Mapping Nutritional Inequality: A Primary Socio-Spatial Analysis of Food Deserts in Santiago de Chile
, Francisco Vergara-Perucich 2,3,*, Carlos Aguirre-Nuñez 4 and Felipe Ulloa-Leon 2Round 1
Reviewer 1 Report
Comments and Suggestions for Authors1.If LISA is a novel application to the field, I suggest having more descriptions in Materials and Methods section, especially regarding Moran's I statistic part. Otherwise, the reader will be lost on the logic.
2.Regarding the unexpected finding of food deserts in high-income areas in Discussion section, please explain the reason to inferencing to the point of [may have an excessive dependence on cars, which compensates for the physical inaccessibility of healthy food supply points]. Will the dependence of cars be more serious in lower income areas? Is there any possibility of lack of sensory appeal of the healthy food for the high-income areas?
Author Response
OBS 1.If LISA is a novel application to the field, I suggest having more descriptions in Materials and Methods section, especially regarding Moran's I statistic part. Otherwise, the reader will be lost on the logic.
RESPONSE 1: Thanks for the observation, changes has been made on this regard in the methodology section.
OBS 2.Regarding the unexpected finding of food deserts in high-income areas in Discussion section, please explain the reason to inferencing to the point of [may have an excessive dependence on cars, which compensates for the physical inaccessibility of healthy food supply points]. Will the dependence of cars be more serious in lower income areas? Is there any possibility of lack of sensory appeal of the healthy food for the high-income areas?
RESPONSE 1: Thanks for the observation, changes has been made on this regard in the discussion section.
Reviewer 2 Report
Comments and Suggestions for AuthorsThe manuscript reports results from geospatial analysis of a city in Chile with regard to presence of food deserts and associated characteristics. As such, it is of interest to the research community. While the paper is generally well written, authors included introductory statements in the Methods and also mix discussion items in the Results. Additionally, authors introduce analysis elements in the Results without prior introduction and explanation in the Methods. Finally, it is not clear how (or if) the authors distinguished between types of food outlets in their analyses. Specific suggestions to improve the clarity, flow, and readability of the manuscript follow.
Introduction
1. Page 2, 2nd paragraph: The acronym LMIC needs definition.
Methods
2. General: Much of the discussion on previous methods used should be in the Introduction, not the Methods.
3. Page 5, last paragraph: It’s a bit odd that authors refer to individual households as food deserts. Typically, an area is considered a food desert. Authors should justify their classification scheme.
4. Page 6: Which shops in Table 1 were considered “healthy food facilities?” Based on the figures, it appears that the authors did not distinguish between food outlets that supply more healthful food options (e.g., grocery stores) and those that supply non-nutritive, calorically dense foods (e.g., convenience stores). If the authors did not distinguish between these types of outlets, then their definition of food desert does not fit their analyses. Authors should consider distinguishing between these types of food outlets and potentially defining and mapping food swamps, areas with an excess of unhealthful foods (e.g., energy dense junk food and snack foods).
Results
5. Page 7: Most of these 2 paragraphs should be in the Discussion, not the Results. Authors need to simply report the results of their analyses without discussing implications. Comment is applicable to entire Results section.
6. Page 10: Suggest deleting reminder sentence – it’s not necessary.
7. Page 10: Authors need to explicitly explain the 2 characteristics represented by their high/low designation.
8. Page 11: This is the first time the term food oasis has been mentioned. Authors need to provide a definition for this term.
9. Page 12: The authors suggest that individuals aged 15-64 represent “a more vibrant workforce.” Are they comparing this “active population” to the elderly population in terms of vibrancy? If so, I don’t believe the comparison is justified, at least the authors have not provided justification for applying this definition to the younger population.
10. Page 12: This is the first time the authors present the socio-material territorial index. This index needs to be included and described in the Methods.
11. Page 12: What do the authors mean by “stark picture” and how does an elderly population add to the “starkness?”
Discussion
12. Page 12: Strongly suggest the authors do not summarize the Introduction and Results sections in the Discussion. It is unnecessary and distracting. Suggest authors restate in the opening sentence the purpose/objective of their study.
13. Page 12: Authors mention other studies reporting patterns of inequality in Santiago but then do not discuss the results or conclusions of these other studies.
14. Page 13, first paragraph: Are the characterizations relevant to the current study? If so, authors need to make this clear. Also, the lower SES characterization seems contradictory with the previous paragraph indicating that food deserts were found in high SES neighborhoods.
15. Page 13, first paragraph: Isn’t greater distance to healthful foods part of the definition for food desert? It is redundant for authors to draw attention to distance when it is part of the definition.
16. Page 13, second paragraph: Delete first paragraph – not necessary.
17. Page 13, second paragraph: Did the authors measure dietary habits in their study? If not, the referenced study is irrelevant to the current discussion.
18. Page 13, fourth paragraph: What do authors mean by “excessive dependence on cars?”
19. Pages 13, fifth paragraph: Delete first sentence. It’s not necessary to state the general purpose of a discussion.
20. Pages 13-14, Conclusions: Conclusions need to be greatly shortened – 1 or 2 paragraphs at most. In the current form, it’s simply a repeat of the Introduction and Discussion.
Table 1
21. What types of shops were considered “healthy food suppliers?”
Table 2
22. Table is difficult to interpret. Suggest authors put the food desert/food oasis labels at the top of the table (i.e., first row merged across table) to free up room so that the text can be made larger.
23. What do the letter column headers signify? What does the total signify?
24. Most of the row labels require definition/explanation (e.g., what indices, 40% less incomes from what, active population).
25. Why is it important to report all 5 SES categories? Why not group the lower SES and higher SES together? This would allow for side-by-side comparisons between food deserts and food oases making the table information easier to interpret.
Figure 2
26. Legend needs explanation. The figure should stand alone from the text. What do blue dots and pink lines signify? Did authors distinguish between food outlets carrying healthful foods and those carrying primarily nonnutritive, high caloric foods?
Figure 3
27. Legend needs explanation. The figure should stand alone from the text. What do the colors signify? What do the numbers signify?
Figure 4
28. Legend needs explanation. The figure should stand alone from the text. To what do the 2 high/low designations refer? What does the pink color signify?
Figure 5
29. Legend needs explanation. The figure should stand alone from the text. What do the blue dots and red color signify?
Author Response
Introduction
OBS 2.1. Page 2, 2nd paragraph: The acronym LMIC needs definition.
RESPONSE 1: Thanks for the observation, changes has been made on this regard in the introduction section by changing the acronym by Low- and Middle-Income Countries.
Methods
OBS 2. General: Much of the discussion on previous methods used should be in the Introduction, not the Methods.
RESPONSE 2: Thanks for the observation, changes has been made on this regard in and part of the literature presented on spatial epidemiology was moved to the introduction.
OBS 3. Page 5, last paragraph: It’s a bit odd that authors refer to individual households as food deserts. Typically, an area is considered a food desert. Authors should justify their classification scheme.
RESPONSE 3: Thanks for the observation, changes has been made to clarify this confusing wording.
OBS 4. Page 6: Which shops in Table 1 were considered “healthy food facilities?” Based on the figures, it appears that the authors did not distinguish between food outlets that supply more healthful food options (e.g., grocery stores) and those that supply non-nutritive, calorically dense foods (e.g., convenience stores). If the authors did not distinguish between these types of outlets, then their definition of food desert does not fit their analyses. Authors should consider distinguishing between these types of food outlets and potentially defining and mapping food swamps, areas with an excess of unhealthful foods (e.g., energy dense junk food and snack foods).
RESPONSE 4: Thank you for the observation. We included all shops that, in the particular case of Chile and based on the information from OpenStreetMap, offer healthy food, excluding other types of shops that do not. A clarification note was added to avoid confusion.
Results
OBS 5. Page 7: Most of these 2 paragraphs should be in the Discussion, not the Results. Authors need to simply report the results of their analyses without discussing implications. Comment is applicable to entire Results section.
RESPONSE 5: Thanks for the observation, changes has been made on this regard deleting some sections that were also presented in the discussion in order to make more descriptive the results section.
OBS 6. Page 10: Suggest deleting reminder sentence – it’s not necessary.
RESPONSE 6: Thanks for the observation, the phrase was deleted.
OBS 7. Page 10: Authors need to explicitly explain the 2 characteristics represented by their high/low designation.
RESPONSE 7: This observation was addressed.
OBS 8. Page 11: This is the first time the term food oasis has been mentioned. Authors need to provide a definition for this term.
RESPONSE 8: This observation was addressed.
OBS 9. Page 12: The authors suggest that individuals aged 15-64 represent “a more vibrant workforce.” Are they comparing this “active population” to the elderly population in terms of vibrancy? If so, I don’t believe the comparison is justified, at least the authors have not provided justification for applying this definition to the younger population.
RESPONSE 9: Thanks for the observation, changes has been made to clarify this confusing wording.
OBS 10. Page 12: This is the first time the authors present the socio-material territorial index. This index needs to be included and described in the Methods.
RESPONSE 10: Thanks for the observation, changes has been made in the methodology section explaining this indicator.
OBS 11. Page 12: What do the authors mean by “stark picture” and how does an elderly population add to the “starkness?”
RESPONSE 11: Thanks for the observation, changes has been made to clarify this confusing wording.
Discussion
OBS 12. Page 12: Strongly suggest the authors do not summarize the Introduction and Results sections in the Discussion. It is unnecessary and distracting. Suggest authors restate in the opening sentence the purpose/objective of their study.
RESPONSE 12: Thanks for the observation, changes has been made following your suggestions.
OBS 13. Page 12: Authors mention other studies reporting patterns of inequality in Santiago but then do not discuss the results or conclusions of these other studies.
RESPONSE 13: Thanks for the observation, changes has been to address this missing point.
OBS 14. Page 13, first paragraph: Are the characterizations relevant to the current study? If so, authors need to make this clear. Also, the lower SES characterization seems contradictory with the previous paragraph indicating that food deserts were found in high SES neighborhoods.
RESPONSE 14: Thanks for the observation, the issue has been amended.
OBS 15. Page 13, first paragraph: Isn’t greater distance to healthful foods part of the definition for food desert? It is redundant for authors to draw attention to distance when it is part of the definition.
RESPONSE 15: Thanks for the observation, it was redundant indeed, we removed the paragraph.
OBS 16. Page 13, second paragraph: Delete first paragraph – not necessary.
RESPONSE 16: Thanks for the observation, we removed the paragraph.
OBS 17. Page 13, second paragraph: Did the authors measure dietary habits in their study? If not, the referenced study is irrelevant to the current discussion.
RESPONSE 17: Thanks for the observation, we removed the paragraph.
OBS 18. Page 13, fourth paragraph: What do authors mean by “excessive dependence on cars?”
RESPONSE 18: Thanks for the observation, introduced a change for clarity.
OBS 19. Pages 13, fifth paragraph: Delete first sentence. It’s not necessary to state the general purpose of a discussion.
RESPONSE 19: Thanks for the observation, we removed the phrase.
OBS 20. Pages 13-14, Conclusions: Conclusions need to be greatly shortened – 1 or 2 paragraphs at most. In the current form, it’s simply a repeat of the Introduction and Discussion.
RESPONSE 20: Thanks for the observation, the whole conclusion section was re-written.
Table 1
OBS 21. What types of shops were considered “healthy food suppliers?”
RESPONSE 21: Thanks for the observation, it was clarified in the text.
Table 2
OBS 22. Table is difficult to interpret. Suggest authors put the food desert/food oasis labels at the top of the table (i.e., first row merged across table) to free up room so that the text can be made larger.
OBS 23. What do the letter column headers signify? What does the total signify?
OBS 24. Most of the row labels require definition/explanation (e.g., what indices, 40% less incomes from what, active population).
OBS 25. Why is it important to report all 5 SES categories? Why not group the lower SES and higher SES together? This would allow for side-by-side comparisons between food deserts and food oases making the table information easier to interpret.
RESPONSE 22-25: Thanks for the observation, we splited the table to facilitate its reading.
Figure 2
OBS 26. Legend needs explanation. The figure should stand alone from the text. What do blue dots and pink lines signify? Did authors distinguish between food outlets carrying healthful foods and those carrying primarily nonnutritive, high caloric foods?
RESPONSE 26: Thanks for the observation, changes have been made in the methodology section for clarification.
Figure 3
OBS 27. Legend needs explanation. The figure should stand alone from the text. What do the colors signify? What do the numbers signify?
RESPONSE 27: Thanks for the observation, changes have been made in the for clarification.
Figure 4
OBS 28. Legend needs explanation. The figure should stand alone from the text. To what do the 2 high/low designations refer? What does the pink color signify?
RESPONSE 28: Thanks for the observation, changes have been made in the for clarification.
Figure 5
OBS 29. Legend needs explanation. The figure should stand alone from the text. What do the blue dots and red color signify?
RESPONSE 29: Thanks for the observation, changes have been made in the for clarification.
Round 2
Reviewer 2 Report
Comments and Suggestions for AuthorsThe authors have done a good job addressing some of my previous comments/suggestions. However, many were not addressed although authors stated “changes were made.” Specific suggestions to improve the clarity, flow, and readability of the manuscript follow.
Introduction
1. Page 2, last paragraph: Acronym GIS requires definition.
2. Page 3, 2nd paragraph: Sentence beginning Joyner et al is a run-on. Suggest splitting into 2 sentences (begin 2nd sentence at “The study underscores”).
Methods
3. Page 3: Opening paragraph belongs in the Introduction.
4. Page 8, 2nd paragraph: Acronym LISA was previously defined. No need to do so again.
Results
5. Page 12: Again, acronym LISA was previously defined. No need to keep defining it throughout manuscript.
6. Page 12: Again, authors need to explicitly explain the 2 characteristics represented by their high/low designation. If the first high/low designation represents lack of access, what does the second high/low designation represent? This information is necessary to interpret all 4 categories, not just the first (red) and last (blue).
7. Page 14, 1st paragraph: Age range in parentheses requires a unit (i.e., years).
8. Page 14, 1st paragraph: What do authors mean by “land values are considerably lower”? The land value in Table 2 for D (think it’s D could be E) is 17.1 while the corresponding value in Table 3 is 18.2 for a difference of 1.1. Not sure that can be described as “considerable.”
9. Page 14, 1st paragraph: Similar to previous comment the SMTI of 0.9095 for column ABC1 in Table2 is higher (not lower) than the corresponding value of 0.9044 in Table 3.
10. Page 14, 1st paragraph: Last sentence has subject-verb mismatch (multiple subjects require matching verb). Additionally, authors are making generalizations that do not hold true across the board for food deserts and food oases. See previous comment and comparisons of household incomes reveal very little differences between food deserts and food oases for at least 2 of the letter groups.
Discussion
11. Page 15, 2nd paragraph: Sentence beginning “In these areas” requires a reference.
12. Page 15, 2nd paragraph: Last sentence does not make sense.
13. Page 15, last paragraph: Authors already discuss this unexpected finding in 2nd paragraph. Suggest authors delete this paragraph or combine it (removing repetitive sentences/topics) with the 2nd paragraph.
Tables 2 and 3
14. Again, tables are difficult to interpret. Column letter headers do not line up with statistics that follow making it difficult to determine which values correspond to which columns.
15. Again, what do the letter column headers signify? What does the total signify?
16. Again, most of the row labels require definition/explanation (e.g., what indices, 40% less incomes from what, active population).
17. Authors report an excessive amount of accuracy for their proportional values (e.g., index values). Suggest reporting only 2 significant digits past the decimal for interpretability and ease of making comparisons.
Figures 2-5
18. Again, legends require explanation. The figures should stand alone from the text.
19. In Figure 4, “clusters” is misspelled.
Author Response
Dear Reviewer
We appreciate the thoughtful feedback and constructive comments provided by you. In response to these comments, we have thoroughly revised the manuscript, ensuring that all issues and comments have been fully addressed. Plese find here each response:
Introduction
- Page 2, last paragraph: Acronym GIS requires definition.
RESPONSE: Thanks for this observation. Changes has been made.
- Page 3, 2ndparagraph: Sentence beginning Joyner et al is a run-on. Suggest splitting into 2 sentences (begin 2nd sentence at “The study underscores”).
RESPONSE: Thanks for the precise comment. Changes has been made.
Methods
- Page 3: Opening paragraph belongs in the Introduction.
RESPONSE: Changes has been made and the paragraph was moved to the introduction.
- Page 8, 2ndparagraph: Acronym LISA was previously defined. No need to do so again.
RESPONSE: Thanks for this suggestion. Changes has been made.
Results
- Page 12: Again, acronym LISA was previously defined. No need to keep defining it throughout manuscript.
RESPONSE: Thanks for this suggestion. Changes has been made.
- Page 12: Again, authors need to explicitly explain the 2 characteristics represented by their high/low designation. If the first high/low designation represents lack of access, what does the second high/low designation represent? This information is necessary to interpret all 4 categories, not just the first (red) and last (blue).
RESPONSE: Thanks for the observation, a clarification was added to the paragraph.
- Page 14, 1stparagraph: Age range in parentheses requires a unit (i.e., years).
RESPONSE: Thanks for this suggestion. Changes has been made.
- Page 14, 1stparagraph: What do authors mean by “land values are considerably lower”? The land value in Table 2 for D (think it’s D could be E) is 17.1 while the corresponding value in Table 3 is 18.2 for a difference of 1.1. Not sure that can be described as “considerable.”
RESPONSE: Thanks for the observation, now it is expressed in the percentual difference of 6% instead of adding an adjective.
- Page 14, 1stparagraph: Similar to previous comment the SMTI of 0.9095 for column ABC1 in Table2 is higher (not lower) than the corresponding value of 0.9044 in Table 3.
RESPONSE: Thanks for the observation, but you the text refers to the total not the specific of ABC1 population. The total in food deserts is 0.7853 and in oasis it is 0.8009. This was now clarified in the text.
- Page 14, 1stparagraph: Last sentence has subject-verb mismatch (multiple subjects require matching verb). Additionally, authors are making generalizations that do not hold true across the board for food deserts and food oases. See previous comment and comparisons of household incomes reveal very little differences between food deserts and food oases for at least 2 of the letter groups.
RESPONSE: Thanks for the observation. This issue arises from having separated the tables, given that the difference between Food Deserts and Food Oases is quite significant, as evidenced in the new Table 4, which precisely summarizes the results and presents the differences for each variable in order.
Discussion
- Page 15, 2ndparagraph: Sentence beginning “In these areas” requires a reference.
RESPONSE: Thanks for this suggestion. Changes has been made.
- Page 15, 2ndparagraph: Last sentence does not make sense.
RESPONSE: Thanks for this suggestion. Changes has been made, the last sentence was deleted.
- Page 15, last paragraph: Authors already discuss this unexpected finding in 2ndparagraph. Suggest authors delete this paragraph or combine it (removing repetitive sentences/topics) with the 2nd paragraph.
RESPONSE: Thanks for this suggestion. Changes has been made by mixing both paragraphs and deleting some unnecessary sentences.
Tables 2 and 3
- Again, tables are difficult to interpret. Column letter headers do not line up with statistics that follow making it difficult to determine which values correspond to which columns.
RESPONSE: Thanks for this observation. Changes has been made to expand on how to read the tables. Also, the inclusion of table 4 may help to this end.
- Again, what do the letter column headers signify? What does the total signify?
RESPONSE: Thanks for this observation. Changes has been made as indicated in response 14.
- Again, most of the row labels require definition/explanation (e.g., what indices, 40% less incomes from what, active population).
RESPONSE: Thanks for this observation. Changes has been made as indicated in response 14.
- Authors report an excessive amount of accuracy for their proportional values (e.g., index values). Suggest reporting only 2 significant digits past the decimal for interpretability and ease of making comparisons.
RESPONSE: Thanks for this observation but we do prefer to use 4 decimals.
Figures 2-5
- Again, legends require explanation. The figures should stand alone from the text.
RESPONSE: We do not understand this request, as legends are already explained in the text and most of journals indicate that figures should be explained in the text, not in the figure.
- In Figure 4, “clusters” is misspelled.
RESPONSE: Thanks for this suggestion. Changes has been made.
