Developing an agenda for research about policies to improve access to healthy foods in rural communities: a concept mapping study

Abstract

BackgroundPolicies that improve access to healthy, affordable foods may improve population health and reduce health disparities. In the United States most food access policy research focuses on urban communities even though residents of rural communities face disproportionately higher risk for nutrition-related chronic diseases compared to residents of urban communities. The purpose of this study was to (1) identify the factors associated with access to healthy, affordable food in rural communities in the United States; and (2) prioritize a meaningful and feasible rural food policy research agenda.MethodsThis study was conducted by the Rural Food Access Workgroup (RFAWG), a workgroup facilitated by the Nutrition and Obesity Policy Research and Evaluation Network. A national sample of academic and non-academic researchers, public health and cooperative extension practitioners, and other experts who focus on rural food access and economic development was invited to complete a concept mapping process that included brainstorming the factors that are associated with rural food access, sorting and organizing the factors into similar domains, and rating the importance of policies and research to address these factors. As a last step, RFAWG members convened to interpret the data and establish research recommendations.ResultsSeventy-five participants in the brainstorming exercise represented the following sectors: non-extension research (n = 27), non-extension program administration (n = 18), “other” (n = 14), policy advocacy (n = 10), and cooperative extension service (n = 6). The brainstorming exercise generated 90 distinct statements about factors associated with rural food access in the United States; these were sorted into 5 clusters. Go Zones were established for the factors that were rated highly as both a priority policy target and a priority for research. The highest ranked policy and research priorities include strategies designed to build economic viability in rural communities, improve access to federal food and nutrition assistance programs, improve food retail systems, and increase the personal food production capacity of rural residents. Respondents also prioritized the development of valid and reliable research methodologies to measure variables associated with rural food access.ConclusionsThis collaborative, trans-disciplinary, participatory process, created a map to guide and prioritize research about polices to improve healthy, affordable food access in rural communities.

The spatial distribution of gender differences in obesity prevalence differs from overall obesity prevalence among US adults

“…Clustering patterns seen in this study may be driven by occupational, physical activity, transportation, or nutrition policies with differential impacts among genders. Unfortunately, the determinants of obesity in rural areas - those states showing clustering in this study - are poorly understood (19). Potential determinants include gendered household or work roles, food and beverage taxes, SNAP/WIC options, menu labeling efforts, access to recreational or health-focused amenities, and transportation and commuting patterns.…”

Cross-sector analysis of socioeconomic, racial/ethnic, and urban/rural disparities in food policy enactment in the United States

“…Residents in rural areas are likely to face different barriers to healthy food access compared to their urban and suburban counterparts. Johnson et al identified many policy research needs for rural areas, including economic development and barriers to food assistance programs (Johnson et al, 2014). A systematic review of nutrition policy and environmental strategies in rural areas noted several factors that need to be considered in such communities, such as long distances to food stores, local cultures and food preferences, and the need for strong local partnerships (Calancie et al, 2015).…”

Farm Direct at Five Years: An Early Assessment of Oregon's Farm-Focused Cottage Food Law

“…As Jablonski, Hendrickson, Vogel, and Schmit (2017) explain in a recent review article, local food systems can generate rural economic development, but social, cultural, physical, political, and other forms of wealth that contribute to community well-being are also meaningful outcomes that deserve more attention. For example, researchers have suggested that farmers markets and other DTC venues can increase healthy food access in rural communities (Johnson et al, 2014). However, there is still little empirical evidence of these claims, especially related to direct sales of processed foods.…”