Unexpected Neighborhood Sources of Food and Drink: Implications for Research and Community Health

Introduction: Studies of neighborhood food environments typically focus on select stores (especially supermarkets) and/or restaurants (especially fast-food outlets), make presumptions about healthfulness without assessing actual items for sale, and ignore other kinds of businesses offering foods/drinks. The current study assessed availability of select healthful and less-healthful foods/drinks from all storefront businesses in an urban environment and considered implications for food-environment research and community health. Methods: Cross-sectional assessment in 2013 of all storefront businesses (n=852) on all street segments (n=1,253) in 32 census tracts of the Bronx, New York. Investigators assessed for healthful items (produce, whole grains, nuts, water, milk) and less-healthful items (refined sweets, salty/fatty fare, sugar-added drinks, and alcohol), noting whether items were from food businesses (e.g., supermarkets and restaurants) or other storefront businesses (OSB, e.g., barber shops, gyms, hardware stores, laundromats). Data were analyzed in 2017. Results: Half of all businesses offered food/drink items. More than one seventh of all street segments (more than one third in higher-poverty census tracts) had businesses selling food/drink. OSB accounted for almost one third of all businesses offering food/drink items (about one quarter of businesses offering any healthful items and more than two thirds of businesses offering only less-healthful options). Conclusions: Food environments include many businesses not primarily focused on selling foods/drinks. Studies that do not consider OSB may miss important food/drink sources, be incomplete and inaccurate, and potentially misguide interventions. OSB hold promise for improving food environments and community health by offering healthful items; some already do.