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社区医学与健康教育

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Supplemental Nutrition Assistance Program (SNAP) Participant’s Proximity to Healthy Food Availability within Convenience Stores and the Association with Dietary Intake, Fayette County, Ky 2010-2011

Kelly J Sorge and Alison A Gustafson

Background: Food environment has been shown to affect the dietary intake of an individual. It is hypothesized that the type of food available in convenience stores and the proximity of those stores to a consumer may influence the purchasing decisions of those shopping a these food outlets. Methods: A cross-sectional survey was used to assess the dietary intake of SNAP participants in Fayette County, Kentucky, compared to the availability of healthful foods options at convenience stores and gas stations, which were within a close proximity to their homes (ten minute drive time or within 20 miles). Food audits were conducted in 35 gas stations and food marts, a total availability score ranged from 0-16, price was scored based on a similar protocol to NEMS-S. A higher scores will indicate better availability and price of healthy foods. 24-hour dietary recalls were then collected from 147 participants to obtain Healthy Eating Index scores. Results: On average, SNAP participants did not meet the daily dietary recommendations for consuming fruits and vegetables. Stores with more healthful options were an average of nine miles and produced an average HES score for participants of 1.03. Where as stores with low availability of healthful options were only located an average of two miles away and produced an average HES score for participants of 1.06. Among those who live close to gas stations with low availability of healthy food items was associated with lower odds of consuming at least one serving of fruit (OR 0.84 95% CI [0.60, 0.95]), and lower odds of consuming one serving of milk (OR 0.88 95% CI [0.72, 0.96]) compared to those who live farther away. Proximity to convenience stores and pharmacies with low availability of healthy food had lower odds of consuming more than five servings of grains per day (OR 0.87 95% CI [0.78, 0.95]) compared to those who live farther away. Conclusion: The results indicate that there is a significant association between having healthful food available at convenience stores and the dietary intake of those living within close proximity to those stores. This implies that there is a need for further interventions on the community level to make available more healthy food choices at these stores.