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New grocery stores in underserved areas

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

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Financing initiatives or zoning regulation changes can be structured to bring grocery stores or supermarkets to underserved neighborhoods. Grocery stores or supermarkets that sell a wide variety of fresh fruits and vegetables, dairy products, meat, baked goods, packaged, and frozen items are less available in low income than in middle income neighborhoods, in predominately black than white neighborhoods, and in urban than suburban areas (Powell 2007). 

Expected Beneficial Outcomes

Increased access to healthy food
Increased healthy food consumption
Reduced obesity rates

Evidence of Effectiveness

Attracting new grocery stores to underserved areas is a suggested strategy to increase access to healthy food in these communities (CDC-Supermarkets, US DHHS-Healthy food financing, IOM-Government obesity prevention 2009). Greater supermarket availability has been associated with lower prevalence of obesity and overweight (Morland 2006, Larson 2009a, Ford 2009); children who live far away from a grocery store appear to have higher BMIs than children living closer to a store (Carroll-Scott 2013). Some studies associate increased supermarket availability with increased fruit and vegetable intake, especially among blacks (Morland 2002). Other studies find no association, suggesting that more comprehensive strategies may be needed to promote dietary behavior change (Cummins 2014Boone-Heinonen 2011, Sadler 2013), such as reducing prices and increasing marketing of healthy foods (Ghosh-Dastidar 2014). Additional evidence is needed to confirm effects.

Attracting new grocery stores to low income areas 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).


United States

The US Department of Health and Human Services is working with the Treasury and the Department of Agriculture to provide funding to help attract grocery stores and supermarkets to food deserts through its Healthy Food Financing Initiative (HFFI) (US DHHS-Healthy food financing). The national HFFI is modeled on the Pennsylvania Fresh Food Financing Initiative that supported 88 projects in urban and rural areas across the state (TRF-PFFFI). Pennsylvania’s program also inspired similar programs in Arizona, Colorado, Georgia, Illinois, Louisiana, Maryland, Massachusetts, Minnesota, Mississippi, New Jersey, New York, Tennessee, and Texas (Food Trust 2011).

As of 2011, 11 states and Washington DC have enacted healthy food retail legislation; in nine cases this legislation focuses on attracting grocery stores and supermarkets to underserved areas. Seven states have introduced such legislation that either did not pass or is pending further action (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 March 13, 2018
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 22, 2018
ChangeLab-Food retail - ChangeLab Solutions. Healthy food retail. Accessed on December 1, 2015
ChangeLab-Getting to grocery - ChangeLab Solutions. Getting to grocery: Tools for attracting healthy food retail to underserved neighborhoods. Accessed on December 14, 2015
LHC-Rockeymoore 2014 - Rockeymoore M, Moscetti C, Fountain A. Rural Childhood Obesity Prevention Toolkit. Leadership for Healthy Communities (LHC), Center for Global Policy Solutions, Robert Wood Johnson Foundation. 2014. Accessed on February 22, 2018
PolicyLink-Grocery store 2008 - PolicyLink. Grocery store attraction strategies: A resource guide for community activists and local governments. 2008. Accessed on January 25, 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 February 22, 2018
SRTSNP-Safe routes to healthy foods - Safe Routes to School National Partnership (SRTSNP). Healthy communities: Safe routes to healthy foods. Accessed on May 17, 2018
Uplift Solutions-Supermarkets - Uplift Solutions. Uplift's national food access work supports full service supermarkets in underprivileged communities with the triple bottom line: Business profitability, community wellness, and environmental sustainability. Accessed on November 19, 2015
US Treasury-CDFI Fund - US Department of the Treasury (US Treasury). Community development financial institutions (CDFI) fund: New markets tax credit program. Accessed on February 27, 2017

Citations - Description

Powell 2007* - Powell LM, Slater S, Mirtcheva D, Bao Y, Chaloupka FJ. Food store availability and neighborhood characteristics in the United States. Preventive Medicine. 2007;44(3):189-95. Accessed on November 10, 2015

Citations - Evidence

Boone-Heinonen 2011 - Boone-Heinonen J, Gordon-Larsen P, Kiefe CI, et al. Fast food restaurants and food stores: Longitudinal associations with diet in young to middle-aged adults: The CARDIA study. Archives of Internal Medicine. 2011;171(13):1162–70. Accessed on December 1, 2015
Carroll-Scott 2013* - Carroll-Scott A, Gilstad-Hayden K, Rosenthal L, et al. Disentangling neighborhood contextual associations with child body mass index, diet, and physical activity: The role of built, socioeconomic, and social environments. Social Science & Medicine. 2013;95:106-14. Accessed on December 1, 2015
CDC-Supermarkets - Centers for Disease Control and Prevention (CDC). Retail food stores: Grocery stores and supermarkets Accessed on December 14, 2015
Cummins 2014 - Cummins S, Flint E, Matthews SA. New neighborhood grocery store increased awareness of food access but did not alter dietary habits or obesity. Health Affairs. 2014;33(2):283-291. Accessed on March 1, 2016
Ford 2009* - Ford PB, Dzewaltowski DA. Disparities in obesity prevalence due to variation in the retail food environment: Three testable hypotheses. Nutrition Reviews. 2008;66(4):216-28. Accessed on May 24, 2016
Ghosh-Dastidar 2014* - Ghosh-Dastidar B, Cohen D, Hunter G, et al. Distance to store, food prices, and obesity in urban food deserts. American Journal of Preventive Medicine. 2014;47(5):587-595. Accessed on March 1, 2016
IOM-Government obesity prevention 2009* - Institute of Medicine (IOM), National Research Council (NRC), Committee on Childhood Obesity Prevention Actions for Local Governments. Local government actions to prevent childhood obesity. (Parker L, Burns AC, Sanchez E, eds.). Washington, DC: National Academies Press; 2009. Accessed on February 23, 2018
Larson 2009a* - Larson NI, Story MT, Nelson MC. Neighborhood environments: Disparities in access to healthy foods in the U.S. American Journal of Preventive Medicine. 2009;36(1):74-81;e10. Accessed on November 20, 2015
Morland 2002 - Morland K, Wing S, Diez Roux A. The contextual effect of the local food environment on residents' diets: The atherosclerosis risk in communities study. American Journal of Public Health. 2002;92(11):1761-7. Accessed on November 18, 2015
Morland 2006* - Morland K, Diez Roux AV, Wing S. Supermarkets, other food stores, and obesity: The atherosclerosis risk in communities study. American Journal of Preventive Medicine. 2006;30(4):333-9. Accessed on May 24, 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
Sadler 2013 - Sadler RC, Gilliland JA, Arku G. A food retail-based intervention on food security and consumption. International Journal of Environmental Research and Public Health. 2013;10(8):3325-46. Accessed on November 10, 2015
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 February 22, 2018

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
Food Trust 2011 - The Food Trust. Harnessing the power of supermarkets to help reverse childhood obesity: Public health and supermarket experts explore grocery store marketing practices to promote healthier and lower-calorie foods. Princeton: Robert Wood Johnson Foundation (RWJF), The Food Trust; 2011. Accessed on November 20, 2015
TRF-PFFFI - The Reinvestment Fund (TRF). Pennsylvania Fresh Food and Financing Initiative (FFFI). Accessed on November 9, 2015
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 February 22, 2018

Page Last Updated

May 4, 2016

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