新冠疫情期间线上食品获取渠道的变化及其与贫困的关联：一项纵向分析。

Changes in online food access during the COVID-19 pandemic and associations with deprivation: a longitudinal analysis.

机构信息

MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.

出版信息

Lancet. 2022 Nov;400 Suppl 1:S54. doi: 10.1016/S0140-6736(22)02264-4. Epub 2022 Nov 24.

DOI:10.1016/S0140-6736(22)02264-4

PMID:36930000

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9691057/

Abstract

BACKGROUND

Food prepared out-of-home is typically energy dense and nutrient poor. Online food delivery services such as Just Eat and Deliveroo facilitate access to this food. The number of outlets accessible through these services reportedly increased in England during the COVID-19 pandemic, possibly exacerbating inequalities in access to unhealthy food. We investigated changes in online food outlet access, and the extent to which they were socioeconomically patterned throughout the COVID-19 pandemic.

METHODS

In November, 2019, and monthly between June, 2020, and March, 2022, we used automated methods to construct a dataset containing information about all outlets in England registered to accept orders through the company Just Eat. Across 2118 postcode districts, we identified the number of accessible outlets. We used a negative binomial generalised estimating equation to investigate changes in the number of accessible outlets over time, adjusting for population density, the number of food outlets in the physical food environment, and rural urban classifications. We stratified analyses by deprivation quintile (Q). All data were publicly available.

FINDINGS

Across England, the median number of outlets accessible online decreased from 63·5 (IQR 16·0-156·0) in November, 2019, to 57·0 (11·0-163·0) in March, 2022. However, we observed variation across deprivation quintiles. In March 2022, the median number of outlets accessible online was 175·0 (104·0-292·0) in the most deprived areas (Q5) compared to 27·0 (8·5-60·5) in the least deprived (Q1). In adjusted analyses, we estimated that the number of outlets accessible online in the most deprived areas was 10% higher in March, 2022, compared to November, 2019 (incidence rate ratio [IRR)] 1·10 [1·07-1·13]). By contrast, in the least deprived areas, we estimated a 19% decrease (IRR 0·81 [0·79-0·83]) in food outlets.

INTERPRETATION

During the first 2 years of the COVID-19 pandemic, the number of food outlets accessible online increased only in the most deprived areas. We could not determine the extent to which the changes we observed were already underway. Nevertheless, increased online food outlet access might prompt unhealthy food consumption and undermine public health interventions implemented in the physical food environment. Further research could examine changes in the type of food outlets accessible online and through our dataset, seek to understand the extent to which changes in access are associated with changes to food practices, diet quality, and health.

FUNDING

National Institute for Health Care Research School for Public Health Research, Medical Research Council.

摘要

背景

外出就餐的食物通常热量高、营养低。Just Eat 和 Deliveroo 等在线食品配送服务使人们更容易获得这些食物。据报道，在 COVID-19 大流行期间，英国可通过这些服务获得的外卖店数量有所增加，这可能加剧了获取不健康食品方面的不平等。我们研究了在线食品店的访问量变化，以及在 COVID-19 大流行期间，这些访问量在多大程度上存在社会经济模式。

方法

在 2019 年 11 月和 2020 年 6 月至 2022 年 3 月期间每月，我们使用自动化方法构建了一个包含英格兰所有通过 Just Eat 公司接受订单的门店信息的数据集。在 2118 个邮政编码区，我们确定了可访问的门店数量。我们使用负二项式广义估计方程来研究随着时间的推移可访问门店数量的变化，同时考虑了人口密度、物理食品环境中的食品店数量和城乡分类。我们按贫困五分位数（Q）进行分层分析。所有数据均公开可用。

结果

在英格兰，可在线访问的门店中位数从 2019 年 11 月的 63.5（IQR 16.0-156.0）减少到 2022 年 3 月的 57.0（11.0-163.0）。然而，我们观察到不同贫困五分位数之间存在差异。在 2022 年 3 月，最贫困地区（Q5）可在线访问的门店中位数为 175.0（104.0-292.0），而最贫困地区（Q1）为 27.0（8.5-60.5）。在调整分析中，我们估计最贫困地区可在线访问的门店数量在 2022 年 3 月比 2019 年 11 月增加了 10%（发病率比 [IRR] 1.10 [1.07-1.13]）。相比之下，在最不贫困地区，我们估计食品店数量下降了 19%（IRR 0.81 [0.79-0.83]）。

解释

在 COVID-19 大流行的头 2 年，可在线访问的食品店数量仅在最贫困地区增加。我们无法确定我们观察到的变化在多大程度上已经开始。尽管如此，在线食品店访问量的增加可能会促使人们食用不健康的食物，并破坏在实体食品环境中实施的公共卫生干预措施。进一步的研究可以检查可在线访问和通过我们的数据集访问的食品店类型的变化，试图了解访问量的变化在多大程度上与食品消费行为、饮食质量和健康状况的变化有关。