Date of Award


Document Type

Campus Access Thesis


Epidemiology and Biostatistics



First Advisor

Angela Liese


Introduction: The rise in obesity rates has increased research into unhealthful dietary behaviors. Limited access to food outlets, such as grocery stores and supermarkets, is a major problem for many low income populations.

Purpose: We explored potential differences in healthy food availability perceptions and food shopping behaviors between residents living in the areas designated as having low food access versus those with high food access.

Methods: Data came from a cross-sectional telephone survey of 968 residents living in eight counties of South Carolina. The survey asked about residents' healthy food availability perceptions and food shopping behaviors. Data from an eight-county food environment field census were used to replicate the CDC (Centers for Disease Control and Prevention) healthier food retail tract measure and USDA ERS (United States Department of Agriculture Economic Research Services) food desert measure. Ordinary Least Squares regression, which estimated adjusted means and logistic regression, which estimated odds ratios, were used to analyze the data.

Results: Residents of non-healthier retail tracts, according to the CDC's designation, were significantly more likely to rate their food environment and food shopping access as poor, to travel further distances to their primarily utilized food store (10.5 vs. 6.4 miles), and to accumulate more total shopping miles per week (31.2 vs. 15.9 miles) than residents living in healthier food retail tracts. Residents of food deserts as designated by the USDA ERS food access measure, had a lower odds of shopping at a supercenter (OR, 0.39; 95% CI, 0.16 - 0.95) than residents of non-food deserts.

Conclusion: Residents of low food access areas had different food shopping behaviors and perceptions of healthy food availability as compared to residents of high food access areas, depending on the food access measure. The results are novel because no previous research has looked at these food access measures in conjunction with any subjective measures. These findings should motivate communities and policy advocates to use the results to better approach widespread healthy food access issues in the US.


© 2012, Inderbir Singh Sohi