This study addresses links between economic and nutritional variation in an urban North American setting. We employed a mixed-methods approach including mapping, semi-structured interviews, and food outlet surveys to investigate the public health impact of variation in the cost and availability of food between two socioeconomically distinct neighbourhoods of the City of Hamilton, Ontario, Canada. Food cost in supermarkets was not found to be higher in the low-income neighbourhood, though it was much higher in the variety stores that predominate in the low-income neighbourhood. Moreover, there was a very low availability of produce in the variety stores. Reduced fresh produce availability and lower incomes have the potential to negatively influence public health in the less-affluent study area by increasing the difficulty of acquiring healthy foods.