Fruit and Vegetable Access Differs by Community Racial Composition and Socioeconomic Position in Detroit, Michigan

OBJECTIVE: To compare the availability, selection, quality, and price of fresh fruit and vegetables at food stores in four Detroit-area communities: 1) predominately African-American, low socioeconomic position (SEP); 2) racially heterogeneous, low SEP; 3) predominately African-American, middle SEP; and 4) racially heterogeneous, middle SEP. DESIGN: Cross-sectional observational survey, conducted fall 2002. SETTING: Detroit, Michigan SAMPLE: Overall, 304 food stores located in the four communities were evaluated: chain grocery, large independent grocery, "mom-and-pop" grocery, specialty (meat, fruit and vegetable markets), convenience without gasoline, and liquor stores. MAIN OUTCOME MEASURES: Availability was indicated by whether a store carried fresh fruit or vegetables, selection was based on a count of 80 fruit and vegetables, quality was evaluated according to USDA guidelines for a subset of 20 fruit and vegetables, and price was assessed for 20 fruit and vegetables by using the lowest-cost method. RESULTS: Mean quality of fresh produce was significantly lower in the predominately African-American, low-SEP community than in the racially heterogeneous, middle-SEP community. Differences in the types of stores present only partially explained this quality differential. The predominately African-American, low-SEP community had more than four times more liquor stores and fewer grocery stores per 100,000 residents than the racially heterogeneous, middle-SEP community. Mean overall selection and price of fresh produce at stores did not differ among communities. CONCLUSIONS: Increasing access to high-quality fresh produce in low-income communities of color is a critical first step toward improving health through better dietary practices in this population.