The Grocery Gap: Who Has Access to Healthy - The Food Trust

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PolicyLinkThe Food TrustAccess to fresh produce and otherhealthful foods in nearby storesSeveral recent studies go beyond usingsupermarkets as proxies for healthy food accessand conduct in-store surveys to more accuratelymeasure the availability of healthy food items innearby stores. 13, 21, 91, 122, 123 Others use residentsurveys to measure access to nutritious andquality foods and eating behaviors. 5, 124 Of the sixstudies in this category, all of them found thatincreased availability of produce or of specifichealthy foods (such as low-fat milk as a percentageof all milk) is associated with the increasedconsumption of those foods. Findings include:• In New Orleans, proximity to storesstocking more fresh produce isassociated with higher vegetableconsumption. Each additional meter ofshelf space devoted to fresh vegetablesis associated with an additional 0.35servings of vegetables per day. 13• For participants in a communitybasedhealth promotion program inColorado, greater shelf space allocatedto fresh produce correspondedwith greater increases in fruit andvegetable consumption. 122• The proportion of low-fat milk in storesis positively and directly related to itsconsumption according to a New Yorkstate study 21 and a study that examinedareas of California and Hawaii. 123• One study asked residents to ranktheir access to healthy food and thenexamined their rankings in relation totheir diets. Residents living in areas rankedby themselves or others as having theworst food environments were 22 to35 percent less likely to eat a healthydiet than those living in areas ranked ashaving the best food environments. 913. Access to healthy food isassociated with diet-relateddiseaseIn addition to making it possible—and evenmore likely—for residents to eat healthy diets,the availability of healthy food in communitiesis related to a host of diet-related diseasesincluding obesity and overweight, diabetes, andcardiovascular disease. Seventeen studies examinedthe relationship between healthy food accessand diet-related health outcomes; approximatelyhalf were conducted by academics and half wereconducted by policy researchers. Twelve found14, 24, 25, 27, 34, 45, 47, 72, 73, 125,a positive relationship,126, 128 127, 129, 145three studies had mixed results,78, 104and two studies had contrary findings.Access to supermarketsFive studies found that proximity to supermarketscorresponds with a lower body mass index (BMI),or rates of obesity, diabetes, or diet-related deathamong adults, 27, 71-73, 125 and one found the samecorrelation among adolescents. 45 Only two studiesfocused on children. One found that supermarketaccess was associated with lower BMI amongchildren in lower-density counties in Indianapolis(but not in higher-density ones). 127 The other trackedkindergarteners over four years and found that,controlling for individual characteristics, higherfruit and vegetable prices in their city or metrocorresponded with weight gain, but the density ofrestaurants, convenience stores, or grocery storesaround their schools did not make a difference. 145• Adults living in neighborhoods withsupermarkets or with supermarkets andgrocery stores have the lowest rates ofobesity (21 percent) and overweight(60–62 percent) and those living inneighborhoods with no supermarketsand access to only convenience stores,smaller grocery stores, or both had thehighest rates (32–40 percent obesity;73–78 percent overweight), according toa study of more than 10,000 adults. 125• The lack of supermarket accesscorresponds with higher rates of dietrelateddeath in Philadelphia. 2718
PolicyLinkThe Food TrustThe Economic Impacts of Fresh Food RetailersDirect Economic Impacts:• Job opportunities• Local tax revenuesIndirect Economic Impacts:• Revitalized neighborhood housing markets• Asset-building for low-income homeowners (via appreciating real estate assets)• Workforce training and development• New businesses surrounding the store• Additional spending in the local economy generated by the store and the new jobs itcreates (the “multiplier effect”)• In Los Angeles, a longer distancetraveled to reach a grocery store wasassociated with higher BMI. Thosewho traveled more than 1.75 miles toa supermarket weighed 0.8 BMI unitsmore (4.8 pounds for a 5’5” person). 34• A national study of more than 70,000teens also found that increased availabilityof chain supermarkets was associatedwith lower rates of overweight. 45Food outlet mixSeveral studies 14, 24, 25, 47, 126 have found thatthe mix of food stores available to residents isassociated with diet-related health outcomes:• Californians and New Yorkers living inareas with higher densities of fresh foodmarkets compared to convenience storesand fast food restaurants have lowerrates of obesity. In California, obesity anddiabetes rates were 20 percent higherfor those living in the least healthy “foodenvironments,” controlling for individualfactors. 14 In New York City, increasing“BMI-healthy” food stores in New Yorkneighborhoods corresponded withlower obesity rates (though decreasing“BMI-unhealthy” stores did not). 47• In Indianapolis, BMI values correspondwith access to supermarkets and fastfood restaurants. Researchers estimatethat adding a new grocery store to ahigh-poverty neighborhood translatesinto a three pound weight decrease, andeliminating a fast food restaurant from afast food dense neighborhood (six or morefast food restaurants per square kilometer)translates into a one pound decrease. 126• A 2009 study of Chicago’s food desertsfound that as the distance to the nearestgrocer increases relative to the distance tothe nearest fringe food outlet, the Years ofPotential Life Loss (YPLL) due to diseasessuch as cancer, cardiovascular disease,diabetes, and liver disease increases. Thisrelationship is significant in AfricanAmerican communities, but less clear forwhite and Hispanic communities. 254. New and improved healthyfood retail in underservedcommunities creates jobs andhelps to revitalize low-incomeneighborhoodsBeyond the benefits to individual health describedabove, fresh food markets contribute to the overallhealth of neighborhoods and communities.Grocery stores are known by economic developmentpractitioners to be high-volume “anchors” thatgenerate foot traffic and attract complementarystores and services like banks, pharmacies, videorentals, and restaurants. 131 Yet compared to thestudy of food access and its health impacts, thestudy of economic impacts related to food retaildevelopment is an area of relatively limited research.Several methods have been developed to estimatethe demand for food retail in underserved19
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The Grocery Gap: Who Has Access to Healthy - The Food Trust

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