Greater neighborhood travel, grocery store selection and self-reported health: Results from the Los Angeles Family and Neighborhood Survey

This study describes the role of spatial accessibility in the choice of self-reported grocery shopping locations in a sample of 2,430 adults from the Los Angeles Family and Neighborhood Survey (L.A. FANS). Applying a model of spatial accessibility to a subset of 900 shoppers who shopped in large markets, either at the nearest large market or the non-nearest large market, residents of very poor tracts were more likely to shop at the non-nearest large market compared to poor or non-poor tract residents. Similar to the findings of prior studies, residents of very poor Census tracts have fewer large markets in their home Census tracts. However very poor and non-poor residents on average were found to live similar distances from the nearest large markets, while poor Census tract residents live closer, on average, to large markets than either group. Disparities in spatial accessibility and components like store attractiveness were found to influence behavior. Different levels of spatial accessibility were found to result in different travel behavior patterns, which may alter the relative importance of local large grocery markets among groups with different travel behavior patterns. These results suggest an indirect rather than direct link between these local large markets and health behaviors or health outcomes. Multiple Geographic Information System (GIS) datasets were linked to create relative measures of spatial accessibility yielding the above results. This is in contrast to most studies which assume exposure is limited to Census tract boundaries or fixed distances from home.