Neighborhood socioeconomic characteristics and differences in the availability of healthy food stores and restaurants in Sao Paulo, Brazil

Abstract

Differential access to healthy foods has been hypothesized to contribute to health disparities, but evidence from low and middle-income countries is still scarce. This study examines whether the access of healthy foods varies across store types and neighborhoods of different socioeconomic statuses (SES) in a large Brazilian city. A cross-sectional study was conducted in 2010–2011 across 52 census tracts. Healthy food access was measured by a comprehensive in-store data collection, summarized into two indexes developed for retail food stores (HFSI) and restaurants (HMRI). Descriptive analyses and multilevel models were used to examine associations of store type and neighborhood SES with healthy food access. Fast food restaurants were more likely to be located in low SES neighborhoods whereas supermarkets and full service restaurants were more likely to be found in higher SES neighborhoods. Multilevel analyses showed that both store type and neighborhood SES were independently associated with in-store food measures. We found differences in the availability of healthy food stores and restaurants in Sao Paulo city favoring middle and high SES neighborhoods.

Association of neighbourhood food availability with the consumption of processed and ultra-processed food products by children in a city of Brazil: a multilevel analysis

“…Also, interventions in the school food environment (which include when and where children obtain foods and the types of options available during the school day), through making UF-MPF more available and banning the sales of RCP, should also be considered as an important driver to promote healthier consumption patterns among children (81) . Although the existence of supermarkets in the neighbourhood has been positively associated with fruit and vegetable availability and consumption in high-and middleincome countries (78,(82)(83)(84)(85) , the contribution that these food stores make to the availability of RCP cannot be ignored. The rapid increase and dominance of supermarkets throughout developed areas of Latin America, Africa and Asia in the last few decades has contributed, at least in part, to the increased availability of processed food products at low cost (21,(86)(87)(88) and the subsequent shift in consumption from staple and unprocessed foods to energy-dense and ultra-processed foods (21,26,89) .…”

The role of the local retail food environment in fruit, vegetable and sugar-sweetened beverage consumption in Brazil

“…For community food environment measures, we decided to exclude small/independently owned grocery stores and corner stores because they were found to have a low availability of healthy foods such as FV in São Paulo (23) .…”

Geographic and socioeconomic distribution of food vendors: a case study of a municipality in the Southern Brazil

“…Another study from São Paulo found that fast food restaurants were more likely to be located in neighborhoods with low socioeconomic levels; and supermarkets and restaurants were more likely to be found in neighborhoods with higher socioeconomic levels 35 .…”