Sean C. Lucan is a practicing family physician in the Bronx, NY, and a former Robert Wood Johnson Clinical Scholar. Dr. Lucan’s research focuses on how different aspects of urban food environments may influence what people eat, and what the implications are for obesity and chronic diseases, particularly in low-income and minority communities. His work has been recognized by the NIH Loan Repayment Program for Health Disparities Research four times.
Questions and Answers
Currently I’m focused on understudied aspects of urban food environments (e.g., street vendors, farmers’ markets, food pantries, and outdoor food advertising). Of note, the food environment is much broader than select food stores (e.g., supermarkets) and restaurants (e.g., fast-food outlets). In fact, foods and beverages are nearly ubiquitous; I am completing research now showing that a surprising amount of food and drink come from less-intuitive store-front retail (e.g., barber shops, beauty salons, Laundromats, auto shops, etc.). Much of my work suggests that our current knowledge and working understanding of food environments and so-called “food deserts” may be quite limited at best, and inaccurate at worst.
Many of my projects have had policy implications. My assessment of snack foods available to school children in urban corner stores suggested recommendations for food manufacturers, local governments, non-profit organizations, corner-store owners, and consumers (a.k.a. customers and constituents)(full text). My recent analyses of mobile food vendors suggested how urban food carts, trucks, and stands could contribute to—rather than detract from—community nutrition and health (full text, full text). Other work I have done explicitly demonstrated a method for policy planning and policy assessment using basic GIS techniques (full text). Most recently, a multilevel analysis I performed suggested that adding supermarkets to urban neighborhoods might improve residents’ perceptions of supermarket accessibility but might not increase their fruit-and-vegetable consumption (full text). I am proud of all this work, and very grateful to my many collaborators and co-investigators.
Most research occurs from “the ivory tower”, removed from the situations, conditions, and real-world considerations on the ground. The separation between observer and observed inevitably leads to problems with implementation of well-meaning initiatives and unintended consequences from seemingly rational policies. I personally conducted an interview study with members of an urban, low-income, minority community about their perceived promoters and barriers to healthy and less-healthy eating. The policy-relevant insights I gained from this “hands-on” work could never have come from crunching data from secondary sources (full text, full text, full text).
Regarding challenges to the generation and communication of good evidence:
- Tunis SR. Lack of evidence for clinical and health policy decisions. BMJ. 2013;347:f7155, PMID 24343113
Regarding policies/recommendations based on weak evidence:
- Alexander PE, Bero L, Montori VM, Brito JP, Stoltzfus R, Djulbegovic B, Neumann I, Rave S, Guyatt G. World Health Organization recommendations are often strong based on low confidence in effect estimates. J Clin Epidemiol. Jan 3 2014, PMID 24388966
Regarding wasted effort in generating redundant evidence:
- Siontis KC, Hernandez-Boussard T, Ioannidis JP. Overlapping meta-analyses on the same topic: survey of published studies. BMJ. 2013;347:f4501, PMCID: 3716360.