Healthy food in convenience stores
Community in Action
Convenience stores, corner stores, or gas station markets often provide the only retail food options in food deserts and neighborhoods with low incomes. Corner stores sell a limited selection of food items and other products; these items are frequently non-perishable and unhealthy. Corner stores can also carry fresh produce and healthier food options. Initiatives to encourage stocking more fresh produce and healthier food options can include financial incentives, promotion and marketing, infrastructure investment (e.g., purchasing new refrigeration units or display stands), and produce supply chain development1.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased healthy foods in food deserts
Increased access to fruits & vegetables
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Increased healthy food purchases
Reduced emissions
What does the research say about effectiveness?
There is some evidence that offering fresh produce and other healthy foods in convenience stores increases access to and purchasing of healthy foods, especially in food deserts and urban and rural communities with low incomes2, 3, 4, 5, 6, 7. Environmental changes in retail stores improve food environments and influence dietary choices8. Establishing financial incentives for convenience stores to increase availability and variety of healthy foods and beverages is a suggested strategy to prevent obesity9. However, additional evidence is needed to confirm effects, especially regarding consumption changes6, 7, 10.
Multi-component corner store interventions that include changes to food provision (e.g., increasing produce availability, reducing availability of unhealthy foods), infrastructure (e.g., adding or increasing refrigeration, adding produce displays) and communication (e.g., point-of-purchase signs, educational flyers, promotional giveaways) have shown consistent improvements in the availability and sale of healthy foods as well as consumer knowledge about healthy eating2. Healthy food initiatives such as store owner training, point-of-purchase promotions, and product grouping, display, and placement can increase stocking and sales of healthy foods in small, urban stores; store owner training is associated with the greatest effects3. Consumers with limited exposure to corner store interventions appear to change behaviors only modestly; increasing the proportion of participating stores in urban environments will likely lead to greater changes in behavior11. Increasing the variety of fruits and vegetables in convenience stores has also been associated with an increased likelihood that customers will purchase fruits and vegetables12. A Baltimore-based pilot study suggests pairing urban farms with corner stores can increase variety and availability of produce and may be a feasible model in urban areas with lower incomes, especially if strong community support exists13. Increasing shelf space for healthy food options is associated with self-reported increases in healthy food consumption7.
Increasing visibility for fruits and vegetables may increase produce purchases among customers using WIC benefits4. Another study suggests women, individuals using WIC/SNAP benefits, and Hispanics/Latinos are more likely to purchase at least one type of healthy food in response to a healthy corner store initiative. Tailoring corner store interventions to appeal to various populations may improve reach14. For example, in New York City, a healthy corner store initiative designed to appeal to youth customers suggests that 10 to 18 year olds are willing to purchase healthy snack packs made with whole grains, fruits, and vegetables15. Increasing access to healthy foods in convenience stores alone may not address nutritional disparities across socio-economic groups; more comprehensive, sustained initiatives including educational materials, reductions in unhealthy food availability, and financial incentives for consumers may be needed to help change preferences for unhealthy food, support purchase of higher priced items, and improve weight outcomes10, 16, 17.
Healthy food initiatives in corner stores that increase availability and consumption of fresh produce, especially seasonal, local produce, may reduce emissions from fossil fuels used to produce, process, and transport food18, 19, 20. Such initiatives may also reduce the energy intensity of an individual’s diet if more plant-based foods are consumed in place of animal products18.
A San Francisco-based study suggests programs offering stores incentives to participate in a healthy food retail program can increase produce sales, reduce tobacco availability and sales, and may encourage neighboring stores to increase their healthy food options21, 22. Healthy corner store initiatives have been associated with increases in healthy items stocked by store owners, in daily foot traffic and transactions23, in produce visibility and availability, and in weekly produce sales24. Interviews with rural convenience store owners suggest that assistance promoting healthy foods, handling and sourcing perishables, and maintaining a SNAP retailer license may increase store participation25.
Available evidence suggests the most influential factors for successful healthy food retail initiatives are price, product availability, promotion and advertisement of healthy products, and point-of-purchase product information8. A New Orleans-based case study suggests fresh produce can be more profitable than energy dense snacks; stocking and promoting healthy fresh produce may be more financially feasible than store owners believe26. Potential barriers to increasing fresh produce include store operators’ perceptions about cost, infrastructure, customer demand, produce marketability, and the process of becoming an authorized WIC retailer, and produce wholesalers’ hesitation to invest in small-scale business opportunities27, 28. A Detroit-based case study suggests healthy food initiatives in corner stores in urban areas experiencing rapid population decline may require additional and ongoing subsidies to maintain operations29.
Local corner store customers report shopping at corner stores because transportation to larger stores is lacking; hot, prepared foods are available; and they have daily shopping needs for children or other family members27. Engaging community residents and understanding neighborhood context while planning changes to corner store offerings30, coordinating changes at many corner stores31, and working closely with store owners to design and implement culturally sensitive programs may increase the likelihood of success32, 33.
Implementation Examples
Interventions to increase healthy food options at corner stores are happening around the country, especially in urban areas such as Philadelphia, PA34; Providence, RI35; Minneapolis, MN36; San Francisco, CA37, and Washington, D.C.38. Some rural communities are also working to increase healthy food options at convenience stores, for example, in Sipaulovi Village in the Hopi Nation in northern Arizona39 and in rural Lincoln County, Wisconsin40.
Many state health departments have efforts to improve healthy food retail opportunities in convenience stores, for example, the Healthy Retail Task Force in Massachusetts; the Stock Healthy, Shop Healthy program in Missouri; the Healthy Corner Stores initiative in New Jersey; Pennsylvania’s Healthy Corner Stores Initiative, and Wisconsin’s CHANGE Coalitions41.
The U.S. Department of Health and Human Services is working with the Department of the Treasury and the Department of Agriculture through the Healthy Food Financing Initiative (HFFI) to provide funding to increase access to healthy foods in convenience stores around the country, especially in food deserts in urban and rural areas42. As of 2016, 11 states and Washington, D.C. have enacted healthy food retail legislation. In California, Oklahoma, and Washington, D.C., this legislation includes initiatives to increase healthy food availability in convenience stores. In Maryland, Massachusetts, and Mississippi this legislation offers financial assistance to promote healthy food retail, although only Maryland’s legislation includes funding for the initiative43, 44.
Implementation Resources
CDC-Healthy retail food - Centers for Disease Control and Prevention (CDC). Retail food stores: Small retail locations.
PolicyLink-Corner stores 2008 - PolicyLink. Equitable development toolkit: Corner stores. 2008.
Food Trust-Corner stores - The Food Trust. What we do: In corner stores.
Food Trust-HCSN - The Food Trust. The National Healthy Corner Stores Network (HCSN).
ChangeLab-Food retail - ChangeLab Solutions. Healthy food retail.
ChangeLab-Health on the shelf - ChangeLab Solutions. Health on the shelf: A guide to healthy small food retailer certification programs.
DC Central Kitchen-Healthy corners 2018 - DC Central Kitchen. Building healthy corners: A best practice guide in three phases. 2018.
HER-Laska 2016 - Laska M, Pelletier J. Minimum stocking levels and marketing strategies of healthful foods for small retail food stores. Healthy Eating Research (HER). 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.
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.
CDC-HFR 2014 - Centers for Disease Control and Prevention (CDC), Division of Nutrition, Physical Activity, and Obesity. Healthier food retail (HFR): An action guide for public health practitioners. 2014.
PAS-Zoning 2016 - Planning Advisory Service (PAS). Planning & zoning for health in the built environment. American Planning Association (APA); 2016.
SRTSNP-Safe routes to healthy foods‡ - Safe Routes to School National Partnership (SRTSNP). Healthy communities: Safe routes to healthy foods.
ISU-Food and sustainability resources - Iowa State University (ISU), Sustainable Food Processing Alliance. Online resources for food and sustainability.
Footnotes
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1 CDC-Healthy retail food - Centers for Disease Control and Prevention (CDC). Retail food stores: Small retail locations.
2 Gittelsohn 2012 - Gittelsohn J, Rowa M, Gadhoke P. Interventions in small food stores to change the food environment, improve diet, and reduce risk of chronic disease. Preventing Chronic Disease. 2012;9:110015.
3 Wensel 2019 - Wensel CR, Trude ACB, Poirier L, et al. B’more Healthy Corner Stores for Moms and Kids: Identifying optimal behavioral economic strategies to increase WIC redemptions in small urban corner stores. International Journal of Environmental Research and Public Health. 2019;16(1).
4 Thorndike 2017 - Thorndike AN, Bright OJM, Dimond MA, Fishman R, Levy DE. Choice architecture to promote fruit and vegetable purchases by families participating in the Special Supplemental Program for Women, Infants, and Children (WIC): Randomized corner store pilot study. Public Health Nutrition. 2017;20(7):1297-1305.
5 Paek 2014 - Paek H-J, Oh HJ, Jung Y, et al. Assessment of a healthy corner store program (FIT Store) in low-income, urban, and ethnically diverse neighborhoods in Michigan. Family & Community Health. 2014;37(1):86–99.
6 Ayala 2013 - Ayala GX, Baquero B, Laraia BA, Ji M, Linnan L. Efficacy of a store-based environmental change intervention compared with a delayed treatment control condition on store customers’ intake of fruits and vegetables. Public Health Nutrition. 2013;16(11):1953–60.
7 AHA-Mozaffarian 2012 - Mozaffarian D, Afshin A, Benowitz NL, et al. Population approaches to improve diet, physical activity, and smoking habits: A scientific statement from the American Heart Association (AHA). Circulation. 2012;126(12):1514-1563.
8 Middel 2019 - Middel CNH, Schuitmaker-Warnaar TJ, Mackenbach JD, Broerse JEW. Systematic review: A systems innovation perspective on barriers and facilitators for the implementation of healthy food-store interventions. International Journal of Behavioral Nutrition and Physical Activity. 2019;16(108).
9 CDC MMWR-Khan 2009 - Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. Morbidity and Mortality Weekly Report (MMWR). 2009;58(RR-07):1-26.
10 Albert 2017 - Albert SL, Langellier BA, Sharif MZ, et al. A corner store intervention to improve access to fruits and vegetables in two Latino communities. Public Health Nutrition. 2017;20(12):2249-2259.
11 Gittelsohn 2010 - Gittelsohn J, Song HJ, Suratkar S, et al. An urban food store intervention positively affects food-related psychosocial variables and food behaviors. Health Education & Behavior. 2010;37(3):390–402.
12 Martin 2012a - Martin KS, Havens E, Boyle KE, et al. If you stock it, will they buy it? Healthy food availability and customer purchasing behaviour within corner stores in Hartford, CT, USA. Public Health Nutrition. 2012;15(19):1973–8.
13 Gudzune 2015 - Gudzune KA, Welsh C, Lane E, et al. Increasing access to fresh produce by pairing urban farms with corner stores: A case study in a low-income urban setting. Public Health Nutrition. 2015;18(Suppl 15):2770-2774.
14 Tibbits 2018a - Tibbits M, Wang H, Soliman G, et al. Demographic differences in healthy food purchases in a corner store intervention. Journal of Hunger and Environmental Nutrition. 2018;13(4):531-539.
15 Leak 2019 - Leak TM, Setiono F, Gangrade N, Mudrak E. Youth willingness to purchase whole grain snack packs from New York City corner stores participating in a healthy retail program. International Journal of Environmental Research and Public Health. 2019;16(18).
16 NBER-Handbury 2016 - Handbury J, Rahkovsky I, Schnell M. Is the focus on food deserts fruitless? Retail access and food purchases across the socioeconomic spectrum. National Bureau of Economic Research (NBER). 2016: Working Paper 21126.
17 Lawman 2015 - Lawman HG, Vander Veur S, Mallya G, et al. Changes in quantity, spending, and nutritional characteristics of adult, adolescent and child urban corner store purchases after an environmental intervention. Preventive Medicine. 2015;74:81-85.
18 Ringling 2020 - Ringling KM, Marquart LF. Intersection of diet, health, and environment: Land grant universities’ role in creating platforms for sustainable food systems. Frontiers in Sustainable Food Systems. 2020;4(70).
19 SSSA-McIvor 2017 - McIvor K. Soils in the city: Community gardens. Soil Science Society of America (SSSA). 2017.
20 CCAFS-Campbell 2012 - Campbell B. Is eating local good for the climate? Thinking beyond food miles. Research Program on Climate Change, Agriculture and Food Security (CCAFS), CGIAR Research Programs. 2012.
21 Minkler 2019 - Minkler M, Estrada J, Dyer S, et al. Healthy retail as a strategy for improving food security and the built environment in San Francisco. American Journal of Public Health. 2019;109(S2):S137-S140.
22 Minkler 2018 - Minkler M, Estrada J, Thayer R, et al. Bringing healthy retail to urban “food swamps”: A case study of CBPR-informed policy and neighborhood change in San Francisco. Journal of Urban Health. 2018;95(6):850-858.
23 Paluta 2019 - Paluta L, Kaiser ML, Huber-Krum S, Wheeler J. Evaluating the impact of a healthy corner store initiative on food access domains. Evaluation and Program Planning. 2019;73:24-32.
24 Young 2018 - Young S, DeNomie M, Sabir JA, Gass E, Tobin J. Around the corner to better health: A Milwaukee corner store initiative. American Journal of Health Promotion. 2018;32(6):1353-1356.
25 Haynes-Maslow 2018 - Haynes-Maslow L, Osborne I, Jilcott Pitts S, et al. Rural corner store owners’ perceptions of stocking healthier foods in response to proposed SNAP retailer rule changes. Food Policy. 2018;81:58-66.
26 Dunaway 2016 - Dunaway LF, Mundorf AR, Rose D. Fresh fruit and vegetable profitability: Insights from a corner store intervention in New Orleans, Louisiana. Journal of Hunger and Environmental Nutrition. 2017;12(3):352-361.
27 BeLue 2020 - BeLue R, NDao F, McClure S, Alexander S, Walker R. The role of social issues on food procurement among corner store owners and shoppers. Ecology of Food and Nutrition. 2020;59(1).
28 O Malley 2013 - O’Malley K, Gustat J, Rice J, Johnson CC. Feasibility of increasing access to healthy foods in neighborhood corner stores. Journal of Community Health. 2013;38(4):741–9.
29 Pothukuchi 2016 - Pothukuchi K. Bringing fresh produce to corner stores in declining neighborhoods: Reflections from Detroit FRESH. Journal of Agriculture, Food Systems, and Community Development. 2016;7(1).
30 Larson 2013 - Larson C, Haushalter A, Buck T, et al. Development of a community-sensitive strategy to increase availability of fresh fruits and vegetables in Nashville’s urban food deserts, 2010-2012. Preventing Chronic Disease. 2013;10(1):E125.
31 Widener 2013 - Widener MJ, Metcalf SS, Bar-Yam Y. Agent-based modeling of policies to improve urban food access for low-income populations. Applied Geography. 2013;40:1–10.
32 Moore 2013 - Moore LV. Supporting healthful eating through retail environmental change: Communities putting prevention to work. Preventing Chronic Disease. 2013;10:E189.
33 Gittelsohn 2014 - Gittelsohn J, Laska MN, Karpyn A, Klingler K, Ayala GX. Lessons learned from small store programs to increase healthy food access. American Journal of Health Behavior. 2014;38(2):307–15.
34 Food Fit Philly-HCS - Food Fit Philly. Healthy corner stores: Eat healthy in your corner store.
35 EJL-HCSI - Environmental Justice League of Rhode Island (EJL). Healthy corner store initiative (HCSI).
36 MDHFS-HCSP - Minneapolis Department of Health and Family Support (MDHFS). Minneapolis healthy corner store program: Making produce more visible, affordable and attractive. Minneapolis: Minneapolis Department of Health and Family Support (MDHFS); 2021.
37 SFDPH-Healthy retail - San Francisco Department of Public Health (SFDPH), San Francisco Office of Economic and Workforce Development, Office of the Mayor. Healthy Retail SF: Building healthy corner stores & healthy communities.
38 DC Hunger Solutions-HCSP - DC Hunger Solutions. FEED (Food, Environment, and Economic Development) DC Act and the Healthy Food Retail program.
39 Secakuku 2009 - Secakuku S, Jamison S, Andaluz I. Marketing healthy foods in a rural convenience store setting. Rural Connections. 2009.
40 CDC-Stader - Stader K. Success stories: Corner stores in rural Wisconsin provide residents with fresh produce. Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion.
41 CDC DNPAO-HFR - Centers for Disease Control and Prevention (CDC), Division of Nutrition Physical Activity and Obesity (DNPAO). Current practices in healthy food retail (HRF): Small stores.
42 US DHHS-Healthy food financing - U.S. Department of Health and Human Services (U.S. DHHS), Administration for Children & Families (ACF). Healthy food financing initiative.
43 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.
44 NCSL-Essex 2016 - Essex A, Shinkle D, Bridges M. State legislative trends in local foods 2012-2014: Healthy grocery retail. National Conference of State Legislators (NCSL). 2016.
Related What Works for Health Strategies
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