The United States Department of Agriculture recommends filling half of your plate with fruits and vegetables[i].  Their ChooseMyPlate.gov website offers customized guidelines for produce consumption based on age, physical activity and gender.  However, nationwide, many Americans are not eating sufficient fruits and vegetables, and many adults routinely eat fast foods and drink sugary beverages. In many cases, one of the causes for poor nutrition is difficulty accessing and affording healthy foods.

Using the 2012 Southeastern Pennsylvania (SEPA) Household Health Survey, this article reviews the data on nutrition and some of the barriers to healthy eating faced by adults in our region. The Southeastern Pennsylvania Household Health Survey is administered by telephone in more than 10,000 households in the SEPA region, including Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties. Every two years, this survey collects key health information on SEPA residents to support health programs across the five county area.

The 2012 Southeastern Pennsylvania Household Health Survey found that about one in five adults in SEPA (22.8%) eats just one serving of fruits or vegetables each day, and one in twenty five (3.9%) eat no fruits or vegetables.   More than one-half of SEPA adults (53.0%) eat fewer than three servings of fruits or vegetables each day.   This represents approximately 1,624,600 adults in our region who may not be getting adequate nutrition.

o    Men are less likely to make fruits and vegetables a regular part of their diet; six in ten men in the region (60.0%) eat fewer than three servings of fruits and vegetables each day.

o    There is some variation in fruit and vegetable consumption in our area by race and ethnicity. While just under one-half of white adults (46.9%) eat fewer than three servings of fruits or vegetables each day, so do about two-thirds of both Black adults (67.6%) and Latino adults (65.0%).

o    In our region, adults living below the federal poverty level are more likely to eat fewer than three servings of fruits or vegetables each day than are adults living above it.  More than seven in ten poor adults (71.5%) eat three or fewer servings as compared with 50.6% of adults living above the federal poverty level.   This means that about 257,900 adults in SEPA are living in poverty and may be at risk for poor nutrition (Figure 1).

Adults in our region who eat fewer than three servings of fruits and vegetables per day are also more likely to eat fast food each week than adults who consume three or more servings of fruits or vegetables each day:  48.4% of adults who eat fewer than three servings of fruits and vegetables daily also eat fast food at least weekly, while about one-third of adults who do eat three or more servings of produce each day, 34.8%, also eat fast food at least weekly. Across Southeastern Pennsylvania, more than four in ten adults (42.2%) eat fast food at least once a week.

Skipping meals

One in eight adults in SEPA (12.5%) has cut the size of a meal or skipped a meal in the past year because there was not enough money for food.

Latino adults and Black adults are more likely to report cutting or skipping a meal than are white adults; about one in four Latino adults (24.1%), one in five Black adults (19.5%) and one in eleven White adults (8.8%) report cutting or skipping a meal because of cost. 

Adults in Philadelphia are more likely to cut or skip a meal than are adults in the surrounding counties.  Nearly one in five Philadelphia adults (18.3%) eat fewer than three servings of fruits or vegetables each day, as compared with 6.8% of Chester County adults, 7.8% of Montgomery County adults, 9.2% of Bucks County adults and 11.8% of Delaware County adults (Figure 2).

Access to Fruits and Vegetables

Across SEPA a small percentage of adults (5.2%) say that it is difficult or very difficult to find fruit in their neighborhood, however wide variation emerges across racial/ethnic groups.  One in ten Black (10.7%) and Latino (10.3%) adults says it is difficult or very difficult to find fruit in their neighborhood, as compared with 2.6% of White adults. 

Philadelphia residents are more likely to describe fruit as difficult to find (9.4%) as compared with adults in Delaware (4.3%), Chester (2.9%), Bucks (2.5%) and Montgomery (1.6%) counties.

About one in eight adults living below the federal poverty level (13.0%) describes fruit as difficult or very difficult to find in their neighborhood, as compared with 4.2% of adults living above the federal poverty level.

Conclusion

Many adults in SEPA face challenges in accessing a healthy diet.  Cost of food and the availability of fresh foods in some neighborhoods in SEPA can be limiting. In addition, some geographic areas and some socio-demographic groups face more difficulty in obtaining the foods that they need to be healthy. Wider access to both nutritional counseling and education as well as food resources could have a positive impact on the nutrition of SEPA residents. 

For more information about these findings, please contact Rose Malinowski Weingartner at rosemw@phmc.org.

To download this article as a PDF, click here.

To read more about our previous data findings, please click here.