessment, and the proposal to assess only the presence of healthy food options (overlooking the presence of unhealthy options) have been some of the barriers to the use of different versions of the NEMS [ 22 , 41 ].…”

“…There are still few studies that present summary measures for the assessment of the consumer food environment [ 13 ]. Most summary indicators proposed in these studies are only applicable in certain types of establishments that sell foods to be consumed later, such as supermarkets [ 20 , 21 , 22 , 23 , 24 ]. Besides, the construction of these measures is quite complex [ 21 , 23 , 25 ], which hinders their large-scale use and/or application to specific realities [ 18 ].…”