Mapping Food Insecurity-Related 2-1-1 Calls in a 10-County Area of Central Texas by Zip Code: Exploring the Role of Geographic Food Access, Urbanicity and Demographic Indicators.

Food insecurity is a public health issue that affects 12% of Americans. Individuals living in food insecure households are more likely to suffer from conditions such as undernutrition, obesity and chronic diseases. Food insecurity has been linked to limited geographic access to food; however, past studies have used limited measures of access which do not fully capture the nuances of community context. The purpose of this study was to explore the association between food insecurity and geographic food access by level of urbanicity. 2-1-1 calls made in 2018 in Central Texas were classified as food needs versus non-food needs. Supermarket and convenience stores were mapped using ArcGIS. Geographic food access was operationalized as the presence of supermarkets and convenience stores: within the zip code; only in neighboring zip codes; and not located within or in neighboring zip codes. Descriptive statistics and binomial logistic regression were used to examine associations between geographic access and 2-1-1 food calls, stratified by level of urbanicity. 11% of the 2-1-1 calls made in 2018 (N = 55,405) were regarding food needs. Results showed that peri-urban and rural callers living in zip codes that only had supermarkets in neighboring zip codes had greater odds of calling about food needs compared to those that had supermarkets within the zip code. These findings indicate that geographic food access is associated with food insecurity, but this relationship varies by urbanicity. Thus, the development of food insecurity mitigation programs in peri-urban and rural areas is needed.