Abstract
Low-income older adults residing in urban food deserts face profound barriers to accessing fresh fruits and vegetables, compounding their risk for chronic, diet-related conditions. This mixed-methods study evaluated the impact of a subsidized mobile produce market initiative on dietary quality and food security among low-income seniors (aged 65 and older) living in subsidized housing complexes in Detroit, Michigan. Over a 12-month period, we monitored participants (n = 184) who received bi-weekly access to a mobile market offering a 50% subsidy on all fresh fruits and vegetables. Quantitative dietary quality was assessed using 24-hour dietary recalls to calculate the Healthy Eating Index-2015 (HEI-2015), while food security was measured using the USDA Food Security Survey Module. Qualitative focus groups (n = 4 focus groups, total participants = 32) explored participants' lived experiences, perceived accessibility, and systemic barriers. Quantitative findings demonstrated a statistically significant improvement in mean HEI-2015 scores, which rose from 51.2 at baseline to 58.7 at 12 months (p < 0.01), driven primarily by increased consumption of whole fruits and dark green vegetables. Concurrently, the prevalence of food insecurity among participants decreased by 22% (p < 0.05). Qualitative analysis revealed that proximity, financial relief via the subsidy, and the social environment of the market visits were major drivers of behavioral change, though physical mobility challenges and extreme winter weather remained persistent barriers. These findings suggest that subsidized mobile markets are a highly effective, community-level public health intervention to improve nutritional health and mitigate food insecurity among vulnerable urban seniors.
