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Disparities in healthy food access are well documented in cross-sectional studies in communities across the United States. However, longitudinal studies examining changes in food environments within various neighborhood contexts are scarce. In a sample of 142 census tracts in four low-income, high-minority cities in New Jersey, United States, we examined the availability of different types of food stores by census tract characteristics over time (2009–2017). Outlets were classified as supermarkets, small grocery stores, convenience stores, and pharmacies using multiple sources of data and a rigorous protocol. Census tracts were categorized by median household income and race/ethnicity of the population each year. Significant declines were observed in convenience store prevalence in lower- and medium-income and majority black tracts (p for trend: 0.004, 0.031, and 0.006 respectively), while a slight increase was observed in the prevalence of supermarkets in medium-income tracts (p for trend: 0.059). The decline in prevalence of convenience stores in lower-income and minority neighborhoods is likely attributable to declining incomes in these already poor communities. Compared to non-Hispanic neighborhoods, Hispanic communities had a higher prevalence of small groceries and convenience stores. This higher prevalence of smaller stores, coupled with shopping practices of Hispanic consumers, suggests that efforts to upgrade smaller stores in Hispanic communities may be more sustainable.

To evaluate a Produce Prescription Programme's utilisation, and its effects on healthy food purchasing and diabetes control among participants with type 2 diabetes. Prospective cohort study using participants' electronic health records (EHR) and food transaction data. Participants were categorized as \"Frequent Spenders\" and \"Sometimes Spenders\" based on utilisation frequency. Multivariate regressions assessed utilisation predictors; and programme effects on fruit/vegetable purchasing (spending, expenditure share, variety) and on diabetes-related outcomes (HbA1c, BMI, blood pressure). Patients enrolled by clinics in Durham, North Carolina, USA. Participants received $40 monthly for fruits and vegetables at a grocery store chain. 699 food-insecure participants (353 with diabetes). Being female and older was associated with higher programme utilisation; hospitalisations were negatively associated with programme utilisation. Frequent Spender status was associated with $8.77 more in fruit/vegetable spending (p < 0.001), 3.3% increase in expenditure share (p = 0.007), and variety increase of 2.52 fruits and vegetables (p < 0.001). For $10 of Produce Prescription Dollars spent, there was an $8.00 increase in fruit/vegetable spending (p < 0.001), 4.1% increase in expenditure share, and variety increase of 2.3 fruits/vegetables (p < 0.001). For the 353 participants with diabetes, there were no statistically significant relationships between programme utilisation and diabetes control. Programme utilisation was associated with healthier food purchasing, but the relatively short study period and modest intervention prevent making conclusions about health outcomes. Produce Prescription Programmes can increase healthy food purchasing among food-insecure people, which may improve chronic disease care.

Background The epidemic of non-communicable diseases (NCDs) is a growing concern worldwide and Singapore is no exception to this global trend. As part of measures to address this concern, the Singapore government will implement a mandatory color-coded front-of-package (FOP) nutrition label for beverages, called Nutri-Grade (NG), which will complement the existing FOP label, Healthier Choice Symbol (HCS) logos, currently displayed on select food and beverage items. NG grades beverages on a four-point scale, A (healthiest) to D (least healthy), in terms of sugar and saturated fat levels. This study aimed to evaluate the effectiveness of the NG label on nutritional quality of pre-packaged beverages using a fully functional online grocery store. Methods We conducted a 2-arm crossover trial involving actual purchases with 138 participants randomly exposed to: 1) Control with HCS logos displayed on qualifying items; 2) Similar to Control except that all beverages displayed the NG label. The effects of the NG label were estimated using a linear mixed-effects model that addresses correlations between repeated measures and accommodates missing data. Results We found that the NG label encouraged consumers to choose beverages with higher ratings. This led to a reduction in sugar from beverages purchased by 1.51 g [95% CI: − 2.68, − 0.34] per serving but was not effective at reducing saturated fat purchased (− 0.009 g [95% CI: − 0.22, 0.20]) per serving or improvements in overall diet quality, measured by the weighted (by the number of servings) average Nutri-Score value ranging from 1 to 5 (− 0.024 [95% CI: − 0.13, 0.08]). Conclusions Results suggest that the Nutri-Grade label is likely to reduce sugar purchased from beverages. However, to improve overall diet quality in Singapore, additional measures will be needed. Trial registration This trial was registered on ClinicalTrials.gov under the identifier: NCT05018026 on 24th August 2021.

Background Violent crime (i.e., homicide, armed robbery, aggravated assault, and rape) continues to be a major public health concern in America. Several studies have linked the availability and density of specific features of the retail food environment, such as convenience stores and liquor stores, to violent crime rates due to the criminal activity that often occurs in and near these retailers. Nevertheless, there continues to be limited understanding of how other features (e.g., grocery stores, supercenters, restaurants, etc.) are associated with violent crime occurrence. This study aimed to fill this gap in knowledge by examining U.S. county-level associations between food retailer availability and violent crime rate. Methods We analyzed 2014 data on 3108 counties from the U.S. Department of Agriculture’s Food Environment Atlas and Department of Justice’s Unified Crime Reporting Program. Per capita food retailer measures represented the number of stores per 10,000 county residents. Violent crime rate represented the number of police reported violent crimes per 10,000 county residents. We used spatial lag regression models to assess associations between per capita retailer availability and violent crime rate after adjusting for potential confounders (e.g., % under 18, % Black, % Hispanic, % poverty, population density, etc.). In addition, we examined stratified OLS regression models to evaluate associations by metropolitan county status. Results Adjusted spatial regression models revealed that greater supercenter availability [β: 2.42; 95% CI: 0.91–3.93; p -value: 0.001] and greater fast food restaurant availability [β: 0.30; 95% CI: 0.18–0.42; p -value: < 0.001] were associated with higher violent crime rate. Greater availability of farmers’ markets [β: -0.42; 95% CI: -0.77 – − 0.07); p -value: 0.02] was associated with lower violent crime rate. Associations varied between metropolitan and non-metropolitan counties. Stratified OLS models revealed that greater grocery store availability was associated with lower violent crime rate among metropolitan counties only. Greater fast food restaurant availability was associated with lower violent crime rate among non-metropolitan counties only. Conclusions Certain features of the retail food environment appear to be associated with county-level violent crime rates in America. These findings highlight the need for additional research on the influence of food retail and food landscape on violent crime occurrence at the community level.

This research examines the consumer nutrition environment in the selected neighborhoods identified as food deserts, food swamps, and food oases in Austin, Texas, by considering food availability, food price, food quality, and food labeling. A food auditing instrument M-TxNEA-S (He Jin, San Marcos, TX, USA) was developed to capture the unique dietary culture and food preferences in Texas. A total of 93 food items in 14 grocery stores and supermarkets (GS) and 32 convenience stores (CS) were surveyed. The GS in food swamps and food oases were found to offer significantly more healthy foods than the CS. The availability of healthy food in the GS in the food swamps and food oases is significantly higher than that of the GS from the food deserts; CS in the three neighborhoods did not exhibit a significant difference in healthy food availability. There was no significant difference between the price for the healthy items (lower fat, lower calorie, and whole grain) and that for the regular food options. No significant difference was found for food quality or food labeling between the stores from the different types of neighborhoods. The GS in food deserts are small grocery stores carrying limited ranges of foods. The establishment of larger food stores in the food deserts might not be very rewarding, but opening more small grocery stores with healthier options may alleviate food issues.

Most food retailers display foods in prominent locations as a marketing strategy (i.e. 'placement promotions'). We examined the extent to which households with children change their food and beverage purchases in response to these promotions. We analysed a novel dataset of all products promoted in two supermarkets from 2016 to 2017, including promotion dates and locations (e.g. aisle endcaps and front registers). We linked promotions to all purchases from the supermarkets from 2016 to 2017 by a cohort of households with children. We calculated the number of weekly promotions in each of thirteen food and beverage groups (e.g. bread; candy) and used fixed effects regressions to estimate associations between number of weekly promotions and households' weekly food purchases, overall and by Supplemental Nutrition Assistance Program (SNAP) participation. Two large supermarkets in Maine, USA. Eight hundred and twenty-one households with children. Most promotions (74 %) were for less healthy foods. The most promoted food groups were sweet and salty snacks (mean = 131·0 promotions/week), baked goods (mean = 68·2) and sugar-sweetened beverages (mean = 41·6). Households generally did not change their food group purchases during weeks when they were exposed to more promotions for those groups, except that a 1-sd increase in endcap candy promotions (about 1 promotion/week) was associated with $0·19/week (about 14·5 %) increase in candy purchases among SNAP nonparticipants (adjusted < 0·001). In-store placement promotions for food groups were generally not associated with purchases of promoted food groups, perhaps because exposure to unhealthy food marketing was consistently high. Substantial changes to in-store food marketing may be needed to promote healthier purchases.

Grocery shopping is an integral part of everyday life in every household. Due to the increasing decline in the number of grocery stores, it is difficult to find grocery shops close to home, especially in rural areas. For certain population groups, such as older people and/or people with limited mobility, people living alone and single parents, as well as households without a car, it is difficult to get groceries within walking distance. In addition, the gaps in local supply also mean a decline in the quality of life of the affected population. This study addresses the question of what role small rural grocery stores play in the shopping behavior of residents of rural areas and how they rate them. Using a quantitative consumer survey (n = 238), the shopping behavior and relationship to five sites in the Main-Spessart region of Bavaria, Germany were analyzed. The surveyed customers visit the rural stores several times a week (57.1%), especially for necessities (62.2%) and weekly shopping (13.1%). The product range (including fresh products), proximity to the place of residence, as well as the social function are most valued. Four different customer types were identified: the Uninvolved (35.6%), the Supporters (15.5%), the Motivated (25.8%) and the Socials (23.2%). The study shows that small rural grocery stores can contribute significantly to the food supply in poorly supplied areas. The degree of use varies depending on the individual life circumstances and needs. Using the location as a place for social exchange is a very relevant factor (60.5%). The targeted use of the store as a social meeting place is highly dependent on the additional infrastructure provided (e.g., a café corner). These results can help decision-makers to gain a better understanding of the users and consequently to better assess potentials of small rural grocery stores.

Limited research exists on the mental health (MH) of grocery store workers (GSWs), who have been on the frontlines throughout the COVID-19 pandemic. A disaster MH conceptual model incorporating demographics, disaster exposure and threat (COVID-19 fear and workplace threat perception), perceived stress, and social support (lack of from family and friends) was utilized to predict MH outcomes (anxiety, depression, and post-traumatic stress symptoms; PTSS) of GSWs. GSWs (n = 842) were recruited through a regional union in California. The participants were diverse (62.1% female) and were 18–69 years of age (M = 41.5, SD = 13.9). They completed an online survey regarding COVID-19 fear, workplace threat perception, perceived stress, lack of social support, and workplace needs/recommendations for support. Three hierarchical linear regression models were run assessing each MH outcome. Thematic analysis coding and an inductive approach were utilized for analyzing open-ended responses of workplace needs/recommendations. Females and younger GSWs (ages 18–29 years old) on average, reported higher MH symptoms than males and older age groups, respectively. COVID-19 fear and perceived stress were significant predictors of anxiety, while COVID-19 fear, workplace threat perception, and perceived stress significantly predicted depression and PTSS, explaining almost half of the variance for each model. Social support and demographics were not predictive of MH outcomes. Almost half of GSWs (40%) requested increased safety protections in the workplace. Feelings of fear of COVID-19, threat in the workplace, and overall perceived stress are predictive of GSWs’ MH outcomes. Increasing feelings of safety in the workplace and reducing stress may lessen MH symptoms.