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Snapshots of Urban and Rural Food Environments: EPOCH-Based Mapping in a High-, Middle-, and Low-Income Country from a Non-Communicable Disease Perspective

Spires, M., Berggreen-Clausen, A., Kasujja, F. X., Delobelle, P., Puoane, T., Sanders, D. and Daivadanam, M. (2020). Snapshots of Urban and Rural Food Environments: EPOCH-Based Mapping in a High-, Middle-, and Low-Income Country from a Non-Communicable Disease Perspective. Nutrients, 12(2), 484.. doi: 10.3390/nu12020484


A changing food environment is implicated as a primary contributor to the increasing levels of non-communicable diseases (NCDs). This study aimed to generate snapshots of selected external food environments to inform intervention strategies for NCD prevention in three countries: Uganda (low income), South Africa (middle income) and Sweden (high income), with one matched pair of urban–rural sites per country. Fifty formal and informal food retail outlets were assessed, and descriptive and comparative statistical analyses were performed. We found that formal food retail outlets in these countries had both positive and negative traits, as they were the main source of basic food items but also made unhealthy food items readily available. The Ugandan setting had predominantly informal outlets, while the Swedish setting had primarily formal outlets and South Africa had both, which fits broadly into the traditional (Uganda), mixed (South Africa) and modern (Sweden) conceptualized food systems. The promotion of unhealthy food products was high in all settings. Uganda had the highest in-community advertising, followed by South Africa and Sweden with the lowest, perhaps related to differences in regulation and implementation. The findings speak to the need to address contextual differences in NCD-related health interventions by incorporating strategies that address the food environment, and for a critical look at regulations that tackle key environment-related factors of food on a larger scale.

Publication Type: Article
Additional Information: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: food environment; low-, middle- and high-income countries; food retail outlets; food promotion
Subjects: G Geography. Anthropology. Recreation > GE Environmental Sciences
H Social Sciences > HM Sociology
Q Science > QR Microbiology > QR180 Immunology
R Medicine > RA Public aspects of medicine
T Technology > TX Home economics
Departments: School of Health Sciences > Healthcare Services Research & Management
Date Deposited: 25 Jun 2020 13:06
Text - Published Version
Available under License Creative Commons: Attribution International Public License 4.0.

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