Exploring Geographic Variations in Community and Consumer Food Environments for Children

Research indicates that diet influences the risk of childhood obesity, as well as other related health issues such as cardiovascular disease and type 2 diabetes. Given that families are spending more money on food away from home now than ever before, it is crucial to understand the food environment (FE) as it pertains to children. This thesis examines geographic variations in children’s FEs among varying levels of neighbourhood urbanicity and socioeconomic status, and Canada-US differences in three North American study areas: London, ON, Middlesex County, ON, and Rochester, NY, through the use of children’s menu audits and GIS-based analysis. In the London-Middlesex region, both level of urbanicity and level of socioeconomic distress are associated with junk food outlet density around elementary schools, while urbanicity is associated with branded marketing and inclusion of unhealthy desserts on children’s menus. When comparing London and Rochester, results indicate Canada-US differences exist and that neighbourhood restaurant quality increases with income level in Rochester, while in London, neighbourhood restaurant quality decreases with income level and increases with unemployment and percentage of lone parent families. These results indicate socioeconomically disadvantaged residents with fewer resources have fewer quality options available in Rochester while disadvantaged residents in London have better access to healthier options. The findings presented in this thesis not only contribute to the body of literature on children’s FEs, but support the development and implementation of restaurant and neighbourhood interventions focused on the promotion of healthy restaurant choices for children