Food shopping patterns in rural Appalachia: The environmental context of dietary behavior

Increasing evidence demonstrates that the food environment, including the accessibility of healthy food options near the homes of individuals, is one important predictor of dietary quality. The widespread existence of rural food deserts has been established in many parts of the US. However, relatively little work has looked at how people in rural food deserts access their food in these environments and what features of food outlets are most important in their decisions about where to shop. Understanding the decision-making process of households in these limited environments is critical to the design of effective dietary interventions. This research utilized a telephone survey (N=635) to examine food shopping behavior in rural Appalachia Kentucky, a region characterized by food deserts and disproportionate rates of obesity and other outcomes of poor diet, including cancer, diabetes, and heart disease. The relationship between types of stores utilized, frequency of shopping, distance to various food outlets, importance of different types of food outlets as a source of fruits and vegetables, factors involved in store selection, and demographic variables are presented. Ramifications of these findings for future interventions to promote healthy eating in the region will be explored.