Amy Hillier

Closing the Grocery Gap in Underserved Communities: The Creation of the Pennsylvania Fresh Food Financing Initiative

The issue of access to healthy foods has been central to the work of many community-based organizations around the country. One such organization, The Food Trust, launched an effective advocacy campaign to bring awareness and policy change to the issue. The Food Trusts efforts with its partners resulted in the creation of the Pennsylvania Fresh Food Financing Initiative, the nations first statewide financing program to increase supermarket development in underserved areas. This article focuses on a key component of the advocacy campaign: the creation of an evidence-based report that served as a strong, credible foundation for the campaign. The steps that were taken to find partners, obtain and analyze the data, and disseminate the findings are described. In addition, the outcomes of the Fresh Food Financing Initiative are discussed.

How Far Do Low-Income Parents Travel to Shop for Food? Empirical Evidence from Two Urban Neighborhoods

Research on the impact of the built environment on obesity and access to healthful foods often fails to incorporate information about how individuals interact with their environment. A sample of 198 low-income WIC recipients from two urban neighborhoods were interviewed about where they do their food shopping and surveys were conducted of food stores in their neighborhoods to assess the availability of healthful foods. Results indicate that participants rarely shop at the closest supermarket, traveling on average 1.58 miles for non-WIC food shopping and 1.07 miles for WIC shopping. Findings suggest that access to healthful foods is not synonymous with geographic proximity.

The Impact of WIC Food Package Changes on Access to Healthful Food in 2 Low-Income Urban Neighborhoods

OBJECTIVE To evaluate the impact of the 2009 food package changes for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on the availability of healthful food. DESIGN Survey of all food stores in the study area before and after the changes were implemented. SETTING Two low-income neighborhoods in Philadelphia, 1 predominantly African-American, the other predominantly Hispanic. PARTICIPANTS One hundred forty one supermarkets, grocery stores, and non-chain corner stores identified through field enumeration. MAIN OUTCOME MEASURES Nutrition Environment Measure Survey for Stores (NEMS-S) to determine availability, price, and quality of fruit, vegetables, milk, cereal, beans, canned fish, meat, whole grains, and juice. ANALYSIS Comparison of NEMS-S scores before and after food package changes using t tests and ordinary least squares regression to understand the role of supermarket status, WIC participation, and racial and income composition in predicting NEMS-S scores; geographic information systems to calculate proximity of residents to food stores. RESULTS The availability of healthful food increased significantly in stores, overall, with more substantial increases in WIC-authorized stores. Supermarket status, WIC retail status, and NEMS-S scores at baseline were significant predictors of NEMS-S scores after the food package changes. CONCLUSIONS AND IMPLICATIONS Changes in the WIC food package were associated with increased availability of healthful food in 2 low-income neighborhoods.

Clustering of unhealthy outdoor advertisements around child-serving institutions: A comparison of three cities

Using GPS devices and digital cameras, we surveyed outdoor advertisements in Austin, Los Angeles and Philadelphia. GIS and hot spot analysis revealed that unhealthy ads were clustered around child-serving institutions in Los Angeles and Philadelphia but not in Austin. Multivariate generalized least square (GLS) regression models showed that percent black (p<0.04) was a significant positive predictor of clustering in Philadelphia and percent white (p<0.06) was a marginally significant negative predictor of clustering in Los Angeles after controlling for several land use variables. The results emphasize the importance of zoning and land use regulations to protect children from exposure to unhealthy commercial messages, particularly in neighborhoods with significant racial/ethnic minority populations.

Predicting Housing Abandonment with the Philadelphia Neighborhood Information System

ABSTRACT: Several large US cities, including Chicago, Los Angeles, New York, and Philadelphia, have developed information systems to distribute property-level housing data to community organizations and municipal agencies. These early warning systems are also intended to predict which properties are at greatest risk of abandonment, but they have rarely used statistical modeling to support such forecasts. This study used logistic regression to analyze data from the Philadelphia Neighborhood Information System in order to determine which properties were most likely to become imminently dangerous. Several different characteristics of the property, including whether it was vacant, had outstanding housing code violations, and tax arrearages as well as characteristics of nearby properties were identified as significant predictors. Challenges common to the development of early warning systems—including integrating administrative data, defining abandonment, and modeling temporal and spatial data—are discussed along with policy implications for cities like Philadelphia that have thousands of vacant and abandoned properties.

Who Received Loans? Home Owners' Loan Corporation Lending and Discrimination in Philadelphia in the 1930's

The lending record of the Home Owners’ Loan Corporation (HOLC) has received little attention compared with HOLC’s residential security maps. Specifically, the extent to which HOLC practiced racial and ethnic discrimination in the process of making and servicing more than a million loans to homeowners during the Depression has not been carefully examined. Using primary sources including HOLC publications, newspaper articles, 1930 census data, and mortgage records from Philadelphia, this research shows that HOLC did make loans to African Americans, Jews, and immigrants. Evidence suggests, however, that HOLC supported racial segregation in the process of reselling properties acquired through foreclosure.

Objective and Self-Reported Factors Associated With Food-Environment Perceptions and Fruit-And-Vegetable Consumption: A Multilevel Analysis

Introduction Few studies have assessed how people’s perceptions of their neighborhood environment compare with objective measures or how self-reported and objective neighborhood measures relate to consumption of fruits and vegetables. Methods A telephone survey of 4,399 residents of Philadelphia, Pennsylvania, provided data on individuals, their households, their neighborhoods (self-defined), their food-environment perceptions, and their fruit-and-vegetable consumption. Other data on neighborhoods (census tracts) or “extended neighborhoods” (census tracts plus 1-quarter–mile buffers) came from the US Census Bureau, the Philadelphia Police Department, the Southeastern Pennsylvania Transportation Authority, and the federal Supplemental Nutrition Assistance Program. Mixed-effects multilevel logistic regression models examined associations between food-environment perceptions, fruit-and-vegetable consumption, and individual, household, and neighborhood characteristics. Results Perceptions of neighborhood food environments (supermarket accessibility, produce availability, and grocery quality) were strongly associated with each other but not consistently or significantly associated with objective neighborhood measures or self-reported fruit-and-vegetable consumption. We found racial and educational disparities in fruit-and-vegetable consumption, even after adjusting for food-environment perceptions and individual, household, and neighborhood characteristics. Having a supermarket in the extended neighborhood was associated with better perceived supermarket access (adjusted odds ratio for having a conventional supermarket, 2.04 [95% CI, 1.68–2.46]; adjusted odds ratio for having a limited-assortment supermarket, 1.28 [95% CI, 1.02–1.59]) but not increased fruit-and-vegetable consumption. Models showed some counterintuitive associations with neighborhood crime and public transportation. Conclusion We found limited association between objective and self-reported neighborhood measures. Sociodemographic differences in individual fruit-and-vegetable consumption were evident regardless of neighborhood environment. Adding supermarkets to urban neighborhoods might improve residents’ perceptions of supermarket accessibility but might not increase their fruit-and-vegetable consumption.

How important is perception of safety to park use? A four-city survey

Our purpose was to determine the relative importance of individual- and park-related characteristics in influencing both local park use and specific engagement in active sports, walking and sedentary pursuits. We surveyed 3815 adults living within 0.80 km of one of 24 study parks in four US metropolitan areas. Chi-square statistics and baseline-category logit models examined how perceived safety and park characteristics were related to park visitation and types of park activities, controlling for city, individual and park characteristics. Survey participants who perceived the parks as safe (88%) had 4.6 times the odds (95% CI 3.5–6.0) of reporting having visited the study park. Men and African Americans were more likely, and older individuals and those who self-reported being in fair or poor health less likely to perceive parks as safe. Parks having low incivilities scores and those with four or more different facilities, such as tennis courts, swimming pools, basketball courts, etc., were more likely than parks with fewer facilities to be perceived as safe. While park facilities had a much smaller odds ratio for predicting park visits (1.8), it affected 70% of the population. The implication is, if these associations are causal, modifying park facilities may have a greater population impact than improving perceptions of park safety. Our findings are consistent with studies suggesting that increasing the variety of park facilities and offering more organised activities may encourage physical activity among specific target groups.

Physical Activity Surveillance in Parks Using Direct Observation

Introduction Primary features of observational public health surveillance instruments are that they are valid, can reliably estimate physical activity behaviors, and are useful across diverse geographic settings and seasons by different users. Previous studies have reported the validity and reliability of Systematic Observation of Play and Recreation in Communities (SOPARC) to estimate park and user characteristics. The purpose of this investigation was to establish the use of SOPARC as a surveillance instrument and to situate the findings from the study in the context of the previous literature. Methods We collected data by using SOPARC for more than 3 years in 4 locations: Philadelphia, Pennsylvania; Columbus, Ohio; Chapel Hill/Durham, North Carolina; and Albuquerque, New Mexico during spring, summer, and autumn. Results We observed a total of 35,990 park users with an overall observer reliability of 94% (range, 85%–99%) conducted on 15% of the observations. We monitored the proportion of park users engaging in moderate-to-vigorous physical activity (MVPA) and found marginal differences in MVPA by both city and season. Park users visited parks significantly more on weekend days than weekdays and visitation rates tended to be lower during summer than spring. Conclusion SOPARC is a highly reliable observation instrument that can be used to collect data across diverse geographic settings and seasons by different users and has potential as a surveillance system.

The value of conducting door-to-door surveys

This paper argues that door-to-door surveys are a valuable tool for collecting information about health and the environment in urban areas in a manner consistent with community-based participatory research principles. We describe in detail how a door-to-door survey on food shopping and physical activity was conducted with the primary food shopper in 514 households on 30 randomly selected blocks in West and Southwest Philadelphia over seven weeks during the summer of 2010. We identify the elements of our door-to-door protocol that had benefits for the quality of the data collected, flow of data collection, the perceived safety of interviewers and residents, and that informed subsequent phases of this multimethod four-year study of urban food and physical activity environments. We conclude that door-to-door surveys are appropriate and valuable in certain research contexts, when spending time in a community, conducting observations and building relationships are central to the goals and success of a study.