Abstract
Policy makers in several major cities have used quantitative data about local food environments to identify neighborhoods with inadequate access to healthy food. We conducted qualitative interviews with residents of a healthy food priority area to assess whether residents’ perceptions of food access were consistent with previous quantitative findings, and to better understand lived experience of food access. We found that proximity to stores, transportation mode, and cost shaped decisions about food shopping. The local food bank played an important role in improving food access. Participants had varied suggestions for ways to improve the neighborhood, both related and unrelated to the food environment.
Highlights
There are numerous benefits of a healthy diet rich in fruits and vegetables, including lower risk for cardiovascular disease and obesity [1,2], type 2 diabetes [1,3], and all-cause mortality [2]
Four primary themes emerged from analysis: (1) proximity and transportation mode shaped most food-related decisions; (2) participants perceived healthy food as available but expensive; (3) the neighborhood food bank played a central role in changing neighborhood food access; and (4) participants’ suggestions for ways to improve the neighborhood both included and spanned beyond the food environment
For the domain of availability, participants discussed availability of healthy food when prompted, but few continuously or organically brought up topics related to the supply of healthy food in their neighborhood. While these findings suggest that the domains of accessibility and affordability play the greatest role in influencing food access and food-related decision making, another explanation is that these domains are easier to measure, which is consistent with the fact that the majority of research on the food environment has focused on affordability, availability, and accessibility [10]
Summary
There are numerous benefits of a healthy diet rich in fruits and vegetables, including lower risk for cardiovascular disease and obesity [1,2], type 2 diabetes [1,3], and all-cause mortality [2]. Despite these known benefits, most U.S adults do not eat the recommended daily amount of fruits and vegetables [4], and neighborhood disparities in healthy food access may exacerbate this problem. Availability encompasses the sufficiency of the healthy food supply; accessibility encompasses proximity of and ease of traveling to food stores, with geographic distance and travel time as important measures; affordability encompasses price; acceptability encompasses attitudes about the food environment, including if food meets personal requirements; and accommodation encompasses individuals’ requirements for food and food stores, such as store hours [10]
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