Knowledge, barriers, and predictors of colorectal cancer screening in an Appalachian church population.

INTRODUCTION

Fruits and vegetables (F&Vs) are important parts of a healthy, balanced diet. Consumption of F&Vs is low among residents of socioeconomically disadvantaged communities. We investigated and compared retail F&V availability in urban and rural underserved communities in New York State.

METHODS

All food retail stores and farmers' markets (N = 263) in downtown Albany and in Columbia and Greene counties in New York State were visited and surveyed. Food stores were classified as F&V stores if they stocked more than the minimum varieties of fresh F&Vs defined by this study and as fruit-for-snack stores if they had ready-to-eat fruits only. Store density per 10,000 residents was calculated as a standardized measure of F&V availability. Adjustment weights were created to incorporate store size and business hours into the analysis.

RESULTS

The weight-adjusted density (per 10,000 residents) of F&V stores was 4.6 in Albany's minority neighborhood (reference category), 11.4 in Albany's racially mixed neighborhood (P = .01), 7.8 in Columbia and Greene counties' rural community (P = .10), and 9.8 in Columbia and Greene counties' small-town community (P = .02). Significant differences were not found in fruit-for-snack stores, which ranged from 2.0 per 10,000 in the mixed neighborhood to 3.4 per 10,000 in the rural community.

CONCLUSION

The urban minority neighborhood had the most barriers to fresh F&Vs in retail outlets, even when compared with the rural community. The low availability of retail F&Vs in the minority neighborhood was attributed to the lack of supermarkets and not the absolute lack of food stores. Public health intervention strategies to increase retail F&V availability in urban minority neighborhoods may aid in mitigating these disparities.