Abstract
Good nutrition reduces the risk of chronic disease, but many vulnerable populations do not have equitable access to healthy food. People who are lower-income, non-White, older, or disabled, have increased likelihood of not owning a vehicle and of being dependent on public buses to source healthy, affordable food. Our study took place in three municipalities targeted by the Rhode Island Department of Health for equity-focused interventions. Our methodology aimed to overcome limitations of prior analyses of public transit food access. We determined healthy food sources, stratifying their affordability with market basket pricing data and community input. Using a geographic information system (GIS), we identified the transit bus service areas of the sources. Our novel approach included employing a fixed bus wait time, determining bus travel times based on schedule combined with historical data, and determining acceptable travel times through a community leader survey. We analyzed access by subgroups including those experiencing poverty, older adults, those without cars, and those with disabilities. We found that 45% of the population in the most urban municipality had bus access to discounted healthy food, and no one in the two less urban municipalities did. Bus access to six food pantries was limited to 15%-28% of the population. Our approach, combining spatial analysis informed by surveys and community input, can increase the ease and accuracy of analyzing bus access to healthy, affordable food and is replicable in other regions and extensible to other types of destinations and services and to rail transit.