Environment influences food access and resulting shopping and dietary behaviors among homeless Minnesotans living in food deserts

Qualitative and quantitative methods were used to investigate how shopping behaviors and environment influence dietary intake and weight status among homeless Minnesotans living in food deserts. Seven focus groups (n = 53) and a quantitative survey (n = 255), using the social cognitive theory as the theoretical framework, were conducted at two homeless shelters (S1 and S2) in the Twin Cities area. Heights, weights, and 24-h dietary recalls were also collected. Food stores within a five-block radius of the shelters were evaluated for the price and availability of foods and compared to the Thrifty Food Plan's market basket prices (MBP). Results showed that almost 80% of the sample was overweight or obese, with women consuming less than the recommended level for the fruits, vegetables, and milk food groups and excess for the fats/oils/sweets food group. Focus groups and participant surveys indicated that the shelter infrastructure and surrounding community influenced the types of foods available, food store access, and the foods purchased and consumed. Participants relied on food assistance programs, including food stamps, to supplement their food supply; however, some felt the high food prices at neighboring stores limited food choice and that food stamps did not adequately cover food costs. Results from the food store survey found the majority of food prices exceeded Midwest or national MBP. To promote healthier dietary intake and weight status, community-based interventions and city planners should aim to increase access to food through improved food availability and food access within the shelter environment and surrounding community.