Abstract
Efforts to transform corner stores to better meet community dietary needs have mostly occurred in urban areas but are also needed in rural areas. Given important contextual differences between urban and rural areas, it is important to increase our understanding of the elements that might translate successfully to similar interventions involving stores in more rural areas. Thus, an in-depth examination and comparison of corner stores in each setting is needed. A mixed methods approach, including windshield tours, spatial visualization with analysis of frequency distribution, and spatial regression techniques were used to compare a rural North Carolina and large urban (Los Angeles) food environment. Important similarities and differences were seen between the two settings in regards to food environment context, spatial distribution of stores, food products available, and the factors predicting corner store density. Urban stores were more likely to have fresh fruits (Pearson chi2 = 27.0423; p < 0.001) and vegetables (Pearson chi2 = 27.0423; p < 0.001). In the urban setting, corner stores in high income areas were more likely to have fresh fruit (Pearson chi2 = 6.00; p = 0.014), while in the rural setting, there was no difference between high and low income area in terms of fresh fruit availability. For the urban area, total population, no vehicle and Hispanic population were significantly positively associated (p < 0.05), and median household income (p < 0.001) and Percent Minority (p < 0.05) were significantly negatively associated with corner store count. For the rural area, total population (p < 0.05) and supermarket count were positively associated (p < 0.001), and median household income negatively associated (P < 0.001), with corner store count. Translational efforts should be informed by these findings, which might influence the success of future interventions and policies in both rural and urban contexts.
Highlights
Residents of low income urban and rural areas disproportionately suffer from diet-related morbidity and mortality [1,2,3,4,5,6]
Graffiti and disrepair affecting the appearance of stores was more common in the urban areas compared to the rural areas, including spray paint “tagging” and barred windows for security
Our study indicates important similarities and differences between corner stores in urban and rural environments
Summary
Residents of low income urban and rural areas disproportionately suffer from diet-related morbidity and mortality [1,2,3,4,5,6]. While there are undoubtedly many reasons for these disparities, one important cause is the unique food environment exposures experienced by both of these populations [7] These disparities in health may result from these areas being classified as food deserts, that is food environments lacking health-promoting foods, areas composed of predominantly lower income neighborhoods and communities [8], or classified as "food swamps”, that is, environments inundated with hyper-processed, energy-dense, nutrient-poor foods [9]. In addition to less access to healthy foods, lower-income, minority, and rural neighborhoods may have greater access to energydense foods, with a greater presence of convenience stores, which may lead to less healthy diets and higher levels of obesity [12] Given these findings, Larson, Story, and Nelson (2009) called for a push for policy action and intervention to ensure equitable access to healthy foods [12]
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