BACKGROUND Accumulating evidence suggests the important role of the home food environment in an individual's dietary intake. OBJECTIVE This study examined the associations of individual and neighborhood-level factors with the availability of healthy and unhealthy foods in the home using a nationally representative sample from the 2007 to 2008 and 2009 to 2010 National Health and Nutrition Examination Surveys (NHANES). DESIGN A cross-sectional study design was used with NHANES merged with the 2000 census data. Food availability was measured through self-report questionnaire regarding the frequency of foods or drinks available in the home. PARTICIPANTS The analysis included 8,975 participants aged 19 to 65 years. STATISTICAL ANALYSES PERFORMED Associations of individual and neighborhood factors with home food availability (always or most of the time available) were assessed using logistic regression modeling accounting for NHANES' complex survey design and weights. Individual-level and neighborhood-level factors were simultaneously included in the analysis. RESULTS Family income-to-needs ratio was positively associated with the availability of dark green vegetables (odds ratio [OR]=1.07; 95% CI=1.00 to 1.13), fat-free or low-fat milk (OR=1.16; 95% CI=1.07 to 1.25), and salty snacks (OR=1.12; 95% CI=1.04 to 1.20) in the home. College graduates were more likely to have fruits (OR=1.96, 95% CI=1.48 to 2.60), vegetables (OR=1.48; 95% CI=1.16 to 1.88), and fat-free or low-fat milk (OR=1.81; 95% CI=1.55 to 2.12) and less likely to have salty snacks (OR=0.77; 95% CI=0.63 to 0.95) and sugary drinks (OR=0.46, 95% CI=0.37 to 0.57) available compared with non-college graduates. Tract socioeconomic status (SES) scores were positively associated with fruit (OR=1.15; 95% CI=1.02 to 1.29), vegetable (OR=1.14; 95% CI=1.03 to 1.26), and fat-free or low-fat milk (OR=1.25; 95% CI=1.10 to 1.42) availability. Urban residents were associated with greater availability of fruits (OR=1.47; 95% CI=1.05 to 2.08) and fat-free or low-fat milk (OR=1.33; 95% CI=1.02 to 1.73) in the home compared with rural residents. Food desert status was not associated with home food availability. CONCLUSIONS The results show that SES at both individual (education, income) and neighborhood level was linked to home food availability, suggesting a need to improve the home food environment for socioeconomically disadvantaged individuals and neighborhoods.

中文翻译：

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个人和社区因素与家庭食物供应的关联：来自国家健康和营养检查调查的证据

背景技术越来越多的证据表明家庭食物环境对个人饮食摄入的重要作用。目的 本研究使用 2007 年至 2008 年和 2009 年至 2010 年国家健康和营养检查调查 (NHANES) 的全国代表性样本，探讨了个人和社区层面的因素与家庭中健康和不健康食品的供应之间的关系。设计 NHANES 采用横断面研究设计并结合 2000 年人口普查数据。食物供应情况是通过关于家庭中食物或饮料的频率的自我报告调查问卷来衡量的。参与者 该分析包括 8,975 名年龄在 19 岁至 65 岁之间的参与者。进行的统计分析 使用考虑了 NHANES 复杂调查设计和权重的逻辑回归模型来评估个人和邻里因素与家庭食物供应（总是或大部分时间可用）之间的关联。个人层面和社区层面的因素同时纳入分析中。结果 家庭收入需求比与深绿色蔬菜（比值比 [OR]=1.07；95% CI=1.00 至 1.13）、脱脂或低脂牛奶（OR=1.16；95）的供应呈正相关。 % CI=1.07 至 1.25），以及在家中吃咸味零食（OR=1.12；95% CI=1.04 至 1.20）。大学毕业生更有可能吃水果（OR=1.96，95% CI=1.48至2.60）、蔬菜（OR=1.48；95% CI=1.16至1.88）和脱脂或低脂牛奶（OR=1.81） ; 95% CI=1.55 至 2.12），与不吃咸味零食（OR=0.77；95% CI=0.63 至 0.95）和含糖饮料（OR=0.46，95% CI=0.37 至 0.57）的可能性较小大学毕业生。群体社会经济地位（SES）评分与水果（OR=1.15；95% CI=1.02至1.29）、蔬菜（OR=1.14；95% CI=1.03至1.26）和脱脂或低脂牛奶呈正相关。 （OR=1.25；95% CI=1.10 至 1.42）可用性。与农村居民相比，城市居民在家中更容易获得水果（OR=1.47；95% CI=1.05至2.08）和脱脂或低脂牛奶（OR=1.33；95% CI=1.02至1.73）居民。食物沙漠状况与家庭食物供应无关。结论 结果表明，个人（教育、收入）和社区层面的社会经济地位与家庭食物供应量相关，表明需要改善社会经济弱势个人和社区的家庭食物环境。