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

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Abstract

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.

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Notes

  1. The lead investigators of the UM-KC research project included Walker C. Poston, C. Keith Haddock, and Joseph Hughey.

References

  1. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006; 295(13): 1549-1555.

    Article  CAS  PubMed  Google Scholar 

  2. Jetter KM, Cassady DL. The availability and cost of healthier food alternatives. Am J Prev Med. 2006; 30(1): 38-44.

    Article  PubMed  Google Scholar 

  3. Nord M, Andrews M, Carlson S. Household food security in the United States, 2006. Washington: U.S. Department of Agriculture; 2007. Report No. ERR-49.

  4. Nord M, Andrews M, Carlson S. Household food security in the United States, 2004. Washington: Economic Research Service; 2005. Report No. ERR-49.

  5. Nord M, Andrews M, Carlson S. Household food insecurity in the United States, 2007. Washington: U.S. Department of Agriculture; 2008. Report No. ERR-60.

  6. Adams EJ, Grummer-Strawn L, Chavez G. Food insecurity is associated with increased risk of obesity in California women. J Nutr. 2003; 133: 1070-1074.

    CAS  PubMed  Google Scholar 

  7. Casey PH, Simpson PM, Gossett JM, et al. The association of child and household food insecurity with childhood overweight status. Pediatrics. 2006; 118(5): e1406-e1413.

    Article  PubMed  Google Scholar 

  8. Beaulac J, Kristjansson E, Cummins S. A systematic review of food deserts, 1966–2007. Prev Chronic Dis. 2009; 6(3): 1-10.

    Google Scholar 

  9. Baker E, Schootman M, Barnidge E, Kelly C. The role of race and poverty in access to foods that enable individuals to adhere to dietary guidelines. Prev Chronic Dis. 2006; 3(3): 1-11.

    Google Scholar 

  10. Chung C, Myers SL. Do the poor pay more for food? An analysis of grocery store availability and food price disparities. J Consum Aff. 1999; 33(2): 276-296.

    Article  Google Scholar 

  11. MacQueen KM, McLellan E, Metzger DS, et al. What is community? An evidence-based definition for participatory public health. Am J Public Health. 2001; 91(12): 1929-1938.

    Article  CAS  PubMed  Google Scholar 

  12. Moore LV, Diez Roux AV. Associations of neighborhood characteristics with the location and type of food stores. Am J Public Health. 2006; 96(2): 325-331.

    Article  PubMed  Google Scholar 

  13. Morland K, Wing S, Diez Roux A, Poole C. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med. 2002; 22(1): 23-29.

    Article  PubMed  Google Scholar 

  14. Sloane DC, Diamant A, Lewis LB, et al. Improving the nutritional resource environment for healthy living through community-based participatory research. J Gen Intern Med. 2003; 18: 568-575.

    Article  PubMed  Google Scholar 

  15. Moore LV, Diez Roux A, Brines S. Comparing perceptions-based and geographic information system (GIS)-based characterizations of the local food environment. J Urban Health. 2008; 85(2): 206-216.

    Article  PubMed  Google Scholar 

  16. McKinnon RA, Reedy J, Morrissette MA, et al. Measure of the food environment: a compilation of the literature, 1990–2007. Am J Prev Med. 2009; 36(4S): S124-S133.

    Article  PubMed  Google Scholar 

  17. Zenk S, Powell L. U.S. secondary schools and food outlets. Health Place. 2008; 14(2): 336-346.

    Article  PubMed  Google Scholar 

  18. Moore L, Roux A, Nettleton A, Jacobs D. Associations of the local food environment with diet quality—a comparison of assessments based on surveys and geographic information systems: the multi-ethnic study of atherosclerosis. Am J Epidemiol. 2008; 167(8): 917-924.

    Article  PubMed  Google Scholar 

  19. Wang M, Kim S, Gonzalez A, MacLeod K, Winkleby M. Socioeconomic and food-related physical characteristics of the neighborhood environment are associated with body mass index. J Epidemiol Community Health. 2007; 61: 491-498.

    Article  PubMed  Google Scholar 

  20. Alwitt L, Donley T. Retail stores in poor urban neighborhoods. J Consum Aff. 1997; 31(1): 139-164.

    Google Scholar 

  21. Morland K, Filomena S. Disparities in the availability of fruits and vegetables between racially segregated urban neighborhoods. Public Health Nutr. 2007; 10: 1481-1489.

    Article  PubMed  Google Scholar 

  22. Liese AD, Weis KE, Pluto D, Smith E, Lawson A. Food store types, availability, and cost of foods in a rural environment. J Am Diet Assoc. 2007; 107(11): 1916-1923.

    Article  PubMed  Google Scholar 

  23. Sallis J, Nader P, Rupp J, Atkins C, Wilson W. San Diego surveyed for heart healthy foods and exercise facilities. Public Health Rep. 1986; 101(2): 216-219.

    CAS  PubMed  Google Scholar 

  24. Freedman DA. Local food environments: they're all stocked differently. Am J Community Psychol. 2009; in press.

  25. Odoms-Young AM, Zenk SN, Mason M. Measuring food availability and access in African-American communities: implications for intervention and policy. Am J Prev Med. 2009; 36(4S): S145-S150.

    Article  PubMed  Google Scholar 

  26. Giskes K, Van Lenthe FJ, Brug J, Mackenbach JP, Turrell G. Socioeconomic inequalities in food purchasing: the contribution of respondent-perceived and actual (objectively measured) price and availability of foods. Prev Med. 2007; 45: 41-48.

    Article  CAS  PubMed  Google Scholar 

  27. Moore LV, Diez Roux A, Nettleton JA, Jacobs DR. Associations of the local food environment with diet quality: a comparison of assessments based on surveys and geographic information systems. Am J Epidemiol. 2008; 167(8): 917-924.

    Article  PubMed  Google Scholar 

  28. Freedman DA. Politics of food access in food insecure communities. Nashville: Vanderbilt University; 2008. Dissertation.

  29. Lytle LA. Measuring the food environment: state of the science. Am J Prev Med. 2009; 36(4S): S134-S144.

    Article  PubMed  Google Scholar 

  30. U.S. Census Bureau. Decennial Census. Washington: U.S. Census Bureau; 2000.

    Google Scholar 

  31. Bickel G, Nord M, Price C, Hamilton W, Cook J. Guide to Measuring Household Food Security. Alexandria: U.S. Department of Agriculture; 2000.

    Google Scholar 

  32. Gittelsohn J, Sharma S. Physical, consumer, and social aspects of measuring the local food environment among diverse low-income populations. Am J Prev Med. 2009; 36(4S): S161-S165.

    Article  PubMed  Google Scholar 

  33. Glanz K. Measuring food environments. Am J Prev Med. 2009; 36(4S): S93-S98.

    Article  PubMed  Google Scholar 

  34. Mujahid MS, Diez Roux AV, Morenoff JD, Raghunathan R. Assessing the measurement properties of neighborhood scales: from psychometrics to ecometrics. Am J Epidemiol. 2007; 165: 858-867.

    Article  PubMed  Google Scholar 

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Acknowledgements

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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Correspondence to Darcy A. Freedman.

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Freedman, D.A., Bell, B.A. Access to Healthful Foods among an Urban Food Insecure Population: Perceptions versus Reality. J Urban Health 86, 825–838 (2009). https://doi.org/10.1007/s11524-009-9408-x

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  • DOI: https://doi.org/10.1007/s11524-009-9408-x

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