Boston Public Housing Residents Lack Access to Healthy Foods.
Access and affordability are key barriers to Boston public housing residents who want to eat healthy and exercise, with many citing challenges getting to markets that have fresh fruits, vegetables, and meats, according to a study led by School of Public Health researchers.
Residents interviewed for the study, published in a special issue of the Journal of Prevention & Intervention in the Community, expressed disdain for expensive bodegas and corner stores, but said transportation problems made it hard for them to travel to “lower-priced, higher variety markets.”
They also identified cost, the requirement of a checking account or credit card, and a lack of affordable childcare as barriers to joining a gym where they could exercise.
The findings, based on focus-group interviews with 67 English- or Spanish-speaking residents of four city housing developments, shed light on the reasons why public housing residents are more likely to report fair or poor overall health status, diabetes, obesity, and a lack of physical activity compared with other Boston residents of comparable income levels.
The interviews showed that the residents had a clear understanding of what constitutes healthy foods and enjoyed preparing meals, but were stymied by transportation and money problems.
“Their knowledge of healthy nutritional choices, food preparation, and diet was not the primary barrier to healthy eating,” the authors said. Instead, “we learned of immediate needs and opportunities for interventions focused on transportation to low-cost, high-quality food purchasing options and gyms. These interventions could be tested among various public and private entities, from transportation companies (taxi-cab services) to the Transportation Authority.”
They said the provision of shuttle services provided by supermarkets also could be explored.
The study was funded by the CDC via the Partners in Health and Housing Prevention Research Center (PHH-PRC) at BU, a partnership between academic researchers at SPH, the Boston Housing Authority (BHA), the Boston Public Health Commission (BPHC), and the Community Committee for Health Promotion, representing residents of public family housing developments. Each year, the PHH-PRC provides small grants to new research initiatives aimed at improving the health of BHA residents. The SPH research team was awarded a grant to conduct eight focus groups at four developments in different neighborhoods of Boston.
Among the concerns cited by the residents interviewed were: the lack of access to affordable, quality meats; the challenges of relying on transportation by bus; and the abundance of fast-food restaurants and other unhealthy food choices.
At two of the four developments, residents said that bus service to preferred supermarkets did not run on weekends or evenings. Many participants described the disparate bus schedules “as a very basic fact of life,” and reported taking the bus to the supermarket and getting a taxi back when they were burdened by heavy grocery bags, the study says.
Taxi service also was a challenge.
“For those living near the border of another city or town where they prefer to shop, taxis charge an additional fee for crossing town lines, and once at the supermarket, it is often difficult to find a taxi willing to take them back across town lines to their homes,” the study says.
The authors also said many residents lack knowledge about the “benefits and incentives” of shopping at farmers’ markets, suggesting the need for better community education. Also, they suggested that gyms near the developments could design programs for low-income residents who do not have bank accounts, and that community centers should increase outreach and education about their programs and facilities.
The study’s lead author, assistant professor of environmental health Madeleine Scammell, worked with the BPHC to share the findings with Housing Authority officials and residents, and to highlight programs and opportunities in the area of each development.
According to Scammell, “BPHC and the Boston Housing Authority, along with the City of Boston, continue to look at ways to increase access to affordable and quality healthy food and beverages, as well as free or low-cost physical activity opportunities for all public housing residents.”
Other authors include: Shioban Torres, Julie Wayman, Nechama Greenwood, Lauren Kozlowski, and Deborah Bowen, all affiliated with the PHH-PHR; and Gerry Thomas, of the PHH-PRC and the Community Initiative Bureau of the Boston Public Health Commission.
Submitted by: Lisa Chedekel