The Food Access Research Atlas (FARA) is a common measure of food access developed by the US Department of Agriculture. However, its sole focus on supermarkets lacks specificity for culturally appropriate food. This ecological study assesses the relationship of FARA and our novel Yelp-based Ethnic Store Measure with diabetes rates among Asian Americans and Native Hawaiians or Pacific Islanders (AAPI).

This study leveraged crowd-sourced Yelp data to develop six culturally appropriate food access variables and compare them with FARA at the census tract (CT) level. Estimates of CT AAPI diabetes rates were calculated from hospital and emergency department discharge data. Spatial trends were examined visually and with Moran’s I. Ordinary least squares (OLS) and spatial lag regression (SLR) models assessed covariate-adjusted z-score standardised associations between food access measures and AAPI diabetes rates.

San Diego, California, USA

All 626 CT in San Diego, CA

Most food access variables showed strong spatial autocorrelation. The FARA measure – percent of AAPI population beyond 0·5 miles of a supermarket – was positively associated with AAPI diabetes in OLS (1·88; 95 % CI 0·76, 3·0; P = 0·001) but not SLR. Our Yelp-based variable – number of AAPI restaurants per AAPI population – was negatively associated with AAPI diabetes in both OLS (–1·15; 95 % CI –2·17, –0·13; P = 0·03) and SLR (–1·32; P = 0·004). No other variables were significantly associated with diabetes.

Area-level, culturally sensitive measures of food access offer valuable insights into the role of culturally appropriate food access on cardiometabolic health among racial and ethnic minorities.

This position paper focuses on healthy ageing for the frailest and institutionalized older adults in the context of the recent pandemic. The paper aims to identify and discuss hindering and promoting factors for healthy ageing in this context, taking both health safety and a meaningful social life into account, in a pandemic situation and beyond.

The recent COVID-19 pandemic has highlighted the vulnerability of frail older adults residing in long-term care institutions. This is a segment of the older population that does not seem to align well with the recent policy trend of healthy and active ageing. The need for healthy ageing in this population has been voiced by professionals and interest organizations alike, alluding to inadequate support systems during the pandemic, conditioned by both previous and newly emerging contextual factors. Supporting healthy ageing in older adults in nursing homes and other residential care settings calls for attending to meaningful social life as well as to disease control.

Findings and early conclusions leading up to the position paper were presented with peer discussions involving healthcare professionals and researchers at two joint EFPC PRIMORE workshops 2021 and 2022, as well as other international research seminars on long-term care. The following aspects of long-term care and COVID-19 were systematically discussed in those events, with reference to relevant research literature: 1. Long-term care policies, 2. pre-COVID state of long-term care facilities and vulnerability to the pandemic, 3. factors influencing the extent of spread of infection in long-term care facilities, and 4. the challenge of balancing between strict measures for infection control and maintaining a meaningful social life for residents and their significant others.

A policy shift towards ageing at home and supporting the healthiest of older adults seems to have had unwarranted effects both for frail older adults, their significant others, and professional care staff attending to their needs. Resulting insufficient investment in primary health care staff and in the built environment for frail older adults in nursing homes were detrimental both for the older adults living in nursing homes, their significant others, and staff. More investment in staff and in physical surroundings might improve the quality of care and the social life of older adults in nursing homes in a non-pandemic situation and be a resource for primary health care staff ensuring both protection from health hazards and a meaningful social life for frail older adults in a pandemic or epidemic situation. As for investing in the physical surroundings, smaller nursing homes are advantageous, with singular resident rooms and for developing out-and indoor spaces for socializing and for meeting with families and other visitors. Regarding investment in staff, there is a documented need for educated staff in full-time positions. Use of part-time or temporary staff should be limited.

To evaluate the direct and indirect associations of obesogenic and leptogenic neighborhood environments with body fat, and pro- and anti-inflammatory adipokines in Brazilian children.

Cross-sectional study. The body fat distribution was assessed using dual-energy X-ray absorptiometry (DXA). Concentrations of leptin and adiponectin were measured. Four hundred meters (0·25 miles) road network buffer was the neighborhood unit used to assess the environmental characteristics around households. Obesogenic and leptogenic environments were the latent variables obtained from the observed characteristics. The mother’s BMI, ultra-processed food consumption, and physical activity before and after school, were tested as mediating variables. A hybrid model of structural equations was used to test the direct and indirect associations of obesogenic and leptogenic environments with body fat, leptin and adiponectin concentrations.

Urban area of Viçosa, Minas Gerais, Brazil.

Children aged 8- and 9-years (n 367).

Obesogenic environment was directly associated with the mother’s BMI (β: 0·24, P = 0·02) and the child’s body fat (β: 0·19, P = 0·02). The mother’s BMI and body fat mediated the association of the obesogenic environment with leptin concentrations (β: 0·05, P = 0·02).

Obesogenic neighborhood environment was directly associated with body fat and mother's BMI, and indirectly associated with leptin concentrations in Brazilian children, mediated by the mother’s BMI and body fat.

To assess the association of obesogenic environmental characteristics around schools with body adiposity and adipokine concentrations in Brazilian children.

Cross-sectional study. Body adiposity was assessed using the dual-energy X-ray absorptiometry. Concentrations of leptin, adiponectin, retinol-binding protein 4 (RBP4) and chemerin were measured. Predominantly ultra-processed food (UPF) stores, public physical activity (PA) facilities, green spaces, walkability, traffic accidents and crime were evaluated. The neighbourhood unit was the 400 m (0·25 miles) road network buffer around schools. The association of environmental characteristics with body adiposity and adipokine concentrations was assessed by linear regression models using generalised estimating equations.

Urban schools (n 24), Viçosa, Minas Gerais, Brazil.

Children aged 8 and 9 years (n 378).

A higher density of predominantly UPF stores and a lower percentage of green space were associated with higher total (β: 0·12; 95 % CI 0·06, 0·18 and β: –0·10; 95 % CI –0·16, –0·04, respectively) and android body fat (β: 0·28; 95 % CI 0·13, 0·43 and β: –0·18; 95 % CI –0·32, –0·04, respectively). In addition, the densities of PA facilities and crime were inversely associated with leptin concentrations. Traffic accidents density and percentage of green spaces around schools had, respectively, a positive and an inverse association with concentrations of adiponectin and RBP4.

Obesogenic environmental characteristics around schools were associated with total and android body fat, as well as with pro-inflammatory adipokine concentrations in Brazilian children from a medium-sized city.