Valuing All Knowledges Through an Expanded Definition of Access

Abstract

Historical racial injustices as well as more recent public and economic policies have culminated in the displacement of supermarkets from some central city neighborhoods. With this displacement, many low-income and minority neighborhoods not only have been deprived of affordable healthful food, but also have experienced prolonged exposure to energy-dense and highly processed snack foods. Partly as a consequence of this loss of supermarkets, diet-related diseases have become prevalent. Our current policies to improve this health issue address only objective measures of access, with little input from community residents, and they are having limited results. In response, I have reconceptualized access as a construct with five dimensions: acceptability, accessibility, accommodation, affordability, and availability. This new expanded view supports both objective and perceived aspects of access and values the knowledge of residents through community-based participatory research, thereby providing a more complete understanding of access.Keywords food access, race, five dimensions of access, grocery gap, health disparity, community-based participatory research, social determinants of health, food desert he increase in youth obesity rates and dietrelated diseases across age groups in lowincome and predominantly minority neighborhoods relative to middle-class White neighborhoods has received national attention of late

Perceived and geographic food access and food security status among households with children

“…This is one of the first attempts to employ a standard instrument to evaluate perceptions of food environment, especially on the availability, quality and affordability of nutritious foods, among households in different food security groups and examine associations with food security status. Perception is a key element of access ( 26 ) and the present study confirmed that perceptions about food access are an important factor associated with food security status among households with children. Sharkey et al .…”

“…Perception is a key element of access (26) , and this study confirmed that perceptions about food access are an important factor associated with food security status among households with children. Sharkey and his colleagues (29) evaluated several perception questions on food environment, including the variety of foods available, the availability of grocery stores and the prices of the foods, in their study among Mexican-origin families in Texas border colonias .…”

“…When policies attempting to improve access to healthy foods have focused on improving proximity to the geographic locations of healthy food stores, the importance of considering self-reported perceptions of food access has been emphasized ( 26 ) , because individual perceptions capture different dimensions of access compared with GIS-based features of the food environment ( 7 , 27 , 28 ) . However, few studies have focused on caregivers’ perceptions of the food environment and household food security status, especially in households with children.…”

Racial Differences in Perceived Food Swamp and Food Desert Exposure and Disparities in Self-Reported Dietary Habits

“…Neighborhood food environments are commonly measured by “objective” measures such as geographic information system (GIS)-based measurements and store audits, but accounting for perceptions (e.g., perceived availability and accessibility of food or food stores measures) is arguably more important [ 17 ]. Though policies attempting to promote healthy eating have mainly focused on improving geographic proximity to the locations of healthy food outlets, the importance of using self-reported individual perceptions of the neighborhood food environment has been demonstrated [ 18 , 19 , 20 ]. Perceived accessibility to different food outlets may reflect individuals’ shopping behaviors, dietary behaviors, and nutritional status as well or better than objective measures of proximity [ 21 , 22 , 23 , 24 , 25 ].…”

Knowledge Visualizations to Inform Decision Making for Improving Food Accessibility and Reducing Obesity Rates in the United States

“…In particular, food accessibility is the geographic location of the food supply and ease of getting to that location [2,3]. Measures for food access within geographic units are provided at the individual and area levels [4].…”