Online Program

CX3 assessment revealed higher pricing of fruits and vegetables in low-income neighborhoods of Los Angeles County, 2013-2014

Sunday, November 1, 2015

Mirna Jewell, MPH, MA, Department of Public Health, Los Angeles County, Los Angeles, CA
Elaine Lai, MPH, Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA
Jack Thompson, MPH, Los Angeles County Department of Public Health, Nutrition and Activity Program, LOS ANGELES, CA
Tony Kuo, MD, MSHS, Department of Family Medicine and the David Geffen School Medicine, University of California, Los Angeles, Los Angeles, CA
Introduction: Emerging evidence suggests that having limited access to fresh, affordable produce is an important barrier to healthy eating. Identifying and understanding geographic influences has utility for public health programming in this regard. The present case study describes the Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention (CX3) Project in Los Angeles County (LAC) where CX3 assessments are being applied in program planning for the local Nutrition Education and Obesity Prevention (NEOP) project.


We analyzed data for SNAP eligible census tracts from CX3 and poverty data from the American Community Survey to examine correlations between fruit and vegetable pricing and percentage of census tracts in surrounding neighborhoods that fall under the federal poverty level (FPL) of CX3 neighborhoods across LAC. The Food Availability and Marketing survey, a component of CX3, collected information regarding fruit and vegetable availability and pricing from grocery stores (n=99) in neighborhoods (n=21) with at least 50% of the population living <185% FPL.


Among grocery stores assessed, 18% had “good to all good” quality fresh produce available. After adjusting for demographic covariates, pricing was higher in predominantly lower-income neighborhoods (AOR=3.9, 95% CI=1.3, 12.0) than higher-income neighborhoods surrounding the CX3 assessments. Similarly, lower income surrounding neighborhoods had marginally less fresh produce (AOR=0.6, 95% CI=0.3, 1.1).

Discussion: CX3 results suggest that quality of produce is less of a barrier to access than the pricing of fresh fruits and vegetables in lower-income neighborhoods. Use of these findings to inform local planning for NEOP is under way.

Learning Areas:

Program planning
Public health or related research

Learning Objectives:
Demonstrate the effectiveness of the Communities for Excellence in Nutrition, Physical Activity and Obesity Prevention project in identifying barriers to access of fruits and vegetables in low-income neighborhoods. Analyze the effects of surrounding neighborhoods on the pricing and access to quality fruits and vegetables in low income neighborhoods.

Keyword(s): Nutrition, Food Security

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have led and advised on analyses on nutrition (e.g., self efficacy of health eating), economic impact of chronic disease on vulnerable populations (e.g., caregivers and productivity losses) and geographic analyses (e.g., animal bites in Los Angeles County). My research interests include effects of neighborhood and individual level indicators on health outcomes and quality of life.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.