Menu Close

Spatial and Social Determinants of Household Food Environments in Central North Carolina


Nicholas, Khristopher M.; Wasser, Heather M.; Thompson, Amanda L.; & Bentley, Margaret E. (2020). Spatial and Social Determinants of Household Food Environments in Central North Carolina. Current Developments in Nutrition, 4(Suppl. 2), 255. PMCID: PMC7258272


Objectives: This study explores sociodemographic predictors of household food environments and tests the hypothesis that they are associated with community food environments.
Methods: Data are from the baseline visit of the Mothers & Others study, an early life obesity prevention trial among 430 African-American mothers in central North Carolina. Healthy Homes Survey (HHS) data assessed household food availability, type and variety. Exploratory factor analysis (EFA) with oblique rotations consolidated 45 HHS variables into household food environment (HFE) types. From data retailer InfoUSA we obtained geocoded data containing all food outlets in the study area to assess proximity and density of food outlets near households. Linear regressions tested associations between maternal and household characteristics and HFE factor scores. Adjusted models tested the association between HFE factor scores, community food environment exposures, and sociodemographic interactions.
Results: EFA retained four HFE types: Factor 1, the healthiest, contained fresh fruits/vegetables (F/V), Factor 2 contained canned F/V, sweets, and salty snacks, Factor 3 contained frozen F/V, candy and sweetened drinks and Factor 4, the least healthful, contained (diet) soda, candy and sweets. SNAP participation was associated with a 23% (CI: –0.42, –0.04) z-score reduction for Factor 1 only. Each additional education level was associated with a 20% (CI: 0.10, 0.31) and 18% (CI: 0.07, 0.29) z-score increase for Factors 1 and 3, respectively. Each 1-unit increase in household size and maternal age accompanied a 6% (CI: 0.001, 0.11) and 3% (CI: 0.01, 0.05) respective z-score increase for Factor 3 only. Each additional dollar store within a 1-mile radius was associated with a 13.8% (CI: –0.22, –0.06) z-score reduction for Factor 3 while each mile closer to a grocery store accompanied a 12.1% (CI: 0.003, 0.24) z-score increase for Factor 3. Among households not receiving SNAP or WIC benefits, each mile closer to a grocery store accompanied a 27% (CI: 0.05, 0.47) and 30% (CI: 0.04, 0.55) respective z-score increase for Factor 1.
Conclusions: Healthy food environments are associated with local food outlet access and household characteristics. However, enrollment in nutrition assistance programs strongly modifies this relationship.


Reference Type

Journal Article

Article Type


Year Published


Journal Title

Current Developments in Nutrition


Nicholas, Khristopher M.
Wasser, Heather M.
Thompson, Amanda L.
Bentley, Margaret E.



Data Set/Study

Mothers & Others study
Healthy Homes Survey (HHS)


United States of America