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Colorado Food Assessment Framework:
 Module 4 – Food Access, Security & Resiliency

                                             DRAFT
                                           May 21, 2011




A handout for the session: “Assessing and Using Food Data to Support Collaborative Policy Decisions” at
the Community Food Security Coalition’s conference, Food Policy from Neighborhood to Nation, Portland,
OR, May 19-21, 2011.




Background on the Project: The Colorado Food Assessment Framework is being developed to assist the
increasing number of community and state advisory groups interested in conducting food assessments of
their local or regional food system in order to inform food policy councils, farm to school efforts, and
other policy action. The Framework consists of four modules: (1) Food Security, Resiliency and Access, (2)
Food and Agriculture Production, (3) Transportation and Distribution, and (4) Food Processing. The
Framework has been developed with the intention of integrating it into an online, interactive tool to
provide a “one-stop shop” for communities to obtain guidance, easily access comprehensive food
systems indicators, and share what they learn, thus contributing to a broader, common body of
knowledge in the state.




                                  DRAFT Document – Not for Distribution

The Colorado Food Assessment Framework is being developed by WPM Consulting and the Center for Systems
Integration on behalf of LiveWell Colorado. This project is sponsored by the Colorado Department of Public
Health and Environment with funding through a cooperative agreement with the Centers for Disease Control and
Prevention, grant number FOA#90101ARRA09. For questions regarding this document, please contact
wendy@WPMconsulting.com.
Worksheet: Planning for Your Community Food Assessment                                            1|Page


 Instructions: Before you can begin to collect data for your community food assessment, you
 will need to decide on the boundaries for your assessment. Use the questions on this
 worksheet to help guide your deliberations. Use the considerations side of the worksheet to
 help inform your discussions. You can either type or write your notes in the blank spaces of the
 worksheet table.
                   Questions to Answer1                                         Considerations
1.    What is the purpose of your food assessment? The
                                                                         Needs Assessment and Planning
     purpose will drive decisions about who should be
                                                                          to identify priorities for action in a
     involved in the assessment, what information is
                                                                          particular community.
     needed, how much time should be devoted to the
     process, what type of data to collect, and how to share             Population-level Surveillance to
     the findings.                                                        monitor       trends    in  access,
                                                                          availability,      quality,    and
                                                                          affordability of food.
                                                                         Research to gain a better
                                                                          understanding of the most
                                                                          important factors in environments
                                                                          affecting obesity and chronic
                                                                          disease.
                                                                         Evaluation to improve programs
                                                                          or policies and to assess their
                                                                          effectiveness.
                                                                         Advocacy to engage stakeholders
                                                                          and decision makers to affect
                                                                          policy and environmental changes
                                                                          in the food environment.




 1Table derived from Pothukuchi, K., Joseph, H., Burton, H., & Fisher, A. (2002). What’s cooking in your food
 system? A guide to community food assessment. Venice, CA: Community Food Security Coalition, pages 53-
 55.


 Prepared by the Center for Systems Integration and WPM Consulting
Worksheet: Planning for Your Community Food Assessment                                 2|Page


               Questions to Answer1                                   Considerations
2. What boundaries are suggested by your assessment      Boundaries can be classified in four ways.
   purposes, goals, and questions? Ask yourself:         Most assessments include more than one
                                                         category:
   What’s the appropriate scale of study to encourage
    community participation, and where is there good 1.      Political or jurisdictional: Most
    potential for such participation?                  common type of boundary used in FAs.
                                                       Data are gathered based on political
   How does the community define its own boundaries such as cities, counties,
    boundaries? Is there a cohesive community sense neighborhoods. Secondary data largely
    within certain boundaries?                         follows these boundaries.


   Do you want to focus on particular ethnic and socio- 2. Service designations: These include
    economic groups, or a mix of groups?                 school districts, voting precincts, census
                                                         tracts, etc. Some secondary data is only
   Is the community representative of larger trends in available by service designations, e.g.,
    the region?                                          census tracts, therefore your FA may, by
                                                         default, include this type of boundary for
   Where do you expect to conduct follow-up activities some data.
     once the assessment is completed?
                                                         3.      Ethnic/cultural/social:   Some
                                                         neighborhoods have distinct, known
                                                         cultural centers even if not officially
                                                         designated. While such boundaries can
                                                         engender a cohesive understanding and
                                                         engagement of a subpopulation, likely
                                                         there will be few if any secondary data
                                                         that falls within these boundary
                                                         designations.


                                                         4. Environmental: Rivers, mountain
                                                         ranges, watersheds can make for natural
                                                         boundaries that are related to food
                                                         systems; however, these are unlikely to
                                                         match with existing data sets.




Prepared by the Center for Systems Integration and WPM Consulting
Worksheet: Planning for Your Community Food Assessment                                     3|Page


                 Questions to Answer1                                    Considerations
3. What kinds of data do you anticipate being central to To conduct a community food assessment,
   your study, and what boundaries are associated with different types of data are useful.
   that data?                                            1. Secondary Data: This is data that has
                                                         already been collected by other
                                                         organizations, e.g., the U.S. government,
                                                         state         government,         non-profit
                                                         organizations,        and       universities.
                                                         Sometimes this data was collected
                                                         specifically to assess food system issues
                                                         but oftentimes the data of interest is part
                                                         of a larger effort to track trends, some of
                                                         which are applicable to understanding
                                                         food systems. Whenever possible, it
                                                         behooves a community to utilize as much
                                                         secondary data as possible. However,
                                                         many communities will find that they
                                                         cannot fully assess their food environment
                                                         based on existing data along. In that case,
                                                         primary data collection will be necessary.


                                                            2. Primary Data: Primary data refers to
                                                            original data collection. There are many
                                                            methods of collecting primary data
                                                            including     through       questionnaires,
                                                            interviews, focus groups, observation, and
                                                            case-studies. The advantage of primary
                                                            data collection is that you can tailor your
                                                            instrument to capture exactly the
                                                            information you need. However, the
                                                            disadvantages are substantial, including
                                                            the time and skill needed to construct a
                                                            valid data collection instrument, and the
                                                            cost of collecting, recording, coding, and
                                                            analyzing the data.




Prepared by the Center for Systems Integration and WPM Consulting
UNDERSTANDING YOUR FOOD ENVIRONMENT
                                                   Using Existing Indicators to as a Starting Place

RETAIL STORES
Strategies and policies to improve the food environment can include increased access to healthier foods such as through retail vendors. Supermarkets
and grocery stores typically sell a higher proportion of fruits and vegetables compared to convenience stores, gas marts and small corner stores.
Research finds that adults’ fruit and vegetable intake increases with the addition of new supermarkets – specifically African Americans’ consumption
increased by 32% for each additional supermarket and Caucasians’ increased by 11% with the presence of one or more supermarkets (Morland, Wing,
& Diez Roux, 2002); yet, there are fewer supermarkets in minority and low income communities than Caucasian and higher socioeconomic
neighborhoods (Morland, Wing, & Diez Roux, 2002; Morland, Wing, & Diez Roux, & Poole, 2002; Galvez et al., 2008). The lack of easy access to fresh
and nutritious food is considered to be a contributing factor to poorer health outcomes among minority and poor populations in the U.S. (Glanz &
Yaroch, 2004).

Strategies and policies to improve the food environment can include increased healthy food options, such as fresh fruit and vegetables through retail
stores in the community. This can include increasing the number of supermarkets and larger grocery stores and/or improving the availability of fresh
food in small retail stores including neighborhood corner stores and convenience stores. However, research finds that supermarkets and large grocery
stores have lower prices than small stores, so to the extent that access to nutritious fresh food is an income barrier (rather than a transportation
barrier), large grocery stores may be more beneficial (Ver Ploeg et al., 2009). However, important “lessons learned” are arising out of pilot projects
that bring fresh fruit and vegetables into convenience stores (Jetter & Cassady, 2010).


1. Indicators for types of stores MORE likely to carry fresh fruit and vegetables: Twelve indicators provide a snapshot of the likely
   availability of fresh produce. Each indicator is measured at the county level.
     Retail Store Indicators – MORE Healthy Outlets                      How will it help us understand Food Access in our community?

 Number of Grocery Stores (county level indicator): The number of
 supermarkets and grocery stores in the county. Grocery stores include
 establishments generally known as supermarkets and smaller grocery
 stores primarily engaged in retailing a general line of food, such as
 canned and frozen foods; fresh fruits and vegetables; and fresh and
 prepared meats, fish, and poultry.



    Prepared by the Center for Systems Integration and WPM Consulting                                                                     1|Page
Retail Store Indicators – MORE Healthy Outlets                        How will it help us understand Food Access in our community?

Percent Change in Number of Grocery Stores (county level
indicator): The percent change in the number of supermarkets and
grocery stores in the county.

Grocery stores/1,000 population (county level indicator): The
number of supermarkets and grocery stores in the county per 1,000
county residents.

Percent of Change in Grocery Stores per 1,000 population
(county level indicator): The percent change in the number of
supermarkets and grocery stores in the county per 1,000 county
residents.

Number of Supercenters and Club Stores (county level indicator):
The number of Supercenters and Warehouse club stores in the county.
Warehouse clubs and supercenters are primarily engaged in retailing a
general line of groceries in combination with general lines of new
merchandise, such as apparel, furniture, and appliances.

Percent Change in Number of Supercenters and Club Stores
(county level indicator): The percent change in the number of
supermarkets & grocery stores in the county per 1,000 county residents.

Supercenters and Club Stores/1,000 population (county level
indicator): The number of Supercenters and warehouse club stores in
the county per 1,000 county residents.

Percent of Change in Supercenters and Club Stores per 1,000
population (county level indicator): Percent change in the number
of supercenters & warehouse club stores in the county per 1,000
residents.



   Prepared by the Center for Systems Integration and WPM Consulting                                                          2|Page
Retail Store Indicators – MORE Healthy Outlets                            How will it help us understand Food Access in our community?

 Number of Specialized Food Stores (county level indicator): The
 number of specialized food stores in the county. Specialized food stores
 include establishments primarily engaged in retailing specialized lines of
 food such as retail bakeries, meat and seafood markets, dairy stores,
 and produce markets.

 Percent Change in Number Specialized Food Stores (county level
 indicator): The percent change in the number of specialized food stores
 in the county.

 Specialized Food Stores per 1,000 population (county level
 indicator): The number of specialized food stores in the county per
 1,000 county residents. Specialized food stores include establishments
 primarily engaged in retailing specialized lines of food such as retail
 bakeries, meat and seafood markets, dairy stores, and produce markets.

 Percent Change in Specialized Food Stores per 1,000 population
 (county level indicator): The percent change in the number of
 specialized food stores in the county per 1,000 residents.



2. Indicators for types of stores LESS likely to carry fresh fruit and vegetables: Eight indicators provide a snapshot of the
   likely availability of fresh produce. Each indicator is measured at the county level.
     Retail Store Indicators – LESS Healthy Outlets                           How will it help us understand Food Access in our community?

 Number of Convenience Stores, no gas (county level indicator):
 The number of convenience stores in the county. Establishments
 known as convenience stores or food marts (except those with fuel
 pumps) are primarily engaged in retailing a limited line of goods that
 generally includes milk, bread, soda, and snacks.



    Prepared by the Center for Systems Integration and WPM Consulting                                                              3|Page
Retail Store Indicators – LESS Healthy Outlets                      How will it help us understand Food Access in our community?

% Change in Number of Convenience Stores, no gas (county
level indicator): % change in the # of convenience stores in the
county.

Convenience Stores, no gas/1,000 population (county level
indicator): The number of convenience stores in the county per
1,000 county residents.

%t Change in in Convenience Stores, no gas/1,000 population
(county level indicator): % change in the number of convenience
stores in the county per 1,000 county residents.

Number of Convenience Stores with gas (county level
indicator): The number of gasoline-convenience stores in the
county. Establishments known as gasoline-convenience stores are
engaged in retailing automotive fuels (for example, diesel fuel,
gasohol, and gasoline) in combination with convenience store or food
mart items. These establishments can either be in a convenience store
(food mart) setting or a gas station setting.

% Change in Number of Convenience Stores with gas (county
level indicator): % change in the number of gasoline-convenience
stores in the county.

Convenience Stores with gas/1,000 population (county level
indicator): The number of gasoline-convenience stores in the county
per 1,000 county residents.

% Change in in Convenience Stores with gas/1,000 population
(county level indicator): % change in the number of gasoline-
convenience stores in the county per 1,000 county residents.



   Prepared by the Center for Systems Integration and WPM Consulting                                                         4|Page
3.    Indicators for types of restaurants MORE likely to carry fresh fruit and vegetables: Four indicators provide a snapshot of
      establishments that are more likely to offer fresh food and residents’ patronage of these establishments.
     Restaurant Indicators - MORE Healthy Options                     How will it help us understand Food Access in our community?

 Number of Full-Service Restaurants (county level
 indicator): The number of full-service restaurants in the county.
 Full-service restaurants include establishments primarily engaged
 in providing food services to patrons who order and are served
 while seated (i.e., waiter/waitress service) and pay after eating.

 Full Service Restaurants/1,000 population (county level
 indicator): The number of full-service restaurants in the county
 per 1,000 county residents.

 Percent Change in Full Service Restaurants per 1000
 population (county level indicator): Percent change in the
 number of full-service restaurants in the county 1,000 county
 residents.

 Restaurant Expenditures per capita (state level indicator):
 Average expenditures on food purchased at limited-service
 restaurants per person per year.

4. Indicators for types of restaurants LESS likely to carry fresh fruit and vegetables: Five indicators provide a snapshot of
   establishments that are less likely to offer fresh food and residents’ patronage of these establishments.
     Restaurant Indicators - LESS Healthy Options                     How will it help us understand Food Access in our community?

 Number of Fast Food Restaurants (county level indicator):
 The number of limited-service restaurants in the county. Limited-
 service restaurants include establishments primarily engaged in
 providing food services (except snack and nonalcoholic beverage
 bars) where patrons generally order or select items and pay
 before eating.


     Prepared by the Center for Systems Integration and WPM Consulting                                                       5|Page
Restaurant Indicators - LESS Healthy Options                      How will it help us understand Food Access in our community?

 Percent Change in Number of Fast Food Restaurants
 (county level indicator): Percent change in the number of
 limited-service restaurants in the county 1,000 county residents.

 Fast Food Restaurants/1,000 population (county level
 indicator): The number of limited-service restaurants in the
 county per 1,000 county residents.

 Percent Change in Fast Food Restaurants per 1000
 Population (county level indicator): Percent change in limited-
 service restaurants in the county per 1,000 county residents.

 Fast Food Expenditures per capita (state level indicator):
 Average expenditures on food purchased at limited-service
 restaurants per person per year.




DIRECT MARKETS
Direct markets cut out the “middle man” or, in food system terminology, the wholesaler or distributor is not needed. Consumers buy directly from the
producer or are themselves part of the production system through gardening programs.

5. Farmers’ Markets
Farmers’ markets connect farmers (or their employees/representatives) directly with the consumer to sell fresh food products. Farmers’ markets have
freshly harvested local produce, food products such as fish and meat, and many also sell prepared foods usually made by local restaurants. Some
farmers markets include nonfood items, have informational booths (e.g., Master Gardeners providing information on backyard composting), and live
music. Farmers’ Markets are often considered not only an outlet for bringing fresh local produce into a community but also a venue that helps build
social capital and increases food systems literacy through conversations between the farmer and buyer. Two indicators track farmers’ markets.


   Direct Market Indicators – Farmers’ Markets                       How will it help us understand Food Access in our community?


    Prepared by the Center for Systems Integration and WPM Consulting                                                                   6|Page
Direct Market Indicators – Farmers’ Markets                         How will it help us understand Food Access in our community?

 # Farmers' markets (county level indicator):
 Number of farmers’ markets in the county. A farmer’s market is a
 retail outlet in which two or more vendors sell agricultural
 products directly to customers through a common marketing
 channel. At least 51 percent of their retail sales are derived
 directly from consumers.

 Farmers' market/1,000 pop (county level indicator):
 Number of farmers’ markets in the county per 1,000 county
 residents. A farmer’s market is a retail outlet in which two or
 more vendors sell agricultural products directly to customers
 through a common marketing channel. At least 51 percent of
 their retail sales are derived directly from consumers.




6. Direct Farm Sales
Community supported agriculture (CSA) is a direct buying relationship between the consumer and farmer. Consumers buy “shares” in advance of the
growing season in exchange for a regular delivery (weekly, biweekly, monthly) of in-season crops produced by the farm. Farm products are generally
delivered by the farm to drop off sites in one or more neighborhoods. CSAs provide more income stability for farmers, which can be particularly
important for the viability of small farms. CSAs are the most common arrangement of direct farm sales, however, other methods include roadside
stands and Neighborhood Supported Agriculture (NSA), the latter still in its infancy.1 Five indicators track direct farm sales.


    Direct Market Indicators – Direct Farm Sales                        How will it help us understand Food Access in our community?

 # Farms with direct sales (county level indicator):
 Number of farms in the county that sell directly to final
 consumers.



    1
     Agriburbia is another type of direct farm sales model. For information click on Agriburbia and the Denver Post article about Agriburbia on Colorado’s Front
    Range

    Prepared by the Center for Systems Integration and WPM Consulting                                                                              7|Page
Direct Market Indicators – Direct Farm Sales                     How will it help us understand Food Access in our community?

 % Farms with direct sales (county level indicator):
 Percent of farms in the county that sell directly to final
 consumers.

 $ Direct farm sales (county level indicator): Value of direct
 farm sales in the county.

 $ Direct farm sales per capita (county level indicator):
 Value of direct farm sales in the county divided by the residents
 of the county.

 Number of Community Supported Agriculture (CSA)
 (directory of registered CSAs in Colorado): Searchable by
 name, county location, and cities served.       Includes phone
 numbers and farm website links, if any.




7. Farm to School Programs
Farm to School programs bring local produce (fruit and vegetables) and products (dairy, eggs, meat) into school meal and snack
programs. There has been a recent uptick in the number of FTS programs across the country, Colorado included. FTS programs go
hand in hand with improvements in school nutritional offerings, an important dietary shift for children of all income brackets but
especially critical for children and teens from low income households whose only nutritious meals may be at school. There are
several databases that have information about farm to school programs. However, none are exhaustive. To get started, pull the
three indicators below.
      Direct Market Indicators – FTS Programs                        How will it help us understand Food Access in our community?
 Farm to school program (county level indicator, locational –
 CO-FTS): Counties with one or more farm-to-school programs
 where “farm-to-school” programs include: direct sourcing from
 local producers, local sourcing through the Department of


    Prepared by the Center for Systems Integration and WPM Consulting                                                       8|Page
Direct Market Indicators – FTS Programs                       How will it help us understand Food Access in our community?
Defense procurement system (known as “DOD Fresh”), school
gardens, farm tours, farm-related nutrition education or other
classroom activities, and school menus and snacks highlighting
locally-sourced or locally-available foods.

Number of schools with educational gardens (locational –
CO-FTS): School gardens serve educational functions to teach
children about food production.         Some schools serve their
garden’s produce in cafeteria meals

Percentage of middle & high schools that offer fruits and
non-fried vegetables as competitive foods. (state level
indicator – CDC; district indicator - local school district food
services).




   Prepared by the Center for Systems Integration and WPM Consulting                                                      9|Page

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Colorado Food Assessment Framework Module 4

  • 1. Colorado Food Assessment Framework: Module 4 – Food Access, Security & Resiliency DRAFT May 21, 2011 A handout for the session: “Assessing and Using Food Data to Support Collaborative Policy Decisions” at the Community Food Security Coalition’s conference, Food Policy from Neighborhood to Nation, Portland, OR, May 19-21, 2011. Background on the Project: The Colorado Food Assessment Framework is being developed to assist the increasing number of community and state advisory groups interested in conducting food assessments of their local or regional food system in order to inform food policy councils, farm to school efforts, and other policy action. The Framework consists of four modules: (1) Food Security, Resiliency and Access, (2) Food and Agriculture Production, (3) Transportation and Distribution, and (4) Food Processing. The Framework has been developed with the intention of integrating it into an online, interactive tool to provide a “one-stop shop” for communities to obtain guidance, easily access comprehensive food systems indicators, and share what they learn, thus contributing to a broader, common body of knowledge in the state. DRAFT Document – Not for Distribution The Colorado Food Assessment Framework is being developed by WPM Consulting and the Center for Systems Integration on behalf of LiveWell Colorado. This project is sponsored by the Colorado Department of Public Health and Environment with funding through a cooperative agreement with the Centers for Disease Control and Prevention, grant number FOA#90101ARRA09. For questions regarding this document, please contact wendy@WPMconsulting.com.
  • 2. Worksheet: Planning for Your Community Food Assessment 1|Page Instructions: Before you can begin to collect data for your community food assessment, you will need to decide on the boundaries for your assessment. Use the questions on this worksheet to help guide your deliberations. Use the considerations side of the worksheet to help inform your discussions. You can either type or write your notes in the blank spaces of the worksheet table. Questions to Answer1 Considerations 1. What is the purpose of your food assessment? The  Needs Assessment and Planning purpose will drive decisions about who should be to identify priorities for action in a involved in the assessment, what information is particular community. needed, how much time should be devoted to the process, what type of data to collect, and how to share  Population-level Surveillance to the findings. monitor trends in access, availability, quality, and affordability of food.  Research to gain a better understanding of the most important factors in environments affecting obesity and chronic disease.  Evaluation to improve programs or policies and to assess their effectiveness.  Advocacy to engage stakeholders and decision makers to affect policy and environmental changes in the food environment. 1Table derived from Pothukuchi, K., Joseph, H., Burton, H., & Fisher, A. (2002). What’s cooking in your food system? A guide to community food assessment. Venice, CA: Community Food Security Coalition, pages 53- 55. Prepared by the Center for Systems Integration and WPM Consulting
  • 3. Worksheet: Planning for Your Community Food Assessment 2|Page Questions to Answer1 Considerations 2. What boundaries are suggested by your assessment Boundaries can be classified in four ways. purposes, goals, and questions? Ask yourself: Most assessments include more than one category:  What’s the appropriate scale of study to encourage community participation, and where is there good 1. Political or jurisdictional: Most potential for such participation? common type of boundary used in FAs. Data are gathered based on political  How does the community define its own boundaries such as cities, counties, boundaries? Is there a cohesive community sense neighborhoods. Secondary data largely within certain boundaries? follows these boundaries.  Do you want to focus on particular ethnic and socio- 2. Service designations: These include economic groups, or a mix of groups? school districts, voting precincts, census tracts, etc. Some secondary data is only  Is the community representative of larger trends in available by service designations, e.g., the region? census tracts, therefore your FA may, by default, include this type of boundary for  Where do you expect to conduct follow-up activities some data. once the assessment is completed? 3. Ethnic/cultural/social: Some neighborhoods have distinct, known cultural centers even if not officially designated. While such boundaries can engender a cohesive understanding and engagement of a subpopulation, likely there will be few if any secondary data that falls within these boundary designations. 4. Environmental: Rivers, mountain ranges, watersheds can make for natural boundaries that are related to food systems; however, these are unlikely to match with existing data sets. Prepared by the Center for Systems Integration and WPM Consulting
  • 4. Worksheet: Planning for Your Community Food Assessment 3|Page Questions to Answer1 Considerations 3. What kinds of data do you anticipate being central to To conduct a community food assessment, your study, and what boundaries are associated with different types of data are useful. that data? 1. Secondary Data: This is data that has already been collected by other organizations, e.g., the U.S. government, state government, non-profit organizations, and universities. Sometimes this data was collected specifically to assess food system issues but oftentimes the data of interest is part of a larger effort to track trends, some of which are applicable to understanding food systems. Whenever possible, it behooves a community to utilize as much secondary data as possible. However, many communities will find that they cannot fully assess their food environment based on existing data along. In that case, primary data collection will be necessary. 2. Primary Data: Primary data refers to original data collection. There are many methods of collecting primary data including through questionnaires, interviews, focus groups, observation, and case-studies. The advantage of primary data collection is that you can tailor your instrument to capture exactly the information you need. However, the disadvantages are substantial, including the time and skill needed to construct a valid data collection instrument, and the cost of collecting, recording, coding, and analyzing the data. Prepared by the Center for Systems Integration and WPM Consulting
  • 5. UNDERSTANDING YOUR FOOD ENVIRONMENT Using Existing Indicators to as a Starting Place RETAIL STORES Strategies and policies to improve the food environment can include increased access to healthier foods such as through retail vendors. Supermarkets and grocery stores typically sell a higher proportion of fruits and vegetables compared to convenience stores, gas marts and small corner stores. Research finds that adults’ fruit and vegetable intake increases with the addition of new supermarkets – specifically African Americans’ consumption increased by 32% for each additional supermarket and Caucasians’ increased by 11% with the presence of one or more supermarkets (Morland, Wing, & Diez Roux, 2002); yet, there are fewer supermarkets in minority and low income communities than Caucasian and higher socioeconomic neighborhoods (Morland, Wing, & Diez Roux, 2002; Morland, Wing, & Diez Roux, & Poole, 2002; Galvez et al., 2008). The lack of easy access to fresh and nutritious food is considered to be a contributing factor to poorer health outcomes among minority and poor populations in the U.S. (Glanz & Yaroch, 2004). Strategies and policies to improve the food environment can include increased healthy food options, such as fresh fruit and vegetables through retail stores in the community. This can include increasing the number of supermarkets and larger grocery stores and/or improving the availability of fresh food in small retail stores including neighborhood corner stores and convenience stores. However, research finds that supermarkets and large grocery stores have lower prices than small stores, so to the extent that access to nutritious fresh food is an income barrier (rather than a transportation barrier), large grocery stores may be more beneficial (Ver Ploeg et al., 2009). However, important “lessons learned” are arising out of pilot projects that bring fresh fruit and vegetables into convenience stores (Jetter & Cassady, 2010). 1. Indicators for types of stores MORE likely to carry fresh fruit and vegetables: Twelve indicators provide a snapshot of the likely availability of fresh produce. Each indicator is measured at the county level. Retail Store Indicators – MORE Healthy Outlets How will it help us understand Food Access in our community? Number of Grocery Stores (county level indicator): The number of supermarkets and grocery stores in the county. Grocery stores include establishments generally known as supermarkets and smaller grocery stores primarily engaged in retailing a general line of food, such as canned and frozen foods; fresh fruits and vegetables; and fresh and prepared meats, fish, and poultry. Prepared by the Center for Systems Integration and WPM Consulting 1|Page
  • 6. Retail Store Indicators – MORE Healthy Outlets How will it help us understand Food Access in our community? Percent Change in Number of Grocery Stores (county level indicator): The percent change in the number of supermarkets and grocery stores in the county. Grocery stores/1,000 population (county level indicator): The number of supermarkets and grocery stores in the county per 1,000 county residents. Percent of Change in Grocery Stores per 1,000 population (county level indicator): The percent change in the number of supermarkets and grocery stores in the county per 1,000 county residents. Number of Supercenters and Club Stores (county level indicator): The number of Supercenters and Warehouse club stores in the county. Warehouse clubs and supercenters are primarily engaged in retailing a general line of groceries in combination with general lines of new merchandise, such as apparel, furniture, and appliances. Percent Change in Number of Supercenters and Club Stores (county level indicator): The percent change in the number of supermarkets & grocery stores in the county per 1,000 county residents. Supercenters and Club Stores/1,000 population (county level indicator): The number of Supercenters and warehouse club stores in the county per 1,000 county residents. Percent of Change in Supercenters and Club Stores per 1,000 population (county level indicator): Percent change in the number of supercenters & warehouse club stores in the county per 1,000 residents. Prepared by the Center for Systems Integration and WPM Consulting 2|Page
  • 7. Retail Store Indicators – MORE Healthy Outlets How will it help us understand Food Access in our community? Number of Specialized Food Stores (county level indicator): The number of specialized food stores in the county. Specialized food stores include establishments primarily engaged in retailing specialized lines of food such as retail bakeries, meat and seafood markets, dairy stores, and produce markets. Percent Change in Number Specialized Food Stores (county level indicator): The percent change in the number of specialized food stores in the county. Specialized Food Stores per 1,000 population (county level indicator): The number of specialized food stores in the county per 1,000 county residents. Specialized food stores include establishments primarily engaged in retailing specialized lines of food such as retail bakeries, meat and seafood markets, dairy stores, and produce markets. Percent Change in Specialized Food Stores per 1,000 population (county level indicator): The percent change in the number of specialized food stores in the county per 1,000 residents. 2. Indicators for types of stores LESS likely to carry fresh fruit and vegetables: Eight indicators provide a snapshot of the likely availability of fresh produce. Each indicator is measured at the county level. Retail Store Indicators – LESS Healthy Outlets How will it help us understand Food Access in our community? Number of Convenience Stores, no gas (county level indicator): The number of convenience stores in the county. Establishments known as convenience stores or food marts (except those with fuel pumps) are primarily engaged in retailing a limited line of goods that generally includes milk, bread, soda, and snacks. Prepared by the Center for Systems Integration and WPM Consulting 3|Page
  • 8. Retail Store Indicators – LESS Healthy Outlets How will it help us understand Food Access in our community? % Change in Number of Convenience Stores, no gas (county level indicator): % change in the # of convenience stores in the county. Convenience Stores, no gas/1,000 population (county level indicator): The number of convenience stores in the county per 1,000 county residents. %t Change in in Convenience Stores, no gas/1,000 population (county level indicator): % change in the number of convenience stores in the county per 1,000 county residents. Number of Convenience Stores with gas (county level indicator): The number of gasoline-convenience stores in the county. Establishments known as gasoline-convenience stores are engaged in retailing automotive fuels (for example, diesel fuel, gasohol, and gasoline) in combination with convenience store or food mart items. These establishments can either be in a convenience store (food mart) setting or a gas station setting. % Change in Number of Convenience Stores with gas (county level indicator): % change in the number of gasoline-convenience stores in the county. Convenience Stores with gas/1,000 population (county level indicator): The number of gasoline-convenience stores in the county per 1,000 county residents. % Change in in Convenience Stores with gas/1,000 population (county level indicator): % change in the number of gasoline- convenience stores in the county per 1,000 county residents. Prepared by the Center for Systems Integration and WPM Consulting 4|Page
  • 9. 3. Indicators for types of restaurants MORE likely to carry fresh fruit and vegetables: Four indicators provide a snapshot of establishments that are more likely to offer fresh food and residents’ patronage of these establishments. Restaurant Indicators - MORE Healthy Options How will it help us understand Food Access in our community? Number of Full-Service Restaurants (county level indicator): The number of full-service restaurants in the county. Full-service restaurants include establishments primarily engaged in providing food services to patrons who order and are served while seated (i.e., waiter/waitress service) and pay after eating. Full Service Restaurants/1,000 population (county level indicator): The number of full-service restaurants in the county per 1,000 county residents. Percent Change in Full Service Restaurants per 1000 population (county level indicator): Percent change in the number of full-service restaurants in the county 1,000 county residents. Restaurant Expenditures per capita (state level indicator): Average expenditures on food purchased at limited-service restaurants per person per year. 4. Indicators for types of restaurants LESS likely to carry fresh fruit and vegetables: Five indicators provide a snapshot of establishments that are less likely to offer fresh food and residents’ patronage of these establishments. Restaurant Indicators - LESS Healthy Options How will it help us understand Food Access in our community? Number of Fast Food Restaurants (county level indicator): The number of limited-service restaurants in the county. Limited- service restaurants include establishments primarily engaged in providing food services (except snack and nonalcoholic beverage bars) where patrons generally order or select items and pay before eating. Prepared by the Center for Systems Integration and WPM Consulting 5|Page
  • 10. Restaurant Indicators - LESS Healthy Options How will it help us understand Food Access in our community? Percent Change in Number of Fast Food Restaurants (county level indicator): Percent change in the number of limited-service restaurants in the county 1,000 county residents. Fast Food Restaurants/1,000 population (county level indicator): The number of limited-service restaurants in the county per 1,000 county residents. Percent Change in Fast Food Restaurants per 1000 Population (county level indicator): Percent change in limited- service restaurants in the county per 1,000 county residents. Fast Food Expenditures per capita (state level indicator): Average expenditures on food purchased at limited-service restaurants per person per year. DIRECT MARKETS Direct markets cut out the “middle man” or, in food system terminology, the wholesaler or distributor is not needed. Consumers buy directly from the producer or are themselves part of the production system through gardening programs. 5. Farmers’ Markets Farmers’ markets connect farmers (or their employees/representatives) directly with the consumer to sell fresh food products. Farmers’ markets have freshly harvested local produce, food products such as fish and meat, and many also sell prepared foods usually made by local restaurants. Some farmers markets include nonfood items, have informational booths (e.g., Master Gardeners providing information on backyard composting), and live music. Farmers’ Markets are often considered not only an outlet for bringing fresh local produce into a community but also a venue that helps build social capital and increases food systems literacy through conversations between the farmer and buyer. Two indicators track farmers’ markets. Direct Market Indicators – Farmers’ Markets How will it help us understand Food Access in our community? Prepared by the Center for Systems Integration and WPM Consulting 6|Page
  • 11. Direct Market Indicators – Farmers’ Markets How will it help us understand Food Access in our community? # Farmers' markets (county level indicator): Number of farmers’ markets in the county. A farmer’s market is a retail outlet in which two or more vendors sell agricultural products directly to customers through a common marketing channel. At least 51 percent of their retail sales are derived directly from consumers. Farmers' market/1,000 pop (county level indicator): Number of farmers’ markets in the county per 1,000 county residents. A farmer’s market is a retail outlet in which two or more vendors sell agricultural products directly to customers through a common marketing channel. At least 51 percent of their retail sales are derived directly from consumers. 6. Direct Farm Sales Community supported agriculture (CSA) is a direct buying relationship between the consumer and farmer. Consumers buy “shares” in advance of the growing season in exchange for a regular delivery (weekly, biweekly, monthly) of in-season crops produced by the farm. Farm products are generally delivered by the farm to drop off sites in one or more neighborhoods. CSAs provide more income stability for farmers, which can be particularly important for the viability of small farms. CSAs are the most common arrangement of direct farm sales, however, other methods include roadside stands and Neighborhood Supported Agriculture (NSA), the latter still in its infancy.1 Five indicators track direct farm sales. Direct Market Indicators – Direct Farm Sales How will it help us understand Food Access in our community? # Farms with direct sales (county level indicator): Number of farms in the county that sell directly to final consumers. 1 Agriburbia is another type of direct farm sales model. For information click on Agriburbia and the Denver Post article about Agriburbia on Colorado’s Front Range Prepared by the Center for Systems Integration and WPM Consulting 7|Page
  • 12. Direct Market Indicators – Direct Farm Sales How will it help us understand Food Access in our community? % Farms with direct sales (county level indicator): Percent of farms in the county that sell directly to final consumers. $ Direct farm sales (county level indicator): Value of direct farm sales in the county. $ Direct farm sales per capita (county level indicator): Value of direct farm sales in the county divided by the residents of the county. Number of Community Supported Agriculture (CSA) (directory of registered CSAs in Colorado): Searchable by name, county location, and cities served. Includes phone numbers and farm website links, if any. 7. Farm to School Programs Farm to School programs bring local produce (fruit and vegetables) and products (dairy, eggs, meat) into school meal and snack programs. There has been a recent uptick in the number of FTS programs across the country, Colorado included. FTS programs go hand in hand with improvements in school nutritional offerings, an important dietary shift for children of all income brackets but especially critical for children and teens from low income households whose only nutritious meals may be at school. There are several databases that have information about farm to school programs. However, none are exhaustive. To get started, pull the three indicators below. Direct Market Indicators – FTS Programs How will it help us understand Food Access in our community? Farm to school program (county level indicator, locational – CO-FTS): Counties with one or more farm-to-school programs where “farm-to-school” programs include: direct sourcing from local producers, local sourcing through the Department of Prepared by the Center for Systems Integration and WPM Consulting 8|Page
  • 13. Direct Market Indicators – FTS Programs How will it help us understand Food Access in our community? Defense procurement system (known as “DOD Fresh”), school gardens, farm tours, farm-related nutrition education or other classroom activities, and school menus and snacks highlighting locally-sourced or locally-available foods. Number of schools with educational gardens (locational – CO-FTS): School gardens serve educational functions to teach children about food production. Some schools serve their garden’s produce in cafeteria meals Percentage of middle & high schools that offer fruits and non-fried vegetables as competitive foods. (state level indicator – CDC; district indicator - local school district food services). Prepared by the Center for Systems Integration and WPM Consulting 9|Page