Disparities in access to healthy and unhealthy foods in central Massachusetts: implications for public health policy.
OBJECTIVE
To analyze geographic and income disparities in access to healthy foods in central Massachusetts.


METHODS
We surveyed 106 (92% of all) food stores longitudinally in the study area between 2007 and 2010. We analyzed the geographic and temporal variations in community- and store-level healthy food availability indices (HFAI) and unhealthy food availability indices (UFAI) overall and by select store and community characteristics.


RESULTS
Twenty-seven of 68 communities in the study area (39.7%) had no food store and 5 (8.3%) had one or few stores with very limited availability of healthy foods, affecting 23.7% of the county population. Lack of food stores was associated strongly with lower housing density and upper tertile of median household income. About 45% of the surveyed stores had inadequate availabilities of healthy food. Store-level HFAI and UFAI scores were highly correlated, and higher among larger stores affiliated with a chain (vs independent). Though healthy foods were usually most available in larger stores, unhealthy foods were widely available in all stores.


CONCLUSIONS
Over half of central Massachusetts communities, mostly rural and small, had either no food store or few stores with limited availabilities of healthy foods. Immediate policy interventions on the food environment are necessary in these communities. Further, without examining what is actually sold in stores, analysis of disparities in access to healthy food relies on the number of food stores, which can lead to a distorted picture of accessibility and mislead community health policies.
a University of Massachusetts Medical School , Worcester , Massachusetts.
Barbara C
BC
Olendzki
Elizabeth
E
Procter-Gray
Nicole M
NM
Wedick
Vijayalakshmi
V
Patil
Hua
H
Zheng
Kevin
K
Kane
Thomas
T
Land
Wenjun
W
Li
D003132:Commerce / Q000592:standards / Q000706:statistics & numerical data*; D005502:Food; D005523:Food Supply / Q000706:statistics & numerical data*; D005843:Geography; D006801:Humans; D007182:Income; D008137:Longitudinal Studies; D008404:Massachusetts; D018673:Nutrition Policy; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012424:Rural Population
access to healthy foods; food environment; food stores; geographic disparity