Dr. Aufses kindly sent me a follow-up after reading the first Food Environment post. Unlike the work related to the Retail Food Environment Index, which looks the proportion of grocery stores and farmers’ markets, compared to fast food and convenience stores, this work looks at the disparity in the availability of specific healthy foods at local stores in different neighborhoods in New York City (East Harlem versus The Upper East Side).

One thing that is nice about the work is the community based, participatory design (members of the East Harlem community helped design and implement the work). That said, in considering what to do about these macro level disparities (i.e., in this case, how can we expect people to eat healthy food if it is unavailable where they shop?), the researchers suggest that “East Harlem residents need to take the following steps to procure diabetes-healthy food:

a) become familiar with which food items (such as low-fat milk) are healthier,

b) recognize that many of their neighborhood stores do not carry these foods and forgo shopping at these undesirable stores,

c) be aware that other stores may offer healthier food choices, and

d) shop at these desirable stores instead.”

While these recommendations clearly make logical sense, another part of the story presented in the paper is the fact that residents of East Harlem may shop in local community stores because they are comfortable and familiar, may extend credit to neighborhood residents. Asking residents to completely change their shopping patterns does not seem to account for these types of psychological factors. Instead (or in addition), it seems that it would make more sense to provide incentives for small local stores to carry healthy foods.