Association for Public Policy Analysis & Management

Panel: How Does Food Store Access Affect Food Shopping Behavior and Diet Quality?

(Poverty and Income Policy)

The Agriculture Reform, Food and Jobs Act of 2014 approved $125 million to the U.S. Department of Agriculture for the Healthy Food Finance Initiative (HFFI). This initiative provides funding for loans and grants to encourage the growth of retailers that sell fresh, healthy foods in areas that may not have many retail options. The ultimate goal of the initiative is to improve diet quality and diet-related health of residents of these underserved areas. There is however, limited evidence that it will be sufficient on its own. This session features three different empirical approaches to evaluate the effect of food store access on food shopping, food intake and diet-related outcomes. The first paper uses the new National Household Survey on Food Acquisitions and Purchases (FoodAPS), which is nationally representative of participants of the Supplemental Nutrition Assistance Program and low-income nonparticipants, and its Geographic Component to examine how proximity to supermarkets and vehicle ownership are related to where survey respondents usually shop for food and why, and to food security and self-reported diet quality. Results from this study are important because they provide a national-level picture of how store proximity relates to shopping behavior, food security, and self-reported diet quality, compared with the importance of other factors such as vehicle ownership and store characteristics such as price. The second paper uses a difference-in-difference approach to link two rounds of data on the local food environment from ERS’ Food Access Research Atlas to two rounds of small area estimates of fruit and vegetable intake and obesity rates derived from the Behavioral Risk Factor Surveillance System (BRFSS). This study compares how much changes in dietary intake and obesity result from changes in local neighborhood socioeconomic factors, such as incomes, and how much can be attributed to changes in local food access. The final paper in this session capitalizes on a natural experiment in two comparable neighborhoods, one of which received a full-service supermarket in 2013. A difference-in-difference approach is used to examine food purchasing behaviors, food intake, and Body Mass Index for a sample of randomly selected households in these two neighborhoods before and after the supermarket opened. This study closely mimics the new HFFI policy intervention and the results provide evidence about the effects of opening a new supermarket in an underserved area. The diversity of the empirical approaches of these three papers should provide crucial evidence on the degree to which HFFI interventions may help improve diet, particularly in the absence of experimental methods and formal evaluation component. Evidence presented in the session will illuminate the degree to which access to healthy food retailers impacts diet relative to other factors that affect food shopping and dietary choice. If food store proximity has a small impact relative to other factors such as price, income or other preferences, then programs such as price subsidies for specific healthy foods, increased SNAP benefits, or in-store marketing and behavioral incentives may be more effective strategies for the new HFFI than developing new store outlets.