Research article
Disparities in Access to Fresh Produce in Low-Income Neighborhoods in Los Angeles

https://doi.org/10.1016/j.amepre.2006.01.009Get rights and content

Background

Access to fresh produce and other healthy foods differs between poor ethnic and wealthier non-ethnic neighborhoods. Given the need to improve access, emergency food organizations, such as food pantries, can provide assistance. Food pantry clients, many living in poor ethnic neighborhoods, are at highest risk for inadequate intake of fruits and vegetables as emergency food assistance often does not include a supply of fresh produce. This study examines the extent to which food pantry clients live within reasonable walking distance of stores carrying fresh produce, and it proposes a strategy to increase accessibility of produce to those clients.

Methods

Addresses for 3985 food pantry clients residing in Pomona, California, in 2003 and 84 food stores categorized as selling a “variety of produce” or “limited produce” were geocoded using geographic information systems technology in 2004. A 0.8-km network buffer was used to measure access to stores. Cluster areas with high densities of food pantry clients, or hot spots, were determined.

Results

Forty-one percent of Pomona food pantry clients were within walking distance of a store with fresh produce. Eighty-three percent were within walking distance of stores with limited produce, and 13% were not within walking distance of either store type. Seventeen cluster areas of food pantry clients accounted for 48% of clients with no access to a produce store.

Conclusions

Using individual-level data allowed for the identification of significant numbers of food pantry clients with limited access to stores carrying a variety of fresh produce. Identification of the location of high concentrations of food pantry clients provides a potential solution to increase fresh fruit and vegetable access via mobile produce trucks.

Introduction

Numerous epidemiologic studies indicate a relationship between increased fruit and vegetable consumption and decreased risk of cardiovascular disease and obesity, as well as better health status overall.1, 2, 3, 4, 5 U.S. households with incomes less than or equal to 130% of the poverty line are most vulnerable for poor health outcomes partly because they purchase fewer fruits and vegetables than higher-income households.6 Lack of access to healthy foods in economically and socially disadvantaged neighborhoods is hypothesized to contribute to a lower intake of fruits and vegetables.7, 8

Access to supermarkets or stores offering a wide variety of healthful foods at reasonable prices has been shown to differ by both income and ethnicity in the United States.7, 8, 9, 10 A large-scale study of 21 U.S. cities documented that ZIP codes with larger numbers of people on public assistance had fewer large grocery stores that offer a greater variety of foods than middle-income neighborhoods.11 Both Morland et al.12 and Zenk et al.13 demonstrated that economically disadvantaged African-American neighborhoods have fewer grocery stores than more affluent white neighborhoods, limiting access to a wide variety of healthy foods at lower prices. The Atherosclerosis Risk in the Community study demonstrated that higher-income neighborhoods in four communities had generally higher energy-adjusted intakes of fruits, vegetables, and fish, and lower intakes of meat, than those living in lower-income neighborhoods. The availability of healthy foods in neighborhood food stores has been shown to vary between nonwhite, poor East Harlem and the adjacent largely white Upper East Side in New York City.14

In addition to the limited access to healthy foods affecting dietary quality, low-income ethnic communities also demonstrate high rates of food insecurity.15 Food-insecure families and individuals often rely on neighborhood food pantries for emergency food assistance. Food pantries are a type of private emergency food assistance, providing low-income households with packages of food items that usually require additional preparation. However, food pantries focus on providing only short-term food assistance and do not carry all types of products, particularly perishable food. This research group has previously reported that the food pantry client population in Pomona CA was composed of groups at greatest risk for consuming a poor diet—homeless, working poor, undocumented immigrants, and a small proportion of elderly.15 Many clients rely on emergency food assistance provided by the food pantry because they do not receive food stamps, their food stamps have run out, or high housing costs have stressed food budgets beyond capacity. The food pantry does not distribute fresh fruits and vegetables to clients on a regular basis, and occasional donations of a single type of fruit or vegetable are limited and distributed quickly due to spoilage, making availability limited. Client visits to the food pantry are limited to once per month, and at each visit clients may receive a small volume of canned or frozen fruits and vegetables.

Clearly, there is a need to supplement food pantry provisions with a reliable source of a variety of low-cost fresh fruits and vegetables. To begin to address this need, this study employed geographic information system (GIS) technology to identify food pantry clients in greatest need for improved access to fresh produce. GIS has been proven to be useful in public health and nutrition research because it allows for the examination of spatial relationships that might influence possible health outcomes.12, 13, 16, 17, 18, 19 The purpose of this study was to test the hypothesis that a greater proportion of food pantry clients in Pomona CA lived within 0.5 mile (0.8 km) of a store selling little or no fresh produce. An additional objective of the study was to determine geographic areas or concentrations of food pantry clients in need of greater access to fresh produce in order to establish an optimal service route for a mobile produce van as a future intervention.

Section snippets

Food Pantry Clients

Addresses for food pantry clients who visited the Beta Food Pantry in Pomona CA in 2003 were made available by the Inland Valley Council of Churches. Bilingual food pantry workers interviewed clients to gather information on eligibility for emergency food assistance, and the data were later entered into the Access database program, (Microsoft Corporation, Seattle WA, 2002) by the food pantry director. Addresses were geocoded by the investigators to include all clients residing within the Pomona

Descriptive Statistics

Of the 3985 food pantry clients included in the analysis, 70% were Hispanic, 40% spoke only Spanish, 62% had not completed high school, and 81% reported an income of <$1000 per month (Table 1). The city of Pomona has a majority population of Hispanics (65%) with large numbers of documented and undocumented immigrants who are Spanish speaking. Seventy-nine percent of food pantry clients in this study were aged <50, which is representative of users of emergency food assistance nationally.22

Spatial Analysis of Food Stores

Store Access

The results support the hypothesis that food pantry clients in Pomona have greatest access to food stores carrying limited produce and least access to food stores carrying a variety of fresh produce. Forty-one percent of the food pantry clients did not live within walking distance of a store carrying a variety of fresh produce. Half of the stores carrying a selection of produce were located on the two main streets in Pomona, so that food pantry clients living more than 0.8 km from the central

Conclusions and Future Research

In spite of the substantial purchasing power of low-income communities, the higher the concentration of poverty, the fewer the supermarkets.24, 26 Residents in low-income neighborhoods are often disadvantaged in lacking access to a healthy diet that includes fresh fruit and vegetables. The results of this current study using individual data demonstrate the utility of GIS to devise strategies to address this concern. Geocoding of individual data relative to food store location reveals the lack

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