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CHAPTER 1 4 Urban Agriculture and Health What Is Known, What Is Possible? benjamin w. chrisinger and sheila golden introduction Urban agriculture has been celebrated for its ability to increase access to and promote consumption of healthy, fresh foods, increase nutritional knowledge, provide restorative spaces, and build social capital in communities (Hodgson , Campbell, and Bailkey 2011). In the last five years, many metropolitan areas across the United States have revised zoning and land-use policies to accommodate urban agriculture (Goldstein et al. 2011; Hodgson 2012; Hendrickson and Porth 2012). Many of these efforts are inspired by a growing body of literature and research that describes beneficial health impacts of urban agriculture. To further develop our understanding of the connections between urban agriculture and health and inform future efforts to improve health with urban agriculture, a focused and practice-oriented research agenda is critical. New research can build compelling datasets and offer useful insights that draw support from public health policy makers and funders. Researching the health impacts of urban agriculture is a difficult task, particularly considering the financial and time limitations of many urban-ag- Urban Agriculture and Health 231 riculture programs. Nonetheless, spending time and resources on evaluation and research can lend greater weight to the larger urban-agriculture movement and may also help increase the competitiveness of grant applications for individual projects. Recognizing this, the chapter is divided into two parts: first, a summary of health benefits linked to urban agriculture found through a comprehensive literature review, and second, ways to think about measuring possible health impacts going forward. We begin by reviewing research that has uncovered a variety of health measures and outcomes associated with urban agriculture, including increased fruit and vegetable consumption as well as improvements to diet, physical activity, psychosocial state, body mass index (BMI), and social cohesion. To broaden the scope of this review, we also present studies documenting connections between health and food markets, such as farmers markets and community-supported agriculture (CSA) programs. The chapter concludes by suggesting tools and frameworks that practitioners can use to tailor evaluations, design health interventions, or conduct general research on the health benefits of urban agriculture. We suggest two different approaches to this research: the first asks how urban agriculture provides access and opportunities that improve health outcomes, and the other considers how urban agriculture might influence healthful attitudes and abilities. For each approach, we offer tools and examples of effective models. We focus broadly on key theories and concepts about the connections between urban agriculture and health, in the hope that readers will apply these ideas in the more detailed case studies and examples that appear in other chapters. state of the evidence: health effects of urban agriculture Are urban-agriculture participants or beneficiaries healthier? Research documenting the health effects of urban agriculture generally falls into one of four categories: dietary habits, physical activity, physiological outcomes, and psychosocial outcomes. Generally speaking, we can measure health outcomes in one of two ways: direct measures and indirect measures. Direct measures are most often char- 232 community health and policy perspectives acteristics that are observed or measured in person, such as BMI, heart rate, or cholesterol levels. Some of these measures are easy to collect, like height and weight (for BMI), while others can be very intrusive and require the collection of medical samples (like a blood draw), dramatically raising the cost and complexity of a study. Because certain health outcomes are difficult to measure directly, researchers frequently choose indirect, observational, or self-reported measures as alternatives. Indirect measures might include dietary recalls, measures of fruit and vegetable consumption, or questionnaires to assess average levels of physical activity. These types of measures can produce equally high-quality and convincing data, as long as researchers are aware of how these data are context -specific representations of health (i.e., self-reported data might depend on how comfortable an individual is with sharing or how well they remember that information; directly measured weight is as accurate as the scale used). Several resources and tools currently provide more detail and information on researched health impacts of urban agriculture. Practitioners who are looking for existing research might find these tools useful. 1. The Community Food Security Coalition’s North American Initiative on Urban Agriculture published a summary of research on health benefits of urban agriculture (Bellows, Brown, and Smit 2005) followed by a literature review of research suggesting nutrition implications of urban farmers markets and community gardens (McCormack et al. 2010). 2...


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