Access to nutritious foods is key to achieving health promotion goals. While there is evidence that nutritious food access is complex, measures assessing multiple domains of access, including spatial-temporal, economic, social, service delivery and personal, are lacking. The current study evaluates psychometric properties of scales designed to measure perceptions of multiple domains of nutritious food access among low-income populations.

A cross-sectional survey was conducted in 2015. Eighty-one items were selected or developed to represent five domains of nutritious food access for food shopping overall and specific to shopping at farmers’ markets. Evaluation of the items included exploratory factor analysis within each domain and internal consistency reliability for each of the sub-scales.

Data were collected in seventeen urban neighbourhoods in Greater Cleveland, Ohio, USA that have high levels of poverty. All participants had access to at least one farmers’ market within 1·6 km (1 mile) of their home to standardize spatial access to nutritious foods.

Adults (n 304) receiving Supplemental Nutrition Assistance Program benefits.

Each domain included multiple sub-domains: spatial-temporal (four), service delivery (two), economic (two), social (three) and personal (three), for a total of fourteen subdomains. The internal consistency reliability for one of the sub-domains was outstanding (>0·90), seven were excellent (0·80–0·89), five were very good (0·70–0·79) and one scale had poor reliability (0·58).

Multiple sub-domains of nutritious food access can be assessed using short measures that have been tested for internal consistency. These measures are suitable for assessing the complex phenomena of nutritious food access among low-income populations.

To assess levels of and identify factors associated with food insecurity on the Navajo Nation.

A cross-sectional study was conducted utilizing the ten-item Radimer/Cornell food insecurity instrument. Sociodemographic, psychosocial and anthropometric data were collected.

Navajo Nation, USA.

Two hundred and seventy-six members of the Navajo Nation were randomly selected at food stores and other community locations.

Of the sample, 76·7 % had some level of food insecurity. Less education (mean years of schooling: P = 0·0001; non-completion of higher education: P = 0·0003), lower full-time employment rates (P = 0·01), and lower material style of life (P = 0·0001), food knowledge (P = 0·001) and healthy eating self-efficacy (P < 0·0001) scores were all positively associated with food insecurity. Perceived expensiveness (P < 0·0001) and perceived inconvenience (P = 0·0001) of healthy choices were also positively associated with food insecurity.

Food insecurity rates on the Navajo Nation are the highest reported to date in the USA and are likely attributable to the extremely high rates of poverty and unemployment. Reducing food insecurity on the Navajo Nation will require increasing the availability of affordable healthy foods, addressing poverty and unemployment, and providing nutrition programmes to increase demand.

Canada’s Aboriginal population is vulnerable to food insecurity and increasingly lives off-reserve. The Canadian Community Health Survey, Cycle 2.2 Nutrition, was used to compare the prevalence and sociodemographic correlates of food insecurity between non-Aboriginal and off-reserve Aboriginal households.

Food insecurity status was based on Health Canada’s revised interpretation of responses to the US Household Food Security Survey Module. Logistic regression was used to assess if Aboriginal households were at higher risk for food insecurity than non-Aboriginal households, adjusting for household sociodemographic factors.

Canada.

Households (n 35,107), 1528 Aboriginal and 33 579 non-Aboriginal.

Thirty-three per cent of Aboriginal households were food insecure as compared with 9 % of non-Aboriginal households (univariate OR 5·2, 95 % CI 4·2, 6·3). Whereas 14 % of Aboriginal households had severe food insecurity, 3 % of non-Aboriginal households did. The prevalence of sociodemographic risk factors for household food insecurity was higher for Aboriginal households. Aboriginal households were more likely to have three or more children (14 % v. 5 %), be lone-parent households (2 1 % v. 5 %), not have home ownership (52 % v. 31 %), have educational attainment of secondary school or less (43 % v. 26 %), have income from sources other than wages or salaries (38 % v. 29 %), and be in the lowest income adequacy category (33 % v. 12 %). Adjusted for these sociodemographic factors, Aboriginal households retained a higher risk for food insecurity than non-Aboriginal households (OR 2·6, 95 % CI 2·1, 3·2).

Off-reserve Aboriginal households in Canada merit special attention for income security and poverty alleviation initiatives.