The Impact of a Grocery Store Closure in One Rural Highly Obese Appalachian Community on Shopping Behavior and Dietary Intake

Abstract

Research has examined how the entry of grocery stores into neighborhoods influences dietary outcomes, yet limited evidence suggests a direct correlation between opening a store and changes in dietary intake. A factor that might influence individuals’ behavior more directly is the closing of a grocery store where residents shop. This study aims to examine how a grocery closure in a rural Appalachian high poverty county is associated with dietary intake. A cohort of n = 152 individuals were recruited to participate in a longitudinal study examining purchasing habits and dietary intake. At time point two, one year later, n = 74 individuals completed the survey via phone. Results indicate those that switched from shopping at a local grocery store to a supercenter significantly increased their dietary intake of fruit (0.2 ± 0.8), fruits and vegetables (1.4 ± 2.7), alcohol (grams) (17.3 ± 54.1), and tomato sauce (0.1 ± 0.3). A local grocery store closure was associated with a change in shopping behavior and dietary intake. Community-level interventions targeting dietary behaviors must account for neighborhood food environment influences, including grocery store availability. Policy aimed at improving food access in rural communities need to consider approaches to improving a variety of food venues with affordable healthy food, while addressing the evolving grocery shopping behaviors of consumers.

Enduring Effects of the COVID-19 Pandemic on Food Access, Nutrition, and Well-Being in Rural Appalachia

“…As a consequence of these conditions, residents reported shifting their purchasing to less nutritious, less expensive food. As reported previously [13], this rural community has only two grocery stores in the county, and while many residents expressed a desire to shop locally, increased food prices were repeatedly mentioned as a barrier. Dollar Stores have expanded in the region, and one participant noted, "Dollar Stores have stepped up and they got more stuff, but it's still not enough variety".…”

“…It is also unknown from our sample whether cutting out meat was entirely due to high costs, or a shortage driven by supply chain issues. Further, altered food purchasing patterns may have been compounded by the closure of one of the three county grocery stores in early 2020 and the farmers' market in summer 2021, resulting in a consistent decline in food-sourcing venues during the acute phase of the pandemic [13]. Thus, locals experienced diminished food access and availability requiring them to alter their food procurement patterns.…”

“…This community faces persistent poverty, with a median household income of $29,386 and an estimated 40.5% of individuals living in poverty [11], and one in five adults is considered food insecure [12]. The food environment in this community offers few nutritious food options with only two grocery stores within county lines, and many residents travel out of the county to shop for groceries in supercenters if they have transportation access [13]. Residents of Martin County experience characteristics of poor quality of life, with nearly 25% of adults reporting poor or fair health and more than five poor physical and mental health days per month [14].…”

Health Behavior Interventions Among People With Lower Socio-Economic Status: A Scoping Review of Behavior Change Techniques and Effectiveness

“…'Restructuring the physical environment' had mixed effects, as it significantly increased behavioral outcomes in the proposed, desired direction eight times, in the undesired direction one time and not at all 14 times 5 . To illustrate, a neighborhood walking route significantly increased weekly time spent walking over nine months in total and for reasons of utility, but not for recreational walking among older adults residing in deprived neighborhoods (Prins et al, 2019) and switching to a supercenter due to the closing of a local grocery store desirably increased dietary intakes such as fruit and vegetables, but also undesirably increased intake of alcohol among residents of a rural high-poverty county (Gillespie et al, 2022). Also 'Material incentives (behavior)' had mixed effects on behavioral outcomes (all regarding tobacco use), as it significantly increased outcomes in a desired direction four times, but had no effects at all three times 6 .…”

A Vanishing Food Infrastructure: The Closure of Food Outlets in Flint in a Pandemic Era

“…Researchers have also investigated the impact of grocery store closures on food accessibility and health in rural communities (Gillespie et al, 2022; Yeager & Gatrell, 2014). Additionally, researchers have examined if opening a larger supermarket or grocery store contributes to closing smaller stores (Guy, 1996; Jia, 2008; Sustain, 2000).…”