What did you do for your PhD?
I wanted to see how living within walking distance of various types of restaurants might impact body mass index (BMI) and the risk of developing diabetes. I focused on adults living in urban, residential areas in Toronto, Mississauga, Brampton and Hamilton. I found that the double whammy of living near lots of fast-food restaurants with few dining alternatives (like sit-down restaurants and cafes) was associated with increased risk of higher BMI and diabetes.
The research suggests that policies that achieve a better balance of restaurant types with more alternatives to fast food could go much farther in reducing the risk of obesity/diabetes. Policies that merely target the volume of fast-food or other retail food outlets may have limited effectiveness without a consideration of the overall balance of the retail food landscape.
Why drew you to the topic?
I was interested in chronic disease related to diet, but realized early on the limitations of behavioural interventions that assume people’s choices and behaviours are primarily shaped by personal decisions and responsibility. I wanted to look at how our everyday environments may “invisibly” shape people’s choices and related health outcomes.
What are you doing at C-UHS?
My PhD focused on a handful of areas in southern Ontario. I also looked at a particular cohort – people who participated in the Canadian Community Health Survey, a large group that is supposed to be representative of the general population. We want to see if our findings are replicable in other settings, and with different cohorts. We’re also looking at other outcomes that may be associated with the local retail food environment, such as hypertension and heart attacks.
What would you like to see happen?
I’d like to see an environment where the healthy food choice is the most available, affordable and preferred choice. Neighbourhood food environment is only part of the equation, however, and a lot more would have to change beyond reducing fast food outlets to meaningfully transform our current food environments.
Are you hopeful?
If you step back, if you think about what’s actually shaping our food environment, those forces seem difficult to tackle – industrial agriculture, multi-national corporations, international trade policies. There’s huge financial interest in the status quo. At the local level there are some opportunities to make things better, and that’s where my work is focused at the moment. Some cities are starting to see food access as part of city planning. The Region of Peel Public Health is about to unveil a strategy related to both built and food environment, and they used some of our work to inform its development.
What does this look like in concrete terms?
Local governments can use zoning policy to create healthier food environments. For example – some are moving to limit the number of fast food outlets around schools. Public institutions that serve food such as hospitals and schools are also a good place to focus. Toronto has a pilot where they’ve partnered with a corner store to see it stock fruits and vegetables. They helped with signage, suppliers, and dealing with issues like spoilage – making sure it was economically viable for the store itself.
One thing you’d like to see happen differently in the research world?
More opportunities to connect to community and policy-makers. Policy design often happens in isolation from researchers and the best available evidence.
Mahendra A, McBrien T, Polsky JY, Robitaille E, Lefebvre M, Minaker LM. Geographic retail food environment measures for use in public health. Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice (in press).
Polsky JY, Glazier RH, Moineddin R, Dunn JR, Booth GL. Relative and absolute availability of fast-food restaurants in relation to the development of diabetes: a population-based cohort study. Canadian Journal of Public Health 2016 Jun 9;107(Suppl. 1):eS27-eS33. DOI: 10.17269/cjph.107.5312.
Polsky JY, Moineddin R, Glazier RH, Dunn JR, Booth GL. Absolute and relative densities of fast-food versus other restaurants in relation to weight status: Does restaurant mix matter? Preventive Medicine 2016; 82(1): 28-34. DOI: 10.1016/j.ypmed.2015.11.008.
Salehi L, Lofters AK, Hoffmann SM, Polsky JY, Rouleau KD. Health and growth status of immigrant and refugee children in Toronto, Ontario: A retrospective chart review. Paediatrics & Child Health 2015; 20(8): e38-e42.
Polsky JY, Moineddin R, Glazier RH, Dunn JR, Booth GL. Exploring food landscapes in southern Ontario: access to more and less healthy food retail according to level of neighbourhood deprivation. Canadian Journal of Public Health 2014; 105(5): e369-e375.