Food environments

The foods that people choose to consume are influenced by the availability, affordability, and accessibility of foods in the environments in which they live, work, and play. Defined by the built and social environments, including physical, social, economic, cultural, and political factors, food environments play an important role in shaping diets and eating habits. A healthy food environment provides equitable access to healthy foods such as fruits, vegetables, whole grains, and healthy snack options in various food retail outlets. There is strong evidence linking diet to the risk of developing chronic diseases, including cancer, coronary heart disease, and stroke, as well as health conditions such as hypertension, diabetes, and obesity. As the prevalence of chronic diseases rises in Canada, public health must increase efforts to curtail this trend to prevent an unsustainable growth in the associated healthcare expenditures and economic burden.

This collection of resources:

• Introduces the concept of healthy food environments and how they pertain to public health and environmental health practice
• Includes tools for measuring local food environments, and planning and implementing appropriate interventions
• Provides an overview of the current state of food environments in Canada

Fundamentals in food environment

• Inequalities in research on food environment policies: An evidence map of global evidence from 2010-2020 (Blanchard et al., 2024)
  This journal article reviews the primary research from 2010-2020 that evaluated the effectiveness, cost-effectiveness, development, and implementation of mandatory and voluntary food environment policies and identifies key research gaps.
   
• Connected food: First steps for an ambitious national food strategy (Boyle et al., 2024)
  This journal article highlights pressures on the global food system including population growth, climate change, and geopolitical instability. A UK perspective is provided on the need for system level changes to the UK’s national food strategy to holistically address the challenges facing food systems.

• Food environment research in Canada: A rapid review of methodologies and measures deployed between 2010 and 2021 (Vaillancourt et al., 2024)
  This review article provides a comprehensive overview of methodologies and measures used to assess food environments in Canada between 2010-2021, including food marketing, labelling, prices, provisions, composition, retail, and trade and investment.

• Special issue: The food environment in Canada, Part I (HPCDP Journal, PHAC, 2017)
  This special issue of the Health Promotion and Chronic Disease Prevention in Canada journal includes several articles on food environments in Canada, ranging from marketing to children, food environment assessment tool in supermarkets in Montreal, healthy eating at schools, and the Ontario food and nutrition strategy.
   
• The Ontario Food and Nutrition Strategy: identifying indicators of food access and food literacy for early monitoring of the food environment (Boucher et al., 2017)
  This journal article introduces the Ontario Food and Nutrition Strategy (OFNS), which aims to improve the health of Ontarians through actions that promote healthy food systems and environments. This report describes the process of identifying indicators for 11 OFNS action areas in two strategic directions: Healthy Food Access, and Food Literacy and Skills.
   
• Food deserts and food swamps: A primer (2017)
  This NCCEH primer discusses food deserts and food swamps and highlights some opportunities for action and collaboration between governments, public health, and business operators.

Creating healthier food environments

• Planning healthy food environments: An analysis of local government municipal public health and wellbeing policy in regional Victoria (Dangerfield et al., 2024)
  This journal article examined seventeen policy documents in Victoria, Australia, including council plans, municipal public health and wellbeing plans, and a food systems strategy to determine how public policy supports the creation of healthy food environments.
   
• Effectiveness of interactive technology-assisted interventions on promoting healthy food choices: a scoping review and meta-analysis (Chew et al., 2023)
  This scoping review examines how technology such as mobile apps, wearable devices, online programs, and social media can influence healthy eating habits. The review analyzed 17 studies involving 3,988 participants, focusing on outcomes like weight, calorie intake, and consumption of various food groups.
   
• Food environment around schools: A systematic scope review (França et al., 2022)
  This systematic scoping review is a review of studies on the food availability and food environment surrounding schools and the potential impact on the health of children and adolescents. The influence of the food environment at home is also discussed.
   
• Mapping the digital food environment: A systematic scoping review (Granheim et al., 2022)
  This systematic scoping review explores how digitalization of food environments, such as the use of technologies to improve food production and distribution, and food and grocery delivery platforms, is reshaping food availability, acquisition, and consumption.
   
• Implementing food environment policies at scale: What helps? What hinders? A systematic review of barriers and enablers (Nguyen et al., 2021)
  This systematic review identifies key barriers and enablers to the implementation of healthy food and drink policies such as healthy retail food availability and promotion to support healthier food environments.
   
• Policies to create healthier food environments in Canada: Experts’ evaluation and prioritized actions using the Healthy Food Environment Policy Index (Food-EPI) (Vanderlee et al., 2019)
  This journal article evaluates food environment policies in Canada using the Healthy Food Environment Policy Index (Food-EPI) tool by enlisting experts from across Canada to rate the policies against best practices.
   
• The impact of community-based food access strategies in high-income countries: a systematic review of randomised controlled trials (Marjanovic et al., 2023)
  This systematic review examines community-based interventions including food pantry-based interventions, mobile produce markets, and community farms and their effectiveness in improving access and purchase of healthy food.

Retail food environments

• Factors influencing implementation, sustainability and scalability of healthy food retail interventions: A systematic review of reviews (Gupta et al., 2022)
  This systematic review analyzes factors that influence the success of healthy food retail interventions, including implementation, sustainability, and scalability, to improve the healthiness of consumers’ food choices and purchases.

• Retail food environment intervention planning: Interviews with owners and managers of small- and medium-sized rural food stores (Hasdell et al., 2021)
  This journal article describes the outcomes of interviews with owners and operators of rural food stores in British Columbia during the planning process of a health promotion intervention. The study assessed the importance of business models, regional travel, balancing food choices and profitability, and relationships with suppliers, among other considerations.
   
• A systematic review of the effect of retail food environment interventions on diet and health with a focus on the enabling role of public policies (Mah et al., 2019)
  This systematic review describes the state of evidence on the effectiveness of retail food environment interventions in influencing diet, and explores the underlying role of public policy by reviewing population-level interventions that promote health in the retail food environment, including community and consumer environments.

Healthy food environments in Indigenous populations

• Food security and climate change impacts in remote and Indigenous communities in British Columbia (Hatch and Hassen, 2024)
  This NCCEH blog describes a project started in 2022 to supplement the Food Costing in BC: Assessing the Affordability of Healthy Eating initiative to better understand and contextualize peoples’ experience of food access and affordability in remote Indigenous and non-Indigenous communities in the province.

• The retail food environment, store foods, and diet and health among Indigenous populations: A scoping review (Luongo et al., 2020)
  This journal article describes the state of knowledge on how retail food environments contribute to diet-related health and obesity among Indigenous populations and assess how the literature incorporates Indigenous perspectives, methodologies, and engagement throughout the research process.

• "To me, policy is government": Creating a locally driven healthy food environment in the Canadian Arctic (Fournier et al., 2019)
  This journal article discusses how policy is perceived by Indigenous populations, and locally-driven strategies to support healthy food environments in Indigenous communities with an emphasis on community involvement and culturally appropriate approaches.