Examining local food environments: Objective and subjective measures of access to healthful foods

There is mounting evidence that local food environments vary by social context with low-income and racial/ethnic minority communities experiencing less access to stores selling a wide variety of healthful foods. Few studies, however, have examined community members' perceptions of access to healthful foods. This analysis compares two sources of data focused on the quality of local food environments: food store audits and self-reported perceptions of local food environment. Data were collected in three primarily African American urban communities in Nashville, TN as a part of a farmers' market intervention study. Thirty-three food store audits and 81 interviews were conducted. Differences between perceptions and store audit indicators were examined using chi-square analyses. Statistically significant differences were noted between self-reported perceptions of local food environments and objective measures from store audits. Sixty-three percent of participants reported that it was easy to buy fresh fruits and vegetables in their neighborhood, yet only 36% of stores sold at least one fresh fruit or vegetable [X2(1, N = 81) = 25.56, p <.05]. Also, 58% of participants reported that it was easy to buy healthy foods in their community, yet only 36% of stores sold at least one healthful option (i.e., fresh fruit/vegetable, low-fat milk) [X2(1, N = 82) = 17.05, p <.05]. Findings reveal that food access is a complex phenomenon; it is not merely a measure of physical access to food. Research approaches that take into account the complexity of local food environments ought to be developed and utilized.