We examined where midlife and older adults with a mobility disability accessed food outside the home in King County, Washington, USA, how they travelled to these food destinations, and facilitators and barriers to food access using qualitative interviews. Thirty-five adults aged ≥50 years with a mobility disability (defined as use of an assistive device for mobility) were interviewed. Supplemental objective information was obtained from a Global Positioning System device worn by participants for 3 days. Participants primarily accessed food at grocery stores, restaurants, and coffee shops/cafés. The most common transportation modes were walking, obtaining a ride from friends, motorized chair/scooter, and public transit. Location and proximity of food destinations were factors affecting participants’ ability to access these destinations. Adequate space, ease of entry, available amenities such as restrooms, and helpful people were facilitators for participants to access food outside the home. 1. Introduction The ability to access food is essential to life and health. Food access is defined as “having sufficient resources to obtain appropriate foods for a nutritious diet” and is one dimension of food security (defined as “including both physical and economic access to food that meets people’s dietary needs as well as their food preferences”) [1]. The prevalence of food insecurity was 7.9% among U.S. households with elderly individuals in 2010 [2]. Difficulty accessing food may negatively affect the nutritional status and health outcomes [3], especially in older adults [4, 5]. Food insecurity was previously reported to be associated with functional impairments in U.S. older adults [6]. Accessing food is a complex process requiring a location to access food, adequate financial and transportation resources, and the cognitive ability to plan and carry out accessing food. Older adults and adults with a disability may have more difficulty accessing food due to physical limitations [7], inability to drive, financial limitations, and environmental limitations, among other factors. Physical limitations are more common in older age: in 2009, 38.4% of adults ≥65 years reported physical limitations (difficulty in stooping, lifting, reaching, grasping, or walking, but no limitations in carrying out activities of daily living or instrumental activities of daily living) [8], and 60.8% of community-dwelling adults ≥65 years in 2010 reported difficulty with at least one basic action (defined as movement, emotional, sensory [seeing or hearing], or cognitive) [9]. Lower
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