Access to healthy food most problematic in low-income neighborhoods

University of GeorgiaFeb 24 2012

Most convenience stores have a wide variety of chips, colorful candies and bottles of sugar-sweetened carbonated beverages. While shoppers can buy calorie-heavy foods wrapped in pretty packages in these locations, what they usually can't find are the fresh produce, whole grains and low-fat dairy products necessary for a healthy diet.

These stores are the only nearby food source for millions of Americans living in what are called food deserts, because they are isolated from affordable healthy food. In recent studies, University of Georgia foods and nutrition researchers uncovered the unequal distribution of food stores in one Southeast community. The first study covered access to stores for people using food stamps, the Supplemental Nutrition Assistance Program, while the second study looked at what healthy foods were available at supermarkets, grocery and convenience stores. Both studies found access to healthy food is most problematic in low-income, predominately black neighborhoods.

"Easy access to affordable healthful foods is essential to promoting health and preventing diseases," said Jung Sun Lee, assistant professor in the UGA College of Family and Consumer Sciences and co-author of a pair of studies examining the food environment on the Florida Panhandle.

"Research examining food environments is a relatively new area in the nutritional sciences," she said. "Understanding the distribution of different kinds of food stores and the kinds and quality of the foods they offer has the potential to provide an explanation of why and how individuals are able or unable to follow dietary recommendations."

The Florida-Georgia connection surfaced when Connie Betterley, a community health promotion coordinator, worked with fellow Leon County Health Department administrators to collect data with a goal of making policy changes and interventions to improve access to healthy food. One of those collaborators was UGA graduate Sohyun Park, who contacted Lee about evaluating the data.

"She knew that UGA graduate students with similar interests in food environments needed data to analyze for their theses and dissertations, so a very nice collaboration developed to complete this project," Betterley said.

The studies examined 48 neighborhoods in Leon County, Fla., whose residents were identified as having high rates of childhood obesity and diet-related deaths. Using Geographic Information System technology and a registry of food stores, the distribution of food stores across neighborhood racial composition, wealth and rurality were examined. Comprehensive food store surveys were used to access the price and availability of healthy foods by food store type, neighborhood income level and racial composition.

Results from the first-ever study of food deserts in relation to food assistance benefits accepting stores will be published by UGA researchers in the March issue of the Journal of Nutrition Education and Behavior.

"The size and types of stores available may have considerable influence on what people purchase and consume, ultimately influencing their health," said Samantha Rigby, a former UGA graduate student and study co-author. "Access to supermarkets has been shown to promote healthful food choices, and these stores are the most likely type of food store to provide the greatest variety of foods at the lowest prices."

SNAP, formerly the Food Stamps Program, provides food assistance to more than 43 million Americans a month. Florida is home to 2.9 million recipients; 10 percent of the population in the study area relies on assistance for food.

"While they may qualify for financial awards, there are no accessible stores that accept SNAP, or stores with enough variety in foods to fully utilize their benefits," Rigby said.

Primarily black neighborhoods tend to have less access to SNAP-accepting supermarkets than white or mixed race neighborhoods. In fact, no supermarket was available in predominately black neighborhoods in Leon County. SNAP-receiving residents in primarily black neighborhoods in the county may have limited shopping options because the food store type that is most likely to accept benefits, supermarkets, is not present.

"Because this racial group historically has a higher prevalence of chronic disease than whites, lack of SNAP stores nearby and resulting limited food choices may further decrease the quality of their diet and health," Rigby said.

An accompanying study looking at foods available in accessible stores was published in the November 2011 issue of the Centers for Disease Control and Prevention's publication Preventing Chronic Disease. The study looked at the availability and price of healthful foods by type of store, neighborhood income level and racial composition within a community that has high rates of diet-related illness and death.

"This study suggests that access to supermarkets and more healthful foods varies by neighborhood, which may negatively influence people's eating behavior," said Angela Leone, a former UGA graduate student and co-author of the article.

A sample of 10 fruits and 10 vegetables was examined in the grocery, supermarket and convenience stores sampled. While supermarkets carried all of the products, grocery stores lacked variety in fruits and convenience stores did not carry any vegetables.

"Fruit availability scores were significantly higher in high-income than in low-income neighborhood stores," Leone said.

All supermarkets carried low-fat milk. About 63 percent of grocery stores had low-fat milk while only 36 percent of convenience stores stocked the healthier dairy option. Whole wheat bread was available in supermarkets, but it was much less likely to be found in grocery stores (38 percent) and convenience stores (7 percent). Identical products also cost more in convenience stores.

"For dietetic professionals such as myself, these studies were eye-opening," Leone said. "We often think there is a lack of nutrition education or nutrition knowledge when in fact there may be other barriers that individuals face that inhibit their ability to follow a healthy diet, such as the nutrition environment that they live in and around."