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Healthy Food Businesses: Models for Improving Diet and Healthy Food Access in Under-Resourced Communities

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 16599

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Special Issue Editors

Dr. Lucia Leone

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Guest Editor

Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
Interests: fruit and vegetable access; food-retail-based interventions; dissemination and implementation; health disparities

Dr. Elizabeth Anderson Steeves

E-Mail Website
Guest Editor

Department of Nutrition, University of Tennessee, Knoxville, TN 37996, USA
Interests: community-based interventions to reduce health disparities and prevent obesity among under-served populations; with a specific emphasis on low-socioeconomic status children and adolescents

Special Issue Information

Dear Colleagues,

On behalf of the International Journal of Environmental Research and Public Health, we are organizing a Special Issue addressing healthy food retail or food service business models. This includes models that are designed to improve health or access to healthy foods and/or serve under-resourced communities. The International Journal of Environmental Research and Public Health is a peer-reviewed scientific journal that publishes manuscripts in the interdisciplinary area of environmental health sciences and public health.

The COVID-19 pandemic has highlighted many instances of food retailers and food service (e.g., restaurants) embracing alternative (and in some instances, more community-minded) models. This, combined with the closure of many food service establishments, underscores a need for research looking at the sustainability of alternative business models, especially in lower-income and minority communities. Food retail already operates on very slim margins, and low food prices often come at the expense of small farmers, food workers, and our environment. We are soliciting research that examines business models and practices that support public health-relevant outcomes. This may include models that expand business interest beyond profit (e.g., supporting local producers, decreasing environmental impact) or advance equity through their business practices (e.g., ownership models or payment models). By having a better understanding of how food business can meet these goals, public health researchers and professionals can help retail food actors to move past the purely profit-driven model which has contributed to current health disparities.

Dr. Lucia Leone
Dr. Elizabeth Anderson Steeves
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

food retail
disparities
retail food environment
food purchasing
grocery stores
restaurants
dietary intake
sustainable business models

Published Papers (6 papers)

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Research

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13 pages, 1310 KiB

Open AccessArticle

Refining the Nutrition Environment Measures Survey (NEMS) for Healthy Community Stores: Adaptations to Capture Alternative Food Retailers and Align with Dietary Guidelines

by Alex B. Hill, Ravneet Kaur, Samantha M. Sundermeir, Christina Kasprzak, Megan Winkler, Sara John, Rachael D. Dombrowski, Bree Bode and Joel Gittelsohn

Int. J. Environ. Res. Public Health 2022, 19(19), 12875; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912875 - 08 Oct 2022

Viewed by 1638

Abstract

Inadequate consumption of healthy food is an ongoing public health issue in the United States. Food availability measures of supply versus consumption of healthy foods are disconnected in many studies. There is a need for an objective assessment of the food environment in order to assess how the food supply aligns with the Healthy Eating Index (HEI). Data were collected as part of the Healthy Community Stores Case Study Project, including a refined Nutrition Environment Measures Survey for Healthy Community Stores (NEMS-HCS) and an updated Healthy Food Availability Index that aligns with the Healthy Eating Index (HFAHEI). This paper will focus on the NEMS-HCS development process, findings, and HFAHEI application. All food items were more likely to be found at grocery stores rather than corner stores. Food pricing was often above the Consumer Price Index averages for six food items. The NEMS-HCS assessment better aligned with the HEI because it included a wider variety of meats, frozen fruits and vegetables, and an increased selection of whole grains. HFAHEI scoring was inclusive of non-traditional and alternative community stores with a health focus, making it suitable for use at the local level, especially in neighborhoods where supermarkets and large chain stores are less common. Full article

(This article belongs to the Special Issue Healthy Food Businesses: Models for Improving Diet and Healthy Food Access in Under-Resourced Communities)

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29 pages, 3665 KiB

Open AccessArticle

Women’s Empowerment, Income, and Nutrition in a Food Processing Value Chain Development Project in Touba, Senegal

by Cheryl O’Brien, Laura Leavens, Cheikh Ndiaye and Djibril Traoré

Int. J. Environ. Res. Public Health 2022, 19(15), 9526; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19159526 - 03 Aug 2022

Cited by 7 | Viewed by 2460

Abstract

To study the impacts of implementing a gender-sensitive value chain development (VCD) initiative in the agri-food sector, we conducted a mixed-methods study of a woman-owned food processing business and its associated value chain in Touba, Senegal. As a result of partnering with a USAID-funded project, the business began producing instant fortified flours, an innovative, higher-value product compared to traditional porridge, using extrusion and fortification techniques. Drawing on Senegalese women’s association networks, the business connected with local women who could work as processors and retailers. Our study’s goal was to explore how the project’s support of this food processing value chain has affected the lives of women processors and retailers, farmers, and medical personnel along the value chain. Particularly relevant to our study is the general lack of opportunities for women to earn their own incomes in the study region, especially outside of the home, and provide for their families. Through surveys, interviews, observations, and novel participatory focus group activities, our study provides qualitative and quantitative evidence of the perceived impacts of value chain development on women’s empowerment, income, and nutrition by key stakeholders in the value chain. We find an often cited barrier to women’s empowerment is the husband’s lack of understanding and limitations placed on women’s mobility, yet we also find perceptions of women’s empowerment in this conservative religious context. Our findings and discussion highlight the need for more research into VCD projects on the complex and, at times, contradictory processes of women’s empowerment. The women in our study expressed a desire for freedom to work outside of the home, and they expressed a need for childcare and contraception. Notably, the women discussed positive community changes, such as infrastructure and the creation of a childcare center, that implicate women’s collective empowerment. We also highlight a promising research opportunity in Senegal to explore the subnational variation in women’s empowerment through VCD. Full article

(This article belongs to the Special Issue Healthy Food Businesses: Models for Improving Diet and Healthy Food Access in Under-Resourced Communities)

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11 pages, 303 KiB

Open AccessArticle

The Online Ordering Behaviors among Participants in the Oklahoma Women, Infants, and Children Program: A Cross-Sectional Analysis

by Qi Zhang, Kayoung Park, Junzhou Zhang and Chuanyi Tang

Int. J. Environ. Res. Public Health 2022, 19(3), 1805; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031805 - 05 Feb 2022

Cited by 8 | Viewed by 1920

Abstract

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the United States (U.S.). Participants in the program redeem their prescribed food benefits in WIC-authorized grocery stores. Online ordering is an innovative method being pilot-tested in some stores to facilitate WIC participants’ food benefit redemption, which has become especially important in the COVID-19 pandemic. The present research aimed to examine the online ordering (OO) behaviors among 726 WIC households who adopted WIC OO in a grocery chain, XYZ (anonymous) store, in Oklahoma (OK). These households represented approximately 5% of WIC households who redeemed WIC benefits in XYZ stores during the study period, which was 1 July to 31 December 2020. This period was during the COVID-19 pandemic but after the temporary lockdown in Oklahoma had been lifted. Descriptive statistics were estimated for WIC OO households’ adoption behaviors and their orders. The Cox proportional hazard model and zero-truncated negative binomial regression were applied to examine the relationship between participants’ socio-demographics and the length of time between 1 July 2020, and their first OO, as well as the number of WIC online orders. About 80% of these online orders were picked up without any changes. Minority households had a significantly longer time before adopting their first OO (hazard ratio (HR) < 1, p < 0.001), while households with a child or a woman participant, or more participants, had a shorter time before adopting OO (HR > 1, p < 0.05). Non-Hispanic black households had a fewer number of OOs than non-Hispanic white households (B = −0.374, p = 0.007). OO adoption varied across socio-demographics. More efforts are needed to ensure equal access and adoption of WIC OO. Full article

(This article belongs to the Special Issue Healthy Food Businesses: Models for Improving Diet and Healthy Food Access in Under-Resourced Communities)

Other

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11 pages, 351 KiB

Open AccessCommentary

A Commentary on the Healthy Community Stores Case Study Project: Implications for Retailers, Policy, and Future Research

by Samantha M. Sundermeir, Megan R. Winkler, Sara John, Uriyoán Colón-Ramos, Ravneet Kaur, Ashley Hickson, Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Julia DeAngelo and Joel Gittelsohn

Int. J. Environ. Res. Public Health 2022, 19(14), 8824; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19148824 - 20 Jul 2022

Cited by 2 | Viewed by 1716

Abstract

In the United States, low-income, underserved rural and urban settings experience poor access to healthy, affordable food. Introducing new food outlets in these locations has shown mixed results for improving healthy food consumption. The Healthy Community Stores Case Study Project (HCSCSP) explored an alternative strategy: supporting mission-driven, locally owned, healthy community food stores to improve healthy food access. The HCSCSP used a multiple case study approach, and conducted a cross-case analysis of seven urban healthy food stores across the United States. The main purpose of this commentary paper is to summarize the main practice strategies for stores as well as future directions for researchers and policy-makers based on results from the prior cross-case analyses. We organize these strategies using key concepts from the Retail Food Environment and Customer Interaction Model. Several key strategies for store success are presented including the use of non-traditional business models, focus on specific retail actors such as store champions and multiple vendor relationships, and a stores’ role in the broader community context, as well as the striking challenges faced across store locations. Further exploration of these store strategies and how they are implemented is needed, and may inform policies that can support these types of healthy retail sites and sustain their efforts in improving healthy food access in their communities. Full article

(This article belongs to the Special Issue Healthy Food Businesses: Models for Improving Diet and Healthy Food Access in Under-Resourced Communities)

10 pages, 299 KiB

Open AccessStudy Protocol

Increasing Healthy Food Access for Low-Income Communities: Protocol of the Healthy Community Stores Case Study Project

by Joel Gittelsohn, Christina M. Kasprzak, Alex B. Hill, Samantha M. Sundermeir, Melissa N. Laska, Rachael D. Dombrowski, Julia DeAngelo, Angela Odoms-Young and Lucia A. Leone

Int. J. Environ. Res. Public Health 2022, 19(2), 690; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19020690 - 08 Jan 2022

Cited by 5 | Viewed by 3685

Abstract

Improving healthy food access in low-income communities continues to be a public health challenge. One strategy for improving healthy food access has been to introduce community food stores, with the mission of increasing healthy food access; however, no study has explored the experiences of different initiatives and models in opening and sustaining healthy food stores. This study used a case study approach to understand the experiences of healthy food stores in low-income communities. The purpose of this paper is to describe the methodology used and protocol followed. A case study approach was used to describe seven healthy food stores across urban settings in the U.S. Each site individually coded their cases, and meetings were held to discuss emerging and cross-cutting themes. A cross-case analysis approach was used to produce a series of papers detailing the results of each theme. Most case studies were on for-profit, full-service grocery stores, with store sizes ranging from 900 to 65,000 square feet. Healthy Food Availability scores across sites ranged from 11.6 (low) to 26.5 (high). The papers resulting from this study will detail the key findings of the case studies and will focus on the challenges, strategies, and experiences of retail food stores attempting to improve healthy food access for disadvantaged communities. The work presented in this special issue will help to advance research in the area of community food stores, and the recommendations can be used by aspiring, new, and current community food store owners. Full article

(This article belongs to the Special Issue Healthy Food Businesses: Models for Improving Diet and Healthy Food Access in Under-Resourced Communities)

15 pages, 2847 KiB

Open AccessProtocol

Identifying Opportunities for Strategic Policy Design to Address the Double Burden of Malnutrition through Healthier Retail Food: Protocol for South East Asia Obesogenic Food Environment (SEAOFE) Study

by Sirinya Phulkerd, Cut Novianti Rachmi, Mohd Jamil Sameeha, Elaine Q. Borazon, Anne-Marie Thow, Helen Trevena, Adila Fahmida Saptari, Yong Kang Cheah, Che Aniza Che Wel, Vanessa T. Marquez, Teeranong Sakulsri, Natjera Thongcharoenchupong and Bee Koon Poh

Int. J. Environ. Res. Public Health 2022, 19(1), 528; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010528 - 04 Jan 2022

Cited by 4 | Viewed by 3582

Abstract

Effective policies that address both the supply and demand dimensions of access to affordable, healthy foods are required for tackling malnutrition in South East Asia. This paper presents the Protocol for the South East Asia Obesogenic Food Environment (SEAOFE) study, which is designed to analyze the retail food environment, consumers’ and retailers’ perspectives regarding the retail food environment, and existing policies influencing food retail in four countries in South East Asia in order to develop evidence-informed policy recommendations. This study was designed as a mixed-methods sequential explanatory approach. The country sites are Malaysia, Indonesia, the Philippines, and Thailand. The proposed study consists of four phases. Phase One describes the characteristics of the current retail food environment using literature and data review. Phase Two interprets consumer experience in the retail food environment in selected urban poor communities using a consumer-intercept survey. This phase also assesses the retail food environment by adapting an in-store audit tool previously validated in higher-income countries. Phase Three identifies factors influencing food retailer decisions, perceptions, and attitudes toward food retail policies using semi-structured interviews with selected retailers. Phase Four recommends changes in the retail food environment using policy analysis and semi-structured interviews with key stakeholders. For the analysis of the quantitative data, descriptive statistics and multiple regression will be used, and thematic analysis will be used to process the qualitative data. This study will engage stakeholders throughout the research process to ensure that the design and methods used are sensitive to the local context. Full article

(This article belongs to the Special Issue Healthy Food Businesses: Models for Improving Diet and Healthy Food Access in Under-Resourced Communities)

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