https://theses.gla.ac.uk/ Theses Digitisation: https://www.gla.ac.uk/myglasgow/research/enlighten/theses/digitisation/ This is a digitised version of the original print thesis. Copyright and moral rights for this work are retained by the author A copy can be downloaded for personal non-commercial research or study, without prior permission or charge This work cannot be reproduced or quoted extensively from without first obtaining permission in writing from the author The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the author When referring to this work, full bibliographic details including the author, title, awarding institution and date of the thesis must be given Enlighten: Theses https://theses.gla.ac.uk/ [email protected] Socio-spatial variations in urban food price and availability and their implications for healthy eating Steven C J Cummins Thesis submitted for the degree of Doctor of Philosophy at the University of Glasgow MRC Social & Public Health Sciences Unit December 2001 © Cummins 2001 ProQuest Number: 10646390 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a com plete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uesL ProQuest 10646390 Published by ProQuest LLO (2017). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States C ode Microform Edition © ProQuest LLO. ProQuest LLO. 789 East Eisenhower Parkway P.Q. Box 1346 Ann Arbor, Ml 48106- 1346 ABSTRACT Background: Previous research has suggested that foods which are beneficial to health are more expensive, and more difficult to obtain, in deprived as compared to affluent areas, and that this may help to explain the greater adherence to healthy eating guidelines in more affluent areas of the UK. Recent government policy initiatives to combat poor access to healthy diets have been partly based upon studies that have investigated intra-urban spatial variations in food price and availability. However those studies which provide the evidence base for government policy are: few in number, on a very small scale, and based upon data which in light of recent changes in the food retail economy may be out of date. Aims: This study aims to rectify these problems, and to update and extend previous surveys. In doing so it addresses four main questions: • Are there spatial variations in food retail provision in urban areas of the UK? • Does the price and availability of food vary by type of shop in an urban area? • Aie there differences in food price and availability by level of deprivation in urban areas? • Which is the strongest predictor of food price and availability: shop location, shop type or magnitude of area level of deprivation? Method: A survey, on foot, of the price and availability of fifty-seven food items taken from the Family Budget Unit’s ‘Modest but Adequate Diet’ (1993) was undertaken in a random sample of food retail stores drawn from the Public Registers of Food Premises covering the Glasgow area, a large and socially heterogeneous urban centre in the West of Scotland. A response rate of 97.7% (n=250) of eligible food stores was achieved. Results: In the majority of cases, the price and availability of these food items did not significantly differ between areas at a variety of spatial scales. Those food items that did significantly differ in price were found, for the most part, to be cheaper in poorer areas. For food availability no real pattern was detected. The location of food shopping opportunities in the city was, on the whole, evenly distributed and the types of stores that present the greatest opportunities in teims of price efficiency and food availability were evenly distributed in poorer areas. Some of those few foods that did differ significantly in price and availability were items whose consumption is discouraged in contemporary dietary guidelines. Conclusion: This project is the largest and most systematic study of spatial variations in food price and availability undertaken to date in the UK. Previous research literature has suggested that food is more expensive and less available in poorer urban areas, and that some deprived urban areas do not have adequate food shopping facilities. This study provides some evidence that this is not the case in Glasgow in the late 1990s. Changes in the food retail economy since the early to mid 1990s may have precipitated this change. ACKNOWLEDGMENTS There have been lots of people of have helped and encouraged me over the course of this thesis. Firstly I would like to thank my supervisor Prof Sally Macintyre. Not only did she provide me with excellent supervision but also allowed me to pursue a whole host of other wonderful academic opportunities (some say diversions) during the course of this thesis. I would also like to thank my colleagues at the MRC Social & Public Health Sciences Unit, particularly Geoff Der for patiently explaining the workings of SPSS. Thanks also go to Professor Leigh Sparks at the University of Stirling and Mark Petti crew at the MRC for reading complete drafts and providing excellent feedback and comments. I have come into contact with a wide variety of people, some of whom have become friends and more, during the course of this thesis. They have provided encouragements, diversions and drunkenness and are too many to mention here. However I would particularly like to mention the following; my parents (despite having to explain what actual use a PhD was on a regular basis), my sister Fiona (for pressing random telephone buttons), Rhona McLennan, James Leek, Caroline McDermott, Helen Betts (for frequent roast dinners) and also my friends back in Southend-on-Sea; Jon, Rob, Jason, Suzy & Carlton (who all assume that a PhD is a route to riches and glory). Special thanks go to Ceinwen for email encouragement and more during the last 12 months. CONTENTS Chapter 1: Literature Review 1 1.1 Geographical inequalities in mortality and morbidity 2 Explanations for geographical differences in 4 mortality and morbidity Compositional and contextual effects on health 4 1.2 Diet, deprivation and context 8 1.2.1 The social patterning of diet 9 1.2.2 The price and availability of food 12 1.2.3 Problems with food price and availability studies in the UK 17 Food economy, food politics and food policy 20 Food deserts in policy documents 20 Contestable evidence? 21 1.3 What this study does 24 Chapter 2: Design and Methods 25 2.1 The study site 26 2.2 Sample frame, size and selection 29 2.2.1 Definition of shops used in the study 31 2.2.2 Selecting shops for the pilot sample 32 2.2.3 Selecting shops for the main sample 34 2.3 Shopping survey design 35 2.3.1 Design of the information leaflet 36 2.3.2 Content of the data collection form 37 General descriptive data 37 Definition of foods in the shopping basket and data collected 37 2.4 Data collection 45 2.4.1 The pilot survey 45 Conducting the pilot survey 46 Changes made as a result of the pilot survey 47 2.4.2 The main survey 48 Response rates for the main survey 49 Data entry, coding and preparation 51 2.5 The inclusion of data from secondary sources 51 A note about the geographical units used in this study 51 Postcode district 52 Postcode sector 52 Measures of deprivation 52 2.6 Method of analysis 53 Statistical tests used in each results chapter 57 Presentation of results 59 Potential problems with statistical analysis 59 Chapter 3: Food Retailing and Food Choice 62 3.1 Food retailing and food choice in Britain 62 Changes in British retail structure 63 3.1.1 British retailers and food choice 66 Food retailers, food products and food choice 66 Food retailers and the re-organisation of retails space in the 67 1980s and early 1990s UK retailing in the late 1990s: rise of the discounters and a 69 return to the high street 3.1.2 The Scottish grocery market 71 The national picture 71 Glasgow’s retail structure 75 3.2 A description of food retailing in the study sample 86 Chapter 4: Shop type differences in food price and availability 94 4.1 Results from the survey: food price 97 Food price in all stores 98 Food price in multiple stores 101 Food price in independent stores 103 Small stores or big stores? 106 Which foods are cheapest in which shops? 115 4.2 Results from the survey: food availability 116 Problems of comparability in measuring food availability 118 by shop type Summary 119 Chapter 5: Area deprivation, food price and food availability 121 5.1 Food price and area deprivation 123 5.1.1 Food price by deprivation at health board locality level 125 All shops 125 Independent stores 126 5.1.2 Food price by deprivation at the postcode district level 129 All shops 129 Independent stores 131 5.1.3 Food price by deprivation at the postocde sector level 134 All shops 134 Independent stores 136 Summary of Chapter 5.1 139 5.2 Food availability and area level of deprivation 142 5.2.1 Food availability by deprivation at the health board locality level 143 All shops 143 Independent stores 145 5.2.2 Food availability by deprivation at the postcode district level 148 All shops 148 Independent stores 150 5.2.3 Food availability by deprivation at the postcode sector level 154 All shops 154 Independent stores 156 Summary of Chapter 5.2 159 Chapter 6: Predicting