Marion County Health Department, Oregon
December 2, 2013
Marion County Health Department, Oregon
December 2, 2013
The Marion County Health Department in Oregon's Willamette Valley is working to improve the health of rural communities and decrease obesity and obesity-related diseases through a Healthy Corner Stores Initiative. This project seeks to improve access to and availability of healthy food options in corner/convenience stores in USDA-identified food deserts in Northern Marion County.
Adult and youth Marion County residents that live in USDA-identified food deserts are the target population of this intervention. These are low-income individuals and families who do not have easy access to full scale grocery stores that sell nutritious, healthy foods because of distance and transportation issues. Corner stores become a primary source of food for rural residents. Those living in these communities are more likely to be minority populations, which in Marion County include: Latinos, Marshall Islanders, Russian/Old Believers and African Americans. Additionally these communities have high percentage of students on free and reduced school lunch programs. These stores are traditionally stocked with high-calorie, low-nutrient junk food which are primary contributors to the obesity epidemic. Youth are included as a target population as corner stores in low-income communities are places young people frequent after school to purchase snacks and beverages. By working with corner store owners to increase their stock of healthy foods, improve marketing of healthy options and improve store infrastructure, shoppers can easily find and purchase healthy food like produce, low-fat dairy and whole grains.
Thanks to a Community Benefit grant from Kaiser Permanente Northwest, Marion County Health Department staff has partnered with independently-owned corner/convenience stores (no chains) in Marion County food deserts to improve health since 2011. Participating store owners agree to make environmental and policy changes by engaging in activities outlined in a tailored Store Plan, intended to guide improvements and meet the community’s needs regarding healthy food options at the store. Customers at each store are surveyed prior to store changes being implemented to provide feedback about interest in purchasing healthy options, likelihood of purchasing healthy options and types of foods they’d like to see for sale. The store surveys provide meaningful insight into the desired changes from the stores customer base. Based on the survey information and the Store Plan, infrastructure and point of sale directives are negotiated with the store owner and purchased by Marion County. Examples include: produce displays for fruits and vegetables, baskets and shelving to store healthy options, signage advertising healthy food, and refrigeration units for low fat dairy products. Marion County provides regular support and technical assistance to store owners during the implementation phase assisting with marketing healthy options, point of sale directives and food presentation.
In the first 2 years of the project we have seen a commitment from store owners to invest in the health of their community. Participating store owners have implemented changes to influence customer shopping patterns for better health. These include store infrastructure improvements, rearranging inventory to showcase healthy options, point of sale directives, increasing inventory of produce and low fat dairy products, branding, labeling, and marketing healthy food options, and using refrigeration units to store perishable foods, among others. The store-specific interventions are designed for the unique customer base of each store. Some participating stores have elected to become SNAP and WIC certified in order to better serve their customers. Store owners report they are not losing money and their customers are buying the newly added healthy foods. While they may not necessarily make a profit from the healthy options, they feel good about the changes they are making for their customers. In the long term we hope to see a decrease in obesity rates and related disease and an increase in reported consumption of fruits and vegetables. More broadly, we aim to raise awareness among food retailers of the opportunity to contribute to healthy communities.
Healthy Corner Stores has been a unique opportunity to partner with the businesses community for better health. Because the Health Department provides some financial assistance in purchasing the store infrastructure improvements, store owners have been willing to take a chance and partner with us. Profit margins and bottom lines are critical for store owners and we must be mindful of this when we pursue their partnership. Turnover in ownership and stores staying in business have been challenges in some cases. Store owners move through the stages of change at a different rate but personal contact and lots of face time have proved successful in engagement and retention. Measuring impact and outcomes is difficult because these independently owned stores do not have sophisticated electronic inventory management systems that track stock and provide sales data. Instead, a store inventory is conducted before and after the intervention to evaluate the foods being sold and marketed, and store owners monitor sales of healthy food informally. Other process measures and outputs can provide meaningful information but we are always looking for better measurement tools. This project can easily be replicated in other communities looking for ways to partner with food retailers for better health.