Abstract
Background: Motivated by concern over lack of access to nutritious food in low-income neighborhoods, healthy food financing initiatives have encouraged the introduction of new supermarkets. Extensive research on the association between the food retail environment and nutrition outcomes has shown mixed results. There has been less research specifically on food security outcomes. Objective: We assessed the association between multiple food environment measures and food security for low-income US households. Methods: By using the USDA's nationally representative 2012-2013 Food Acquisition and Purchase Survey (FoodAPS; n = 4826 households), which provides unique information about neighborhood- and household-level food retailer access, we quantified cross-sectional associations between food environment characteristics and household-level outcomes, with and without regression controls. Logistic regression analysis was used for binary household food security outcomes. Results: Most households bypassed the nearest retailer to select a primary retailer farther from home. For low-income households, distance to the nearest supermarket and to the primary retailer was not associated with food security. In comparison to shopping with households' own automobile, the odds of being food secure were lower for households that used another automobile (OR: 0.59; 95% CI: 0.38, 0.90) or other transportation (OR: 0.32; 95% CI: 0.17, 0.61) to reach the primary retailer. Conclusions: Having a closest supermarket ≤1 mile from home was not associated with household food security. In contrast, the mode of transportation used to access the primary retailer was associated with household food security. In future research, it may be valuable to not only focus on the distance to the nearest supermarket but to investigate the qualities of the food retail environment at distances >1 mile that are most strongly associated with food security outcomes.