The objectives for this study were to examine the location and density of measured food outlets in five rural towns in the Lower Mississippi Delta, determine the spatial location of Delta Healthy Sprouts (DHS) participants' homes in the food environment, and examine relationships between the spatial location of participants' homes and their diet quality. Using a food desert/food swamp framework, food outlet geographic locations were analyzed in relation to one another, the distance between DHS participants' residence and closest food outlets by class were computed, and associations among residents' diet quality, hot spot status, and census tract classification were explored. Of 266 food outlets identified, 11 (4%), 86 (32%), 50 (19%), and 119 (45%) were classified as grocery stores (GS), convenience stores (CS), full-service restaurants (FS), or fast food restaurants (FF), respectively. A third of participants lived in CS hot spots, while 22% lived in FF hot spots. DHS participants lived closer in miles to CS (0.4) and FF (0.5) as compared to GS (1.6) and FS (1.1) outlets. Participants bought most groceries at national chain grocery stores rather than their closest grocery store. The food environments of the five towns and associated neighborhoods in which DHS participants resided were not supportive of healthful eating, containing both food deserts and food swamps, often in overlapping patterns.
Keywords: diet quality; food deserts; food environment; food swamps; hot spot analysis; spatial analysis.