Social, spatial and identity-driven determinants of diet among southern rural women

Abstract

Various factors within a food environment work to influence food choice. Qualitative and quantitative assessments of a rural Florida food environment were conducted to define the food environment and discover how rural women described the influences on their personal food choice; including how they accessed food and decided what food was most important to purchase for themselves and their families. Qualitative findings derived from semi-structured interviews revealed twelve major themes related to Identity Theory, Social Network Theory, and Structural Functionalism. Most women described identities related to being a mother. The mothering identity was related to both negative and positive influences on diet. Women described neglecting personal food preferences and attempts at healthy eating when prioritizing the food choices of their children and spouses. However, the mothering identity also prompted women to demonstrate healthy eating for their children. Social control via interpersonal relationships also played an important role in rural women’s food choices. Higher-income women internalized expectations of others and self-regulated unhealthy eating behaviors by avoiding situations that triggered unhealthy eating. Conversely, low-income women experienced direct social control from their social network. Low-income women’s family members explicitly monitored and commented on their food choices which helped them maintain healthy choices. Quantitative findings described the rural food environment in terms of price, availability, and quality of food using NEMS-S survey tool. Food prices in Archer and Williston were higher compared to average U.S. retail food prices based on national data. Healthy food items were priced similar to less healthy counterparts with the exception of whole wheat bread, which was priced higher than white bread. Less-healthy food items had better availability compared to healthier versions of the same item. For example, 79% of stores sold whole milk compared to 50% of stores that sold low-fat or non-fat milk. Few convenience stores sold any fruit, but when fruit was available in a convenience store it was always rated as acceptable quality. Supermarkets had a wide variety of good quality fruit and vegetables available. NEMS-S objective data on price, availability, and quality were consistent with perceptions of price, availability, and quality derived from qualitative interviews