Diet And Perceptions Change With Supermarket Introduction In A Food Desert, But Not Because Of Supermarket Use

Abstract

Placing full-service supermarkets in food deserts (areas with limited access to healthy foods) has been proposed as an important policy strategy to confront inequalities in healthy food access. Capitalizing on a natural experiment, we enrolled n=1,372 randomly selected households from two comparable neighborhoods, one of which received a full-service supermarket in 2013. We looked at the impact on residents’ diet, perceived access to healthy foods and satisfaction with one’s neighborhood as a place to live. Baseline data was collected in 2011, and follow-up in 2014. Relative to the comparison neighborhood, we found a net positive change in the intervention neighborhood in overall dietary quality, total kilocalories, added sugars, and solid fats, alcohol and added sugars (SoFAAS). However, we did not observe differential improvement in fruit and vegetable intake, whole grain consumption or body mass index (BMI). Regular users of the new supermarket had significantly improved perceived access to healthy foods compared to others, but use of the new supermarket was not related to dietary changes or to improvements with neighborhood satisfaction. Our study is the first to our knowledge to have found significant improvements in multiple dietary outcomes and neighborhood satisfaction among residents of a food desert, following the opening of a supermarket. Our study supports the Healthy Food Financing Initiative and other policies that incentivize food retail venues to locate in food deserts, but we recommend further efforts proceed with caution until research has clarified the mechanisms through which diet is improved and associations with weight status/obesity have been observed.

The Stigma Turbine: A Theoretical Framework for Conceptualizing and Contextualizing Marketplace Stigma

“…Other solutions may require the collaboration of business, government, and community groups. In the case of "food deserts" (locations in underprivileged areas devoid of fresh food retailers), new research has shown that the introduction of new stores promotes little change in entrenched eating habits (Dubowitz et al 2015). Instead, social marketing programs to prompt new food purchasing behaviors must also be implemented.…”

Improving Diet in Low-Income Neighborhoods: Leveraging the Food Environment for Change

“…44 A similar study in Pittsburgh (PA) also found changes in perceptions, but an improvement in diet quality could not be attributed to shopping at the new supermarket. 45 …”

“…For example, policymakers have proposed building new supermarkets in so-called "food deserts" -low-income neighborhoods with poor geographic access to supermarkets -based on a large body of cross-sectional research identifying a link between closer proximity to supermarkets and positive health and diet outcomes. 24 However, the few longitudinal studies that have looked at causality have found no relationship between new neighborhood supermarkets and weight outcomes; [43][44][45] although one study did see higher dietary quality after the supermarket opened, this could not be attributed to use of the supermarket. 45 It's still not clear whether adding supermarkets will result in improving health and it's quite possible that supermarkets could make outcomes worse.…”

A Mixed-Method Assessment of a New Supermarket in a Food Desert: Contributions to Everyday Life and Health

“…[6][7][8] Of studies finding improvements in healthy purchasing, these changes are not attributable to the use of the new retailer. 9,10 Evaluations also highlight the importance of in-store environment, including pricing, placement, and promotions, in motivating behavior change, 6,11 although none have explored shoppers' in-store experiences.…”