Determinants and public health effects of food cost and availability in two neighborhoods of Hamilton, Ontario

Abstract

<p>Diet can powerfully shape human health. Biocultural theory suggests that variation in the cost and availability of food is one factor that affects the health of individuals of differing affluence in dissimilar ways. Though appreciation for the importance of social determinants of healthy eating is growing, very few Canadian studies address links between economic and nutritional variation. To partially address this knowledge gap, this thesis employs a mixed-methods approach including mapping, interviews, face-to-face surveys, and surveys of food cost and availability to investigate whether the cost and availability of food varies between socioeconomically distinct areas of Hamilton, Ontario, and how these differences, if they exist, might differently influence public health in the two areas. Food cost was not found to vary between the two areas, though the availability of food, especially produce, differed. It is suggested that reduced food availability, along with lower incomes and reduced access to transportation, combine to make purchasing foods consistent with a healthy diet more difficult in the less-affluent study area. Interviews with public health workers suggest that this, in conjunction with divergent shopping habits, negatively influences public health in the less-affluent area, but robust quantitative public health data to support or disprove this assertion are lacking at present. As low-income is a strong determinant of inadequate diets, economic approaches designed to make healthy diets more affordable for and readily available to lower-income Canadians are discussed. Links between economics and nutrition are complex; future research into the determinants of healthy eating will need to take into account the dietary, linguistic, and cultural diversity found in contemporary Canadian society, along with temporal and spatial variation in food cost and availability.</p>