Public Health in Oregon - Join The Conversation

I feel it is important to ensure all individuals have access to affordable and nutritious foods. Because grocery stores are moving out of low income neighborhoods, individuals have little selection of healthy foods which to me, raises many ethical concerns. I attended a conference called “Where People, Planning, and Policy Meet” not too long ago. There was a panel discussion about access to affordable and nutritious foods. They showed data after data about there being a lack of supermarkets with fresh fruit, vegetables, low fat and fat free meats in low income, diverse communities compared to middle/upper class white communities. If we look at the relationship among obesity, supermarkets, and convenience stores in neighborhoods, I think it is fair to say location and neighborhood resources do indeed influence a community’s health.

  A solution to this is to implement policies that promote healthy foods in corner stores throughout low income neighborhoods. During the same conference I talked about earlier, Tracey Giang spoke about the work they are doing in Pennsylvania to increase access to healthy foods. She talked about The Pennsylvania Fresh Food Financing Initiative which is a comprehensive, multi faceted 120 million dollar financing fund to build supermarkets in low income neighborhoods. I feel this is a great idea and a good solution to increasing healthful foods in neighborhoods. The initiative was founded in 1992 and works to improve the health of children and adults, promote good nutrition, increase access to nutritious goods, and advocate for better public policy. I encourage all of you to go to the website at http://www.thefoodtrust.com and read about what they are doing. It is inspiring, and so far Illinois, Louisiana, New York, New Jersey and Colorado have come on board.

I believe that healthy corner stores are a step in the right direction to addressing disparities in quality food availability.  There are a few things I think will be essential in making sure these programs are successful.  The first one is to make sure the healthy food is presented attractively and is fresh.  Having lived in a food desert, I can attest to the desire to choose potato chips over fruit because if those options were available at my bodega, there were maybe two pieces of fruit that looked like they had seen better days in a sad little bowl on the counter.  Junk food companies spend a lot of money making sure their product packaging is attractive, and while it is not realistic to have a food artist at every bodega carefully stacking perfect peaches, healthful food does need to be presented in a way that makes people want to buy it.  Making sure it is fresh would most likely be the most important element to that piece.  The other key to making this a successful program would be, as other people have mentioned on here, having the food choices be relevant to the community the store is in.  Store owners are not going to want to give up shelf space to display products that do not sell because they are not relevant to the community.
As I mentioned, I believe healthy corner stores are a step in the right direction, but I think a good main goal should be more grocery stores in neighborhoods.  I realize that it is expensive and time consuming, but with the right incentives, I think it could be done.  The City Planning Comission of New York recently voted to offer tax and zoning incentives to lure larger grocery stores to neighborhoods that lacked them and had a population with lower socio-economic status.  According to a New York Times article on this proposal (http://www.nytimes.com/2009/09/24/nyregion/24super.html?pagewanted=1&_r=1), several supermarket chains were hoping to take advantage of these incentives.  The New York plan is based off of a Pennsylvania plan, and the Pennsylvania plan has been considered successful.  Luring supermarkets to neighborhoods that they may not have considered worthwhile before is a long term project, and solutions like healthy corner stores will act as a smaller solution while those supermarket programs develop.  If the supermarket incentives work, healthy corner stores will act as supplementary and complementary alternatives to those available larger grocery stores.

I believe that healthy corner stores are a key part of addressing disparities in food access in neighborhoods that have limited access to traditional grocery stores and fresh food.  Research has shown that if you change a person’s environment (in this case, the food environment of a neighborhood), it becomes easy for that person to change their behavior.  Likewise, if fresh and healthy food is made easily accessible and affordable, people are likely to buy it.  Healthy corner stores may offer a way to address disparities in food access without the huge infrastructure investments required to build large grocery stores.

For the Health Corner Stores Initiative to begin to address food access issues, corner stores need to not only offer fresh produce and healthier foods, but also limit availability of unhealthy foods (particularly the worst offenders like high fructose corn syrup and trans fats).

I’ve been to two convenience stores recently that are finding success in offering healthy food options and meeting the needs of their customers:
- SeQuential Biofuels Natural Convenience Store in Eugene, OR (http://www.sqbiofuels.com/retail4_cstore.htm) is attached to the fueling station and offers a range of healthier food options, like fresh produce, Kettle brand natural chips and Blue Sky natural sodas.
- Little Green Grocer in the Pearl District in Portland, OR (http://www.littlegreengrocer.com) is a locally-owned, neighborhood-based alternative to the large grocery store chains in the area.  They offer most products typically available in grocery stores, but selection is limited to natural, organic and/or local goods. 

Granted, these outlets are able to offer higher price point products because they cater to higher-income customers, but perhaps they can offer clues on how to scale their operations to a lower price point model.

The “Getting to Grocery” report on http://www.phlpnet.org (mentioned in the article above) offers suggestions on ways to begin to tackle the food disparity issue.  However, with the long list of obstacles standing in the way, partnerships between local government, neighborhood leaders and the business community are needed to move forward.  Heavy-handed policy aside, a financial case must be made in order for business owners to be compelled to participate, whether the money is coming from customers, economic development agencies and/or government.

When it comes to promoting a new program to low income communities, such as a healthy corner store initiative, it’s important to have active community involvement.  After the target regions of the city are determined then a community leader should be sought out for marketing suggestions. Topics that should be discussed are the target group (eg. families, youth or elderly), the food selections and the message.  When it comes to marketing the message it’s important to keep it simple and not overwhelming.

Healthy corner stores will look differently depending on the community and region.  It’s important to have a different point of view and marketing strategy at each healthy corner store.  If the community leader and program organizers determines that families should be targeted, then advertising and incentives will vary compared to a store near a school directed at youth.  If families are the target then it would be a positive approach to offer recipe cards and/or cooking demonstrations to not only promote healthy diet, but family togetherness.  It would also be helpful if food stamps were accepted at healthy corner stores as well as rewards programs for frequent shoppers.  Depending on the ethnic majority at the target region, the food choices may vary to adapt to ethnic food preferences or traditions, though fruits and vegetables should still be the primary food available.  As with any program organizations, it’s important to remember not to jeopardize the target individuals sense of value.  With all things considered, this could be a very successful program if organized with thought.

I think this is an important conversation to have in order to think about creating healthy living and food environments that encourage people to make the healthiest choices.  Farm to school programs, increased nutritional standards for school lunches, school junk-food bans and other programs that have had some success are necessary for making these changes, but I think that in order to make these changes comprehensive, especially in the context of nutrition, we need to look at the everyday choices made available to people in their neighborhoods.

I think we need to be creative by developing reciprocal relationships with storeowners and community leaders in order to find out what needs are specific to the neighborhood.  I think it’s important to have participation from someone familiar with the community in order to plan specific programs.  For example, some neighborhoods may need more fresh produce at their corner store, another may need greater access to foods that are culturally appropriate, another may need to develop policy on food stamp use at their corner store or farmers market and another may need to develop education programs on healthy eating or nutrition.  Also, by combining the efforts to create healthier corner stores with some of these other types of programs, we can make the changes more successful and specific to each community.

I like the idea of focusing efforts on working with corner stores that are already serving the neighborhood, rather than focusing on attracting supermarkets.  In San Francisco, a group of high school students worked to promote the availability of fresh produce and other nutritious food in an underserved area. The teens went through training and then they set up a reciprocal neighborhood program called the Good Neighborhood Project to offer incentives to local store owners. By agreeing to stock a minimum amount of fresh produce, remove cigarette and alcohol advertisements and keep their stores clean, they qualify for benefits including advertising, trainings and neighborhood promotions.

I think the most important component is helping neighborhoods to develop these programs within their community, so that the community can identify the strategies that will be most effective for them.  In the San Francisco example, the students first created surveys to find out community member’s priorities. Maybe creating a survey that could help the neighborhoods recognize their specific needs would be a good way to start the development of these types of programs.