(OR10-01-24) Associations Between the Food Retail Environment and Healthy Food Availability Among Urban Versus Rural Maryland Corner and Convenience Stores

Objectives: Small retail (e.g., corner and convenience) stores are important food sources for low-income residents living in food deserts, or ‘Healthy Food Priority Areas’, where access to nearby supermarkets is limited. In Maryland, these stores often lack fresh, healthy options, in part due to infrastructure constraints. We sought to (1) characterize a sample of urban and rural stores, and (2) assess how in-store factors impact healthy food availability.

Methods: Stores were recruited in Baltimore City (urban; n=10) and Charles County (rural; n=8) via repeated in-person visits. An observational store environmental checklist was completed by a trained researcher to assess the availability and variety of selected foods (e.g., fresh fruits and vegetables, low-fat milk, low-sugar snacks and drinks), as well as store size (e.g., number of aisles), layout (e.g., customer access to products), point-of-purchase marketing (e.g., shelf talkers, promotional signage) and other factors (e.g., store owner characteristics, SNAP and WIC participation). A Healthy Food Availability Index (HFAI) score ranging from 0-27 where a higher score indicates greater availability was calculated for each store. Linear regression analyses were conducted in Stata with HFAI as the dependent variable of interest.

Results: Urban stores had an average of 2.1 aisles while rural stores had an average of 3.43. HFAI scores ranged from 3 to 21 with a mean of 9.31 across all stores. The mean HFAI was higher (10.05) for urban stores compared to rural stores (8.38) although this difference was not significant. Interestingly, store layout and size were not associated with HFAI in this sample. However, WIC participation was associated with a 7.42 increase in HFAI score with adjustment of covariates and an 8.01 HFAI score increase without adjustment, across all stores.

Conclusions: Understanding the nuances in the small food retail environment may help to identify strategies for increasing store owner capacity and willingness to improve healthy food infrastructure and stocking for urban and rural Maryland residents. WIC participation should be further explored as a potential solution for encouraging store owners to keep a minimum stock of certain healthier items.

Funding Sources: R34HL145368; MDH PHPA 1851 Community Healthy Stores Initiative.