Availability, Affordability, and Accessibility of a Healthful Diet in a Low-Income Community, Central Falls, Rhode Island, 2007-2008

BACKGROUND Many Americans have diets that do not meet the dietary guidelines set by the US Department of Agriculture (USDA). Additionally, low-income people have the highest rates of obesity and have difficulty accessing the necessary foods for maintaining a healthful diet. CONTEXT In December 2007 and January 2008, 21 retail food stores in Central Falls, Rhode Island, where residents were predominantly low-income Hispanics, were evaluated for the availability and costs of foods that fulfill the USDA's Thrifty Food Plan (TFP) guidelines. METHODS Each surveyed store was evaluated for variety and weekly cost of 3 different types of market baskets (2 families and an elder). Each store's proximity to public transportation was estimated by using geographic information systems mapping. OUTCOME Only 2 stores in Central Falls and the discount supermarket in an adjacent city, Pawtucket, carried enough variety of foods to fill the TFP basket. At the 2 stores, costs were up to 40% higher, and at the discount store, costs were up to 18% cheaper, than the national average. Each of the stores was accessible by public transportation. INTERPRETATION Meeting the USDA TFP guidelines is difficult in this low-income, predominantly Hispanic city. Although the components of the TFP are available, high prices may make a nutritious diet unaffordable.