Food Equity In Knox County

4/26/2010

Background
Food Equity in Knox
 Household Food Security
County  National Nutrition & Related Research Act of 1990
 Ten Year Comprehensive Plan for NNMR
Community Assessment
↓
Fall 2008 1. Instrument
 Federal Food Security Measurement Program

University of Tennessee Knoxville  2. Definitions:
 food security
Public Health Nutrition
 food insecurity
Graduate Students  hunger

Source: Cohen
2

USDA Food Security Labels and
Definitions (Nord) Community Food Security
Classification
Category Definition  Environments vs. People
Old Term New Terms
 Challenges/Conditions:
High Food Security
No reported indications of food-
access problems or limitations  Social
Food Security Food Security One or two reported
indications—typically of anxiety
 Geographical
Marginal Food over food sufficiency or shortage

 Institutional
Security of food in the house. Little or no
indication of changes in diets or
food intake

Food Insecurity Reports of reduced quality,  Economic
variety, or desirability of diet.
Without Hunger Low Food Security Little or no indication of reduced
food intake
Food Insecurity
Source: Cohen
Reports of multiple indications of
Food Insecurity With Very Low Food
disrupted eating patterns and
Hunger Security reduced food intake 3 4

USDA’s Community Food Security
Assessment Toolkit: Post WWII Present
 There are inadequate resources from which people can purchase
foods.  Suburban migration of middle  Few small and scattered
 The available food purchasing resources are not accessible to all class independently-owned grocery
community members. stores
 The food available through the resources is not sufficient in  Pursuit of food retailers
quantity or variety.  More large suburban chain
 The food available is not competitively priced and thus is not supermarkets
affordable to all households.
 There are inadequate food assistance resources to help low-income
“Food Desert”
people purchase foods at retail markets. -insufficient food resources to maintain a healthy diet
 There are no local food production resources. -supermarkets
 Locally produced food is not available to community members.
 There is no support for local food production resources. Impact
 There is any significant household food insecurity within the Rural and urban food deserts emerged.
community. Low-income neighborhoods disadvantaged.
Source: Cohen
5 Short, Smoyer-Tomic et al 6

Donkin, Larsen, Moreland, Powell

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Summary of Research Findings  Foundation of health disparities complex
&  Important to investigate many possibilities and angles
Implications for Public Health  individual to system

Macro-Level Environment

↓ affordability ↑low-income
↓ variety ↑minorities
Physical Environment Social Environment
Health

Health Disparities?
Donkin, Moreland, Powell, Wang et al Individual Factors
7 8

Story

Goals and Objectives Goals and Objectives
A. Describe the people and geography of Knox County
 Gather and analyze secondary demographic data by sector on total
C. Establish priorities to improve the food environment
population, gender, age, race, education, income, and employment of Knox County.
 Compare Knox County demographics to countywide and statewide  Assess availability of and participation in food
figures
 Assess health status of Knox County residents using secondary assistance and distribution programs.
morbidity and mortality data  Evaluate results in relation to morbidity and mortality
 Identify pertinent trends using available Sector Plans of the Knox
Metropolitan Planning Commission
data

B. Identify possible food inequities in Knox County. D. Provide recommendations for policy and program
 Assess food resource availability by evaluating quantitative data on the
total numbers and types of food resources in relation to demographic initiatives, if applicable, and for further research
features of each of the twelve sectors of Knox County
 Assess food resource availability and affordability by conducting market
basket surveys on three food resources in each of the twelve sectors of
Knox County
 Compare food resource data with health status indicators
9 10

Research Design
Each of Knox County’s 12 planning sectors were
independently researched by sub-committees and
compared to the county as a whole looking at:

Methods 1. Demographics
2. Food availability
3. Food affordability
4. Food accessibility

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Data Sources: Demographics Data Sources: Food Availability

 Moving to the Future (http://www.movingtothefuture.org/) Food Resources as Plotted by MPC
 Figures related to total population, gender, age, income, Grocery/Supermarkets
poverty, employment, race/ethnicity, education, and language
spoken, and additional household factors Secondary Food Retailers
 Information gathered from: Metropolitan Planning Convenience Stores
Commission (MPC) website, (http://www.knoxmpc.org)

Data Sources: Food Availability Data Sources: Food Affordability
Additional Food Resource Considerations
Market Basket Survey
Restaurants
Beer/Wine/ Liquor Stores • Limited service United States Department of Agriculture’s Thrifty
• Full service
• Snack & Non alcoholic Food Plan
• Cafeterias

1. Feeds a family of four for a week
Markets
2. Meets nutrient needs
• Fish and Seafood Markets Emergency Food Service
• Fruit and Vegetable Markets
• Baked Good Stores
• Meat Markets
3. Determines average grocery bill

TFP Weekly Food Usage TFP Weekly Food Usage
Fruits Fresh Green beans 1 lb 7 oz Meat and Meat Alternates Pancake syrup oz
Apples (5 small) 1 lb 4 oz Green peas 15 oz Beef, ground, lean 3 lb 15 oz Chocolate chips 2 oz
Bananas (11 medium) 2 lb 12 oz Breads, Cereals, and Other Grain Products Chicken, fryer 1 lb 13 oz Fruit drink 1 gal
Grapes 1 lb 8 oz Bagels, plain, enriched (4) 8 oz Chicken thighs 2 lb 12 oz Fudgesicles 4
Melon 1 lb Bread crumbs 3 oz Fish, frozen 2 lb Condiments and Spices
Oranges (22 small) 4 lb 12 oz Bread, French 4 oz Tuna fish, canned 12 oz Baking powder .02 oz
Vegetables Bread, white, enriched 2 lb Pork, ground 1 lb 7 oz Baking soda .18 oz
Carrots 1 lb Bread, whole wheat 1 lb Turkey, ground 1 lb Black pepper .16 oz
Celery 5 oz Hamburger buns 8 Turkey ham 11 oz Catsup 1.06 oz
Green pepper 4 oz Dinner rolls 4 Beans, kidney 15 oz Chicken bouillon .71 oz
Lettuce, leaf 9 oz Corn flakes 1 oz Beans, vegetarian, baked 1lb 9 oz Chili powder .79 oz
Onions 1 lb 4 oz Toasted oats 10 oz Eggs, large 17 Cinnamon .08 oz
Potatoes 10 lb 8 oz Flour, white 1 lb 7 oz Fats and Oils Chocolate drink powder 1.52 oz
Tomatoes 6 oz Macaroni 1 lb 5 oz Margarine, stick 15 oz Cumin .05 oz
Canned Fruits Noodles, yolk-free 1 lb 2 oz Shortening 4 oz Onion powder .22 oz
Oranges, mandarin 13 oz Popcorn, microwave 3 oz Salad dressing, mayo 6 fl oz Garlic powder .40 oz
Peaches, light syrup 1 lb 10 oz Rice, white 3 lb 2 oz Vegetable oil 9 fl oz Gelatin, unflavored 2.25 oz
Canned Vegetable Spaghetti 11 oz Sugars and Sweets Italian herb seasoning .03 oz
Mushrooms 4 oz Milk and cheese Sugar, brown 1 oz Lemon juice, bottled .54 oz
Spaghetti sauce 26 oz Evaporated milk 4 oz Sugar, powdered 3 oz Oregano .18 oz
Tomato sauce 8 oz Milk, 1% 9 qt Sugar, granulated 9 oz Paprika .11 oz
Frozen Milk, whole 4 qt Jelly 8 oz Salt .13 oz
Orange juice concentrate (7) 12-oz cans Cheese, cheddar 2 oz Molasses 1 fl oz Soy sauce 2.26 oz
Broccoli 6 oz Cheese, cottage 7 oz Vanilla .52 oz
French fries 11 oz Cheese, mozzarella 1 oz
Data provided by United States Department of Agriculture Data provided by United States Department of Agriculture

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Data Sources: Food Affordability Data Sources: Food Accessibility
Market Basket Food Survey Instrument Sample
Item Item Price
Food Item Weight/ Unit
(Desired)
Weight/Unit
(Actual)
(Lowest
Cost)
 Knoxville Area Transit (KAT)
Fruit—fresh
Apples, any variety
(bagged or loose)
Per lb  Photos
Bananas Per lb

Grapes (green or red) Per lb

Melon (cantaloupe,
Per lb
honeydew, or watermelon)
Oranges, any variety
Per lb
(bagged or loose)
Data provided by United States Department of Agriculture

Data Analysis: Food Affordability
 Average Sector Market Basket Price (ASMBP)

 Average price of individual food items
 Average price per food category Community Characteristics
 Demographics against Market Basket Research
 Food Resource evaluation and comparison

22

Knox County Summary Knox County Summary
 Knoxville:
 Per Capita Income in 2006: $33,963
103.7 sq. mi.

 Unemployment rate 2006: 3.9%
 46% of the total county population
 2000 Census data: Total Population 382,000 individuals
 Employed labor force:
 14% increase from 1990 Census data  Education, health, and social services
 Traffic flow is a major concern occupations
 Existing roadways are inadequate for needs of  Majority Knox County residents:
increasing population and development
 White (88%), Black (8.6%)
 Currently seeking to meet needs by:
 Expanding sidewalk networks
 13 % of population were at or below the poverty
 Increase bicycle paths
level
 Knoxville Area Transit (KAT)
23 24
2000 Census data provided by Knoxville Metropolitan Planning Commission
Data provided by Knoxville Metropolitan Planning Commission

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Total Population of Knox County

 East County, South City, and South
County: fewest number of individuals

 Northwest, North, and Southwest Counties:
largest number of people

Source: Knoxville Metropolitan Planning Commission

Population Distribution & Gender Race & Ethnicity by Sector

2000 Census data provided by Knoxville Metropolitan Planning Commission 2000 Census data provided by Knoxville Metropolitan Planning Commission

Families and Individuals in Poverty
Income by Sector


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4/26/2010

Unemployment Rates of Knox County
Unemployment by Sector
Sectors

Sectors Rate (%) Tennessee United
(%) States (%)
Central City 11.6

South City 7.1 7.2 6.5
West City 3.1

Southwest 2.8
County


Education Level & Income Household Characteristics
Southwest County Southwest County & Central City
Central City West City
& West City Mean House
Value
>$200,000 $58,000
↑ % bachelor’s ↑ % education
& professional < 9th grade
degrees Vehicles per household
VS. Southwest & Northeast 2.0
↑ mean ↓ mean County
family family Central City 1.2
income income Average of Knox 1.78
Data provided by Knoxville Metropolitan Planning Commission 33
County

Market Baskets

2000 Census data provided by Knoxville Metropolitan Planning Commission 35 41

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4/26/2010

Retail Food Resources People Served by Grocery/Supermarkets and
Sector Name Grocery/ Convenience Beer/Wine/ Restaurants Secondary Markets (Meat/ Total
Total Retail Food Resources
Supermarket Stores Liquor (61%) Food Retailers Seafood/Fruit/
(8%) (18%) Stores (7%) Vegetable/Bakeries) Sector People per People per Retail Food
(4%) (3%)
Grocery/Supermarket Resource
Central City 19 30 7 136 9 10 211 Central City 2,534 228

East City 10 16 4 49 8 1 88 East City 2,547 289
North City 5 18 5 63 6 2 99 North City 5,068 255
Northwest City 6 18 4 67 10 1 106 Northwest City 4,662 263
South City 6 12 2 33 5 3 61 South City 3,086 303
West City 11 20 6 140 12 10 199 West City 1,815 102
East County 6 15 1 21 2 1 46 East County 2,218 289
North County 4 22 3 49 8 2 88 North County 10,639 483
Northeast 6 12 0 8 2 0 28 Northeast County 3,636 779
County

Northwest 10 30 4 56 10 2 112 Northwest County 6,286 561
County
South County 6,412 469
South County 3 10 3 21 3 1 41
Southwest County 5,129 267
Southwest 11 32 9 139 15 5 211
County

Total 97 235 48 782 90 38 1,290 Knox County Average 3,713 279


Average Sector Market Basket Price


Fresh Fruits and Vegetables Meat & Dairy Cost as a Percentage of Average Sector
As a Percent of Average Sector Market Basket Market Basket Price
Price

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Average Food Basket Price as a Percentage of
Mean Income by Area
Photographs: Retail Food Resources
 Highest income sector:
Southwest County
 Walgreens

 Lowest income sector:
Central City
 Walgreens


Photographs: Retail Food Resources
 Second highest income
sector: West City
 Kroger
Community Resources
 Second lowest income
sector: South City
 Kroger

51

Food Pantries Food Pantries County Wide

 80 food pantries

 Range of operation from once a month
to five days per week

 Some offer free clothing and furniture

Information from Knoxville Community Action Committee Food Pantry List provided by the Knoxville Community Action Committee. Pantries plotted on Google Map.

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Food Pantries Downtown Community Resources
 Community Action Committee (CAC)
 Homeward Bound Program
 Head Start
 Office on Aging
 Beardsley Farm
 Emergency Food Helpers
 National School Lunch Program
 National School Breakfast Program
 Second Harvest Food Bank
 Supplemental Nutrition Assistance Program (SNAP)
 Tennessee Nutrition and Consumer Education Program
(TNCEP)
 Supplemental Nutrition Program for Women, Infants, and
Children (WIC)
Food Pantry List provided by the Knoxville Community Action Committee. Pantries plotted on Google Map.

Transportation
Central City has 1.2 vehicles per household
 Increase reliance on restaurants and
Transportation
convenience stores
Vehicles per household
Southwest & Northeast 2.1
County
Central City 1.2
Average of Knox 1.78
County
56 57

Map of Knoxville Area Transit (KAT) System
Retail Food Resources
 Allows access to retail food resources
 Kroger-9 routes
 FoodCity- 5 routes
 Wal-Mart- 4 routes

Map provided by Knoxville Area Transit website (http://www.ci.knoxville.tn.us/kat/) Information provided by Knoxville Area Transit website (http://www.ci.knoxville.tn.us/kat/)

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Community Needs
There is a paradox of high availability and
low affordability of food in low income and
minority sectors
Discussion Market Basket survey showed food prices
are higher in low income and minority
sectors compared to more affluent and
primarily Caucasian sectors

Restaurants and convenience stores
60
represent the majority of food resources in 61
every sector

Moreland et al. (2002) Minority Sectors
 Neighborhood characteristics associated with the
location of food stores and food services places

 Findings:
1. Supermarkets were less prevalent in low-
income minority populations
2. Restaurants were most prevalent in low-
income minority populations
3. Fewer households in poor neighborhoods had
access to private transportation 62 63


Central and East City Northeast County and South County
 Low amount of Food stores
 High amount of Grocery stores
- Northeast County and South County have 6 and
- Central and East City have 19 and 10 3 grocery stores respectively
grocery stores respectively
Average mean incomes
Lowest mean incomes Sectors Mean Family Income
Sector Mean Family Income South County $59,193
East City $36,486 Northeast County $49,608
Central City $32,961 Mean County Income $53,978
Mean County Income $53,978 64 65
2000 Census data provided by Knoxville Metropolitan Planning Commission 65

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Market Basket Disparities
Restaurants and Convenience Stores

Restaurants outnumbered grocery and
supermarkets in every sector

Restaurants were 61% of retail food source
and grocery supermarkets were 8%

66 67

Local Food Environment Household Characteristics
 Prevalence of overweight and obesity

673 homes in Central City without
 Environmental influences on diet an partly
considered to involve two pathways: kitchen facilities
1. Access to foods for home consumption from - Food storage and preparation
supermarkets and grocery stores
- Other food alternatives
2. Access to ready made food for home and
out-of-home consumption
68 69

Source: Moreland et al. (2006); Cummins et al. (2005)

In Conclusion Future Considerations
 Distinguish various restaurants available within
communities

 Assess affordability and accessibility of public transit
services

 Involving Key Stakeholders

 Obtaining community’s perception

 Photovoice
Campbell C. Food Insecurity: A Nutritional Outcome or a Predictor Variable? Journal of Nutrition. 1991; 121: 408-415. 70 71
Source: Goodhart FE et al

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References References
 Campbell C. Food Insecurity: A Nutritional Outcome or a Predictor Variable?  Metropolitan Planning Commission (MPC) Sector Plans Online. Knoxville/Knox
Journal of Nutrition. 1991; 121: 408-415 Cohen B. United State Department of County. http://archive.knoxmpc.org/plans/sectorpl.htm Updated February 2002.
Agriculture Economic Research Service. Community Food Security Assessment Accessed October 2008.
Toolkit. http://www.ers.usda.gov/Publications/EFAN02013/. Updated July 2002.  Morland K, Wing S, Roux AVD, Poole C. Neighborhood characteristics associated with
Accessed November 21, 2008. the location of food stores and food service places. Am J of Prev Med. 2002; 22(1):23-
 City of Knoxville. Fares and Passes. 29.
http://www.cityofknoxville.org/kat/web%20pages/general%20info/Fares.asp.  Morland K, Roux AVD, Wing S. Supermarkets, other food stores, and obesity: the
Updated December 1, 2008. Accessed December 2, 2008. atherosclerosis risk in communities study. Am J of Prev Med. 2006; 30(4):333-339.
 City of Knoxville. Bus Route Destinations.  Morland K, Diez Roux AV, Wing S. Supermarkets, other food stores, and obesity: the
http://www.cityofknoxville.org/kat/web%20pages/Schedules/Destinations.asp. atherosclerosis risk in communities study. J of Prev Med. 2006; 30:333-339.
Updated April 6, 2008. Accessed December 2, 2008.  Nord M. United State Department of Agriculture Economic Research Service. Food
 Goodhart FE, Hsu J, Baek JH, Coleman AL, Maresca FM, Miller MB. A view Security in the United States: Definitions of Hunger and Food Security.
through a different lens: photovoice as a tool for student advocacy. Journal of http://www.ers.usda.gov/Briefing/FoodSecurity/labels.htm. Updated November 17,
American College Health. 2006; 55:53-56. 2008. Accessed November 21, 2008.
 Larsen K, Gilliland J. Mapping the evolution of 'food deserts' in a Canadian city:  Powell L, Slater S, Mirtcheva D, Bao Y, Chaloupka F. Food store availability and
Supermarket accessibility in London, Ontario, 1961-2005. International Journal neighborhood characteristics in the United States. Preventive Medicine [serial online].
of Health Geographics. 2008; 7 (Art. No. 16). March 2007; 44(3):189-195. Available from: Academic Search Premier, Ipswich, MA.
 Metropolitan Planning Commission (MPC) Planning Sectors. Knoxville/Knox Accessed November 20, 2008.
County MPC. PDF File of Each Sector, Source US Census Bureau.
http://www.knoxmpc.org/locldata/census00/sectmap.htm Updated September
2002. Accessed October 2008.

References
 Probert K. Moving to the Future. Population Profile Worksheets.
http://www.movingtothefuture.org/story_files/226/226_ss_file3.pdf. Updated 2006.
Accessed October 2008.
 Short A, Guthman J, Raskin S. Food deserts, oases, or mirages? Small markets and
community food security in the San Francisco bay area. Journal of Planning Education
and Research. 2007; 26 (3): 352-364.

Questions???
 Smoyer-Tomic KE, Spence JC, Raine KD, Amrhei C, Cameron N, Yasenovskiy V,
Cutumisu N, Hemphill E, Healy J. The association between neighborhood
socioeconomic status and exposure to supermarkets and fast food outlets. Health Place.
2007; 14:740-754.
 Timperio A, Ball K, Roberts R, Campbell K, Andrianopoulos N, Crawford D.
Children's fruit and vegetable intake: associations with the neighbourhood food
environment. Prev Med. 2008; 46: 331-335.
 United States Department of Agriculture. Community Food Security Assessment
Toolkit.http://www.ers.usda.gov/publications/efan02013/efan02013.pdf. Updated July,
2002. Accessed November 21, 2008
 Wang MC, Kim S, Gonzalez AA, MacLeod KE, Winkleby MA. Socioeconomic and
food-related physical characteristics of the neighbourhood environment are associated
with body mass index. J Epidemiol Community Health. 2007; 61:491-498.

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Food Equity In Knox County

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