"I Shouldn't Have to Drive to the Suburbs": Grocery Store Access, Transportation, and Food Security in Detroit During the COVID-19 Pandemic.

Objective: To explore the relationship between type of grocery store used (chain vs. independent), transportation access, food insecurity, and fruit and vegetable intake in Detroit, Michigan, USA, during the COVID-19 pandemic.

Design: A cross-sectional online survey was conducted from December 2021 to May 2022.

Setting: Detroit, Michigan.

Participants: 656 Detroit residents aged 18 and older.

Results: Bivariate analyses showed that chain grocery store shoppers reported significantly greater fruit and vegetable intake (2.42 vs. 2.14 times/day for independent grocery store shoppers, < 0.001) and lower rates of food insecurity compared to independent store shoppers (45.9% vs. 65.3% for independent grocery store shoppers, < 0.001). Fewer independent store shoppers used their own vehicle (52.9% vs. 76.2% for chain store shoppers, < 0.001). After adjusting for socioeconomic and demographic variables transportation access was strongly associated with increased odds of shopping at chain stores (OR = 1.89, 95% CI [1.21,2.95], = 0.005) but food insecurity was no longer associated with grocery store type. Shopping at chain grocery stores was associated with higher fruit and vegetable intake after adjusting for covariates (1.18 times more per day, = 0.042). Qualitative responses highlighted systemic barriers, including poor food quality, high costs, and limited transportation options, exacerbating food access inequities.

Conclusions: These disparities underscore the need for targeted interventions to improve transportation options and support food security in vulnerable populations, particularly in urban areas like Detroit. Addressing these structural challenges is essential for reducing food insecurity and promoting equitable access to nutritious foods.