Neighborhood Vulnerability and the Consumer Food Environment in an Urban Area.

Abstract

The consumer food environment is an important medium for understanding complex interactions regarding food consumption, health outcomes and social vulnerability. We aimed to analyze the diversity, variety and quality of natural and ultra-processed foods in a Brazilian metropolis. We performed a cross-sectional study, analyzing food stores within a buffer (1600 m) area around 18 randomly selected Health Promotion Program units. We used descriptive analyses and regression models, adjusted by the area's population, to examine associations of consumer food environment variables with the health vulnerability (HVI) of the territory and store type. Low HVI areas had higher fruits and vegetables variety adequacy and better quality, when compared to medium and high/very high HVI areas (p-value < 0.001 and p-value = 0.001). Supermarkets in low HVI areas had almost twice the prevalence of adequate vegetable variety (65.2% vs. 33.3% in high/very high HVI areas, p-value = 0.005). Adjusted by population, areas with high/very high HVI had lower odds of adequate fruit variety when compared to low HVI areas (OR = 0.06; CI 95% = 0.01-0.44; p-value = 0.006). Although consumer preference is important in food acquisition, disparities in quality, diversity and variety within the consumer food environment could lead to difficulties in access to healthy options for vulnerable populations.