Food environment in elementary school catchment areas of varying poverty levels: A qualitative assessment

Objective: Low-income children experience higher rates of obesity and associated co-morbidities. The food environment in elementary catchment areas with the highest, median, and the lowest percent of Philadelphia households in poverty were qualitatively compared to investigate this disparity. Method: An environmental assessment was performed in each catchment using a GPS device. The walking paths spiraled out from the school and averaged 2.75 miles. Food items, food outlets, and promotional signage were documented in field notes and photography. The observations were compared across areas to identify risk factors for unhealthy dietary patterns and childhood obesity. Results: The elementary catchment areas with the lowest poverty (LP) differed markedly from the median poverty (MP) and highest poverty (HP) areas. The LP area had the most food outlets compared to the MP and HP areas (26 vs. 13 vs. 11). The majority of the outlets in the LP area were specialty shops and sit-down restaurants. The majority of the outlets in the MP and HP areas were small-independently owned grocery stores. No fast-food restaurants were located in the MP or HP area assessments and one was located in the LP area assessment. Each area had a large supermarket within one mile of the school. The MP and HP areas had more advertisements for energy-dense, processed foods than the LP area. Conclusion: Aspects of the food environment, particularly food outlets and advertising, differed between elementary catchment areas of high, mid, and low poverty levels. Interventions to reduce childhood obesity should address these environmental risk factors.