Priority Areas for Child Diaper Access: Low-Income Neighborhoods with Limited Retail Access to the Basic Need of Diapers.

Introduction: Although a requirement for the health and hygiene of young children, millions of US families with low-incomes have unmet needs for diapers. The present study explored retail options in Durham County, NC for purchasing diapers in low-income neighborhoods in effort to increase our understanding of the overall context of diaper need. Methods: During June 2018, we visited 63 retailers selling 2460 child diaper products in 29 census tracts with a median household income ≤200% of the federal poverty guideline. Corner stores were the only retailers to sell products without original packaging, including one corner store selling loose diapers for $1.49 each. Next, we calculated bus routes to determine accessibility of the retailer with the lowest prices and greatest selection. One-way bus travel from all other census tracts to a big-box store required taking two buses combined with an average of 11 min walking for an average travel time of 43 min. We deemed census tracts as "priority areas for diaper access" when they were characterized as: (1) low income and (2) low access with no retailer selling all of the 10 most common child diaper sizes. Results: Nearly half (