Urban Foodscape in Transition: Spatiotemporal Characteristics in Healthy and Unhealthy Food Outlets and Socioeconomic Disparities in Wuhan During 2012-2022.

Improving healthy food access is one of the most effective strategies to promote healthy eating. However, few studies examined the spatiotemporal characteristics of both healthy and unhealthy food outlets with both absolute and relative metrics and their socioeconomic disparities at a granular scale over time. We aimed to (1) examine the spatiotemporal characteristics of the healthy and unhealthy food environment (characterized by three complementary absolute and relative metrics) in Wuhan, China, during 2012-2022 and (2) investigate the socioeconomic disparities in multidimensional food environments over time. We found that healthy food outlets and unhealthy food outlets were spatially clustered in the same areas rather than being spatially separated. They were co-evolving with an increasing trend over time. In contrast, some areas with only healthy food outlets have transitioned to areas with mixed food availability. Further, healthy and unhealthy food outlets tend to be spatially concentrated in areas with higher socioeconomic status (SES), especially in highly populated areas. This study contributed to the literature by capturing a more holistic and dynamic picture of the urban foodscape over a 10-year period in Wuhan, China; and improving nuanced understanding of the socioeconomic disparities in the multidimensional food environment at a granular scale over time. Our complementary absolute and relative food accessibility metrics could help advance the characterization of healthy-related multiple environment exposures. Our findings could inform equity-based interventions to improve healthy food access in disadvantaged areas with lower socioeconomic status.