Distance to Store, Food Prices, and Obesity in Urban Food Deserts

Abstract

Background Lack of access to healthy foods may explain why residents of low-income neighborhoods and African Americans in the U.S. have high rates of obesity. The findings on where people shop and how that may influence health are mixed. However, multiple policy initiatives are underway to increase access in communities that currently lack healthy options. Few studies have simultaneously measured obesity, distance, and prices of the store used for primary food shopping. Purpose To examine the relationship among distance to store, food prices, and obesity. Methods The Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health study conducted baseline interviews with 1,372 households between May and December 2011 in two low-income, majority African American neighborhoods without a supermarket. Audits of 16 stores where participants reported doing their major food shopping were conducted. Data were analyzed between February 2012 and February 2013. Results Distance to store and prices were positively associated with obesity (p<0.05). When distance to store and food prices were jointly modeled, only prices remained significant (p<0.01), with higher prices predicting a lower likelihood of obesity. Although low- and high-price stores did not differ in availability, they significantly differed in their display and marketing of junk foods relative to healthy foods. Conclusions Placing supermarkets in food deserts to improve access may not be as important as simultaneously offering better prices for healthy foods relative to junk foods, actively marketing healthy foods, and enabling consumers to resist the influence of junk food marketing.

Incentivizing Fruit and Vegetable Purchasers at Fresh Markets in Lower 9th Ward, New Orleans

“…27 However, price point has been shown to be more important than distance in healthy food choices among residents of low-income neighborhoods. 28 Expanding food options to smaller stores and direct-to-consumer marketing interventions, like food stands, community-supported agriculture and farmers' markets have shown a correlation with an increased consumption of fruits and vegetables. 5,[29][30][31][32] A study of women in North Carolina found that women who shopped at farmers' markets were more likely to consume more fruits and vegetables 30 and the use of an incentive program in New York was shown to increase shopping at markets and self-reported fruit and vegetable consumption.…”

“…During 2017, Sankofa has transitioned the VDP to a SNAP-match program and increased the supplemental incentive amount in order to increase SNAP benefit usage at the markets. 28 Program participants presently receive a match of up to $20 of their SNAP purchases to acquire fruits and vegetables at the Sankofa Fresh Stop and Mobile Markets. Community and organizational partnerships also support Sankofa's efforts to host healthy cooking and gardening educational programs.…”

“…37 That the addition of an incentive program to subsidize the cost or decrease the price of locally available fresh fruits and vegetables increased reported purchases lends additional support to recent research on food deserts that suggests that price, more than location, poses a barrier to access to healthy food. 28 Community, city, and academic partnerships were engaged to develop the produce incentive model, promote offerings, and recruit participants to the program. At the local level, we partnered with the Lower Nine Senior Citizens Center, Daughters of Charity Services at St. Cecilia, Mercy Endeavors and Harmony House to recruit program participants and host Mobile Market sites.…”

Geographic and socioeconomic distribution of food vendors: a case study of a municipality in the Southern Brazil

“…Building supermarkets in food deserts to improve access to healthy foods may not be as effective as offering healthy products at more affordable prices 41 . This is because cost is considered the greatest barrier to a healthy diet, not physical distance or lack of information 42 .…”

A Mixed-Method Assessment of a New Supermarket in a Food Desert: Contributions to Everyday Life and Health

“…[6][7][8] Of studies finding improvements in healthy purchasing, these changes are not attributable to the use of the new retailer. 9,10 Evaluations also highlight the importance of in-store environment, including pricing, placement, and promotions, in motivating behavior change, 6,11 although none have explored shoppers' in-store experiences.…”