Factors Associated with Food Insecurity in Rural Central Appalachia

Abstract

The impoverished rural counties of Central Appalachia have low rates of household food insecurity. Food costs are higher in this region when compared to nearby non-Appalachian counties. The purpose of our cross-sectional study was to explore factors associated with food insecurity and fruit/vegetable consumption in rural Central Appalachia. Participants (n = 123) enrolled in a 12-month nutrition education/cooking skills intervention completed a demographics questionnaire, BLOCK Fruit/Vegetable Screener and USDA Household Food Security Survey Module at baseline of the intervention. Bivariate associations among all covariates (i.e., age, gender, education, household income) and dependent variables (i.e., food insecurity and fruit/vegetable consumption) were analyzed using Spearman’s rank correlation and two-sample t-test. Multivariable associations of food security with other study variables were assessed using linear regression. In the bivariate analysis, age was positively associated with baseline fruit/vegetable consumption (rho = .20, p = 0.01) and negatively associated with food security (rho= -0.31, p = 0.0004). Household income was negatively associated with food security (rho = -0.30, p= 0.0006) and fruit/vegetable consumption was negatively associated with food security (r = -0.21, p = 0.001). In the multiple regression, controlling for age, gender, income and education, greater food insecurity was predictive of lower fruit/vegetable consumption. High rates of food insecurity influence fruit and vegetable consumption in Appalachia and should be considered during development of nutrition interventions targeting individuals living in this region. Additional research is needed to determine nutrition policies most effective in reducing this barrier to healthy dietary habits in Appalachia.