RESUMO
This study explored health outcomes of 301 individuals living within three food secure and three food insecure neighborhoods in a midwestern city by using a multi-level model that included household-level and neighborhood-level variables. Logistic regression was used to analyze the relationship between household participation in food assistance programs, perceptions of neighborhood food access, distance to food stores where participants purchased food regularly, reliance upon social support systems for food provisioning, and use of community-based food system markets and/or programs with various diet-related health outcomes. Participants in food insecure areas had higher rates of obesity and type II diabetes, with variability related to food insecurity. Food assistance users had higher incidences of poor health outcomes. Perceived farmers' market access related to lower incidence of overweight/obesity. The complexity of food access appears to be more than whether there is a food store located nearby. Knowing that food insecurity differs across neighborhoods within a city is important for the development of interventions specific and appropriate for people living in those areas. Social workers and public health practitioners may consider analysis of wages and allotments for federal programs, as our research indicated that 2/3 of food insecure households had someone employed full-time, and households with fixed incomes from federal programs were much more likely to be very low food secure (formerly referred to as food insecure with hunger). Social workers and public health practitioners have opportunities to work with planners and policymakers .