Socioeconomic variations in women's diets: what is the role of perceptions of the local food environment?

Objectives: To test the contribution of perceived environmental factors (food availability, accessibility and affordability) to mediating socioeconomic variations in women's fruit, vegetable and fast food consumption. Methods: A community sample of 1580 women from 45 neighbourhoods provided survey data on their socioeconomic position (SEP) (education and income); diet (fruit, vegetable and fast food consumption); and the perceived availability of, access to and cost of healthy food in their local area. Results: Once perceived environmental variables were considered, the associations between SEP and diet were weak and non-significant, suggesting that socioeconomic differences in diet were almost wholly explained by perceptions of food availability, accessibility and affordability. Conclusions: Strategies to decrease socioeconomic inequalities in diet could involve promoting inexpensive ways to increase fruit and vegetable consumption, and ensuring that people of low SEP are aware that many healthy foods are available at relatively low cost. Future research should also confirm if perceptions match objective measures of food availability, accessibility and affordability, in order to address the real and/or perceived lack of healthy options in low SEP neighbourhoods.