New grocery stores in underserved areas

Financing initiatives or zoning regulation changes can be structured to bring grocery stores or supermarkets to underserved neighborhoods. Grocery stores or supermarkets that sell a wide variety of fresh fruits and vegetables, dairy products, meat, baked goods, packaged, and frozen items are less available in low income than in middle income neighborhoods, in predominately black than white neighborhoods, and in urban than suburban areas (). 

Expected Beneficial Outcomes (Rated)

  • Increased access to healthy food

Other Potential Beneficial Outcomes

  • Increased healthy food consumption

  • Reduced obesity rates

Evidence of Effectiveness

Attracting new grocery stores to underserved areas is a suggested strategy to increase access to healthy food in these communities (CDC-Supermarkets, US DHHS-Healthy food financing, ). Greater supermarket availability has been associated with lower prevalence of obesity and overweight (, , ); children who live far away from a grocery store appear to have higher BMIs than children living closer to a store (). Some studies associate increased supermarket availability with increased fruit and vegetable intake, especially among blacks (Morland 2002). Other studies find no association, suggesting that more comprehensive strategies may be needed to promote dietary behavior change (Cummins 2014Boone-Heinonen 2011, Sadler 2013), such as reducing prices and increasing marketing of healthy foods (). Additional evidence is needed to confirm effects.

Attracting new grocery stores to low income areas alone may not address nutritional disparities across socio-economic groups; educational materials and financial incentives for consumers may be needed to help change preferences for unhealthy food and support purchase of higher priced items (NBER-Handbury 2015).

Impact on Disparities

Likely to decrease disparities

Implementation Examples

The US Department of Health and Human Services is working with the Treasury and the Department of Agriculture to provide funding to help attract grocery stores and supermarkets to food deserts through its Healthy Food Financing Initiative (HFFI) (US DHHS-Healthy food financing). The national HFFI is modeled on the Pennsylvania Fresh Food Financing Initiative that supported 88 projects in urban and rural areas across the state (TRF-PFFFI). Pennsylvania’s program also inspired similar programs in Arizona, Colorado, Georgia, Illinois, Louisiana, Maryland, Massachusetts, Minnesota, Mississippi, New Jersey, New York, Tennessee, and Texas (Food Trust 2011).

As of 2011, 11 states and Washington DC have enacted healthy food retail legislation; in nine cases this legislation focuses on attracting grocery stores and supermarkets to underserved areas. Seven states have introduced such legislation that either did not pass or is pending further action (CDC-State initiatives healthy food). 

Implementation Resources

PolicyLink-Grocery store 2008 - PolicyLink. Grocery store attraction strategies: A resource guide for community activists and local governments. 2008.

ChangeLab-Food retail - ChangeLab Solutions. Healthy food retail.

ChangeLab-Getting to grocery - ChangeLab Solutions. Getting to grocery: Tools for attracting healthy food retail to underserved neighborhoods.

AHA-VFHK toolkits - American Heart Association (AHA), Robert Wood Johnson Foundation (RWJF). Voices for healthy kids (VFHK): Toolkits to make the healthy choice the easy choice in the places where children live, learn and play.

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.

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.

US Treasury-CDFI Fund - US Department of the Treasury (US Treasury). Community development financial institutions (CDFI) fund: New markets tax credit program.

LHC-Rockeymoore 2014 - Rockeymoore M, Moscetti C, Fountain A. Rural Childhood Obesity Prevention Toolkit. Leadership for Healthy Communities (LHC), Center for Global Policy Solutions, Robert Wood Johnson Foundation. 2014.

Uplift Solutions-Supermarkets - Uplift Solutions. Uplift's national food access work supports full service supermarkets in underprivileged communities with the triple bottom line: Business profitability, community wellness, and environmental sustainability.

SRTSNP-Safe routes to healthy foods - Safe Routes to School National Partnership (SRTSNP). Healthy communities: Safe routes to healthy foods.

Citations - Evidence

* Journal subscription may be required for access.

IOM-Government obesity prevention 2009* - Institute of Medicine (IOM), National Research Council (NRC), Committee on Childhood Obesity Prevention Actions for Local Governments. Local government actions to prevent childhood obesity. (Parker L, Burns AC, Sanchez E, eds.). Washington, DC: National Academies Press; 2009.

US DHHS-Healthy food financing - US Department of Health and Human Services (US DHHS), Administration for Children & Families (ACF). Healthy food financing initiative.

Boone-Heinonen 2011 - Boone-Heinonen J, Gordon-Larsen P, Kiefe CI, et al. Fast food restaurants and food stores: Longitudinal associations with diet in young to middle-aged adults: The CARDIA study. Archives of Internal Medicine. 2011;171(13):1162–70.

Morland 2006* - Morland K, Diez Roux AV, Wing S. Supermarkets, other food stores, and obesity: The atherosclerosis risk in communities study. American Journal of Preventive Medicine. 2006;30(4):333-9.

Larson 2009a* - Larson NI, Story MT, Nelson MC. Neighborhood environments: Disparities in access to healthy foods in the U.S. American Journal of Preventive Medicine. 2009;36(1):74-81;e10.

Ford 2009* - Ford PB, Dzewaltowski DA. Disparities in obesity prevalence due to variation in the retail food environment: Three testable hypotheses. Nutrition Reviews. 2008;66(4):216-28.

Carroll-Scott 2013* - Carroll-Scott A, Gilstad-Hayden K, Rosenthal L, et al. Disentangling neighborhood contextual associations with child body mass index, diet, and physical activity: The role of built, socioeconomic, and social environments. Social Science & Medicine. 2013;95:106-14.

Morland 2002 - Morland K, Wing S, Diez Roux A. The contextual effect of the local food environment on residents' diets: The atherosclerosis risk in communities study. American Journal of Public Health. 2002;92(11):1761-7.

Sadler 2013 - Sadler RC, Gilliland JA, Arku G. A food retail-based intervention on food security and consumption. International Journal of Environmental Research and Public Health. 2013;10(8):3325-46.

CDC-Supermarkets - Centers for Disease Control and Prevention (CDC). Retail food stores: Grocery stores and supermarkets

NBER-Handbury 2015 - Handbury J, Rahkovsky I, Schnell M. What drives nutritional disparities? Retail access and food purchases across the socioeconomic spectrum. National Bureau of Economic Research (NBER). 2015: Working Paper 21126.

Cummins 2014 - Cummins S, Flint E, Matthews SA. New neighborhood grocery store increased awareness of food access but did not alter dietary habits or obesity. Health Affairs. 2014;33(2):283-291.

Ghosh-Dastidar 2014* - Ghosh-Dastidar B, Cohen D, Hunter G, et al. Distance to store, food prices, and obesity in urban food deserts. American Journal of Preventive Medicine. 2014;47(5):587-595.

Citations - Implementation Examples

* Journal subscription may be required for access.

US DHHS-Healthy food financing - US Department of Health and Human Services (US DHHS), Administration for Children & Families (ACF). Healthy food financing initiative.

TRF-PFFFI - The Reinvestment Fund (TRF). Pennsylvania Fresh Food and Financing Initiative (FFFI).

Food Trust 2011 - The Food Trust. Harnessing the power of supermarkets to help reverse childhood obesity: Public health and supermarket experts explore grocery store marketing practices to promote healthier and lower-calorie foods. Princeton: Robert Wood Johnson Foundation (RWJF), The Food Trust; 2011.

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.

Date Last Updated

May 4, 2016