Purpose: There is a growing body of evidence that income indicators and racial compositions of urban neighborhoods mediate access to food stores and healthy foods. The purpose of this study was to determine whether there were any differences in access (availability, quality and cost) to fruits and vegetables between two racially homogeneous regions, one considered low-income and the other middle-income, in the City of Atlanta, Georgia. Methods: This was a cross-sectional, exploratory study. A convenience sample of 56 food stores (convenience, grocery and supermarket) was assessed over a three-week period. The stores were surveyed using an instrument developed to capture availabilities of fresh items, the quality of these and the ability of the food stores to meet the Thrifty Food Plan (TFP) 2006 fruit and vegetable categories for a reference family of four. Each category had constraints (variety and weights), and lowest-cost items were identified to meet these. Store to 10,000 population ratios and percent median income required to fulfill the TFP fruits and vegetables were calculated. Fisher’s Exact Tests and Chi Square were used to analyze categorical data. ANOVA analyses were used to determine differences in costs between the regions for the complete TFP fruit and vegetable basket and for price differences for each fruit and vegetable category among stores within each region. Results: The food store to 10,000 ratios were 5.8 and 3.7, respectively, for the low-income region and middle-income region. The low-income region grocery store ratio was 2.7, compared to 0.9 for the middle-income. Access to fresh items, quality of these and numbers of stores meeting each category and the complete TFP basket were not significantly different between the regions. The low-income region had a significantly greater number of stores that met whole fruits (p=0.03) and the variety constraint for other vegetables, which was four types (p=0.05). The TFP category weights were difficult to achieve with most categories in deficits. The majority of the lowest-cost items identified were canned fruits and vegetables. There were no significant differences between the regions for the costs of each category. The low-income region had a significantly greater number of stores charging more than the mean ($52.91±14.85) for the complete TFP fruit and vegetable basket (p=0.04). Store types and not income was the significant factor contributing to the price differences between the regions for the complete TFP basket. Within region analyses indicated significant price differences for several categories among the store types. Typically, convenience stores and/or grocery stores charged significantly more for certain categories than did supermarkets. Conclusion: There were few differences in overall availability, quality and category comparisons. The low-income region potentially pays more for the TFP 2006 fruits and vegetables for a family of four. Cost has been cited as a barrier to complying with healthy diets. More research needs to be undertaken to aid in policy development in consideration of healthy food cost implications for low-income families. Further education efforts are required to guide low-income families on how the TFP can be met optimally on a budget.

Master of Science / Department of Human Nutrition / Mary Meck Higgins / Because of the ever-changing nature of the economy and the food environment, research as recent as 2010 may not be relevant to today’s discussion on food insecurity, food deserts, obesity rates, and nutritional quality in the U.S. population’s diet. Today, people of low socioeconomic status in the U.S. are at risk for overweight, obesity, and chronic illnesses such as type 2 diabetes, hypertension, and certain cancers. In this report, I investigate published research about low-income populations in the U.S. relative to the food environment and describe implications for healthcare professionals implementing interventions with these populations, discussed in the following categories: Dietary Intake Quality and Socioeconomic Status; Food Insecurity; Barriers to Quality Food Access in the U.S. Food Environment; Communities Alleviating Food Insecurity; Food-Related Perceptions, Attitudes, and Behaviors; Homelessness and Food-Related Behaviors; Why Do People Buy What They Buy?; Nutrition Assistance Programs and Policies; Current U.S. Food Costs; and Comparing the Nutritional Value Versus Price of Foods. Although the literature on the subject of low-income diet quality is thorough, much of it needs to be updated with current data on food prices, food environments, and U.S. diet quality. For this purpose, I compiled the most recent data from the National Bureau of Labor & Statistics on food prices to discuss the elevated food prices of healthful foods as opposed to less healthful foods. I also created a one-month menu based on the U.S. Department of Agriculture’s Thrifty Food Plan budget allowance in order to follow a healthful diet in this harsh economic climate utilizing the Dietary Guidelines for Americans 2010 and the Affordable Nutrients Index.