Anne Findlay

Large scale food retailing as an intervention for diet and health: quasi-experimental evaluation of a natural experiment

Objectives: To assess the effect on fruit and vegetable consumption, self reported, and psychological health of a “natural experiment”—the introduction of large scale food retailing in a deprived Scottish community. Design: Prospective quasi-experimental design comparing baseline and follow up data in an “intervention” community with a matched “comparison” community in Glasgow, UK. Participants: 412 men and women aged 16 or over for whom follow up data on fruit and vegetable consumption and GHQ-12 were available. Main outcome measures: Fruit and vegetable consumption in portions per day, poor self reported health, and poor psychological health (GHQ-12). Main results: Adjusting for age, sex, educational attainment, and employment status there was no population impact on daily fruit and vegetable consumption, self reported, and psychological health. There was some evidence for a net reduction in the prevalence of poor psychological health for residents who directly engaged with the intervention. Conclusions: Government policy has advocated using large scale food retailing as a social intervention to improve diet and health in poor communities. In contrast with a previous uncontrolled study this study did not find evidence for a net intervention effect on fruit and vegetable consumption, although there was evidence for an improvement in psychological health for those who directly engaged with the intervention. Although definitive conclusions about the effect of large scale retailing on diet and health in deprived communities cannot be drawn from non-randomised controlled study designs, evaluations of the impacts of natural experiments may offer the best opportunity to generate evidence about the health impacts of retail interventions in poor communities.

Reducing inequalities in health and diet: findings from a study on the impact of a food retail development

The health and diet impacts of a large-scale food retail development within a deprived area of Glasgow (Springburn) are reported. The study used a prospective quasi-experimental design which compared changes in diet and psychological health in an area where a new hypermarket was built (the intervention area) with a similarly deprived comparison area in Glasgow (Shettleston). A postal survey was undertaken both before and one year after the hypermarket was built, to assess changes in diet, self-reported health, and perceptions of neighbourhood. Changes in the retail structure of both areas were assessed through a ‘before-and-(repeated)-after’ intervention shop count survey. Qualitative data on diet, the neighbourhood, and the impact of the store were collected through focus groups. The quantitative study found limited improvements in diet and health. There was weak evidence for the impact of the hypermarket on population diet. There was weak evidence that poor psychological health in the intervention area reduced. Amongst those who ‘switched’ to the new hypermarket there was weak evidence of a small improvement in mean fruit and vegetable consumption but good evidence of psychological health improvement. Qualitative and retail survey results reinforce this, identifying perceptions of areal improvement through redevelopment and a small positive impact of the new store on the retail structure of the intervention area.

Large scale food retail interventions and diet.

Ensuring communities have good access to healthy affordable food is one of the governments joined up strategies to improve public health and reduce health inequalities.1,2 Policy solutions for deprived communities without good access—food deserts—have focused on improving provision of food retail as part of a wider suite of recommendations for population dietary change focused around awareness, affordability, and acceptability.3 However, the evidence for the widespread existence of food deserts and their impact on population health has been contested.4,5 This has meant that although retail based policy recommendations to reduce diet related health inequalities now exist,1,2 the evidence to inform how, when, and where to reduce these inequalities is only now emerging. Recently completed projects in Newcastle, Leeds, and Glasgow have started to provide us with this evidence.6-8 The Newcastle study concludes that food deserts exist only for a minority of people who do not or cannot shop outside their immediate locality and for whom the locality suffers from poor retail provision of foods that compose a healthy diet. Key predictors of healthy eating were found to be dietary knowledge, relative affluence, and healthy lifestyle—retail provision was not independently associated with diet. The Leeds and Glasgow studies were both prospective evaluations of the impact of large scale food retailing. Utilising an uncontrolled before-after design the Leeds study concluded that access to food improved notably after the intervention. The average distance travelled to the main food store fell to under 1 km, and the percentage of people walking to the main food store tripled to over 30%. Substantial increases in consumption of fruit and vegetables of between 0.25 and 0.5 portions per day were also reported, particularly for respondents who switched to the new provision. In contrast the Glasgow study, a controlled quasi-experimental study, found little evidence for an overall effect of the intervention for fruit and vegetable consumption in portions per day. For those consumers who switched their main food shopping to the new store an improvement in consumption of around 0.35 portions per day was seen though the evidence for this was very weak. A substantial positive improvement in one measure of psychological health (GHQ-12) and a weak positive effect on self reported health was seen in switchers. How should this evidence be interpreted? Firstly, the term food desert, although a striking metaphor, has unintentionally led to such polarisation of views by researchers, policy makers, and other interest groups so as to be of limited further use. The authors of the Newcastle study propose that the focus should be on food equity instead.6 Secondly, ambiguity remains over whether large scale food retail interventions work. Despite the reporting of positive changes in fruit and vegetable consumption in the Leeds study, pre-intervention and post-intervention designs alone rarely provide compelling evidence that an intervention has been successful. Changes in the prevalence of risk factors and outcomes may be observed to change over time in the absence of any intervention.9 Observed changes therefore may not be due to the intervention itself but to an independent secular trend. Additionally, the effects of other ongoing local, regional, or national initiatives may confound the results of evaluations. Without a matched community control, attributing any independent effect of the intervention itself is difficult. Study designs with community comparisons must adequately control for potential confounding factors. Overall, retail interventions may have either a small but important effect or no effect on diet and health. Although these studies had similar aims and results, uncertainty over the efficacy of retail led interventions stems from problems of interpretation owing to differences in study design. However, the implications for the future development of dietary interventions are similar. Changes in fruit and vegetable consumption, although small, are consistent with other evidence. Two recent reviews of dietary interventions for cancer risk found an average increase of 0.6 portions of fruit and vegetables per day,10,11 and relatively small increases in fruit and vegetable consumption may have encouraging prospects for the prevention of disease.12 The potential negative impacts of large scale retail interventions need to be understood and accounted for—improved retail provision may also increase the availability of foods associated with poor diet. Activities such as advertising and price promotion that surround store opening may be important mediators of impact and effect. If new retail provision is to have an impact on diet and health, we need a multidimensional approach that also tackles food awareness, affordability, and acceptability in addition to retail change. Changing access through improving retail provision alone may not have a substantial impact on diet and health. Changing knowledge without ensuring access seems problematic intuitively. An approach that changes knowledge and access simultaneously may have a better chance of securing improvements in diet and health and a reduction in health inequalities.

Switched: store switching behaviours

Purpose – The purpose of this paper is to investigate store‐switching behaviours for main food‐shopping consequent on a change in operator for a major superstore; to relate results to previous research findings on store‐switching levels; and to use the results to emphasise new directions and dimensions for store‐switching research.Design/methodology/approach – A two‐phase random household postal survey on main food‐shopping behaviour was conducted in a central Scottish city. The two phases, separated by one year, bracketed the change of a main food store from Safeway to Morrisons. A proportion of respondent households in the two phases (45 per cent) was common and represents matched subjects, allowing investigation of store‐switching behaviour.Findings – The aggregate switching rate is higher (27.4 per cent) than found in previous UK research, despite the locational/accessibility component being held constant. No aggregate differences between switchers/non‐switchers on socio‐economic or demographic ground...

The Importance of Store Operator on Superstore Employment Levels

Information from 175 superstores, operated by three companies, is used to investigate the importance of store operator in setting superstore employment levels and types of employment. Store operator is shown to be a significant factor determining employment numbers and types in British superstores.

European retail journals: a bibliometric analysis

The 1990s have seen a major expansion in both the interest in retailing as an academic research subject and in the availability of European retail academic journals. Using a bibliometric approach, this paper investigates the development of published academic retail research in these journals. It identifies different emphases within the retail journals and retail research. Overall, however, retailing is identified increasingly as a synthetic rather than an interdisciplinary subject. A gulf between the direction that European scholars and US scholars are following is considered.

The impact of scanning on employment in UK food stores: A preliminary analysis

New technology increasingly is being introduced into retailing at the operational level. One particular example is bar code scanning in food stores. By July 1986 there were 636 shops in the UK with operational scanning systems at point‐of‐sale, and of these 60 per cent were food stores. It has been suggested that scanning checkouts can cause change in employment structures and even job loss. This paper investigates some of the employment implications of laser scanning checkouts in a sample of food stores.

Far from the 'Magic of the Mall': Retail (Change) in 'Other Places'

Abstract A pre-occupation with the ‘new’ and a focus on corporate retailers and spaces has led to a lack of consideration of change and issues in secondary or ‘other places’ of retail. Using a longitudinal survey methodology, data on retail stock, churn, vacancy and use are considered for one such ‘other place’ – Shettleston in Glasgow. The data show complex dimensions and aspects of vulnerability and resilience, compounded by reactions to exogenous retail and other economic and social changes. Far from being ‘seedy, pre-historical backwaters’, Shettleston and similar ‘other’ places can be vital, local centres playing a variety of useful roles. They require support and attention every bit as much as more high profile town centres and high streets.

Defining the Local Labour Market: An Application of Log-Linear Modelling to the Analysis of Labour Catchment Areas

This study is an attempt to identify key factors which interact with journey-to-work characteristics to determine the delimitation of local labour markets. A case study of superstores is used. The results are useful in formulating expectations for the extent of different labour markets for superstores. This type of information may be of value in assessing the spatial employment impact of a new superstore and thus has important implications for planning decisionmaking.

The UK Research Assessment Exercise (RAE 2008) and retail research output

The 2008 Research Assessment Exercise in the United Kingdom provides a further opportunity to consider changing trends and patterns in retail research, following on a previous commentary in this journal. This comparison shows that pressures continue to mount and are impacting retail knowledge creation and dissemination practices, not least in terms of those engaged in retail research, the topics and approaches utilised, the publication tactics and strategies and thus the standing of retail research in the United Kingdom and its reputation internationally.