title: Urban food environments and residents' shopping behaviors.
abstract: BACKGROUND
  Food environments may promote or undermine healthy behaviors, but questions remain regarding how individuals interact with their local food environments.
  
  
  OBJECTIVE
  This study incorporated an urban food environment audit as well as an examination of residents' food shopping behaviors within that context.
  
  
  METHODS
  In 2010, the research team audited the variety and healthfulness of foods available in 373 Philadelphia stores, using the validated Nutrition Environment Measures Survey in Stores (NEMS-S); higher scores indicate more diverse and healthful food inventories. The team also surveyed urban residents (n=514) regarding their food shopping. Descriptive and multivariate analyses (conducted in 2012) assessed variation in retail food environments and in shoppers' store choices.
  
  
  RESULTS
  Corner and convenience stores were common (78.6% of food retail outlets) and had the lowest mean NEMS-S scores of any store type. Most participants (94.5%) did their primary food shopping at higher-scoring chain supermarkets, and the majority of participants did not shop at the supermarket closest to home. Supermarket offerings varied, with significantly fewer healthful foods at supermarkets closest to the homes of disadvantaged residents. In multivariate analyses, participants were significantly more likely to shop at supermarkets closest to home if those supermarkets had higher NEMS-S scores.
  
  
  CONCLUSIONS
  These data suggest that, when possible, shoppers chose supermarkets that offered more variety and more healthful foods. Findings from this study also reinforce concern regarding unhealthy immediate food environments for disadvantaged residents, who disproportionately relied on nearby stores with more limited food items. Interventions to improve nutrition and health should address not only food store proximity but also diversity of healthful foods available.
authors.affiliation: Department of Family Medicine and Community Health, Philadelphia, Pennsylvania. Electronic address: carolyncannu@gmail.com.
authors.forename: Carolyn C
authors.initials: CC
authors.lastname: Cannuscio
authors.forename: Karyn
authors.initials: K
authors.lastname: Tappe
authors.forename: Amy
authors.initials: A
authors.lastname: Hillier
authors.forename: Alison
authors.initials: A
authors.lastname: Buttenheim
authors.forename: Allison
authors.initials: A
authors.lastname: Karpyn
authors.forename: Karen
authors.initials: K
authors.lastname: Glanz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D003132:Commerce / Q000706:statistics & numerical data*; D003625:Data Collection; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D058870:Food, Organic; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015143:Philadelphia; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult