Does neighborhood social economic status affect food selection?

Background: Research on healthy food access has focused on neighborhood food availability as a key influence on dietary behaviors. This study examined the relationships between neighborhood SES, food store types, and availability of healthy foods during winter months in Fargo, ND. Methods: Trained surveyors used the Nutrition Environment Measure Survey-Stores (NEMS-S) to document availability of healthy food items in sixty retail food stores (96% of total community retail food stores) categorized as ‘ethnic grocery', ‘traditional grocery', and ‘convenience'. Healthy food items considered were fruits, vegetables, low fat/fat free milk, and reduced fat/ fat free items. Community neighborhoods are divided by elementary school district, allowing neighborhood SES to be determined by percent free and reduced price lunch and grouped as High or Low SES. Results: Cross tab analysis and chi-square test showed no significant relationship between neighborhood SES and store type (÷²=.665, p=.717). Significant relationships were determined between store type and three of the four healthy food categories (fruits: ÷²=12.61, p=.002; vegetables ÷²=19.67, p=<.001; low fat/fat free milk: ÷²=36.59, p=<.001). Significant relationships were noted between neighborhood SES and two healthy food categories (fruit: ÷²=8.95, p=.003; vegetables: ÷²=7.22, p=.007). Discussion: Retail food stores are a critical community resource for providing healthy nutrition choices. This research shows that store type, especially traditional grocery stores, has the greatest influence on availability of healthy foods, with SES also exerting some effect. Therefore, a lack of traditional grocery stores may limit the availability of healthy foods, regardless of other retail venues or neighborhood SES.