Objective

In response to recent national efforts to increase the availability of healthy food in small stores, we sought to understand the extent to which small food stores could implement the newly published Healthy Small Store Minimum Stocking Recommendations and reflect on the new US Department of Agriculture Food and Nutrition Service's final rule for stocking of staple foods for Supplemental Nutrition Assistance Program–approved retailers.

Design

We collected qualitative and quantitative data from 57 small stores in four states (Arizona, Delaware, Minnesota, and North Carolina) that accepted Supplemental Nutrition Assistance Program but not Special Supplemental Nutrition Assistance Program for Women, Infants, and Children benefits. Data from semistructured, in-depth interviews with managers/owners were transcribed, coded, and analyzed. We collected quantitative store inventory data onsite and later performed descriptive analyses.

Results

Store interviews revealed a reluctant willingness to stock healthy food and meet new recommendations. No stores met recommended fruit and vegetable stocking, although 79% carried at least one qualifying fruit and 74% carried at least one qualifying vegetable. Few stores met requirements for other food categories (ie, whole grains and low-fat dairy) with the exception of lean proteins, where stores carrying nuts or nut butter were more likely to meet the protein recommendation. Water and 100% juice were widely available and 68% met basic healthy beverage criteria.

Conclusions

In contrast to the inventory observed, most owners believed store stock met basic recommendations. Further, findings indicate that small stores are capable of stocking healthy products; however, technical and infrastructure support, as well as incentives, would facilitate shifts from staple to healthier staple foods. Retailers may need support to understand healthier product criteria and to drive consumer demand for new products.

In March 2020, the COVID-19 pandemic triggered a sudden and severe economic downturn. Between February and May 2020, the number of unemployed individuals rose by more than 14 million, resulting in an unprecedented increase in the unemployment rate, which went from 3.8% in February to 14.4% in April. Even though unemployment has declined in recent months, with some individuals returning to work, the rate is still much higher than it was one year ago (7.9% in September 2020 vs. 3.5% in September 2019). Further, as of September 2020, there are 19.4 million persons unable to work due to the pandemic, as well as 6.3 million persons working only part time even though they would prefer to work more.

In the face of the coronavirus (COVID-19) pandemic, food assistance programs adapted quickly and in unprecedented ways to meet the challenges of high unemployment, disruptions in the food supply, and school closures. Supported by US Department of Agriculture’s COVID-19 program-specific waivers, some programs relaxed their eligibility criteria, while others improvised on delivery modalities or temporarily increased benefits.1 To examine food assistance program participation and participant experiences during the first few months of the pandemic, we collected online survey data in July 2020 from a sample of over 1,500 U.S. households, representative of the US population. This brief summarizes participation in key food assistance programs, namely, the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Program for Women Infants and Children (WIC), School Food Programs, as well as emergency food assistance provided through Food Pantries. 

Many factors influence children’s health behaviors and health outcomes. The Social Ecological Model (SEM) groups these factors into interactive layers, creating a framework for understanding their influence and for designing interventions to achieve positive change. The layers of influence in the SEM include individual, interpersonal, organizational, community, and policy factors (see figure). The New Jersey Child Health Study (NJCHS) was designed to examine how specific layers of the SEM, particularly food and physical activity environments in schools and communities, affect obesity outcomes in children

With more than 19 million confirmed COVID-19 cases across the United States1 and over 500,000 in Arizona as of December 2020, the ongoing pandemic has had devastating impacts on local, national, and global economies. Prior to the pandemic (February 2020), based on U.S. Bureau of Labor Statistics data, the unemployment rate in Arizona was 6.5%, compared to 4.9% at the national level.3 Since the beginning of the COVID-19 pandemic (March 2020), the United States has experienced striking increases in the unemployment rate, reaching 13.2% in April. Similarly, in Arizona, the unemployment rate jumped to over 13.5% in April. The unemployment rates have since declined both nationally and in Arizona but remain higher compared to February 2020. In November 2020 (the most recent data available), the national unemployment rate was 6.7%, while in Arizona the rate was 7.8%—the 10th highest unemployment rate among all U.S. states.