ICUH 2016

1. Julia Díez, Usama Bilal, Alba Cebrecos, Amanda Buczynski,
Robert Lawrence, Thomas Glass, Joel Gittelsohn, Francisco
Escobar and Manuel Franco
Comparing local availability and
accessibility to healthy foods
across countries: A case study in
Madrid (Spain) and Baltimore (US)

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Background
o Diet is a cardiovascular risk factor influenced
by the local food environment
o Local food environments are a good example
of a mass influence on population diets
o Inconsistencies around social gradients in
contextual healthy food availability exist
between US and Europe-based studies

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Conceptual framework
Franco M., Bilal. U.,
Diez J (2016). Food
Environment. The
Encyclopedia of Food
and Health. B.
Caballero, Finglas, P.,
and Toldrá, F. . Oxford:
Academic Press,
Oxford: Academic
Press. 3: 22-26.

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Aim
 To understand cross-national differences in the
local food environment between Madrid and
Baltimore by comparing an average neighborhood
in each city in terms of food store types,
availability, and accessibility to healthy foods.

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Methods
Study context
We selected one neighborhood (~15000 pop.) in
each city selecting median areas in terms of:
• Educational level
• Aging
• Segregation
• Urban form

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Methods
Variables
• Availability
• Field observations using NEMS-s audit tool
• “Healthy Food Availability Index” (0-28.5)
• “Fruit&Vegetables Availability index” (0-10)
• Accessibility
• Pedestrian network analysis
• Walking distance of 200m, 400m, 800m

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Results
Map of the different food stores within the study areas

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Results
Healthy Food Availability Index
Madrid Baltimore

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Results
Fruits & Vegetables Availability Index
Madrid Baltimore

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Access by walking to high healthy food stores
Results

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Public market in Madrid
Las Ventas Madrid

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Farmer Market in Baltimore
Waverly (Baltimore)

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Conclusions
Our results may help promoting intervention
from local city agencies to allocate resources
to improve existing small-sized food stores
and public markets, and to improve walkable
urban environments.