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Prev Chronic Dis. 2014 Mar 27;11:E47. doi: 10.5888/pcd11.130324.

Objective and self-reported factors associated with food-environment perceptions and fruit-and-vegetable consumption: a multilevel analysis.

Author information

1
Department of Family and Social Medicine, Albert Einstein College of Medicine | Montefiore Medical Center, 1300 Morris Park Ave, Block Building, Room 410, Bronx, NY 10461. E-mail: slucan@yahoo.com.
2
School of Design, University of Pennsylvania, Philadelphia, Pennsylvania.
3
Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York.
4
Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

INTRODUCTION:

Few studies have assessed how people's perceptions of their neighborhood environment compare with objective measures or how self-reported and objective neighborhood measures relate to consumption of fruits and vegetables.

METHODS:

A telephone survey of 4,399 residents of Philadelphia, Pennsylvania, provided data on individuals, their households, their neighborhoods (self-defined), their food-environment perceptions, and their fruit-and-vegetable consumption. Other data on neighborhoods (census tracts) or "extended neighborhoods" (census tracts plus 1-quarter-mile buffers) came from the US Census Bureau, the Philadelphia Police Department, the Southeastern Pennsylvania Transportation Authority, and the federal Supplemental Nutrition Assistance Program. Mixed-effects multilevel logistic regression models examined associations between food-environment perceptions, fruit-and-vegetable consumption, and individual, household, and neighborhood characteristics.

RESULTS:

Perceptions of neighborhood food environments (supermarket accessibility, produce availability, and grocery quality) were strongly associated with each other but not consistently or significantly associated with objective neighborhood measures or self-reported fruit-and-vegetable consumption. We found racial and educational disparities in fruit-and-vegetable consumption, even after adjusting for food-environment perceptions and individual, household, and neighborhood characteristics. Having a supermarket in the extended neighborhood was associated with better perceived supermarket access (adjusted odds ratio for having a conventional supermarket, 2.04 [95% CI, 1.68-2.46]; adjusted odds ratio for having a limited-assortment supermarket, 1.28 [95% CI, 1.02-1.59]) but not increased fruit-and-vegetable consumption. Models showed some counterintuitive associations with neighborhood crime and public transportation.

CONCLUSION:

We found limited association between objective and self-reported neighborhood measures. Sociodemographic differences in individual fruit-and-vegetable consumption were evident regardless of neighborhood environment. Adding supermarkets to urban neighborhoods might improve residents' perceptions of supermarket accessibility but might not increase their fruit-and-vegetable consumption.

PMID:
24674635
PMCID:
PMC3970773
DOI:
10.5888/pcd11.130324
[Indexed for MEDLINE]
Free PMC Article
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