Spotlight on Poverty: Pandemic Made Unequal Access to Food Even Worse, Study Suggests

Ohio State Geography student Armita Kar was interviewed by Spotlight on Poverty about our study of how COVID exacerbated unequal food access in low income communities. Armita is co-advised by myself and Dr. Huyen Le.

Pandemic Made Unequal Access to Food Even Worse, Study Suggests

COVID-19 exacerbates unequal food access

New publication: Kar, A., Motoyama, Y., Carrel, A., Miller, H.J. and Le, H.T.K. (2021) “COVID-19 exacerbates unequal food access,” Applied Geography, 134, 102517.

Abstract. Inequality to food access has always been a serious problem, yet it became even more critical during the COVID-19 pandemic, which exacerbated social inequality and reshaped essential travel. This study provides a holistic view of spatio-temporal changes in food access based on observed travel data for all grocery shopping trips in Columbus, Ohio, during and after the state-wide stay-at-home period. We estimated the decline and recovery patterns of store visits during the pandemic to identify the key socio-economic and built environment determinants of food shopping patterns. The results show a disparity: during the lockdown, store visits to dollar stores declined the least, while visits to big-box stores declined the most and recovered the fastest. Visits to stores in low-income areas experienced smaller changes even during the lockdown period. A higher percentage of low-income customers was associated with lower store visits during the lockdown period. Furthermore, stores with a higher percentage of white customers declined the least and recovered faster during the reopening phase. Our study improves the understanding of the impact of the COVID-19 crisis on food access disparities and business performance. It highlights the role of COVID-19 and similar disruptions on exposing underlying social problems in the US.

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Opioid treatment deserts

The latest outcome from our opioid overdose mapping project: we find disparities across neighborhoods and racial groups in access to opioid treatment providers:

Hyder A, Lee J, Dundon A, Southerland LT, All D, Hammond G, and Miller, H.J. (2021) Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county. PLoS ONE 16(5): e0250324. https://doi.org/10.1371/journal.pone.0250324

Abstract

Objectives.  An Opioid Treatment Desert is an area with limited accessibility to medication-assisted treatment and recovery facilities for Opioid Use Disorder. We explored the concept of Opioid Treatment Deserts including racial differences in potential spatial accessibility and applied it to one Midwestern urban county using high resolution spatiotemporal data.
Methods

We obtained individual-level data from one Emergency Medical Services (EMS) agency (Columbus Fire Department) in Franklin County, Ohio. Opioid overdose events were based on EMS runs where naloxone was administered from 1/1/2013 to 12/31/2017. Potential spatial accessibility was measured as the time (in minutes) it would take an individual, who may decide to seek treatment after an opioid overdose, to travel from where they had the overdose event, which was a proxy measure of their residential location, to the nearest opioid use disorder (OUD) treatment provider that provided medically-assisted treatment (MAT). We estimated accessibility measures overall, by race and by four types of treatment providers (any type of MAT for OUD, Buprenorphine, Methadone, or Naltrexone). Areas were classified as an Opioid Treatment Desert if the estimate travel time to treatment provider (any type of MAT for OUD) was greater than a given threshold. We performed sensitivity analysis using a range of threshold values based on multiple modes of transportation (car and public transit) and using only EMS runs to home/residential location types.

Results. A total of 6,929 geocoded opioid overdose events based on data from EMS agencies were used in the final analysis. Most events occurred among 26–35 years old (34%), identified as White adults (56%) and male (62%). Median travel times and interquartile range (IQR) to closest treatment provider by car and public transit was 2 minutes (IQR: 3 minutes) and 17 minutes (IQR: 17 minutes), respectively. Several neighborhoods in the study area had limited accessibility to OUD treatment facilities and were classified as Opioid Treatment Deserts. Travel time by public transit for most treatment provider types and by car for Methadone-based treatment was significantly different between individuals who were identified as Black adults and White adults based on their race.

Conclusions.  Disparities in access to opioid treatment exist at the sub-county level in specific neighborhoods and across racial groups in Columbus, Ohio and can be quantified and visualized using local public safety data (e.g., EMS runs). Identification of Opioid Treatment Deserts can aid multiple stakeholders better plan and allocate resources for more equitable access to MAT for OUD and, therefore, reduce the burden of the opioid epidemic while making better use of real-time public safety data to address a public health epidemic that has turned into a public safety crisis.