title: Community Perspectives on Access to and Availability of Healthy Food in Rural, Low-Resource, Latino Communities.
abstract: Attention has focused on the food environment as a result of the growing concern with obesity rates among Latinos in rural areas. Researchers have observed associations between a lack of physical access to affordable produce in areas where supermarkets and grocery stores are limited and poor dietary intake and obesity; these associations are high in rural, low-resource neighborhoods with a high population of Latino residents. We aimed to engage residents of low-resource, Latino-majority neighborhoods in discussions of food access in a rural yet agricultural community setting, which is typically described as a "food desert."
  
  
  
  We used a mixed-methods approach and conducted 3 focus groups (n = 20) and in-depth interviews (n = 59) and surveys (n = 79) with residents of a rural yet agricultural community. We used thematic analysis to explore residents' perceptions of access to healthy foods.
  
  
  
  Residents (n = 79; mean age, 41.6 y; 72% female; 79% Latino; 53% Spanish-speaking) reported that dollar and discount stores in this agricultural area provided access to produce; however, produce at retail stores was less affordable than produce at nonretail outlets such as fruit and vegetable stands. Gifts and trades of fruits and vegetables from neighbors and community organizations supplied no-cost or low-cost healthy foods. Residents' suggestions to improve food access centered on lowering the cost of produce in existing retail outlets and seeking out nonretail outlets.
  
  
  
  Our findings contribute to understanding of the food environment in low-resource, rural yet agricultural areas. Although such areas are characterized as "food deserts," residents identified nonretail outlets as a viable source of affordable produce, while indicating that the cost of retail produce was a concern. Innovative policy solutions to increase healthy food consumption must focus on affordability as well as accessibility, and consider alternate, nonretail food outlets in agricultural areas.
authors.affiliation: University of California, Merced, 5200 North Lake Rd, Merced, CA 95343. Email: zvaldez@ucmerced.edu.
authors.forename: Zulema
authors.initials: Z
authors.lastname: Valdez
authors.affiliation: University of California, Merced, California.
authors.forename: A Susana
authors.initials: AS
authors.lastname: Ramírez
authors.affiliation: University of California, Merced, California.
authors.forename: Erendira
authors.initials: E
authors.lastname: Estrada
authors.affiliation: Merced County Department of Public Health, Merced, California.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Grassi
authors.affiliation: Merced County Department of Public Health, Merced, California.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Nathan
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California; D005260:Female; D017144:Focus Groups; D005523:Food Supply / Q000706:statistics & numerical data*; D005638:Fruit / Q000600:supply & distribution; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009765:Obesity; D011204:Poverty Areas; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014675:Vegetables / Q000600:supply & distribution; D055815:Young Adult