An Exploratory Study of Local Food Affordability and Factors Related to Household Food Security and Food Purchasing Decisions

摘要

Objectives: This study examined food affordability in Las Cruces, New Mexico and piloted instruments to explore factors in household food security and purchasing. Methods: Affordability was assessed at three retailers using the USDA Food Store Survey Inventory and Thrifty Food Plan index. Ninety-eight shoppers completed the short form of the USDA Household Food Security Scale, and two tools developed for the present study. Fischer's Exact Test was used to determine independence of food security status in relation to each variable of interest. Results: One retailer was affordable for families with young children; two were affordable for families with older children. Marital status was related to household food security. Some families classified as food secure according to USDA protocol reported not purchasing needed foods because of cost. Conclusions: There is room for community health promotion efforts to focus on helping divorced families maintain food security and for rethinking food security classification. The research reported in this article was supported by a Health Oriented Themes project grant from the Paso del Norte chapter of the Society for Public Health Education. Introduction Many factors influence food choice. Preference is a major reason for choosing certain foods over others ( 1 ), but far from the only reason. Given that food preferences develop during early childhood ( 2 ), even our tastes may not be under our control, and other factors are even less likely to be personally controllable. Because food choices are important for individual and population health, the federal government has developed educational materials for the public, and nutrition information standards for the food industry. Recent years have seen the design and implementation of federal dietary guidelines; laws mandating food label content; and other laws designed to increase public awareness of nutritional issues. In 1980, the US Department of Agriculture (USDA) and the US Department of Health, Education, and Welfare (now the US Department of Health and Human Services [US DHHS]) established the first dietary guidelines for the nation ( 3 ). The newest edition emphasizes a semi-personalized approach to diet ( 4 ), offering consumers even more information with which to make healthy decisions.With information, though, has come less activity for most Americans and an increasingly processed diet marketed to our desires for familiar, easily prepared, and tasty food. The food industry devotes 20 times the USDA education expenditure to advertising, primarily promoting processed and packaged foods ( 5 ). While some may argue food choices remain personal choices, this imbalance obviously influences those choices.Food choices, and barriers people face regarding them, are more critical than ever. In the United States, 65% of adults were overweight or obese in 2002 ( 6 ). No distinction is made between obesity and overweight in children; however, between 1999 and 2000, 15% of children (aged 6 to 11) and 15% of adolescents (aged 12 to 19) were overweight ( 7 , 8 ). The number of overweight adults and children, with accompanying risks of chronic disease, has increased dramatically in the past four decades, with most of the change since 1990 ( 9 , 8 , 7 ). This rapid change and concurrent research findings suggest that environment may be more influential than genetics ( 10 , 11 , 12 ).In light of easy access to nutrition information, poor food choices by a majority of the population likely reflect other factors. While dietary problems are not limited to people of low socioeconomic status, diet-related diseases increasingly are recognized as health disparities ( 13 ). Thus, exploring socioeconomic factors and associated barriers may help to inform new interventions. In a rich country with relatively low unemployment, inadequate access to nutritious food might seem irrelevant in public health campaign outcomes. However, the federal government has been monito