Federal food policy changes led to increased availability of healthy foods at smaller urban corner stores in Baltimore, new Johns Hopkins Bloomberg School of Public Health research suggests. Increases in healthy food were greatest in corner stores and in neighborhoods with a majority of black residents.
Many residents of cities such as Baltimore, where the study was conducted, reside in what are known as food deserts, on blocks far from supermarkets and inhabited by people with little access to transportation. There, residents are often forced to buy food from corner and convenience stores where shelves are usually not stocked with healthy options, potentially leading to worse diets. Poor diet is one of the biggest risk factors for death and illness in the United States, responsible for more than 600,000 deaths in 2010 alone, researchers say.
By looking at the changes in healthy food availability in a sample of food stores in the city of Baltimore between 2006 and 2012, researchers found that corner stores, particularly in neighborhoods with large numbers of black residents, were modestly but significantly more likely to carry a larger number of those healthful choices. The researchers, reporting in the November issue of Health Affairs, say their findings suggest that boosting healthful food options at corner stores could be a more feasible alternative to the costly option of building supermarkets.
One of the big changes that occurred between 2006 and 2012 came in 2009, when the federal Special Supplemental Nutrition Program for Women, Infants and Children (WIC) required participating stores to improve food offerings by carrying more healthy options such as fruits and vegetables or whole wheat bread. The changes to this food stamps-like program for pregnant women and children at nutritional risk appeared to drive much of the increase in nutritious food in the small corner stores.
"This study shows us that, at a policy level, we can have an impact on the availability of healthy food in communities of individuals who are underserved," says study leader Laura K. Cobb, a recent DrPH recipient from the Bloomberg School. "It's not always practical to build new supermarkets, but this tells us we can impact healthy food availability in neighborhoods that need it the most by improving offerings at small corner stores."
For the study, the researchers used data from 118 corner stores collected in 2006 as part of the Multi-Ethnic Study of Atherosclerosis and again in 2012 under the auspices of the Johns Hopkins Center for a Livable Future. Both datasets assessed healthy food availability by assigning points to various healthy options on the shelves.
In 2006, the stores had an average healthy food availability score of 7.06 out of a possible 18. Stores in census tracts where more than 60 percent of residents are black had the lowest scores (6.4 versus 8.19 in tracts where more than 60 percent of residents are white; and 8.76 in tracts without a racial majority). In 2012, the average score jumped by 1.25 points, with neighborhoods with a majority of residents who are white increasing by .18 points and neighborhoods with a majority of residents who are black increasing by 1.52 points.
"Things are getting a little better, but not dramatically better," Cobb says. "What we have learned is that the WIC policy change is likely responsible for much of the modest but real improvement in healthy food availability. Given the difficulty of impacting change in small stores, much of the policy focus has been on decreasing food deserts by increasing the number of supermarkets in these areas.
"Our findings indicate that stores that carry a limited variety of food may be more receptive to stocking healthier food than previously thought, particularly within neighborhoods with a majority of black residents. Policies targeting healthy food availability in corner stores have the potential not only to increase healthy food availability but also to decrease health disparities."
"Baltimore City Stores Increased Availability of Healthy Food After WIC Policy Change" was written by Laura K. Cobb; Cheryl A. M. Anderson; Lawrence J. Appel; Jessica Jones-Smith; Usama Bilal; Joel Gittelsohn; and Manual Franco.
The study was supported by grants from the National Institutes of Health's National Heart, Lung, and Blood Institute (T32HL007024), National Institute of Diabetes and Digestive Kidney Disease (2T32DK062707-11A1); the Center for a Livable Future-Lerner Fellowship; the La Caixa Fellowship; the Sociedad Espanola de Epidemiologica; and the Escuela Nacional de Sanidad.