Date of Award


Document Type

Open Access Dissertation


Epidemiology and Biostatistics



First Advisor

Angela D Liese


Neighborhood food environments have been associated with dietary intake and obesity. Measures of the food environment have typically been characterized with geographic information systems (GIS)-based measures, however, the use of perception-based measures of the food environment have increased in frequency. Few studies have fully examined the relationship between perceptions and GIS-based measures of the food environment, especially considering the congruency between perceived and GIS-based presence of specific retail food outlets, nor the relationship between food outlets and perceived availability of healthy foods or fast food opportunities.

Telephone survey data from 705 residents in an eight-county region of South Carolina were used to examine the relationship between GIS-based measures of food outlets and residents' perceptions. Perception measures included the residents' perceived availability of specific food outlets types (including supermarkets and fast foods), the availability of healthy foods (fresh fruits and vegetables and low fat foods), and the availability of fast food restaurants. GIS-based measures include the actual presence (yes or no) of food outlets within each resident's neighborhood and the availability (number of) and accessibility (distance to nearest) to specific food outlets.

Significant findings indicate residents' perceived the presence of food outlets in their food environment quite well with percent agreements, present or not, for food outlets ranging from 67.1% to 83.5%. Sensitivities ranged from 82.3% to 92.5% with supermarkets and convenience stores having excellent values (92.5% and 90.1%, respectively). However, the availability (number of) food outlets in a neighborhood did not have a significant association with perceived availability of healthy foods, whereas accessibility (distance to the nearest), specifically for supermarkets, dollar and variety stores, and fast food restaurants, was significantly associated with perceptions of healthy foods. Lastly, only the availability and accessibility of drug and pharmacy stores and accessibility of supermarkets were significantly associated with perceived fast food availability.

Findings suggest that residents are quite aware of the presence of food outlets in their food environment, however, many of the associations between GIS-based availability and accessibility of food outlets and perceived availability of healthy foods and fast food opportunities are not significant. Factors such as the size and urbanicity of a residents' GIS-based neighborhood may affect associations between perceived and GIS-based measures.

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