Start Date: March 2023

ID #: CAS067

Organization: Johns Hopkins University

Project Lead: Joel Gittelsohn

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Study Overview and Key Findings

Improving healthy food access in low-income communities continues to be a public health challenge. One promising approach has been opening supermarkets in low-income neighborhoods or converting existing food retail operations to emphasize healthy options. The overall goal of this study was to use a case study approach to understand the experiences of healthy food stores in low-income communities.

This is the first study to explore in-depth the experiences of different initiatives and models for opening and sustaining healthy food stores in low-income, urban settings. The research team used a case study approach to describe strengths and weaknesses, lessons learned, and key strategies for success in such stores. Store case studies were conducted among seven healthy food stores in Baltimore, Boston, Buffalo, Chicago, Detroit, Minneapolis and Washington DC. More details on methods of the study are included in the protocol paper.

Recommendations based on the initial findings (please see the commentary paper for complete recommendations and explanations:

  • Store-level recommendations:
    • Commit to, and invest in community engagement
    • Hire local staff
    • Engage with multiple, diverse vendors
    • Utilize alternative ownership/financial models such as a non-profit or co-op
    • Implement needs-based or loyalty programs for customers
    • Identify and work with store champions
  • Future research directions:
    • Explore how stores operationalize the strategies described above (i.e., community engagement, multiple vendor relationships, and alternative business models).
    • Simulate or test the feasibility of the potential policies and strategies related to the activities described above using tools such as casual loop diagrams and system dynamics modeling to assess their potential impacts.
    • Understand which of these practices and policies are feasible and acceptable to store owners, and what they are willing to engage in. Similarly, understand which of these practices policymakers are most willing to support.
  • Policy implications:
    • Consider incentivizing stores who engage in the activities/strategies described above (investing in the community, hiring locally, implementing loyalty or needs-based programs, etc.).
    • Support initiatives that aim to localize the food system.
    • Increase funding for technical assistance and capacity building for smaller stores attempting to utilize an alternative business model and to help navigate paperwork and stocking challenges related to accepting federal nutrition program benefits.
    • Expand federal nutrition program guidelines to make participating as a WIC and/or SNAP vendor more accessible to smaller, locally owned, mission-driven stores with fewer resources.
    • Prioritize smaller stores with fewer staff and resources in emergency relief acts in future national or global crises.

These results can be used to help existing stores increase store usage and increase stocking of healthy items, and help new stores set up a model for success using community engagement and collaborating with community stakeholders to increase healthy food access in their neighborhoods.

Study Results and Resources

Case Studies

Published Papers

The full data set from this study, including transcripts, is not publicly available. If you are interested in accessing this data set for future research, contact Dr. Joel Gittelsohn at jgittel1@jh.edu.

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