Where do people find healthy foods and places to be physically active in their neighborhoods and communities? If you follow the latest methodology, you would use GIS to plot all of the food service establishments, grocery and convenience stores and recognizable activity centers (such as Boys & Girls Clubs, YW/MCAs, fitness centers, parks, etc...). With easily accessible databases on such establishments and mapping software, creating these types of maps are much easier than they were not so long ago. As examples, fast food restaurants in New Orleans were plotted by Block, Scribner & DeSalvo (2004) to explore whether the density of fast food restaurants in certain neighborhoods (in this case, black and low-income ones) may contribute to the understanding of environmental causes of the obesity epidemic.
Research has shown that supermarkets in the US, on average, have 10% lower prices than other food retailers including convenience stores and “mom-and-pop” stores. Kaufman (1999) mapped access of low-income households to larger grocery stores by calculating annual food stamp redemptions by stores in 36 rural, high poverty counties in the lower Mississippi Delta. He found that over 70% of the food stamp eligible population in this area had to make trips of more than 30 miles to reach the less expensive supermarkets. Not surprisingly then, only 42% of food stamp redemptions were made at large supermarkets, and led to the conclusion that large numbers of poor households in these counties lack access to lower-cost foods.
Larsen & Gilliland (2008) used GIS mapping software to document the number and location of supermarkets in London, Ontario over the last 40+ years. They found that "spatial inequalities" in access to supermarkets have increased over time to where there are now food deserts in inner-city neighborhoods.
I wanted to add some examples here using physical activity 'places' as the point-of-interest, but surprisingly found that a Google Scholar search of "maps physical activity" returned no studies among the first 200 that used GIS systems to understand 'spatial inequality' and access issues in ways like we have seen for nurtrition and food issues. Some of you may recall a ealier piece on the [murmur] project that was a remapping and cultural preservation mashup that encouraged walking via guided or enabled tours of neighborhoods using mobile technology.
There are many GIS mapping software options available, but to try it out first Google maps is among the least costly (in terms of money and learning curve) and if it's good enough for the New York Times and The Guardian, well...give it a try (here's a quick one I did on the location of graduate courses in social marketing across the world a while back - feel free to add to it!) and also read through Google Maps Mania for more inspiration on how to make maps work for you and your puzzles.
You may have noticed the examples were quite specific descriptions of problems - lack of easy access - but fell short on insights into how to solve the puzzle (unless you belong to the 'top-down' crowd who would gesture to a point on the map and exclaim "Put one here!" and consider their work done).
My proposal is that we expand the use of GIS mapping software to develop an objective base from which to evolve environments to ones that provide equitable opportunities and access for people - to purchase affordable, healthy products; use safe places for physical activity; and engage in behaviors that improve their health and well-being.
But what if we also complemented this approach with another one that sought to gain perspective and insight into how people view their environment with respect to these behaviors?
What if we...
- didn't have distribution systems but places where people could play
- didn't use focus groups but designed research to fit the puzzle and people
- didn't assess knowledge and attitudes but sought insight into motivation and values
- didn't start with analyzing people but first assumed that it was something in their environment
As someone who designs interventions for public health and social change, I would likely find more value in the maps people draw for us about food outlets and places to be physically active than the plotting of data on Rand McNally. What they believe is around them may be more important in how they go about their lives and make food and activity choices than the objective reality. Giving people the opportunity to describe for us how they perceive, construct and experience their environment is a step in moving from description to insight. And allowing them to express themselves in ways other than words moves us closer to narrowing the “say - mean” gap and designing programs based on their lives and not just on data points.
Grant McCracken recently discussed how the remapping process is one way of creating culture. His examples included the iconic 'View from New York' map that demonstrated psychological space as much as geographic persepctive, a food map of the New York Subway system, and a map by a 3-year-old of New York City. These types of maps don't replace other ones; they give us an insight or another perspective for navigation in the world of the people we intend to serve. If we aspire with social marketing to create a culture of healthier food choices and more opportunities for physical activity, shouldn't we have some maps? Not only for what it objectively looks like, and how people see it for themselves today -- but what it should look like in the future from their perspective as well (and not just from the planners POV)?
There is some evidence in public health that the approach is feasible. Hume, Salmon & Ball (2005) asked 147, 10-year-old children to draw maps of their home and neighborhood environments to understand their perceptions of their environments, and to examine associations between these perceptions and objectively measured physical activity. A subsample of children were also asked to photograph places and things in these environments that were important to them. "The maps were analyzed for themes, and for the frequency with which particular objects and locations appeared. Physical activity was objectively measured using accelerometers. Six themes emerged from the qualitative analysis of the maps and photographs: the family home; opportunities for physical activity and sedentary pursuits; food items and locations; green space and outside areas; the school and opportunities for social interaction. Of the 11 variables established from these themes, one home and two neighborhood factors were associated with children's physical activity." (quote from the abstract)
What stands out in their findings is that fewer than half of the children drew any physical opportunities at home while 2/3s drew some type of sedentary activity. School playgrounds figured prominnetly in many depictions of physical activity opportunities outside of the home. Also interesting to me was that 70% of children identified at least one food outlet on their maps and, among the girls, this was postively associated with moderate levels of physical activity. The authors assume this finding may reflect that the food outlets are destinations to walk to or could reflect greater knowledge of their neighborhhods because they move around them more than the sedentary girls. Unfortunately, the authors did not take the next step in this paper of moving from insights to programs. But by now you may be getting some ideas.
And if asking people individually to do this may seem time and labor intensive, you could also try cowdsourcing the project and let people add their own locations and comments through free mapping platform Crowdmap.
So try going out with people and have them give you a guided tour of their life. Who knows what you'll discover?
Block, J.P., Scribner, R.A. & DeSalvo, K.B. (2004). Fast food, race/ethnicity, and income: A geographic Analysis. American Journal of Preventive Medicine, 27: 211-217.
Hume, C., Salmon, J. & Ball, K. (2005). Children's perceptions of their home and neighborhood environments, and their association with objectively measured physical activity: a qualitative and quantitative study. Health Education Research, 20:1-13. (free pdf)
Kaufman, P. R. (1999). Rural poor have less access to supermarkets, large grocery stores. Rural Development Perspectives, 13: 19-26. (free pdf)
Larsen, K. & Gilliland, J. (2008). Mapping the evolution of 'food deserts' in a Canadian city: Supermarket accessibility in London, Ontario, 1961–2005. International Journal of Health Geographics, 2008, 7: 16 doi:10.1186/1476-072X-7-16.(html version)