Buffalo-based study aims to connect the dots on food access

BUFFALO, N.Y. -- Researchers know from many previous studies what prevents cash-strapped shoppers in underserved communities from buying more fresh produce. But little is known about which strategies are most likely to reach the people who need them, or have the most success in improving the diets of people in lower income areas.

A new University at Buffalo study based in Western New York is the first that simultaneously examined the preferences of community members and compared those with the community-based programs and resources available to identify the most viable strategies for addressing disparities in healthy food consumption.

Previous research has shown that only 12% and 7% of adults living at or below the poverty line meet fruit and vegetable recommendations, respectively.

"We continue to find that cost, food preferences, availability, access and limited food assistance eligibility and/or benefits are persistent barriers. Residents of underserved communities feel that increasing the affordability of fruits and vegetables through incentives, nutrition education, and increased access to healthy food options will help them to eat more fruits and vegetables," said Christina Kasprzak, lead author on the study published in the Journal of Hunger & Environmental Nutrition.

"We also found that healthy food incentives, mobile produce markets, and nutrition education are acceptable and preferred food access strategies," added Kasprzak, a PhD candidate in community health and health behavior in UB's School of Public Health and Health Professions.

Researchers conducted 13 focus groups with 98 lower-income participants in urban areas of Western New York. Eight of the focus groups were conducted at local Women, Infant and Children (WIC) offices, while the remaining five were recruited by community organizations that serve lower-income families. The research team also interviewed 17 grocery store owners or managers, farmers, food distributors, and representatives from community organizations that currently or would be willing to address food access issues.

How to match needs

"Our research evaluated the capacity among local stakeholders to address the needs of lower-income communities, and made recommendations of how we can match this capacity to the preferences voiced in the focus groups with lower-income individuals," Kasprzak said.

"By capitalizing on where there are matches between lower-income communities' preferences and stakeholders we can ensure our efforts to expand healthy food access are viable," Kasprzak said. "We don't necessarily need to completely abandon the mismatches between programs and preferences, but we should heed community members' suggestions for these programs and avoid blindly establishing programs that may not be fruitful."

Cost, limited availability and accessibility, taste preferences and limited federal nutrition eligibility and benefits were the most frequently mentioned barriers to fruit and vegetable consumption. Study participants expressed frustration with having to decide between buying fresh produce and less healthy food options because of cost differences.

Another recurring theme among study participants was that they said they often had to travel outside their neighborhood, which required transportation, to find affordable and high-quality produce.

Researchers also reported that twice as many participants felt they lacked access to healthy food as those who said they had access.

What did participants say would help them buy and eat more fresh foods? Increasing the affordability, as well as nutrition education and recipe ideas. Some participants expressed a desire to learn healthier ways to prepare foods unique to their culture.

Include the working poor

Many participants favored increasing federal nutrition program benefits -- such as Supplemental Nutrition Assistance Program (SNAP) -- or expanding the eligibility requirements for these programs to include the working poor.

On the retail side, store owners and managers interviewed said they'd be willing to expand their fresh produce offerings to meet customers' demands, while supporting efforts to improve the health of the community.

For corner stores -- whose prices generally are known to be higher -- owners wanted guidance on what to stock, how to price and promote those items, and where to source fruits and vegetables.

Farmers expressed a willingness to accept SNAP benefits for Community Supported Agriculture (CSA) shares, and to provide produce to urban corner stores.

Kasprzak was pleasantly surprised to learn that there is ample opportunity for local stakeholders to help lower-income communities access and eat more fruits and vegetables.

"By connecting the dots, we can potentially enhance the reach of existing programs that are preferred by these communities," she said.

Ultimately, though, the barriers of cost of fruits and vegetables and limited eligibility and benefits for nutrition assistance programs are not wholly addressed by the food access programs discussed in the research paper, Kasprzak notes.

"For example, an incentive program makes fruits and vegetables more affordable but does not directly drive down the cost of produce. Therefore, more concerted efforts at the state or national level are needed."

"We know that many of the programs that community members would like to see already exist, but budget and expertise to market these programs are often lacking in small organizations," added Lucia Leone, PhD, the senior author on the paper and an assistant professor of community health and health behavior at UB. "Support from local policy makers is crucial for both getting the word out about these programs and ensuring their sustainability."

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