title: Food Accessibility and Perceptions of Shopping Difficulty among Elderly People Living Alone in Japan.
abstract: This aim of this study was to describe the association between shopping difficulty and food accessibility for elderly people living alone in Japan.
  
  
  
  A cross-sectoral, multilevel survey was designed to measure shopping difficulty from a food accessibility perspective. The questionnaire was distributed by mail.
  
  
  
  The sample was drawn from seven towns and cities across Japan.
  
  
  
  A geographic information system was used to select the sample: it identified the proximity of elderly people living alone to a supermarket. In total, 2,028 elderly people (725 men and 1,303 women) responded to the questionnaire.
  
  
  
  The binary dependent variables were shopping is easy/shopping is difficult. A logistic regression analysis adjusting for age and area of residence and using stepwise variable analyses was performed.
  
  
  
  The response rate was 58.6%. Overall, 14.6% of elderly men and 21.7% of elderly women consider shopping difficult. The stepwise logistic analysis showed that the food accessibility factors strongly related to shopping difficulty are infrequent car use (women: OR = 6.97), walking difficulties (men: OR = 2.81, women: OR = 3.48), poor eyesight (men: OR = 2.26, women: OR = 1.75), not cooking lunch by oneself (men: OR = 1.63, women: OR = 1.72), not having anyone to help with food shopping (women: OR = 1.45) and living over 1 km away from a supermarket (men: OR = 2.30, women: OR = 2.97).
  
  
  
  The study concludes that elderly people's assessment of shopping difficulty is related to their food accessibility. Important food accessibility aspects include car or motorbike ownership, walking continuously for 1 km, poor eyesight, and having cooking skills and having someone to help with shopping. These physical activity restrictions have a greater influence on shopping difficulty than do either income or proximity to a supermarket.
authors: Midori Ishikawa, PhD, RD, Department of Health Promotion. National Institute of Public Health, 2-3-6 Minami, Wako, Saitama 351-0197, Japan, Tel: +81-(0)48-458-6230; Fax: +80-(0)48-469-7683, E mail: ishikawa@niph.go.jp.
authors: M
authors: M
authors: Ishikawa
authors: T
authors: T
authors: Yokoyama
authors: T
authors: T
authors: Nakaya
authors: Y
authors: Y
authors: Fukuda
authors: Y
authors: Y
authors: Takemi
authors: K
authors: K
authors: Kusama
authors: N
authors: N
authors: Yoshiike
authors: M
authors: M
authors: Nozue
authors: K
authors: K
authors: Yoshiba
authors: N
authors: N
authors: Murayama
mesh_terms: D000368:Aged; D003296:Cooking; D005260:Female; D005502:Food; D005523:Food Supply; D015577:Geriatric Assessment; D006801:Humans; D007182:Income; D057187:Independent Living / Q000523:psychology*; D007564:Japan; D008297:Male; D010465:Perception; D011795:Surveys and Questionnaires; D014186:Transportation; D016138:Walking