BackgroundLow-income and minority communities have higher rates of nutrition-related chronic diseases than do high-income and nonminority communities and often have reduced availability to healthful foods. Corner store initiatives have been proposed as a strategy to improve access to healthful foods in these communities, yet few studies evaluating these initiatives have been published.Community ContextSuburban Cook County, Illinois, encompasses 125 municipalities with a population of more than 2 million. From 2000 through 2009, the percentage of low-income suburban Cook County residents increased 41%; African-American populations increased 20%, and Hispanic populations increased 44%. A 2012 report found that access to stores selling healthful foods was low in several areas of the county.MethodsBeginning in March 2011, the Cook County Department of Public Health recruited community institutions (ie, local governments, nonprofit organizations, faith-based institutions) who recruited corner stores to participate in the initiative. Corner stores were asked to add new, healthful foods (May–June 2011) to become eligible to receive new equipment, marketing materials, and enhanced community outreach (July 2011–February 2012).OutcomesNine community institutions participated. Of the 53 corner stores approached, 25 (47%) participated in the trial phase, which included offering 6 healthful foods in their stores. Of those, 21 (84%) completed the conversion phase, which included expansion of healthful foods through additional equipment and marketing and promotional activities.InterpretationCommunity institutions can play a key role in identifying and engaging corner stores across jurisdictions that are willing and able to implement a retail environment initiative to improve access to healthful foods in their communities.

Public health research has increasingly focused on how access to resources affects health behaviors. Mapping environmental factors, such as distance to a supermarket, can identify intervention points toward improving food access in low-income and minority communities. However, the existing literature provides little guidance on choosing the most appropriate measures of spatial access. This study compared the results of different measures of spatial access to large food stores and the locations of high and low access identified by each. The data set included U.S. Census population data and the locations of large food stores in the six-county area around Chicago, Illinois. Six measures of spatial access were calculated at the census block group level and the results compared. The analysis found that there was little agreement in the identified locations of high or low access between measures. This study illustrates the importance of considering the access measure used when conducting research, interpreting results, or comparing studies. Future research should explore the correlation of different measures with health behaviors and health outcomes.

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To characterize participants of a statewide healthy food incentive program in terms of shopping behaviors, surveys were collected at farmers markets (N = 436) and grocery stores (N = 131). Farmers market and grocery store respondents were mostly forty-five to fifty-four years old (21 percent to 24 percent) and female (72 to 82 percent). Grocery store respondents were more diverse. Farmers market participants were more likely to be female (p = .011), not have children (p = .006), and traveled further compared to grocery store participants. As healthy food incentive programs expand, participant characteristics should inform tailored outreach to expand to diverse populations to have a greater public health impact.

Food-oriented markets, such as food innovation districts (FIDs), have been touted as potential methods to address complex societal issues involving the environment, poverty, and health. On this front the Grand Rapids Downtown Market (DTM) was created in 2013, envisioned as a vibrant public space for local food, entrepreneurship, community health, and jobs. An innovative, collective response to the interconnected and urgent problems of poverty, access, health, diet, and environment, the DTM can serve as a case study through which the value and necessity of a wicked problems framework become apparent. Wicked problems literature demonstrates that collaborative and iterative processes are essential to effective and inclusive transformational change of food systems, while also emphasizing that there can be no final, ideal solution. On the other hand, as an FID intentionally located in a low-income neighborhood, the DTM has been subject to criticism about top-down, expensive, and exclusionary practices aimed at gentrification. In the end, this analysis suggests that while FIDs can address local problems resulting from dominant food systems and practices, they can also function as a gentrifying force. Efforts more directly aimed at bottom-up, participatory engagement are essential to making collectively systemic, equitable changes in current food systems and practices. Emphasizing the need for bridge institutions, we argue that it is essential to value actively a wider array of knowledge cultures.