Rural and Urban Differences in the Associations between Characteristics of the Community Food Environment and Fruit and Vegetable Intake

Abstract Objective To examine the relationship between measures of the household and retail food environments and fruit and vegetable (FV) intake in both urban and rural environmental contexts. Design A cross-sectional design was used. Data for FV intake and other characteristics were collected via survey instrument and geocoded to the objective food environment based on a ground-truthed (windshield audit) survey of the retail food environment. Setting One urban and 6 contiguous rural counties. Participants This study involved 2,556 residents of the Brazos Valley, Texas, who were selected through random-digit dialing. Main Outcome Measure Two-item scale of FV intake. Analysis Data were analyzed using chi-square analysis, 2-sample t tests, and linear regression. Results Distance to supermarket or supercenter was insignificant in the urban model, but significant in the rural model ( β = -.014, P < .010, confidence interval = -.024, -.003). Conclusions and Implications Retail food environments have different impacts on FV intake in urban and rural settings. Interventions to improve FV intake in these settings should account for the importance of distance to the retail food environment in rural settings.