Access to Healthy Food in Low-Income Communities Office of Legislative Research September 29, 2011 Tatiana Andreyeva, PhD Yale University

Overview Understanding food access Promising strategies to improving food access

Understanding Food Access

What is Access to Healthy Food? Measured by access to a full-service supermarket/ large grocery store - No supermarket within a mile and no access to a vehicle million of US households (2.2%) Easy access to affordable and nutritious food Limited access if:

% households no car & >1mi to supermarket, CT 2006 Source: ERS USDA Food Environment Atlas 1.7% 1.9% 2.0% 1.4% 2.4% 2.3% 3.6% 2.9%

Food Deserts

Areas with limited access to affordable and nutritious food 23.5 million Americans (~8%) live in food deserts - Low-income areas more than a mile from a supermarket - Low-income rural areas more than 10 miles from a supermarket

% households low-income & >1mi to supermarket, CT 2006 Source: ERS USDA Food Environment Atlas 4.1% 6.7% 5.1% 3.8% 6.9% 8.5% 13.8% 10.5%

Why Food Access Important? Impacts diet quality, health, obesity Has socio-demographic inequalities Affects food prices and food choices Responds to policy changes

Supermarkets in Inner Cities (Los Angeles)

Source: Shaffer at al., 2002, Occidental College Report Number of Full-Service Supermarket Chain Stores in Inner City Los Angeles

Barriers to Healthy Eating Limited access to affordable and healthy food Limited time, cooking skills, awareness Abundance, convenience, lower cost, massive advertising of energy-dense low-nutrient foods Our defaults are set for eating less nutritious food

Promising Strategies to Improving Food Access

Economic Approaches  Changes in food assistance programs  Develop new grocery stores  Improve existing small stores

Changes in Food Assistance Programs  Increase demand for healthy foods Revisions in WIC food packages  Set standards for vendors Minimum stocking requirements  Increase participation in WIC and SNAP Purchasing power in underserved areas

Revisions to WIC Food Packages Reduction in dairy fat, juice Increase in whole grains, cash vouchers for fruit and vegetables New stocking requirements for WIC stores Implemented nationwide Oct 2009

Better Food Access due to WIC Package Revisions Significant increase in supply of healthy foods in WIC stores Pre-post inventory of ~300 stores in CT, Improved availability, variety of healthy foods, especially whole grains Some improvement in non-WIC stores Effect larger in low-income communities Source: Andreyeva et al 2011.

Effects on WIC Retailers Stores adapted quickly to new WIC requirements Demand determines supply

Develop New Grocery Stores Better information tools Data on business potential of low-income communities Dedicated financing sources PA Fresh Food Financing Initiative Federal Healthy Food Financing Initiative Help with site identification and development Zoning, tax incentives, training

Improve Small Stores Connect stores with resources Financial and technical assistance Increase customer spending power Promote SNAP and WIC participation Financial incentives Lower permit fees, subsidized loans Zoning policies

Philadelphia Food Trust Healthy Corner Store Initiative Borradaile et al, Pediatrics 2009 Pre-intervention Average child’s store visit: $1.07 spent 360 calories purchased

Partnering with Stores Develop “Snackin’ Fresh” marketing Help owners stock fruit salads, bottled water Provide refrigeration units to stock produce

Peaches and Greens (Detroit)

Recommendations Promote participation in WIC and SNAP Encourage application for funding through Healthy Food Financing Initiative Conduct up-to-date needs assessment in CT Address problem of mini-food deserts

Thank You!