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Food Store Types, Availability, and Cost of Foods in a Rural Environment

https://doi.org/10.1016/j.jada.2007.08.012Get rights and content

Abstract

Objective

To characterize the built nutritional environment in terms of types and number of food stores, availability, and cost of selected food items in a rural area.

Design

A cross-sectional survey of food stores conducted in 2004.

Subjects/setting

We selected a rural county (population 91,582; 1,106 square miles). Food stores identified from a database were mapped and presence, location, and store type verified by ground-truthing. Stores were surveyed for availability and cost of selected foods.

Main outcome measures

Price and availability of a limited number of staple foods representing the main food groups.

Statistical analyses performed

Availability comparisons used least square means models and price comparisons used t tests.

Results

Of 77 stores identified, 16% were supermarkets, 10% grocery stores, and 74% convenience stores. There were seven stores per 100 square miles and eight stores per 10,000 residents. Availability of more healthful foods was substantially higher at supermarkets and grocery stores. For instance, low-fat/nonfat milk, apples, high-fiber bread, eggs, and smoked turkey were available in 75% to 100% of supermarkets and groceries and at 4% to 29% of convenience stores. Foods that were available at both supermarkets and convenience stores tended to be substantially more expensive at convenience stores. The healthful version of a food was typically more expensive than the less healthful version.

Conclusions

In this rural environment, stores offering more healthful and lower-cost food selections were outnumbered by convenience stores offering lower availability of more healthful foods. Our findings underscore the challenges of shopping for healthful and inexpensive foods in rural areas.

Section snippets

Methods

This study was conducted in Orangeburg County, South Carolina, a rural county with a total population of 91,582. Orangeburg, the largest city, has a population of 12,765 (13). We selected Orangeburg County because of its geographic proximity to Columbia, SC, and because it covers a large land area containing rural, mixed, and urban Census tracts. Data were collected in fall/winter 2004 as part of a broader pilot effort.

Results

Orangeburg County is located southeast of Columbia in the Midlands region of South Carolina. It covers 1,106 square miles and 20 Census tracts (Table 1). The majority of Orangeburg’s population is African American (61%) and 67% live in a rural area, as defined by the United States Census Bureau. Other important socioeconomic and demographic characteristics are shown in Table 1.

We identified a total of 77 food stores in Orangeburg County, including 12 supermarkets (16%), eight grocery stores

Discussion

A small body of literature has recently emerged demonstrating that in the United States, neighborhoods differ markedly with respect to the number and types of food stores (17). Moore and Diez-Roux (17) have studied three communities, including parts of Baltimore, MD (242 square miles), Manhattan and the Bronx, NY (26 square miles), and Forsyth County, North Carolina (410 square miles). The percentage of stores that were supermarkets was much higher in predominantly white areas, and percentage

Conclusions

Our work adds to a growing body of evidence suggesting that rural populations face great disparities in terms of many health outcomes and health behaviors. Although the Dietary Guidelines for Americans (1) are intended for all US residents, our study suggests that rural residents may be at a marked disadvantage when it comes to meeting these guidelines. In our study area, only one fourth of all food stores supported the specific healthful dietary choices surveyed. Stores offering more-healthful

A. D. Liese is an associate professor, K. E. Weis is a doctoral candidate, E. Smith is a recent masters graduate, and A. Lawson is a professor, Department of Epidemiology and Biostatistics; D. Pluto is associate director, Prevention Research Center and research assistant professor, Department of Health Promotion, Education, and Behavior; all at the Arnold School of Public Health, University of South Carolina, Columbia.

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    A. D. Liese is an associate professor, K. E. Weis is a doctoral candidate, E. Smith is a recent masters graduate, and A. Lawson is a professor, Department of Epidemiology and Biostatistics; D. Pluto is associate director, Prevention Research Center and research assistant professor, Department of Health Promotion, Education, and Behavior; all at the Arnold School of Public Health, University of South Carolina, Columbia.

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