Understanding the Food Environment in a Low-Income Urban Setting: Implications for Food Store Interventions

Obesity and other diet-related chronic disease affect low-income ethnic minority populations at high rates. Formative research was used to develop a food store-based intervention for low-income African Americans in Baltimore City. A combination of qualitative and quantitative methods were used, including in-depth interviews with food store owners (n = 19) and low-income residents (n = 17), food source assessment (n = 11 census tracts), a consumer survey (n = 50), and direct observations (n = 6). Healthy food options were poorly available in low-income census tracts, with no fresh fruits and vegetables sold in 6 census tracts. Local consumers purchase less healthy options and prepare foods in ways that add fat. Corner stores are a common food source, but store owners expressed reservations about stocking healthier food options, citing low consumer demand for healthier products. Residents were unhappy with the limited range of healthy food options available but tended to see obesity as the result of poor personal and parental choices. Neighborhood food stores have the potential to provide healthy food choices, reinforce health messages, increase the population reached by nutritional interventions, and work with local residents to facilitate healthier dietary choices.