Availability, quality and price of produce in low-income neighbourhood food stores in California raise equity issues

Abstract

Objective: To assess produce availability, quality and price in a large sample of food stores in low-income neighbourhoods in California.

Design: Cross-sectional statewide survey.

Setting: Between 2011 and 2015, local health departments assessed store type, WIC (Supplemental Nutrition Program for Women, Infants, and Children)/SNAP (Supplemental Nutrition Assistance Program) participation, produce availability, quality and price of selected items in stores in low-income neighbourhoods. Secondary data provided reference chain supermarket produce prices matched by county and month. t Tests and ANOVA examined differences by store type; regression models examined factors associated with price.

Subjects: Large grocery stores (n 231), small markets (n 621) and convenience stores (n 622) in 225 neighbourhoods.

Results: Produce in most large groceries was rated high quality (97 % of fruits, 98 % of vegetables), but not in convenience stores (25 % fruits, 14 % vegetables). Small markets and convenience stores participating in WIC and/or SNAP had better produce availability, variety and quality than non-participating stores. Produce prices across store types were, on average, higher than reference prices from matched chain supermarkets (27 % higher in large groceries, 37 % higher in small markets, 102 % higher in convenience stores). Price was significantly inversely associated with produce variety, adjusting for quality, store type, and SNAP and WIC participation.

Conclusions: The study finds that fresh produce is more expensive in low-income neighbourhoods and that convenience stores offer more expensive, poorer-quality produce than other stores. Variety is associated with price and most limited in convenience stores, suggesting more work is needed to determine how convenience stores can provide low-income consumers with access to affordable, high-quality produce. WIC and SNAP can contribute to the solution.

Keywords: equity; low-income; price; quality; Fruits and vegetables; Health disparities; Produce availability; Retail food stores; SNAP-Ed.

Fig. 1

Locations in which stores included in the CX³ (Communities of Excellence in Nutrition, Physical Activity, and Obesity Prevention) sample are situated; cross-sectional statewide survey in low-income neighborhoods in California, 2011–2015

Fig. 2

(colour online) Average lowest price of seven common fruits and vegetables in the sample stores, by store type (, supermarkets/large groceries; , small markets; , convenience stores), compared with average lowest price of the items in chain supermarket stores in the same county and the same month; cross-sectional statewide survey in low-income neighborhoods in California, 2011–2015. Diagonal line indicates where points would lie if average price in sampled stores and average price in same-county, same-month grocery stores were equal.