This quasi-experimental study aimed to evaluate the effect of a large chain supermarket opening in a predominantly low-income and African American community in Chicago, IL, on the existing retail food environment, which comprised mostly small stores that stock few staple food items. The overabundance of small food stores is particularly concerning because recent studies have found that excess availability of unhealthy food retailers (i.e., food swamp) is a better community-level predictor of obesity than poor availability of healthy food retailers (i.e., food desert) [23, 24]. Like other large urban centers in the U.S., many of Chicago’s communities that are considered a food swamp or desert have a large percentage of poor and minority residents [6, 7, 25]. African American residents comprise 33% of Chicago’s population but nearly 80% of the residents that live in a food desert . Furthermore, the metropolitan Chicago area is one of the most segregated urban centers in the U.S. with high levels of black-white segregation . Chicago’s racial segregation has been linked to geographic inequities in health across the city [27, 28]. Since low-income African Americans are more at risk of chronic disease [29–31], addressing geographic disparities in healthy food access may narrow health inequities in Chicago.
The addition of a new supermarket to Englewood’s retail food environment greatly expanded healthy food availability and promotion in the community. However, the entry of the supermarket did not lead to significant changes to food and beverage availability and marketing in nearby small food stores at one or two years after the opening. While statistically significant, changes to regular cheese availability (at one-year post intervention), salty snack availability at check-out (at one-year post intervention), and interior store promotion of other sweetened beverages (at two-years post-intervention) do not reflect a substantive change to the food landscape. These results underscore the hypothesis that small food stores in low resourced communities are not likely to alter their food and beverage stocking and marketing practices if a supermarket opens. Small food stores in these communities may fill a specific need of current residents, which keeps them economically viable despite new competition from a full-service grocer. A qualitative study by Sherman et al. (2015) highlighted the socio-cultural and economic significance of corners stores in low-income urban communities . They reported that corner store usage often starts as a young age, and most use these stores to conveniently obtain discretionary items such as snacks and sugar-sweetened beverages . Thus, the goods and services supplied by the supermarket may not supplant the primary motive for small food store usage by many community residents.
The findings from the current study are comparable to two other studies that recently evaluated the impact of introducing a HFFI-supported supermarket to a predominately low-income African American community [19, 20]. Singleton et al. (2019) reported that opening a discount supermarket, a Save-A-Lot, in a low-income area of Rockford, IL did not affect food and beverage availability and marketing in existing small food stores after one year post-opening (N = 22) . Like the current study, many of the stores audited in Rockford were limited-service stores that stocked few staple food items . Ghosh-Dastidar et al. (2017) conducted a natural experiment to examine how introducing a new supermarket to a low-income African American community in Pittsburgh, PA impacted healthy and unhealthy food availability and pricing in nearby stores (N = 26) after a year . They, too, found few changes in net food availability after the supermarket opened, although some changes in the pricing of certain food items were reported . Economic studies provide some insight into this topic as well. For example, studies by Ailawadi et al. (2010) and Hausman and Leibtag (2007) documented how introducing a mass merchandiser (e.g., Wal-Mart or K-Mart) affected nearby retail stores [17, 18]. While these studies linked the introduction of a mass merchandiser to loss of smaller discount retailers, they do not provide information on how these stores impact the existing retail food environment. Overall, the current state of evidence indicates that introducing a supermarket to a low-resourced urban community results in minimal change to food and beverage availability and marketing in existing small food stores. This evidence should be considered when putting the implications of large-scale healthy food retail expansion policies, such as the HFFI, into context.
Despite the increasing number of research studies on the HFFI [3, 13, 19, 20, 33–35], its effect on public health and healthy equity remains unclear. Expanding healthy food retail in low-resourced communities can potentially address major dietary concerns such as food insecurity and poor diet quality . While the current study did not assess how the new supermarket impacted consumer food and beverage purchasing, food insecurity, or dietary intake in Englewood, a limited number of other studies have addressed this [35–38]. Overall, the evidence suggests that community perceptions of healthy food availability improve after a supermarket opens, but significant improvements in diet-related behaviors such as fruit and vegetable purchasing and consumption are not often observed [35–38]. Needed are studies that evaluate positive and negative changes to individual (e.g., food purchasing behavior, family feeding practices), community (i.e., social cohesion, blight), and other store-level factors (i.e., pricing, supply chains) in addition to food and beverage availability and marketing in smaller food stores . The findings from studies that evaluated the impact of new mass merchandisers highlight an important concern: the possibly of business and residential displacement [16–18]. While it may generate jobs, the introduction of a high-end supermarket such as Whole Foods Market© to a low-income minority community may also have unintended adverse consequences on the housing and financial security of currents residents. Recent studies on gentrification displacement have demonstrated both gradual and abrupt shifts in socio-demographics, housing value, and food retail outlet availability in response to new real estate investment projects [40–42]. This is a major concern that must be considered as future initiatives are introduced to improve the food landscape in low-income minority communities.
Strengths and Limitations
The strengths and limitations of the research should be noted. Using the Illinois PRC Food Store Observation Tool to audit stores was a strength because it features a large variety of food and beverage availability and marketing variables. The study design was a strength because a complete audit of all small food stores found in the intervention and comparison areas was performed at baseline and for two years follow-up. Nonetheless, the small sample size of small food stores found in the intervention and comparison areas may have affected the DID regression analyses, specifically the ability to detect significant differences between communities over time. A larger sample size of stores would have permitted a more robust assessment of change in food and beverage availability. Change in food and beverage pricing over time was not assessed in the current study. Given findings from similar studies that evaluated price, it is possible that existing small food stores in the current study altered their price of staple foods and snack items in response to the opening of the new supermarket . Future studies should consider longitudinal changes to price and pricing strategies of healthy and unhealthy foods and beverages. No individual-level data were collected from community residents that allow an evaluation of changes in consumer food purchasing, decision-making, or dietary practices over time. Since this study was conducted solely in Chicago, findings may not be generalizable to other large urban centers in the U.S. or abroad.