0d19e7515727b5fe285a6b7db64a1721 303858.pdf 09f9e064ebba804b6a4d90b39c964a6cd27e46bb 303858.pdf 81cb47427c4b81ca2ee5c7495e8a9d2887c5e240269a4fce34d4e7fefd8a2708 303858.pdf Title: Retail Food Environment around Schools in Barcelona by Neighborhood Socioeconomic Status: Implications for Local Food Policy Subject: Childhood obesity is a relevant public health problem. The school food environment has been identified as an important factor for promoting healthy eating behaviors. This study assessed the availability of and proximity to unhealthy food stores around schools (n = 22) in the city of Barcelona and its association with neighborhood socioeconomic status (NSES). We conducted this cross-sectional study between 2019 and 2020. First, we identified all food retailers (n = 153) within a 400-m buffer around each school and identified those selling unhealthy food products. Then, we used Poison regression models to measure the association between NSES and the healthy food availability index (HFAI), adjusting for population density and distance. A total of 95% of the food establishments studied were classified as unhealthy (n = 146). In all, 90% of schools that had, at least, two unhealthy retailers in their proximity. There were significant differences in the mean distance to unhealthy establishments according to neighborhood SES and population density (p < 0.05). We found a positive association between schools located in higher SES neighborhoods and a higher availability and affordability of healthy food products (IIR = 1.67, 95% CI = 1.45–1.91 p = 0.000). We found strong social inequalities in the supply of healthy foods in Barcelona. Local food policy interventions addressing retail food environment around schools should consider socioeconomic inequalities. Keywords: food environment; food access; nutrition environment measures surveys; health inequalities; socioeconomic status; geographic information system; schools; children Author: Catalina Londoño-Cañola, Gemma Serral, Julia Díez, Alba Martínez-García, Manuel Franco, Lucía Artazcoz and Carlos Ariza Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Dec 30 07:32:31 2022 CET ModDate: Fri Dec 30 07:38:34 2022 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3909521 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- WLENKM+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 JRXZLC+VnURWPalladioL Type 1 Custom yes yes no 15 0 QUTSLM+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 DGZYFJ+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 TOKUQV+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 LWQXII+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 IKKWKP+CMSY10 Type 1 Builtin yes yes no 77 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 84 0 BNJIAM+PalatinoLinotype TrueType WinAnsi yes yes no 98 0 BNJIBO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 101 0 NPNEGI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 118 0 NPNEGK+PalatinoLinotype TrueType WinAnsi yes yes no 121 0 NPNEGM+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 124 0 IUDKMW+VnURWPalladioL-Italic Type 1 Custom yes yes no 140 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-12-06 02:45:32 CET RepresentationInformation: 303858.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-12-05 09:50:54 CET Size: 3909521 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 323 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design Destination: subsection.2.1 Children: Item: Title: School Sampling Destination: subsubsection.2.1.1 Item: Title: Retail Food Environment Destination: subsubsection.2.1.2 Item: Title: Area-Level Covariates Destination: subsubsection.2.1.3 Item: Title: Statistical Analysis Destination: subsection.2.2 Item: Title: Results Destination: section.3 Children: Item: Title: Counts, HFAI, and Distance of Unhealthy Food Stores Destination: subsection.3.1 Item: Title: Association between the Healthy Food Availability Index (HFAI) and the NSES Destination: subsection.3.2 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Retail Food Environment around Schools in Barcelona by Neighborhood Socioeconomic Status: Implications for Local Food Policy Author: Catalina Londoño-Cañola, Gemma Serral, Julia Díez, Alba Martínez-García, Manuel Franco, Lucía Artazcoz and Carlos Ariza Subject: Childhood obesity is a relevant public health problem. The school food environment has been identified as an important factor for promoting healthy eating behaviors. This study assessed the availability of and proximity to unhealthy food stores around schools (n = 22) in the city of Barcelona and its association with neighborhood socioeconomic status (NSES). We conducted this cross-sectional study between 2019 and 2020. First, we identified all food retailers (n = 153) within a 400-m buffer around each school and identified those selling unhealthy food products. Then, we used Poison regression models to measure the association between NSES and the healthy food availability index (HFAI), adjusting for population density and distance. A total of 95% of the food establishments studied were classified as unhealthy (n = 146). In all, 90% of schools that had, at least, two unhealthy retailers in their proximity. There were significant differences in the mean distance to unhealthy establishments according to neighborhood SES and population density (p < 0.05). We found a positive association between schools located in higher SES neighborhoods and a higher availability and affordability of healthy food products (IIR = 1.67, 95% CI = 1.45 1.91 p = 0.000). We found strong social inequalities in the supply of healthy foods in Barcelona. Local food policy interventions addressing retail food environment around schools should consider socioeconomic inequalities. Keywords: food environment; food access; nutrition environment measures surveys; health inequalities; socioeconomic status; geographic information system; schools; children Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Dec 30 07:32:31 CET 2022 ModDate: Fri Dec 30 07:38:34 CET 2022 ID: 0x5c7d226352aaaafcbc189fbecf9263a3, 0x5c7d226352aaaafcbc189fbecf9263a3 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: QUTSLM+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 241 FontDescriptor: FontName: QUTSLM+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: QLBIEB+URWPalladioL-BoldItal FontSubset: true FirstChar: 110 LastChar: 112 FontDescriptor: FontName: QLBIEB+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: DGZYFJ+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 241 FontDescriptor: FontName: DGZYFJ+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: WLENKM+VnURWPalladioL-Bold FontSubset: true FirstChar: 189 LastChar: 189 FontDescriptor: FontName: WLENKM+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: TOKUQV+URWPalladioL-Ital FontSubset: true FirstChar: 40 LastChar: 121 FontDescriptor: FontName: TOKUQV+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: IUDKMW+VnURWPalladioL-Italic FontSubset: true FirstChar: 160 LastChar: 226 FontDescriptor: FontName: IUDKMW+VnURWPalladioL-Italic Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: IKKWKP+CMSY10 FontSubset: true FirstChar: 20 LastChar: 21 FontDescriptor: FontName: IKKWKP+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: JRXZLC+VnURWPalladioL FontSubset: true FirstChar: 129 LastChar: 243 FontDescriptor: FontName: JRXZLC+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 61, 279, 152, 288 Annotation: Subtype: Link Rect: 34, 267, 82, 276 Annotation: Subtype: Link Rect: 34, 164, 96, 186 Annotation: Subtype: Link Rect: 126, 90, 154, 99 Annotation: Subtype: Link Rect: 34, 78, 147, 87 Annotation: Subtype: Link Rect: 34, 756, 180, 792 Annotation: Subtype: Link Rect: 515, 756, 560, 792 Annotation: Subtype: Link Rect: 320, 642, 331, 655 Annotation: Subtype: Link Rect: 440, 642, 451, 655 Annotation: Subtype: Link Rect: 536, 642, 547, 655 Annotation: Subtype: Link Rect: 122, 631, 133, 643 Annotation: Subtype: Link Rect: 528, 168, 535, 177 ActionDest: 134 Annotation: Subtype: Link Rect: 535, 168, 542, 177 ActionDest: 134 Annotation: Subtype: Link Rect: 487, 155, 494, 164 ActionDest: 134 Annotation: Subtype: Link Rect: 222, 118, 229, 126 ActionDest: 134 Annotation: Subtype: Link Rect: 197, 17, 342, 28 Annotation: Subtype: Link Rect: 416, 17, 560, 28 Annotation: Subtype: Link Rect: 34, 388, 87, 407 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 411, 735, 418, 744 ActionDest: 134 Annotation: Subtype: Link Rect: 280, 698, 287, 707 ActionDest: 134 Annotation: Subtype: Link Rect: 541, 685, 548, 694 ActionDest: 134 Annotation: Subtype: Link Rect: 315, 660, 322, 669 ActionDest: 134 Annotation: Subtype: Link Rect: 264, 635, 271, 644 ActionDest: 134 Annotation: Subtype: Link Rect: 371, 597, 378, 606 ActionDest: 134 Annotation: Subtype: Link Rect: 381, 597, 393, 606 ActionDest: 134 Annotation: Subtype: Link Rect: 237, 510, 249, 519 ActionDest: 134 Annotation: Subtype: Link Rect: 544, 497, 556, 506 ActionDest: 134 Annotation: Subtype: Link Rect: 253, 447, 265, 456 ActionDest: 134 Annotation: Subtype: Link Rect: 259, 422, 271, 431 ActionDest: 134 Annotation: Subtype: Link Rect: 387, 359, 399, 368 ActionDest: 134 Annotation: Subtype: Link Rect: 436, 284, 448, 293 ActionDest: 134 Annotation: Subtype: Link Rect: 451, 283, 463, 293 ActionDest: 134 Annotation: Subtype: Link Rect: 519, 246, 531, 255 ActionDest: 134 Annotation: Subtype: Link Rect: 531, 246, 543, 255 ActionDest: 134 Annotation: Subtype: Link Rect: 544, 246, 556, 255 ActionDest: 134 Annotation: Subtype: Link Rect: 282, 221, 294, 230 ActionDest: 134 Annotation: Subtype: Link Rect: 294, 221, 306, 230 ActionDest: 134 Annotation: Subtype: Link Rect: 395, 158, 406, 167 ActionDest: 134 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 323, 669, 335, 678 ActionDest: 134 Annotation: Subtype: Link Rect: 353, 656, 365, 665 ActionDest: 137 Annotation: Subtype: Link Rect: 369, 593, 381, 602 ActionDest: 137 Annotation: Subtype: Link Rect: 368, 581, 380, 590 ActionDest: 137 Annotation: Subtype: Link Rect: 190, 468, 202, 477 ActionDest: 137 Annotation: Subtype: Link Rect: 523, 455, 535, 464 ActionDest: 137 Annotation: Subtype: Link Rect: 202, 354, 213, 363 ActionDest: 137 Annotation: Subtype: Link Rect: 214, 354, 226, 363 ActionDest: 137 Annotation: Subtype: Link Rect: 243, 266, 255, 276 ActionDest: 137 Annotation: Subtype: Link Rect: 432, 241, 444, 250 ActionDest: 137 Annotation: Subtype: Link Rect: 309, 116, 321, 125 ActionDest: 134 Annotation: Subtype: Link Rect: 335, 103, 347, 112 ActionDest: 137 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 296, 685, 308, 694 ActionDest: 137 Annotation: Subtype: Link Rect: 223, 647, 235, 657 ActionDest: 137 Annotation: Subtype: Link Rect: 235, 647, 247, 657 ActionDest: 137 Annotation: Subtype: Link Rect: 270, 585, 282, 594 ActionDest: 134 Annotation: Subtype: Link Rect: 282, 585, 294, 594 ActionDest: 137 Annotation: Subtype: Link Rect: 543, 585, 555, 594 ActionDest: 137 Annotation: Subtype: Link Rect: 322, 509, 334, 518 ActionDest: 137 Annotation: Subtype: Link Rect: 334, 509, 346, 518 ActionDest: 137 Annotation: Subtype: Link Rect: 196, 446, 208, 455 ActionDest: 137 Annotation: Subtype: Link Rect: 342, 384, 354, 393 ActionDest: 137 Annotation: Subtype: Link Rect: 246, 321, 258, 330 ActionDest: 137 Annotation: Subtype: Link Rect: 267, 182, 279, 192 ActionDest: 134 Annotation: Subtype: Link Rect: 280, 183, 292, 192 ActionDest: 137 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 212, 717, 218, 729 ActionDest: 81 Annotation: Subtype: Link Rect: 307, 354, 313, 366 ActionDest: 88 Annotation: Subtype: Link Rect: 219, 228, 226, 240 ActionDest: 88 Annotation: Subtype: Link Rect: 517, 178, 524, 190 ActionDest: 88 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 218, 185, 225, 197 ActionDest: 108 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 259, 248, 271, 257 ActionDest: 134 Annotation: Subtype: Link Rect: 272, 248, 283, 257 ActionDest: 134 Annotation: Subtype: Link Rect: 284, 248, 296, 257 ActionDest: 137 Annotation: Subtype: Link Rect: 472, 210, 484, 219 ActionDest: 134 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 189, 735, 201, 744 ActionDest: 134 Annotation: Subtype: Link Rect: 455, 710, 467, 719 ActionDest: 137 Annotation: Subtype: Link Rect: 424, 622, 436, 631 ActionDest: 137 Annotation: Subtype: Link Rect: 322, 597, 334, 606 ActionDest: 137 Annotation: Subtype: Link Rect: 335, 597, 347, 606 ActionDest: 137 Annotation: Subtype: Link Rect: 476, 585, 488, 594 ActionDest: 137 Annotation: Subtype: Link Rect: 488, 585, 500, 594 ActionDest: 137 Annotation: Subtype: Link Rect: 352, 522, 364, 531 ActionDest: 134 Annotation: Subtype: Link Rect: 279, 497, 291, 506 ActionDest: 134 Annotation: Subtype: Link Rect: 266, 484, 278, 493 ActionDest: 137 Annotation: Subtype: Link Rect: 203, 447, 215, 456 ActionDest: 134 Annotation: Subtype: Link Rect: 216, 447, 228, 456 ActionDest: 134 Annotation: Subtype: Link Rect: 388, 409, 400, 418 ActionDest: 137 Annotation: Subtype: Link Rect: 401, 409, 413, 418 ActionDest: 137 Annotation: Subtype: Link Rect: 413, 409, 425, 418 ActionDest: 137 Annotation: Subtype: Link Rect: 518, 396, 530, 406 ActionDest: 134 Annotation: Subtype: Link Rect: 531, 396, 543, 406 ActionDest: 137 Annotation: Subtype: Link Rect: 543, 396, 555, 406 ActionDest: 137 Annotation: Subtype: Link Rect: 426, 384, 438, 393 ActionDest: 137 Annotation: Subtype: Link Rect: 540, 321, 552, 330 ActionDest: 134 Annotation: Subtype: Link Rect: 367, 83, 379, 92 ActionDest: 145 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 201, 610, 213, 619 ActionDest: 145 Annotation: Subtype: Link Rect: 424, 445, 560, 456 Annotation: Subtype: Link Rect: 165, 433, 276, 444 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 162, 673, 199, 684 Annotation: Subtype: Link Rect: 205, 673, 241, 684 Annotation: Subtype: Link Rect: 126, 650, 507, 661 Annotation: Subtype: Link Rect: 369, 592, 406, 603 Annotation: Subtype: Link Rect: 412, 592, 448, 603 Annotation: Subtype: Link Rect: 342, 569, 380, 580 Annotation: Subtype: Link Rect: 386, 569, 422, 580 Annotation: Subtype: Link Rect: 228, 534, 266, 545 Annotation: Subtype: Link Rect: 329, 511, 366, 522 Annotation: Subtype: Link Rect: 245, 489, 282, 499 Annotation: Subtype: Link Rect: 174, 455, 212, 465 Annotation: Subtype: Link Rect: 394, 431, 431, 442 Annotation: Subtype: Link Rect: 439, 408, 477, 419 Annotation: Subtype: Link Rect: 483, 408, 519, 419 Annotation: Subtype: Link Rect: 264, 385, 301, 396 Annotation: Subtype: Link Rect: 117, 363, 155, 373 Annotation: Subtype: Link Rect: 131, 328, 168, 338 Annotation: Subtype: Link Rect: 351, 304, 389, 315 Annotation: Subtype: Link Rect: 447, 281, 484, 292 Annotation: Subtype: Link Rect: 460, 258, 497, 269 Annotation: Subtype: Link Rect: 472, 235, 510, 246 Annotation: Subtype: Link Rect: 99, 213, 137, 223 Annotation: Subtype: Link Rect: 205, 179, 243, 189 Annotation: Subtype: Link Rect: 274, 155, 312, 166 Annotation: Subtype: Link Rect: 104, 121, 142, 131 Annotation: Subtype: Link Rect: 314, 86, 351, 97 Annotation: Subtype: Link Rect: 56, 63, 175, 74 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 113, 711, 151, 721 Annotation: Subtype: Link Rect: 344, 699, 560, 710 Annotation: Subtype: Link Rect: 56, 687, 67, 698 Annotation: Subtype: Link Rect: 419, 676, 560, 687 Annotation: Subtype: Link Rect: 56, 664, 180, 675 Annotation: Subtype: Link Rect: 333, 652, 501, 664 Annotation: Subtype: Link Rect: 239, 618, 560, 629 Annotation: Subtype: Link Rect: 56, 606, 102, 617 Annotation: Subtype: Link Rect: 411, 583, 449, 594 Annotation: Subtype: Link Rect: 59, 550, 96, 560 Annotation: Subtype: Link Rect: 244, 526, 560, 537 Annotation: Subtype: Link Rect: 56, 514, 302, 525 Annotation: Subtype: Link Rect: 248, 492, 285, 502 Annotation: Subtype: Link Rect: 187, 480, 291, 491 Annotation: Subtype: Link Rect: 262, 458, 299, 468 Annotation: Subtype: Link Rect: 519, 434, 557, 445 Annotation: Subtype: Link Rect: 190, 400, 228, 410 Annotation: Subtype: Link Rect: 113, 366, 150, 376 Annotation: Subtype: Link Rect: 192, 308, 229, 318 Annotation: Subtype: Link Rect: 394, 273, 432, 284 Annotation: Subtype: Link Rect: 438, 273, 474, 284 Annotation: Subtype: Link Rect: 163, 239, 201, 249 Annotation: Subtype: Link Rect: 207, 239, 243, 249 Annotation: Subtype: Link Rect: 309, 215, 347, 226 Annotation: Subtype: Link Rect: 353, 215, 389, 226 Annotation: Subtype: Link Rect: 169, 193, 207, 203 Annotation: Subtype: Link Rect: 179, 170, 216, 180 Annotation: Subtype: Link Rect: 389, 147, 426, 157 Annotation: Subtype: Link Rect: 493, 124, 530, 134 Annotation: Subtype: Link Rect: 361, 100, 398, 111 Annotation: Subtype: Link Rect: 372, 77, 410, 88 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 217, 722, 254, 733 Annotation: Subtype: Link Rect: 267, 710, 560, 721 Annotation: Subtype: Link Rect: 56, 699, 231, 710 Checksum: ebdf0904 Type: CRC32 Checksum: 0d19e7515727b5fe285a6b7db64a1721 Type: MD5 Checksum: 09f9e064ebba804b6a4d90b39c964a6cd27e46bb Type: SHA-1 Checksum: 81cb47427c4b81ca2ee5c7495e8a9d2887c5e240269a4fce34d4e7fefd8a2708 Type: SHA-256