a1 Epidemiology & Community Health, University of Minnesota, 1300 S. 2nd Street, WBOB Suite 300, Minneapolis, MN 55454-1015, USA
a2 Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
a3 Children’s Hospital & Research Center Oakland, Oakland, CA, USA
a4 Center for Human Nutrition, Johns Hopkins University, Baltimore, MD, USA
Objective Given that small food stores may be important retail food sources in low-income urban communities, our objective was to examine cross-city comparative data documenting healthy food availability within such facilities, particularly those located in low-income areas and nearby schools.
Design Food stores in Baltimore, Maryland; Minneapolis/St. Paul, Minnesota; Oakland, California; and Philadelphia, Pennsylvania were selected for assessment based on proximity to low-income schools. Stores were defined as: (i) single-aisle (n 45); (ii) small (2–5 aisles; n 52); and (iii) large (≥6 aisles; n 8). Staff conducted in-store audits to assess the presence/absence of twenty-eight healthy items, organized within five categories: (i) fresh fruits/vegetables, (ii) processed fruits/vegetables, (iii) healthy beverages/low-fat dairy, (iv) healthy snacks and (v) other healthy staple foods.
Results The availability of healthy food items was low, particularly in single-aisle and small stores, and there was significant cross-site variability in the availability of healthy snacks (P < 0·0001) and other healthy staple foods (P < 0·0001). No cross-site differences existed for fruits/vegetables or healthy beverages/low-fat dairy availability. Healthy food availability scores increased significantly with store size for nearly all food/beverage categories (P < 0·01).
Conclusions Overall, healthy food availability in these venues was limited. Region-specific factors may be important to consider in understanding factors influencing healthy food availability in small urban markets. Data suggest that efforts to promote healthy diets in low-income communities may be compromised by a lack of available healthy foods. Interventions targeting small stores need to be developed and tailored for use in urban areas across the USA.
(Received March 05 2009)
(Accepted October 26 2009)
(Online publication December 08 2009)