Corner stores, convenience stores, and bodegas in two lower-income North Philadelphia neighborhoods began carrying fruits, vegetables, whole-grain products, and other healthy foods after the federal government made changes to a popular food aid program, a study out today says.
Corner stores often carry high-fat, high-sugar junk foods like soda, chips, and other products that, if eaten in excess, can lead to weight gain and even obesity. This study found that changes made in 2009 to the Special Supplemental Nutrition Program for Women, Infants, and Children (often called the WIC program) prompted stores participating in WIC to start offering healthier foods. In addition, the changes in the federal program might have had a positive impact on all neighborhood food stores, including those that did not participate in WIC.
The selection of foods available through the WIC program, often referred to as the WIC food package, is tailored to meet the special nutritional needs of lower-income pregnant and postpartum women, as well as infants and children up to five years of age who may not have regular access to nutritious foods and are at risk for diet or medical problems. Prior to implementing the new regulations, the U.S. Department of Agriculture commissioned the Institute of Medicine to recommend ways to make the program healthier without making it more expensive for the government or families.
“Changes in the WIC food package helped increase access to healthy foods in two impoverished neighborhoods,” said Amy Hillier, PhD, lead author of the paper and an investigator at the University of Pennsylvania. “Even small corner stores started stocking fruits and vegetables, lower-fat milk, and foods that can help residents stay healthy and reduce their risk of obesity.”
The study, which was supported by the Robert Wood Johnson Foundation through its Healthy Eating Research program, was published by the Journal of Nutrition Education and Behavior. It is one of the first to examine access to healthier foods as a result of the 2009 revisions in the WIC program. Research conducted by the Altarum Institute and the Rudd Center for Food Policy and Obesity at Yale University found similar positive changes in states, including Connecticut, New Hampshire, Wisconsin, Pennsylvania, and Colorado.
In 2009, WIC started giving participants in the program vouchers that would pay for fruits and vegetables, tofu, and whole-grain foods such as whole-wheat bread and brown rice. The program made other changes in the approved food package, including a switch from whole-fat to reduced-fat milk.
Hillier and her colleagues assessed 115 stores in two mostly Hispanic and African American neighborhoods. They used a standardized checklist of healthy foods called the Nutrition Environment Measure Survey for Stores to count each store’s inventory in 2009 and again in 2010.
Full-service chain supermarkets in the study area scored highest for availability of healthy foods, and approximately 54 percent of residents in the study area lived within a half-mile of such a store. But Philadelphia also has hundreds of small corner stores or convenience stores, and these are especially common in lower-income areas that Hillier and colleagues studied. Some WIC participants, particularly those without cars, choose to do their WIC shopping at these smaller stores because it is more convenient than getting a ride or taking public transportation to the supermarket, said Hillier.
These small stores scored worse than full-service grocery stores. However, the study found significant improvement in the availability of healthier foods in all food stores participating in WIC, including bodegas, which in North Philadelphia are not part of a chain, but are individually owned.
Convenience stores in the United States typically do not carry healthy foods like reduced-fat milk, brown rice, or whole-grain bread because they do not sell as well as the less-healthy versions of the same foods. However, once WIC started giving vouchers for fruits and vegetables and other healthy foods, small store owners in North Philadelphia seemed happy to stock these food items, Hillier said.
The study also shows that even stores that did not participate in WIC, and thus did not get the voucher incentive, also began to stock their shelves with healthier food items. Other key findings of this study include:
- All food stores in the two neighborhoods improved on a tally designed to measure the availability of healthy foods. Stores participating in the WIC program had a healthy food score that increased by 32 percent from 2009 to 2010, and scores for non-WIC stores went up by 27 percent during the same time frame.
- In 2009, just 50 percent of all food stores in the study area stocked reduced-fat milk, but by 2010 the percentage had jumped to 77 percent. Pediatricians now recommend that children over the age of two drink reduced-fat milk because the switch can help decrease caloric intake and reduce the risk of unhealthy weight gain.
- In 2009, just 33 percent of the stores carried whole-grain bread, but by 2010 that number had jumped to 52 percent. Whole-grain bread offers important nutrients that can help children and adults stay healthy, but small convenience stores often do not stock it.
- In 2009, stores on average carried 7.8 varieties of fruits and vegetables, but by 2010 that number had increased to 9.7. Some corner stores that had not stocked any fruits or vegetables at all before the change started to carry these items for the first time.
While the 2009 revisions in the federal WIC program apply to food stores across the United States, this study looked only at stores in a nearly four-square-mile area of concentrated poverty in North Philadelphia. Additional research will be required to see if the study’s findings apply to food stores in other parts of the country, Hillier said. The study did not assess whether increased access to healthy foods in stores translates to customers consuming more fruits, vegetables, whole-grain products, and other healthy foods. “We think the people frequenting these stores are eating healthier foods but we would need additional research to confirm that,” Hillier said. About Healthy Eating Research Healthy Eating Research is a national program of the Robert Wood Johnson Foundation. The program supports research on environmental and policy strategies with strong potential to promote healthy eating among children to prevent obesity, especially among lower-income and racial and ethnic populations at highest risk for obesity. For more information, visit www.healthyeatingresearch.org. About the Robert Wood Johnson Foundation The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable and timely change. For 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org.