A Tale of Two Cities: A Study of Access to Food, Lessons for Public Health Practice

Objectives: To map food access in the city of Preston in the north-west of England in order to determine access, availability and affordability of healthy food options. Design and methodology: The research design employed a number of distinct methods including: surveys of shops; interviews with local people and shopkeepers; a cost and availability survey of shops in two deprived areas of Preston--Deepdale and Ingol--the former with a majority South Asian population; and the use of geographical information systems to map access and availability. Results: (1) Preston had more fast food outlets (186) [not including restaurants who operate takeaways] than general groceries outlets (165). (2) There were more local shops selling affordable food in the area with the high South Asian population than in Ingol with its white working class population. There were clear gaps in provision and access in the white working class area (Ingol), with shops being more than 500 metres away from where people lived. Shops in this area stocked more familiar "British foods" and less specialist or fresh produce. (3) Analysis of the availability of some healthy options such as brown bread, wholemeal pasta and brown rice showed that they were not widely available within shops in the two areas. (4) The price of the "White British" basket in Ingol was 70.61 British Pounds (cheapest price). For comparable goods in Deepdale, using the most expensive shopping basket, the price for the same basket was 42.47 British Pounds. (5) A South Asian family shopping at a major national supermarket outlet in Deepdale would pay 47.05 British Pounds. Using local shops they could pay between 38.59 British Pounds and 44.28 British Pounds by seeking out the best bargains in five shops (including some top-up items from a national supermarket). (6) At the time of the research a mother with two children, entitled to income support and child allowance, would have to spend 28-32 per cent of her income in local shops and 34 per cent in a supermarket to buy a basket of healthy goods. Conclusions: There is a need to engage proactively with the location of shops in urban areas, to ensure they offer a healthy range of options and are sited near to where people live. The number of fast food outlets needs to be controlled and the food they offer improved.This latter issue of the number of outlets and quality of fast food contributes to an overall obesogenic environment. Access to food is heavily dependent on having access to a car; local shopping and the quality of food on offer are important for key groups such as those on benefits, the elderly, single parents and others with limited access to a car. Proactive policy solutions may lie with the engagement of health agencies with the planning processes in local authorities to ensure that the food retail environment reflects a healthy choice. Local area agreements between health agencies and local authorities offer a way forward, in that they can take into account the expressed needs of local residents. (Contains 1 table and 3 figures.)