Food sources and acquisition by consumers of low income in urban neighborhoods: A conceptual framework and food decision tree.

Food decision-making among urban consumers of low income is comprised of a complex interplay of strategies, influenced by sociodemographic and environmental factors. This study was conducted in the Bronx, New York City, a borough marked by disparities and limited healthy food access. The study aimed to co-develop with urban consumers of low income a conceptual framework representing food procurement decision-making, with special attention paid to the multifaceted dynamics of food acquisition in the context of food insecurity. In-depth interviews and focus group discussions were conducted with bodega customers and food pantry clients to inform a food procurement decision tree. The framework illustrated the hierarchical order of food sources and coping strategies influenced by factors like household income, food assistance program participation, perceived access to food sources, living conditions, and immigration status. While grocery stores and supermarkets were the primary food sources, secondary sources like bodegas and food pantries were relied upon when physical or financial access was constrained, and superstores when resources were available. Farmers' markets and online grocery shopping were tertiary sources and oftentimes unrealistic options for participants. This study highlights the challenges faced by consumers of low income in accessing healthy food and underscores the need for food pantries to meet nutritional and cultural food needs. The findings emphasize the importance of considering contextual factors in interventions and policies to address food insecurity and their implications on community health.