| dc.description.abstract | This study examined the relationships between neighborhood socioeconomic status (SES), measured by free and reduced school lunch rates, the nutrition environment. In the first part of this study trained surveyors used the Nutrition Environment Measure Survey-Stores (NEMS-S) to document availability of healthy food items in sixty retail food stores (96% of total community retail food stores) categorized as `ethnic grocery', `supermarkets', and `convenience'. Community neighborhoods were divided by elementary school district, allowing neighborhood SES to be determined by the percentage of free and reduced price lunch provided to students and are thus grouped as high or low SES neighborhoods. Surveyors also used the NEMS-R to document nutritional availability and promotional signage in 187 restaurants categorized as being full service (n= 93) or fast food (n= 94). Restaurant locations were categorized as low SES, moderate SES, or high SES, based on the number of free and reduced lunch served in neighborhoods public elementary schools. In the second part of this study, Fargo, ND was subdivided by elementary school bounders and free and reduced school lunch rates were collected to categorize schools in to three SES categories. Census block groups were also used to subdivide Fargo and census poverty rates were used to classify SES categories for block groups. To determine access to healthful food choices data from the first part of this study was used to compare between SES indicators (free and reduced lunch rates; census poverty data) and also within groups. Take together; the results from both parts of this study emphasize the need to improve nutrition quality within all communities. This cannot be accomplished without a combination of government policies, consumer involvement, and a change in the food industry system; all are needed to address nutritional availability and access in communities. Governments can set policies to promote good nutrition, incentives to locate food outlets in low income areas and improving zoning laws. Most importantly, governments can work with food outlets to promote healthful eating and nutritional choice making, thereby encouraging the consumer to make the best choice possible for their health. | en_US |
