Understanding social inequalities in terms of neighborhood characteristics and the context to which individuals belong is important for reducing disparities. This article describes how perceptions of food access are related to three physical and social environmental factors: perceived neighborhood walkability, safety, and social cohesion. A cross-sectional survey was conducted with a random sample of 1,500 households in Springfield, Missouri. The main outcome measures were ease of purchase; availability of a large selection and quality; and affordability of fresh fruits and vegetables (FVs) and low-fat products (LFPs). Overall, 63% of respondents reported consuming <5 servings of FVs daily in the past month. Most agreed it was easy to purchase FVs (70%) and LFPs (76%) in their neighborhood and felt there was a large selection available (70% and 71%, respectively). High walkability (odds ratio [OR]: 1.8), low crime (OR: 1.6), and high social cohesion (OR: 1.7) were significantly associated with having greater selection of FVs. High walkability (OR: 1.6) and low crime (OR: 1.6) were associated with greater access to FVs. Given that healthy food access is an important component to improving health outcomes, understanding how to alter environmental features that influence behaviors like eating is important.
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