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Disparities in accessibility to healthy food are a critical public-health concern. Poor access to reasonably priced, nutritious, and good-quality food may lead to poor diet and increase the risks of health problems such as obesity, diabetes, and cardiovascular diseases. This research advances the popular two-step floating catchment area (2SFCA) method by incorporating a kernel density (KD) function to form the ‘KD2SFCA method’. The study applies the method to measure the spatial access to food stores in southwest Mississippi, and examines the interaction between the spatial access and nonspatial factors. The research shows that neighborhoods with higher scores of urban socioeconomic disadvantage actually have better spatial accessibility to food stores; but higher percentages of carless households and lower income in some neighborhoods may compromise overall accessibility. Neighborhoods with stronger cultural barriers tend to be associated with poorer spatial accessibility. The study clearly differentiates spatial and nonspatial factors in access inequalities, and thus helps policy makers to design corresponding remedial strategies.

This study utilised data from the National Income Dynamics Study, a longitudinal study with a sample of approximately 28 000 people, to investigate the cross-sectional and spatial distribution of multimorbidity and the association with socioeconomic disadvantage in South Africa for 2008 and 2012. Multimorbidity increased in prevalence from 2.73% to 2.84% in adults between 2008 and 2012 and was associated with age, socioeconomic deprivation, obesity and urban areas. Hypertension was found frequently coexisting with diabetes. Spatial analysis showed clusters (hot spots) of higher multimorbidity prevalence in parts of KwaZulu-Natal and the Eastern Cape, which compared with the socioeconomic disadvantage spatial pattern. Although these results were limited to a district level analysis, this study has provided a platform for future local level research and has provided insight into the socioeconomic determinants of disease multimorbidity within a developing country.

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