Store Type and Demographic Influence on the Availability and Price of Healthful Foods, Leon County, Florida, 2008

INTRODUCTION: The availability of healthful foods varies by neighborhood. We examined the availability and price of more healthful foods by store type, neighborhood income level, and racial composition in a community with high rates of diet-related illness and death. METHODS: We used the modified Nutrition Environment Measures Survey in Stores to conduct this cross-sectional study in 2008. We surveyed 73 stores (29% supermarkets, 11% grocery stores, and 60% convenience stores) in Leon County, Florida. We analyzed the price and availability of foods defined by the 2005 Dietary Guidelines for Americans as "food groups to encourage." We used descriptive statistics, t tests, analysis of variance, and χ(2) tests in the analysis. RESULTS: Measures of availability for all more healthful foods differed by store type (P < .001). Overall, supermarkets provided the lowest price for most fresh fruits and vegetables, low-fat milk, and whole-wheat bread. Availability of 10 of the 20 fruits and vegetables surveyed, shelf space devoted to low-fat milk, and varieties of whole-wheat bread differed by neighborhood income level (P < .05), but no trends were seen for the availability or price of more healthful foods by neighborhood racial composition. CONCLUSIONS: Store type affects the availability and price of more healthful foods. In particular, people without access to supermarkets may have limited ability to purchase healthful foods. Nutrition environment studies such as this one can be used to encourage improvements in neighborhoods that lack adequate access to affordable, healthful food, such as advocating for large retail stores, farmer's markets, and community gardens in disadvantaged neighborhoods.