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Healthy food in convenience stores

Health Factors: Diet & Exercise
Decision Makers: Employers & Businesses Local Government State Government Nonprofit Leaders
Evidence Rating: Some Evidence
Population Reach: 10-19% of WI's population
Impact on Disparities: Likely to decrease disparities

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Description

Convenience stores, corner stores, or gas station markets often provide the only retail food options in food deserts and low income neighborhoods. Corner stores sell a limited selection of food items and other products; these items are frequently non-perishable and unhealthy. Corner stores can also carry fresh produce and healthier food options.

Expected Beneficial Outcomes

Increased healthy foods in food deserts
Increased access to fruits & vegetables
Increased healthy food purchases

Evidence of Effectiveness

There is some evidence that offering fresh produce and other healthy foods in convenience or corner stores increases access to and purchasing of healthy foods, especially in food deserts and low income urban and rural communities (Gittelsohn 2012, Paek 2014Ayala 2013, AHA-Mozaffarian 2012). Establishing financial incentives for corner stores to increase availability and variety of healthy foods and beverages is a suggested strategy to prevent obesity (CDC MMWR-Khan 2009). However, additional evidence is needed to confirm effects, especially regarding consumption changes (Ayala 2013, AHA-Mozaffarian 2012).

Multi-component corner store interventions that include changes to food provision (e.g., increasing produce availability, reducing availability of unhealthy foods), infrastructure (e.g., adding or increasing refrigeration, adding produce displays, moving unhealthy foods to the back of the store) and communication (e.g., point-of-purchase signs, educational flyers, promotional giveaways) have shown consistent improvements in the availability and sale of healthy foods as well as consumer knowledge about healthy eating (Gittelsohn 2012). Consumers with limited exposure to corner store interventions appear to change behaviors only modestly; increasing the proportion of participating stores in urban environments will likely lead to greater changes in behavior (Gittelsohn 2010). Increasing the variety of fruits and vegetables in convenience stores has also been associated with an increased likelihood that customers will purchase fruits and vegetables (Martin 2012a). Increasing shelf space for healthy food options is associated with self-reported increases in healthy food consumption (AHA-Mozaffarian 2012).

As a greater percentage of corner store’s profits come from snack foods and sugar-sweetened beverages than from fruits and vegetables, altering the mix of foods may be difficult without financial incentives (Bodor 2010). Store operators' perceptions about cost, infrastructure, and customer demand and produce wholesalers' hesitation to invest in small-scale business opportunities can also be barriers to increasing fresh produce (O Malley 2013). Engaging community residents and understanding neighborhood context while planning changes to corner store offerings (Larson 2013), coordinating changes at many corner stores (Widener 2013), and working closely with store owners to design and implement culturally sensitive programs may increase the likelihood of success (Moore 2013Gittelsohn 2014). Increasing access to healthy foods in convenience or corner stores alone may not address nutritional disparities across socio-economic groups; educational materials and financial incentives for consumers may be needed to help change preferences for unhealthy food and support purchase of higher priced items (NBER-Handbury 2015).

Implementation

United States

Interventions to increase healthy food options at convenience or corner stores are happening around the country, especially in urban areas such as Philadelphia, PA (Food Fit Philly-HCS); Providence, RI (EJL-HCSI); Minneapolis, MN (MDHFS-HCSP); and Washington DC (DC Hunger Solutions-HCSP). Some rural communities are also working to increase healthy food options at convenience or gas station stores, for example, in Sipaulovi Village in the Hopi Nation in northern Arizona (Secakuku 2009).

The US Department of Health and Human Services is working with the Treasury and the Department of Agriculture through the Healthy Food Financing Initiative (HFFI) to provide funding to increase access to healthy foods in convenience stores around the country, especially in food deserts in urban and rural areas (US DHHS-Healthy food financing). As of 2011, 11 states and Washington DC have enacted healthy food retail legislation; in California, Oklahoma, and Washington DC, this legislation includes initiatives to increase healthy food availability in convenience or corner stores (CDC-State initiatives healthy food). 

Implementation Resources

AHA-VFHK toolkits - American Heart Association (AHA), Robert Wood Johnson Foundation (RWJF). Voices for healthy kids (VFHK): Toolkits to make the healthy choice the easy choice in the places where children live, learn and play. Accessed on February 4, 2017
CDC-DNPAO data - Centers for Disease Control and Prevention (CDC), Division of Nutrition Physical Activity and Obesity (DNPAO). Nutrition, physical activity and obesity: Data, trends and maps online tool. Accessed on February 2, 2017
CDC-Healthy retail food - Centers for Disease Control and Prevention (CDC). Retail food stores: Small retail locations. Accessed on December 1, 2015
CDC-HFR 2014 - Centers for Disease Control and Prevention (CDC), Division of Nutrition, Physical Activity, and Obesity. Healthier food retail (HFR): An action guide for public health practitioners. 2014. Accessed on March 2, 2016
ChangeLab-Food retail - ChangeLab Solutions. Healthy food retail. Accessed on December 1, 2015
ChangeLab-Health on the shelf - ChangeLab Solutions. Health on the shelf: A guide to healthy small food retailer certification programs. Accessed on March 1, 2016
Food Trust-Corner stores - The Food Trust. What we do: In corner stores. Accessed on November 9, 2015
HCSN - Healthy Corner Stores Network (HCSN). New to healthy corner stores? Accessed on November 9, 2015
PolicyLink-Corner stores 2008 - PolicyLink. Equitable development toolkit: Corner stores. 2008. Accessed on March 15, 2016
PolicyLink-HFAP map - PolicyLink, The Reinvestment Fund (TRF), The Food Trust. Healthy food access portal (HFAP): Research your community interactive map for healthy food access. Accessed on March 1, 2016
YES!-Toolkits - Youth Empowered Solutions (YES!). Toolkits and resources. Accessed on March 4, 2016

Citations - Evidence

AHA-Mozaffarian 2012 - Mozaffarian D, Afshin A, Benowitz NL, et al. Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association (AHA). Circulation. 2012;126(12):1514–63. Accessed on February 6, 2017
Ayala 2013 - Ayala GX, Baquero B, Laraia BA, Ji M, Linnan L. Efficacy of a store-based environmental change intervention compared with a delayed treatment control condition on store customers’ intake of fruits and vegetables. Public Health Nutrition. 2013;16(11):1953–60. Accessed on December 15, 2015
Bodor 2010 - Bodor JN, Ulmer VM, Dunaway LF, Farley TA, Rose D. The rationale behind small food store interventions in low-income urban neighborhoods: Insights from New Orleans. Journal of Nutrition. 2010;140(6):1185–8. Accessed on December 1, 2015
CDC MMWR-Khan 2009 - Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. Morbidity and Mortality Weekly Report (MMWR). 2009;58(RR-07):1-26. Accessed on December 7, 2015
Gittelsohn 2010* - Gittelsohn J, Song HJ, Suratkar S, et al. An urban food store intervention positively affects food-related psychosocial variables and food behaviors. Health Education & Behavior. 2010;37(3):390–402. Accessed on November 17, 2015
Gittelsohn 2012 - Gittelsohn J, Rowa M, Gadhoke P. Interventions in small food stores to change the food environment, improve diet, and reduce risk of chronic disease. Preventing Chronic Disease. 2012;9:110015. Accessed on February 25, 2016
Gittelsohn 2014* - Gittelsohn J, Laska MN, Karpyn A, Klingler K, Ayala GX. Lessons learned from small store programs to increase healthy food access. American Journal of Health Behavior. 2014;38(2):307–15. Accessed on December 15, 2015
Larson 2013 - Larson C, Haushalter A, Buck T, et al. Development of a community-sensitive strategy to increase availability of fresh fruits and vegetables in Nashville’s urban food deserts, 2010-2012. Preventing Chronic Disease. 2013;10(1):E125. Accessed on November 18, 2015
Martin 2012a* - Martin KS, Havens E, Boyle KE, et al. If you stock it, will they buy it? Healthy food availability and customer purchasing behaviour within corner stores in Hartford, CT, USA. Public Health Nutrition. 2012;15(19):1973–8. Accessed on November 17, 2015
Moore 2013 - Moore LV. Supporting healthful eating through retail environmental change: Communities putting prevention to work. Preventing Chronic Disease. 2013;10:E189. Accessed on January 20, 2016
NBER-Handbury 2015 - Handbury J, Rahkovsky I, Schnell M. What drives nutritional disparities? Retail access and food purchases across the socioeconomic spectrum. National Bureau of Economic Research (NBER). 2015: Working Paper 21126. Accessed on March 1, 2016
O Malley 2013* - O’Malley K, Gustat J, Rice J, Johnson CC. Feasibility of increasing access to healthy foods in neighborhood corner stores. Journal of Community Health. 2013;38(4):741–9. Accessed on November 20, 2015
Paek 2014* - Paek H-J, Oh HJ, Jung Y, et al. Assessment of a healthy corner store program (FIT Store) in low-income, urban, and ethnically diverse neighborhoods in Michigan. Family & Community Health. 2014;37(1):86–99. Accessed on December 28, 2015
Widener 2013* - Widener MJ, Metcalf SS, Bar-Yam Y. Agent-based modeling of policies to improve urban food access for low-income populations. Applied Geography. 2013;40:1–10. Accessed on November 9, 2015

Citations - Implementation

CDC-State initiatives healthy food - National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Nutrition, Physical Activity, and Obesity (DNPAO). Initiatives supporting healthier food retail: An overview of the national landscape. Atlanta: Centers for Disease Control and Prevention (CDC); 2011. Accessed on December 10, 2015
DC Hunger Solutions-HCSP - DC Hunger Solutions. Healthy corner store program. Accessed on December 8, 2015
EJL-HCSI - Environmental Justice League of Rhode Island (EJL). Healthy corner store initiative (HCSI). Accessed on December 15, 2015
Food Fit Philly-HCS - Food Fit Philly. Healthy corner stores: Helping corner stores to sell healthy, affordable foods. Accessed on March 15, 2016
MDHFS-HCSP - Minneapolis Department of Health and Family Support (MDHFS). Minneapolis healthy corner store program: Making produce more visible, affordable and attractive. Minneapolis: Minneapolis Department of Health and Family Support (MDHFS); 2012. Accessed on November 17, 2015
Secakuku 2009 - Secakuku S, Jamison S, Andaluz I. Marketing healthy foods in a rural convenience store setting. Rural Connections. 2009. Accessed on March 1, 2016
US DHHS-Healthy food financing - US Department of Health and Human Services (US DHHS), Administration for Children & Families (ACF). Healthy food financing initiative. Accessed on March 13, 2017

Page Last Updated

June 11, 2015

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