Neighbourhood fruit and vegetable availability and consumption: the role of small food stores in an urban environment

OBJECTIVE: Previous studies on the relationship of dietary intake to the neighbourhood food environment have focused on access to supermarkets, quantified by geographic distance or store concentration measures. However, in-store food availability may also be an important determinant, particularly for urban neighbourhoods with a greater concentration of small food stores. This study synthesises both types of information - store access and in-store availability - to determine their potential relationship to fruit and vegetable consumption. DESIGN: Residents in four census tracts were surveyed in 2001 about their fruit and vegetable intake. Household distances to food stores in these and surrounding tracts were obtained using geographical information system mapping techniques. In-store fruit and vegetable availability was measured by linear shelf space. Multivariate linear regression models were used to measure the association of these neighbourhood availability measures with consumption. SETTING: Four contiguous census tracts in central-city New Orleans. SUBJECTS: A random sample of 102 households. RESULTS: Greater fresh vegetable availability within 100 m of a residence was a positive predictor of vegetable intake; each additional metre of shelf space was associated with 0.35 servings per day of increased intake. Fresh fruit availability was not associated with intake, although having a small food store within this same distance was a marginal predictor of fruit consumption. CONCLUSIONS: The findings suggest the possible importance of small neighbourhood food stores and their fresh produce availability in affecting fruit and vegetable intake.     

Food store access and household fruit and vegetable use among participants in the US Food Stamp Program

OBJECTIVE: Recent research on access to food among low-income populations in industrialised countries has begun to focus on neighbourhood food availability as a key determinant of dietary behaviour. This study examined the relationship between various measures of food store access and household fruit and vegetable use among participants in the Food Stamp Program, America's largest domestic food assistance programme. DESIGN: A secondary data analysis was conducted using the 1996-97 National Food Stamp Program Survey. The survey employed a 1-week food inventory method, including two at-home interviews, to determine household food use. Separate linear regression models were developed to analyse fruit and vegetable use. Independent variables included distance to store, travel time to store, ownership of a car and difficulty of supermarket access. All models controlled for a full set of socio-economic variables. SUBJECTS: A nationally representative sample of participants (n=963) in the Food Stamp Program. RESULTS: After controlling for confounding variables, easy access to supermarket shopping was associated with increased household use of fruits (84 grams per adult equivalent per day; 95% confidence interval 5, 162). Distance from home to food store was inversely associated with fruit use by households. Similar patterns were seen with vegetable use, though associations were not significant. CONCLUSIONS: Environmental factors are importantly related to dietary choice in a nationally representative sample of low-income households, reinforcing the importance of including such factors in interventions that seek to effect dietary improvements.     

A comparison of the availability and affordability of a market basket in two communities in the Chicago area

OBJECTIVE: The purpose of the present study was to characterise the food landscape of an inner city African American neighbourhood and its mixed-race suburban neighbour. Detailed analysis focuses on the relationship between community store mix and price, availability and produce quality. DESIGN: A market basket study was completed by members of the Chicago Food Systems Collaborative. The US Department of Agriculture's standard market basket survey and methodology were used. Additional items and analyses were added in consultation with community members. SETTING: Austin is a lower-middle-class African American community of 117,500 on the western edge of Chicago. Oak Park, which borders Austin, is an upper-middle-income suburb of 52,500 with a mixed racial profile.Subjects: A market basket survey of every retail food store in Austin and Oak Park was completed. A total of 134 were included. RESULTS: Results indicate that Austin has many grocery stores and few supermarkets. Many Austin groceries stores carry produce that is usually competitively priced, but often of unacceptable quality. Supermarkets had the best selection. Prices were lowest at discount supermarkets. Prices of packaged items were higher at independent stores than at chain supermarkets, but fresh items were cheaper. CONCLUSIONS: Food access is related more to store type than number. In this study, item availability and produce quality varied greatly between store types. Price differences were complicated and varied by store type and food category. This has consequences in terms of food purchasing decisions and dietary quality that public health professionals should acknowledge.     

Comparisons of Colorado women's cancer screening practices by residence: metropolitan, non-metropolitan, and farm

Combining farm residents and non-farm rural residents into a single category designated as rural may obscure differences in preventive care utilization, including cancer screening practices in each group, because of distinctive characteristics of farmers. This study compared three cancer screening practices (mammography, breast physical examination, and Pap smears) across three residence groups (metropolitan, non-metropolitan, and farms) of Colorado women and described demographic and socioeconomic characteristics of the groups. Females interviewed in the 1993 Colorado Behavioral Risk Factor Surveillance System (BRFSS) were divided into residence as metropolitan or non-metropolitan. Farm residents were female respondents interviewed as part of the Colorado Farm Family Health and Hazard Survey (CFFHHS) conducted in 1993-1997. Univariate and multivariate analyses were conducted to determine characteristics related to the screening practices. Farm women were more likely to be non-Hispanic white and older, to report their health as very good, and to have medical insurance and at least one source of primary care compared to non-metropolitan women. After controlling for related variables, residence was not associated with the screening practices, with the exception of breast physical examination; farm women were less likely to have a recent examination than metropolitan women (OR = 1.50, 95% CI = 1.07-2.10). When non-metropolitan and farm women were combined, there was no association between residence and having had a physical breast examination. There were important differences between non-metropolitan women and farm women in demographic and socioeconomic characteristics, which influenced screening practices. Further studies are needed to examine farm residents' cancer screening practices separately from other rural residents in order to fully understand the implications of these differences for health status in other geographic areas.     

Changes in neighbourhood food store environment, food behaviour and body mass index, 1981--1990

OBJECTIVE: This paper examines trends in the neighbourhood food store environment (defined by the number and geographic density of food stores of each type in a neighbourhood), and in food consumption behaviour and overweight risk of 5779 men and women. DESIGN: The study used data gathered by the Stanford Heart Disease Prevention Program in four cross-sectional surveys conducted from 1981 to 1990. SETTING: Four mid-sized cities in agricultural regions of California. SUBJECTS: In total, 3154 women and 2625 men, aged 25-74 years. RESULTS: From 1981 to 1990, there were large increases in the number and density of neighbourhood stores selling sweets, pizza stores, small grocery stores and fast-food restaurants. During this period, the percentage of women and men who adopted healthy food behaviours increased but so did the percentage who adopted less healthy food behaviours. The percentage who were obese increased by 28% in women and 24% in men.ConclusionFindings point to increases in neighbourhood food stores that generally offer mostly unhealthy foods, and also to the importance of examining other food pattern changes that may have a substantial impact on obesity, such as large increases in portion sizes during the 1980s.     

Hunger and health among undocumented Mexican migrants in a US urban area

OBJECTIVES: To measure the occurrence and correlates of hunger and to evaluate the association between hunger and three health indicators among undocumented Mexican immigrants. DESIGN: Non-probability cross-sectional sample. SETTING: Neighbourhoods within New York City. SUBJECTS: Four hundred and thirty-one undocumented Mexican immigrants living in the USA. RESULTS: Hunger was indicated by approximately 28% of respondents. In a multivariate model, working as a day labourer was associated with hunger (odds ratio (OR) 3.33, 95% confidence interval (CI) 1.83-6.06) while receiving public assistance protected against hunger (OR 0.23, 95% CI 0.06-0.88). In multivariate models, respondents who reported experiencing hunger also reported poorer overall health (OR 1.69, 95% CI 0.95-3.02) and more days of poor mental (P = 0.045) and physical health (P < 0.0001). Greater amount of time lived in the USA was also associated with worse overall health (P = 0.054) and more days of poor mental and physical health (P < 0.01). CONCLUSIONS: The present study shows that food insecurity and hunger may be problems among undocumented migrants living in the USA. Uncertain and unpredictable work schedules and limited access to public assistance may contribute to high levels of hunger, which in turn may also negatively affect mental and physical health. Increasing amount of time lived in the USA is also associated with poorer health indicators. Programmes that provide undocumented migrants with emergency access to resources may reduce food insecurity and lead to improved health outcomes among this vulnerable population.     

Socio-economic pathways to diet: modelling the association between socio-economic position and food purchasing behaviour

OBJECTIVES: To examine the association between education level and food purchasing behaviour and the contribution of dietary knowledge to this relationship; and the association between household income and purchasing behaviour and the contribution made by subjective perceptions about the cost of healthy food.DESIGN AND SETTING: The study was conducted in Brisbane City (Australia) in 2000. The sample was selected using a stratified two-stage cluster design. Data were collected by face-to-face interview from residents of private dwellings (n=1003), and the response rate was 66.4%. Dietary knowledge was measured using a 20-item index that assessed general knowledge about food, nutrition, health and their interrelationships. Food-cost concern was measured using a three-item scale derived from principal components analysis (alpha=0.647). Food purchasing was measured using a 16-item index that reflected a household's purchase of grocery items that were consistent (or otherwise) with dietary guideline recommendations. Associations among the variables were analysed using linear regression with adjustment for age and sex.RESULTS: Significant associations were found between education, household income and food purchasing behaviour. Food shoppers with low levels of education, and those residing in low-income households, were least likely to purchase foods that were comparatively high in fibre and low in fat, salt and sugar. Socio-economic differences in dietary knowledge represented part of the pathway through which educational attainment exerts an influence on diet; and food purchasing differences by household income were related to diet in part via food-cost concern.CONCLUSIONS: Our findings suggest that socio-economic differences in food purchasing behaviour may contribute to the relationship between socio-economic position and food and nutrient intakes, and, by extension, to socio-economic health inequalities for diet-related disease. Further, socio-economic differences in dietary knowledge and concerns about the cost of healthy food play an important role in these relationships and hence should form the focus of future health promotion efforts directed at reducing health inequalities and encouraging the general population to improve their diets.     

Who is food-insecure in California? Findings from the California Women's Health Survey, 2004

OBJECTIVE: To identify factors associated with food insecurity in California women. DESIGN: The California Women's Health Survey is an ongoing annual telephone survey that collects data about health-related attitudes and behaviours from a randomly selected sample of women. Food insecurity of the women was measured by a 6-item subset of the Food Security Module. Statistical procedures included chi-square tests, t-tests, logistic regression analysis and analysis of covariance. SETTING: California, USA. SUBJECTS: Four thousand and thirty-seven women (18 years or older). RESULTS: Prevalence of food insecurity was 25.7%. After controlling for income, factors associated with greater food insecurity were Hispanic or Black race/ethnicity; less than a 12th grade education; being unmarried; less than 55 years old; being Spanish-speaking; having spent less than half of one's life in the USA; sadness/depression; feeling overwhelmed; poor physical/mental health interfering with activities; and fair to poor general health. Among Food Stamp Program (FSP) participants, 71% were food-insecure. Among FSP-eligible women who had not applied for the programme, the prevalence of food insecurity was lower among women responding that they did not need food stamps than in women giving other reasons for not applying (23.9% vs. 66.9%, P < 0.001). Factors associated with food insecurity in FSP recipients included being unable to make food stamps last for 30 days, feeling overwhelmed, and having a birthplace in Mexico or Central America. CONCLUSIONS: Along with several socio-economic variables, poor physical and mental health is associated with food insecurity. Whether food insecurity is a cause or effect of poor health remains in question.     

Parent outcome expectancies for purchasing fruit and vegetables: a validation

OBJECTIVE: To validate four scales -- outcome expectancies for purchasing fruit and for purchasing vegetables, and comparative outcome expectancies for purchasing fresh fruit and for purchasing fresh vegetables versus other forms of fruit and vegetables (F&V). DESIGN: Survey instruments were administered twice, separated by 6 weeks. SETTING: Recruited in front of supermarkets and grocery stores; interviews conducted by telephone. SUBJECTS: One hundred and sixty-one food shoppers with children (18 years or younger). RESULTS: Single dimension scales were specified for fruit and for vegetable purchasing outcome expectancies, and for comparative (fresh vs. other) fruit and vegetable purchasing outcome expectancies. Item Response Theory parameter estimates revealed easily interpreted patterns in the sequence of items by difficulty of response. Fruit and vegetable purchasing and fresh fruit comparative purchasing outcome expectancy scales were significantly correlated with home F&V availability, after controlling for social desirability of response. Comparative fresh vegetable outcome expectancy scale was significantly bivariately correlated with home vegetable availability, but not after controlling for social desirability. CONCLUSION: These scales are available to help better understand family F&V purchasing decisions.     

Strategies to promote healthier food purchases: a pilot supermarket intervention study

OBJECTIVE: To pilot the design and methodology for a large randomised controlled trial (RCT) of two interventions to promote healthier food purchasing: culturally appropriate nutrition education and price discounts. DESIGN: A 12-week, single-blind, pilot RCT. Effects on food purchases were measured using individualised electronic shopping data ('Shop 'N Go' system). Partial data were also collected on food expenditure at other (non-supermarket) retail outlets. SETTING: A supermarket in Wellington, New Zealand. PARTICIPANTS: Eligible customers were those who were the main household shoppers, shopped mainly at the participating store, and were registered to use the Shop 'N Go system. Ninety-seven supermarket customers (72% women; age 40 +/- 9.6 years, mean +/- standard deviation) were randomised to one of four intervention groups: price discounts, nutrition education, a combination of price discounts and nutrition education, or control (no intervention). RESULTS: There was a 98% follow-up rate of participants, with 85% of all reported supermarket purchases being captured via the electronic data collection system. The pilot did, however, demonstrate difficulty recruiting Maori, Pacific and low-income shoppers using the electronic register and mail-out. CONCLUSIONS: This pilot study showed that electronic sales data capture is a viable way to measure effects of study interventions on food purchases in supermarkets, and points to the feasibility of conducting a large-scale RCT to evaluate the effectiveness of price discounts and nutrition education. Recruitment strategies will, however, need to be modified for the main trial in order to ensure inclusion of all ethnic and socio-economic groups.     

Hunger in young children of Mexican immigrant families

OBJECTIVE: To measure rates of hunger and food insecurity among young US-born Latino children with Mexican immigrant parents (Latinos) compared with a non-immigrant non-Latino population (non-Latinos) in a low-income clinic population. DESIGN, SETTING AND SUBJECTS: A repeated cross-sectional survey of 4278 caregivers of children < 3 years of age in the paediatric clinic of an urban county hospital for a 5-year period from 1998 to 2003. A total of 1310 respondents had a US-born child with at least one parent born in Mexico. They were compared with a reference group comprised of non-Latino US-born participants (n = 1805). Child hunger and household food insecurity were determined with the US Household Food Security Scale. RESULTS: Young Latino children had much higher rates of child hunger than non-Latinos, 6.8 versus 0.5%. Latino families also had higher rates of household food insecurity than non-Latinos, 53.1 versus 15.6%. Latino children remained much more likely to be hungry (odds ratio (OR) = 13.0, 95% confidence interval (CI) = 5.9-28.7, P < 0.01) and in household food-insecure households (OR = 6.6, 95% CI = 5.2-8.3, P < 0.01) than non-Latinos after controlling for the following variables in multivariate analysis: child's age, sex, maternal education level, single-headed household status, family size, young maternal age ( < 21 years), food stamp programme participation, TANF (Temporary Assistance to Needy Families, or 'welfare') programme participation and WIC (Women, Infants, and Children) usage, and reason for clinic visit (sick visit versus well-child). CONCLUSION: Young children in Mexican immigrant families are at especially high risk for hunger and household food insecurity compared with non-immigrant, non-Latino patients in a low-income paediatric clinic.     

Socio-economic inequalities in women's fruit and vegetable intakes: a multilevel study of individual, social and environmental mediators

OBJECTIVE: This study employed a multilevel design to test the contribution of individual, social and environmental factors to mediating socio-economic status (SES) inequalities in fruit and vegetable consumption among women. DESIGN: A cross-sectional survey was linked with objective environmental data. SETTING: A community sample involving 45 neighbourhoods. SUBJECTS: In total, 1347 women from 45 neighbourhoods provided survey data on their SES (highest education level), nutrition knowledge, health considerations related to food purchasing, and social support for healthy eating. These data were linked with objective environmental data on the density of supermarkets and fruit and vegetable outlets in local neighbourhoods. RESULTS: Multilevel modelling showed that individual and social factors partly mediated, but did not completely explain, SES variations in fruit and vegetable consumption. Store density did not mediate the relationship of SES with fruit or vegetable consumption. CONCLUSIONS: Nutrition promotion interventions should focus on enhancing nutrition knowledge and health considerations underlying food purchasing in order to promote healthy eating, particularly among those who are socio-economically disadvantaged. Further investigation is required to identify additional potential mediators of SES-diet relationships, particularly at the environmental level.     

Which food-related behaviours are associated with healthier intakes of fruits and vegetables among women?

OBJECTIVE: To examine associations between shopping, food preparation, meal and eating behaviours and fruit and vegetable intake among women. DESIGN: Cross-sectional survey. SETTING: Community-based sample from metropolitan Melbourne, Australia. SUBJECTS: A sample of 1136 women aged 18-65 years, randomly selected from the electoral roll. RESULTS: Food-related behaviours reflecting organisation and forward-planning, as well as enjoyment of and high perceived value of meal shopping, preparation and consumption were associated with healthier intakes of fruits and vegetables. For example, women who more frequently planned meals before they went shopping, wrote a shopping list, enjoyed food shopping, planned in the morning what they will eat for dinner that night, planned what they will eat for lunch, reported they enjoy cooking, liked trying new recipes and who reported they sometimes prepare dishes ahead of time were more likely to consume two or more servings of vegetables daily. Conversely, women who frequently found cooking a chore, spent less than 15 minutes preparing dinner, decided on the night what they will eat for dinner, ate in a fast-food restaurant, ate takeaway meals from a fast-food restaurant, ate dinner and snacks while watching television and who frequently ate on the run were less likely to eat two or more servings of vegetables daily. CONCLUSIONS: Practical strategies based on these behavioural characteristics could be trialled in interventions aimed at promoting fruit and vegetable consumption among women.     

Factors determining the nutrition transition in two Mediterranean islands: Sardinia and Malta

OBJECTIVE: To examine and analyse consumption changes over time of 24 food items between Sardinia and Malta. SETTING: The data were collected in 2001 in Sardinia and 2002 in Malta. DESIGN: A structured qualitative questionnaire, articulated around four main themes: food supply, transformation, preparation and consumption habits, was administered by face-to-face interviews with the help of a local person. It encompassed mainly open-ended questions, which allowed us to measure factors contributing to change. SUBJECTS: Thirty mother-daughter pairs were interviewed in each insular territory. RESULTS: Despite a common trend revealing a shift away from cereals, pulses and potatoes to the benefit of meat products, fats and sugar, our results showed contrasting evolutions in food consumption between both insular societies. Fruit and vegetables, olive oil and fish, which are part of the main features of the Mediterranean diet, were among the top foods for which consumption frequency has increased in Sardinia. In Malta, besides an increase in olive oil and vegetable consumption, cheeses and desserts showed the highest increase. Along with modernity and improved living conditions, enhanced commercial availability and increased diversity of food preparation were also identified as factors contributing to food consumption changes. CONCLUSIONS: Although the Sardo-Mediterranean model is evolving under the impact of modernisation, it is not disappearing. In Malta, however, modernity has led to a more sudden shift from a state of food shortage to one of affluence, but in a cultural context where the identity is no longer Mediterranean but Anglo-Saxon.     

Food insecurity and subsequent weight gain in women

OBJECTIVE: Cross-sectional data indicate that a relationship between household food insecurity and overweight exists among women in the USA. Cross-sectional data cannot determine if food insecurity leads to overweight as some have hypothesised. The purpose of the present study was to examine the relationship of food insecurity with subsequent weight gain in women using data from the Panel Study of Income Dynamics (PSID). DESIGN, SETTING AND SUBJECTS: Panel data from the 1999 and 2001 PSID, a nationally representative sample of households, were analysed using multivariate regression procedures.RESULTS: Average weight gain among all women (n = 5595) was 1.1 kg on average over the two years. There were no significant differences in the percentages of women who gained a clinically significant amount (2.3 kg) by food insecurity status. Overweight women who were on a weight-gain trajectory during the 2-year period gained less if they were food-insecure. This relationship was not observed among healthy-weight or obese women. CONCLUSIONS: Overall, food insecurity does not appear to be strongly associated with subsequent weight gain in women.     

Fast food for family meals: relationships with parent and adolescent food intake, home food availability and weight status

OBJECTIVE: The purpose of the present study was to examine the prevalence of fast-food purchases for family meals and the associations with sociodemographic variables, dietary intake, home food environment, and weight status in adolescents and their parents. DESIGN: This study is a cross-sectional evaluation of parent interviews and adolescent surveys from Project EAT (Eating Among Teens). SUBJECTS: Subjects included 902 middle-school and high-school adolescents (53% female, 47% male) and their parents (89% female, 11% male). The adolescent population was ethnically diverse: 29% white, 24% black, 21% Asian American, 14% Hispanic and 12% other. RESULTS: Results showed that parents who reported purchasing fast food for family meals at least 3 times per week were significantly more likely than parents who reported purchasing fewer fast-food family meals to report the availability of soda pop and chips in the home. Adolescents in homes with fewer than 3 fast-food family meals per week were significantly more likely than adolescents in homes with more fast-food family meals to report having vegetables and milk served with meals at home. Fast-food purchases for family meals were positively associated with the intake of fast foods and salty snack foods for both parents and adolescents; and weight status among parents. Fast-food purchases for family meals were negatively associated with parental vegetable intake. CONCLUSIONS: Fast-food purchases may be helpful for busy families, but families need to be educated on the effects of fast food for family meals and how to choose healthier, convenient family meals.     

A qualitative study exploring socio-economic differences in parental lay knowledge of food and health: implications for public health nutrition

BACKGROUND: The role played by lay knowledge in understanding health inequalities has received increased interest recently. Very little is known, however, about how lay knowledge of food and health varies across social class. The present exploratory study compared and contrasted ways in which people from different social backgrounds draw on and use different forms of lay knowledge about food and health. METHOD: Parents from 40 families were recruited from two socio-economically different suburbs (20 families from each suburb). In-depth interviews were conducted with the mother and father in each family to examine lay knowledge about food and health. All interviews were transcribed and coded for specific themes. Responses from each suburb were compared and contrasted. RESULTS: Different forms of lay knowledge about food and health were noted, especially concerning children's eating habits. Parents in the high-income suburb were more likely to discuss food and health in technical terms informed by contemporary nutritional or medical priorities. Parents in the low-income suburb did not share this discourse, but instead were more likely to discuss food in terms related to children's outward appearance or functional capacity. CONCLUSIONS AND IMPLICATIONS: The research highlights differences in lay knowledge about food and health across social class. It emphasises the need for public health nutrition policy-makers and practitioners to pay attention to lay knowledge on its own terms, rather than attempting to educate from predetermined assumptions, principles and standards.     

Improving the nutritional status of food-insecure women: first, let them eat what they like

OBJECTIVE: To determine the extent to which identified nutrient inadequacies in the dietary intakes of a sample of food-insecure women could be ameliorated by increasing their access to the 'healthy' foods they typically eat. DESIGN: Merged datasets of 226 food-insecure women who provided at least three 24-hour dietary intake recalls over the course of a month. Dietary modelling, with energy adjustment for severe food insecurity, explored the effect of adding a serving of the woman's own, and the group's typically chosen, nutrient-rich foods on the estimated prevalence of nutrient inadequacy. SETTING AND SUBJECTS: One study included participants residing in 22 diverse community clusters from the Atlantic Provinces of Canada, and the second study included food bank attendees in Toronto, Ontario, Canada. Of the 226 participants, 78% lived alone with their children. RESULTS: While nutritional vulnerability remained after modelling, adding a single serving of either typically chosen 'healthy' foods from women's own diets or healthy food choices normative to the population reduced the prevalence of inadequacy by at least half for most nutrients. Correction for energy deficits resulting from severe food insecurity contributed a mean additional 20% improvement in nutrient intakes. CONCLUSIONS: Food-insecure women would sustain substantive nutritional gains if they had greater access to their personal healthy food preferences and if the dietary compromises associated with severe food insecurity were abated. Increased resources to access such choices should be a priority.     

Race and food store availability in an inner-city neighbourhood

BACKGROUND: A growing body of research has shown that disparities in resources, including food stores, exist at the neighbourhood level and the greatest disparities are seen in minority neighbourhoods, the same neighbourhoods at increased risk of obesity and diabetes. Less is known about whether differences in availability of resources by African American or Latino race/ethnicity exist within a single minority community. OBJECTIVE: The present study examined whether census blocks either 75% African American (AA) or 75% Latino (L) are associated with food store availability, as compared with racially mixed (RM) census blocks, in East Harlem, New York. DESIGN/METHODS: A cross-sectional study utilising a walking survey of East Harlem was performed. Food stores were classified into: supermarkets, grocery stores, convenience stores, specialty stores, full-service restaurants and fast-food stores. RESULTS: One hundred and sixty-five East Harlem census blocks were examined; 17 were AA, 34 were L and 114 were RM. Of AA census blocks, 100% had neither supermarkets nor grocery stores. AA census blocks were less likely to have convenience stores (prevalence ratio (PR) = 0.25, 95% confidence interval (CI) 0.07-0.86) compared with RM census blocks. In contrast, predominantly L census blocks were more likely to have convenience stores (PR = 1.8, 95% CI 1.20-2.70), specialty food stores (PR = 3.74, 95% CI 2.06-7.15), full-service restaurants (PR = 1.87, 95% CI 1.04-3.38) and fast-food restaurants (PR = 2.14, 95% CI 1.33-3.44) compared with RM census blocks. CONCLUSIONS: We found that inequities in food store availability exist by race/ethnicity in East Harlem, New York. This has implications for racial/ethnic differences in dietary quality, obesity and obesity-related disorders.