Type, density, and healthiness of food-outlets in a university foodscape: a geographical mapping and characterisation of food resources in a Ghanaian university campus

Abstract

Introduction Food environments are viewed as the interface where individuals interact with the wider food system to procure and/or consume food. Institutional food environment characteristics have been associated with health outcomes including obesity and nutrition-related non-communicable diseases (NR-NCDs) in studies from high-income countries. The objectives of this study were (1) to map and characterise the food-outlets within a Ghanaian university campus; and (2) to assess the healthiness of the food outlets. Methods Data collection was undertaken based on geospatial open-source technologies and the collaborative mapping platform OpenStreetMap using a systematic approach involving three phases: remote mapping, ground-truthing, and food-outlet survey. Spatial analyses were performed using Quantum Geographical Information System (QGIS) and comprised kernel density, buffer, and average nearest neighbour analyses to assess outlet distribution, density, and proximity. A classification system was developed to assess the healthiness of food-outlets within the University foodscape. Results Food-outlets were unevenly distributed over the University foodscape, with many outlets clustered closer to student residencies. Informal food-outlets were the most frequent food-outlet type. Compared to NCD-healthy food-outlets, NCD-unhealthy food-outlets dominated the foodscape (50.7% vs 39.9%) with 9.4% being NCD-intermediate, suggesting a less-healthy university foodscape. More NCD-unhealthy food outlets than NCD-healthy food outlets clustered around student residences. This difference was statistically significant for food outlets within a 100-m buffer (p < 0.001) of student residence and those within 100 and 500 m from departmental buildings/lecture halls (at 5% level of significance). Conclusion Further action, including research to ascertain how the features of the University’s food environment have or are influencing students’ dietary behaviours are needed to inform interventions aimed at creating healthier foodscapes in the study University and other campuses and to lead the way towards the creation of healthy food environments at the home, work, and community levels.

Assessing the Healthfulness of University Food Environments: A Systematic Review of Methods and Tools

“…The most frequently used assessment tool across the studies included in this review was the NEMS, with eight versions used across various settings (e.g., campus dining, vending). For example, four studies used NEMS for restaurants to assess on-campus eateries [6,14,38,47]. An in-depth summary of the most frequently used assessment tools is described in the following sections.…”

“…A summary of the included study characteristics, including assessment type, focus, and scope, is shown in Table 1. Eighteen studies were conducted in the United States [6][7][8][9][10]13,17,18,24,[30][31][32][33][34][38][39][40][41], four in Australia [15,28,42,43], three in Brazil [14,27,44], two in Canada [12,45], and one in Egypt [46], Ghana [47], Italy [48], Lebanon [49], New Zealand [50], Norway [51], Spain [11], South Africa [52], and United Arab Emirates [29]. Thirteen studies compared multiple higher education institutions [6][7][8][9]13,15,28,29,38,43,[49]…”

“…Thirteen studies compared multiple higher education institutions [6][7][8][9]13,15,28,29,38,43,[49][50][51]. Ten studies assessed the campus food environment at singular public institutions [10,14,18,24,27,[39][40][41]44,47], one at a private institution [34], and twelve studies did not indicate the institution type. The authors achieved 83% agreement on item scores before discussing discrepancies and 100% agreement after the consensus process.…”

“…Twenty-one studies reported results of an institutional-level audit: eight audited campus eateries [6,7,12,14,27,38,44,52], four examined vending machines [11,13,17,29], one reviewed food stores [8], and eight had a combination of outlet types [10,15,28,41,42,[45][46][47]. Two studies detailed the changes to a university food environment over time [12,27], whereas all other studies described the food environment at one time point.…”

Relying on the French territorial offer of thermal spa therapies to build a care pathway for long COVID-19 patients

“…Indeed, geographical mapping is mainly used to visualize national and sub-national health data [26]. In public health, geographical mapping is sometimes used collaboratively [27][28][29] or thematically [30], but without really superimposing healthcare needs and resources integrating a care pathway. On the one hand, cartographic interaction and collaboration, representing the dialogue between a human and a map, provides auxiliary background knowledge and auxiliary map-reading tools to facilitate the transfer of geographical knowledge to the public [29].…”