Does Opening a Supermarket in a "Food Desert" Improve Residents' Diets?

A study of a Pittsburgh neighborhood where a supermarket opened after 30 years’ absence found that while residents reported eating fewer calories and less sugar, a perceived better access to healthy foods, and were more satisfied with their neighborhood after the store was built, reported changes in dietary intake were not related to the use of the new grocery store. This surprising conclusion was reported in the November issue of Health Affairs.

Tamara Dubowitz, ScD, SM, MSc, senior policy researcher at RAND Corporation, and coauthors found multiple positive changes following the opening of the supermarket in a former food desert, but the changes in diet were not related to use of the supermarket.

“The only outcome that was directly related to use of the store was perceived access to healthy foods,” Ms Dubowitz said in a statement. Residents who reported the most improved access to healthy foods also used the store more frequently.

Although the researchers found improvement in several components of the residents’ diets, the consumption of fruits and vegetables declined after the supermarket opened. Furthermore, there was no significant change in the rates of overweight or obesity during the study period.

The study was conducted in Pittsburgh’s Hill District, a predominantly African-American neighborhood that had been without a supermarket for 30 years. The experiences in the neighborhood were compared with those of residents in the nearby Homewood neighborhood, a sociodemographically similar area also considered to be a food desert. The 1372 study participants were primarily women and nearly all were African-American.

At the start of the study, most participants from both neighborhoods reported doing their major food shopping at a full-service market outside their own neighborhood. Participants were surveyed before the new store opened and again 7 to 13 months after it opened. In addition to answering questions about their perceptions of access to healthy foods, participants’ heights and weights were measured. Final results are based on the 831 households that participated in both baseline and follow-up data collection.

After the new grocery opened, Hill District residents reported better access to healthy foods and improved satisfaction with their neighborhood, as well as a significant decrease in total calories per day, and reductions in consumption of solid fats, alcoholic beverages, and added sugars. However, contrary to the study’s hypothesis (and the intentions of policy makers) that a supermarket would improve neighborhood residents’ consumption of produce, consumption of fruit and vegetables actually declined in both the intervention and comparison neighborhoods after the new supermarket opened, the researchers noted. This may be because almost all the residents of both neighborhoods shopped before and after the new store’s opening at food retail venues that do not aggressively market produce or incentivize purchasing it.

The investigators conclude that their data show introducing a supermarket into a food desert may lead to improvements in the quality of neighborhood residents’ diet. However, they caution that continued financing of new supermarket placement should proceed with caution and be coordinated with continued research on how store placement impacts diet-related behavior and health.