Indicators of a health promoting local food environment: a conceptual framework to inform urban planning policy and practice
Issue addressed: Access to affordable, nutritious food is a social determinant of health (SDH). Accordingly, many studies have investigated how spatial access to food outlets impacts dietary behaviour, however the evidence is inconsistent. This paper proposes a conceptual framework of the local food environment to inform urban planning policy and practice. It identifies policy-relevant spatial indicators that could be used to measure and monitor local food environments. Methods: Informed by the SDH, a conceptual framework linked to urban planning policy was developed that mapped the potential pathways through which the local food environment contributes to dietary and health outcomes. Academic literature and urban planning policies were reviewed to identify spatial food environment measures at the neighbourhood-level associated with adult dietary intake and obesity. Results: Four spatial measures were selected as indicators of food availability and accessibility. The measures were attributable at the neighbourhood-level and can be operationalized at various geographical scales to enable food environments to be compared and monitored over time. Conclusion: There is growing interest by policy-makers, practitioners and researchers in developing spatial indicators of the built environment. Evidence-based spatial indicators of the local food environment have potential for identifying dietary and health inequities, and inform the development of urban planning policy and practice in local areas. So what? The conceptual framework proposes a set of evidence-based food environment indicators to inform relevant Australian state and local government urban planning policy for improved dietary and health outcomes, and to reduce inequities. These can be applied in local areas to help identify and monitor urban planning policy interventions to improve SDH within cities.