Healthy Food Zones. Assessing Food Outlet Density and Purchasing Behaviours of Students. Thursday October 15, 2015 l 12:00 1:00 pm

Transcription

1 Healthy Food Zones Assessing Food Outlet Density and Purchasing Behaviours of Students Thursday October 15, 2015 l 12:00 1:00 pm Thank you for joining our webinar today! We will be starting shortly at 12:00 pm. You may download the slide deck from the Materials section Candice Einstoss, MHSc, RD, Public Health Nutritionist, Public Health Branch, Community and Health Services Department, Regional Municipality of York Susan Finkelstein, MHSc, RD, Public Health Nutritionist, Public Health Branch, Community and Health Services Department, Regional Municipality of York Heather Pimbert, MSc, Epidemiologist, Public Health Branch, Community and Health Services Department, Regional Municipality of York

2 Healthy Food Zones: Assessing Food Outlets and Purchasing Behaviours of Students October 15, 2015 Candice Einstoss, MHSc RD Susan Finkelstein, MHSc, RD Heather Pimbert, MSc

3 Webinar Overview 1. Background Student Health and the Built Environment 2. Healthy Food Zone Project in York Region Mapping Survey Key Findings 3. Next steps

4 Health of Children and Youth Not meeting Canada Food Guide recommendations In York Region (YR), only 38% of youth meet the fruit & vegetables recommendations (CCHS, 2011) In Canada, 61% of boys and 83% of girls do not meet milk & alternatives recommendations (CCHS, 2007) One quarter of students in YR reported to be overweight or obese in 2013, similar to 2011 and 2009 (OSDHUS, 2012) Poor eating habits as a child most likely progresses into adulthood

5 Creating a Healthy School Nutrition Environment Foundations for a Healthy School (Ontario Ministry of Education, 2014)

6 The Built Environment and Health As students transition to secondary schools their consumption of fast food increases (Freemen et al, 2012) The built environment refers to human-made physical surroundings in which people live, learn, work, and play The way a community is designed can influence people s access to healthy choices and opportunities

7 Food Environments around Schools Students from schools with 5+ chain food retailers within 1 km from their schools were 2.5 times more likely to eat there (Héroux, M et al, 2012) Students with fast food restaurants near their school are more likely to be overweight (Davis et al, 2009; Currie et al, 2009) Fast food & convenience within 1km of kids school junk food purchasing AND Healthy Eating Index scores (He et al, 2012)

8 What is happening elsewhere? Ontario Several Health Units are gathering background data Student surveys on food purchasing habits; GIS mapping of schools British Columbia Published descriptive profiles on the availability of limited service food outlets around schools in BC (Black et al, 2012) Quebec The Quebec Public Health Association published a guide on how to improve the food environment of children by limiting fast-food near schools through sound land-use planning Recent success with two municipal zoning by-laws

9 Overview of Healthy Food Zone Project Overall Goal: To limit unhealthy food choices by advocating for healthy school nutrition environments and for restrictions on new food outlets near secondary schools Gather supporting information specific to York Region Identify Stakeholders & Collaborators Form committee & develop plan to advance issue Advocate for municipal urban planning regulations

10 Overview of Healthy Food Zone Project Steps to gather data: 1. Field observation 2. Research Overall Goal: To limit unhealthy Local GIS mapping food choices by advocating for healthy school nutrition Survey environments of secondary and students for restrictions on new food outlets near secondary schools 3. Analysis of mapping and survey results Gather supporting information specific to York Region Identify Stakeholders & Collaborators Form committee & develop plan to advance issue Advocate for municipal urban planning regulations

11 Healthy Food Zone Research Purpose: To study how the retail food environment surrounding schools (within 1km) influence students food purchasing habits during the school day

12 Mapping Mapped food outlets within a 1 km radius all York Region Secondary Schools to determine extent of issue and establish baseline data Used Health Protection s food safety database Hedgehog for food outlets Needed to define which food outlets were being mapped based on project needs

13 Mapping Food outlet categories were based on: Limited-serve food outlets most likely chosen by students Similar mapping done in BC Assessment of student purchasing habits Findings from the Healthy Food Zone survey

14 Mapping: Food Outlet Categories 4 food outlet categories were created: 1. Convenience Stores - pre-existing classification convenience/variety 2. Supermarket and Deli - pre-existing classification for supermarket - Included outlets with the word deli

15 Mapping: Food Outlet Categories 3. Fast Food No classification: all food take out and restaurants were reviewed to meet criteria: - Restaurants with a separate take-out window and/or without waiter service where customers select and purchase food before consumption, - Must have three or more locations in York Region - Excluded limited operating outlets (e.g., movie theatres) 4. Beverage and Snack Food Stores No classification: several outlets were reviewed to meet criteria: - Independent and chain vendors selling ice cream, frozen yogurt, coffee, specialty beverages and baked goods

16 Food outlets surrounding 10 Schools School Fast Food Convenience Supermarket and Deli Snacks and Beverages Total Alexander Mackenzie Bur Oak SS Dr. G.W Williams SS Keswick HS Maple HS Markville SS Richmond Green SS St. Maximilian Kolbe CHS Stouffville District SS Thornhill SS TOTALS

17 Mapping

18 Mapping: Food Outlet Ranges To determine food outlet range categories, we also mapped ALL York Region Secondary Schools by the number of food outlets within 1km and ranked them Classified the list into four groups: No food outlets Low: 1 7 food outlet Medium: 8 16 food outlets High: 17+ food outlets For analysis, no/low and medium/high food outlet ranges were combined

19 Food outlets surrounding schools For analysis, we combined the no/low and medium/high food zones

20 Secondary Student Survey Section 1: About You Section 2: About the Foods In-School Section 3: About the Food Outside of School Section 4: Food Purchasing Behaviours

21 Secondary Student Survey On-line survey using FluidSurvey Survey included both parental and student consent components Pre-tested survey to assess wording, flow, quit- rate, skip pattern and on-line consent process 10 schools consented to participate

22 Quantitative Methodology Statistical associations were determined using: Chi square test to test for an association Cramer s V test to measure the strength of any associations Odds Ratio s to compare odds of outcomes between food zone categories Analyzed data using STATA

23 Survey Results 567 student responses

24 Schools Survey Results 90% of surveyed schools had a least 1 food outlet within 1 km There was average of 18 food outlets within 1 km Students 97% of students attended a school in a Medium/High food zone 72% would be willing to walk up to 14 minutes one way to purchase food/beverage off-school property

25 Survey Results Secondary school students from the high/medium food zone were 2.95 times more likely to purchase food off school property at least 2-3 times per week. Picture courtesy of M. Aulicino, 2015

26 Frequency of Purchasing Off-Site Survey Respondents 37% purchased 2-3 times/week OR more

27 Frequency of Purchasing from Cafeteria Survey Respondents 16% purchased 2-3 times/week OR more

28 Survey Results Food Themes: Off-School Property Most common reasons for purchasing food/beverage: 1. Food purchased outside of school is cheaper 2. Food purchased outside of school tastes better 3. To hang with friends

29 Survey Results Food Themes: Off-School Property Top 5 food/beverage purchases: 1. Sandwich 4. Specialty Coffee/Drink 2. Pop/Drink 5. Pizza 3. Fries

30 Survey Results Food Themes: Cafeteria Most common reasons for purchasing food/beverage from cafeteria: 1. They don t have time to make or pack a lunch 2. Their friends purchase food/beverage from cafeteria 3. They like the food in the cafeteria

31 Key Findings Food Themes: Cafeteria Top 5 food/beverage purchases from the cafeteria: 1. Cookies 2. Fries 3. Muffins 4. Pizza 5. Pasta & Milk (tied)

32 What the students are saying The food sold at the school cafeteria should strive for better quality in taste and preparation. It should also be conscious of a student's budget. The food in the cafeteria tastes terrible for its over-inflated prices. Eating in the cafeteria would become a lot more appetizing with tastier, healthier, and cheaper options. The caf is disgusting, most of the options are unhealthy and the prices are inflated. there are cheaper options just minutes away from the school. Wish they had more vegan options.

33 Healthy Food Zone Project Gather supporting information specific to York Region Identify Stakeholders & Collaborators Form committee & develop plan to advance issue Advocate for municipal urban planning regulations Overall Goal: To limit unhealthy food choices by advocating for healthy school nutrition environments and for restrictions on new food outlets near secondary schools

34 Next Steps Now Work with School Boards to enhance the physical & social environment and improve food choices in the school - Collaborate with Food Service Providers - Enhance eating areas and serveries - Improve social atmosphere of cafeteria - Student engagement

35 Next Steps Now Gain support and raise awareness of issue through communications to potential stakeholders and collaborators Develop working group of players from different sectors such as public health, research, education, planning, business and municipal decision-makers Involve others who also have a vested interested in limiting food outlets Scope can extend beyond health

36 Next Steps Down the Road Investigate working with a Municipality where there is an opportunity to influence their land-use polices (e.g. Official Plans, Master Plans, Sustainability Plans) Develop angle for action Economic development (e.g. preserve community character) Environmental health (e.g. reduce car traffic/pollutants) Injury prevention (e.g. pedestrian safety) Active transportation Solidify partnerships and determine strategic direction Evaluate regulatory options

37 How to influence change? Example: Zoning By-laws How communities are built and planned directly influences peoples health Zoning can be a tool for limiting the number and location of food outlets surrounding secondary schools More effective and feasible for new communities or dealing with existing schools with no food outlets preventative action

38 United States Zoning Examples Arden Hills, Minnesota (2006) Ban on new fast food outlets within 400 feet of public spaces Concord, Massachusetts (2008) Bans all drive thru and fast food restaurants Detroit, Michigan (2008) Prohibits fast food restaurants within 500 feet of any school

39 Zoning Example Quebec Saint-Laurent (2014) - Implemented a by-law prohibiting drive-through service bordering a residential zone City of Brossard (pending) - Process of adopting a by-law prohibiting all restaurants within 500m of a school

40 In summary Our study shows that the built environment around secondary schools in YR affect student food purchasing behaviours Survey respondents want healthier foods that are tasty, reasonably priced and appealing Zoning by-laws to restrict unhealthy foods near schools is a strategy to create a healthy school nutrition environment

41 For more information

42 Questions?