Journal of Urban Health

, Volume 86, Issue 6, pp 825–838 | Cite as

Access to Healthful Foods among an Urban Food Insecure Population: Perceptions versus Reality

  • Darcy A. FreedmanEmail author
  • Bethany A. Bell


The influence of local food environments on the risk for obesity is important overall, but may be particularly important for food insecure populations in urban settings. Access to healthful foods is most limited among racial and ethnic minorities and low-income populations; these same populations experience the highest rates of obesity and food insecurity. Few valid and reliable measures have been developed to assess the quality of local food environments. This research addresses this gap by introducing an inventory for measuring self-reported perceptions of food access and then compares the perceptions measure to objective assessments of local food environments. Data are focused on an urban population experiencing disproportionate rates of food insecurity. The four-item perceptions of food access inventory had high internal consistency (Cronbach’s alpha = 0.80). Participants’ perceptions of access to healthful foods mirrored the reality of their food environment; however, perceptions of access to alcohol and tobacco were less accurate. Findings suggest that people living in low-income, urban, minority, and food insecure communities can validly assess (in)access to healthful foods. Future research is needed to further validate the perceptions of food access measure introduced and, more importantly, to develop strategies for increasing access to healthful foods in food insecure contexts.


Food security Food access Local food environment Perceptions of food access Obesity Urban Social determinants of health 



This research was supported in part by grants from the Baptist Healing Trust, First Tennessee, AMERIGROUP, and Tennessee Department of Health. Thank you to Liz Aleman, Anna Au, Leigh Forbush, Renee Langston, Mary Kate Mouser, Britta Muller, Laine Peeler, Sharon Shields, and Lynn Shirley for their research assistance and to the study participants for their time. We are thankful to the anonymous reviewers for their thoughtful feedback. We have no financial disclosures to report.


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Copyright information

© The New York Academy of Medicine 2009

Authors and Affiliations

  1. 1.College of Social WorkUniversity of South CarolinaColumbiaUSA
  2. 2.College of EducationUniversity of South CarolinaColumbiaUSA
  3. 3.University of South CarolinaColumbiaUSA

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