Access to food source and food source use are associated with healthy and unhealthy food-purchasing behaviours among low-income African-American adults in Baltimore City

Objective: Although previous research has shown limited availability of healthy food in low-income urban neighbourhoods, the association between food source use and food-purchasing patterns has not yet been examined. We explored food-purchasing patterns in the context of food source use and food source access factors in low-income areas of Baltimore City. Design: Cross-sectional survey. Setting: Predominantly low-income neighbourhoods in East and West Baltimore City. Subjects: A total of 175 low-income African-American adult residents. Results: Supermarkets and corner stores were the most frequently used food sources. Walking was the main form of transportation used by 57% of all respondents, 97% of corner-store shoppers and 49% of supermarket shoppers. Multiple linear regression models adjusting for demographic factors, type of food source used and transportation type found that corner-store use was associated with obtaining more unhealthy food (P = 0.005), whereas driving to the food source was associated with obtaining more healthy food (P = 0.012). Conclusions: The large number of corner stores compared with supermarkets in low-income neighbourhoods makes them an easily accessible and frequently used food source for many people. Interventions to increase the availability and promotion of healthy food in highly accessed corner stores in low-income neighbourhoods are needed. Increased access to transportation may also lead to the use of food sources beyond the corner store, and to increased healthy food purchasing.