Disparities in healthy food access are well documented in cross-sectional studies in communities across the United States. However, longitudinal studies examining changes in food environments within various neighborhood contexts are scarce. In a sample of 142 census tracts in four low-income, high-minority cities in New Jersey, United States, we examined the availability of different types of food stores by census tract characteristics over time (2009–2017). Outlets were classified as supermarkets, small grocery stores, convenience stores, and pharmacies using multiple sources of data and a rigorous protocol. Census tracts were categorized by median household income and race/ethnicity of the population each year. Significant declines were observed in convenience store prevalence in lower- and medium-income and majority black tracts (p for trend: 0.004, 0.031, and 0.006 respectively), while a slight increase was observed in the prevalence of supermarkets in medium-income tracts (p for trend: 0.059). The decline in prevalence of convenience stores in lower-income and minority neighborhoods is likely attributable to declining incomes in these already poor communities. Compared to non-Hispanic neighborhoods, Hispanic communities had a higher prevalence of small groceries and convenience stores. This higher prevalence of smaller stores, coupled with shopping practices of Hispanic consumers, suggests that efforts to upgrade smaller stores in Hispanic communities may be more sustainable.
Objective: Women, Infants, and Children (WIC) cash value vouchers (CVV) have been inconsistently redeemed in Arizona. The objective of this study was to explore perceived barriers to use of CVV as well as strategies participants use to overcome them.
Design: Eight focus groups were conducted to explore attitudes and behaviors related to CVV use.
Setting: Focus groups were conducted at 2 WIC clinics in metro-Phoenix, AZ.
Participants: Participants in WIC who were at least 18 years of age and primarily responsible for buying and preparing food for their households.
Phenomenon of interest: Perceived barriers to CVV use and strategies used to maximize their purchasing value.
Analysis: Transcripts were analyzed using a general inductive approach to identify emergent themes.
Results: Among 41 participants, multiple perceived barriers emerged, such as negative interactions in stores or confusion over WIC rules. Among experienced shoppers, WIC strategies also emerged to deal with barriers and maximize CVV value, including strategic choice of times and locations at which to shop and use of price-matching, rewards points, and other ways to increase purchasing power.
Conclusions and implications: Arizona WIC participants perceived barriers that limit easy redemption of CVV. Useful strategies were also identified that could be important to explore further to improve WIC CVV purchasing experiences.
Disparities in access to healthy food are a key public health concern in the United States (U.S.) Food access is considered as a critical element of food insecurity. Food insecurity can often be prevalent in a region due to lack of healthy food outlets as well as inequitable access to healthy food outlets. A large body of literature pertaining to access to healthy food has reported that conventional food outlets such as supermarkets and large grocery stores may not be equitably distributed across different neighborhoods in a region. There has been limited research on local food access patterns. Despite the few studies focused on access to individual types of local food outlets, such as farmers markets, little is known about whether such access varies among different types of local food outlets and how such access patterns compare with the uneven access to conventional food outlets. This study uses Maricopa County, one of the largest counties in Arizona, as a case study to examine the spatial patterns of access to conventional food markets (i.e. supermarkets or large grocery stores) and four different types of local food outlets, including farmers market, community garden, community supported agriculture (CSA) and mobile food markets. By analyzing the association between healthy food access and neighborhood characteristics, the study suggests that the local food system has a great potential in providing healthy food access to low-income and minority populations of the County than conventional food outlets. The study provides important insights into the way different types of local food outlets offer their availability in space and whether they are more equitable in serving underserved neighborhoods. The findings from this study can assist both government agencies and city planner formulate strategies to improve access to healthy food in disadvantaged neighborhoods.