Neighborhoods - A Corner Store Diet

GSU, Morehouse, and the CDC collaborate on a Healthy Corner Store Initiative

046806 Neighborhood Stores1 3 48
Photo credit: Eric Cash
FRESH TO GO: Mary Anne Adams (left) and Margaret Hooker in Capitol V at Metro Foods, one of the shops participating in their Healthy Corner Store Initiative

There's no shortage of convenience stores on Atlanta's west and southwest sides. Supermarkets are another story. A number of neighborhoods in the area such as Capitol View qualify as food deserts — places with poverty rates higher than 20 percent and more than a third of residents living at least a mile from a grocery store. Not surprisingly, chronic disease tends to show up in areas where access to fresh, healthy foods is limited. To begin addressing these issues, Georgia State University professor Rodney Lyn, in collaboration with the Morehouse School of Medicine, has launched a Healthy Corner Store Initiative. It's being implemented across an area that includes Neighborhood Planning Units T, V, X, Y, and Z (from Lakewood and Sylvan Hills up through Adair Park and West End) with $400,000 from the CDC's Racial and Ethnic Approaches to Health, or REACH, grant program. Lyn and his team, which includes Mary Anne Adams and Margaret Hooker, who work in GSU's School of Public Health's Center of Excellence on Health Disparities Research, are working directly with neighbors, neighborhood groups, and store owners to make healthy foods available to more Atlantans. Their goal is to have 21 stores enrolled by the time the three-year program wraps in fall 2017.

What issues do you see where you're working in Atlanta?

Rodney Lyn: When you go NPU-V all the way up through the westside, where we've been doing work [in predominantly African-American neighborhoods], the profile is fairly similar in terms of the burden of chronic disease, HIV, diabetes, heart disease, obesity. Hypertension is a major burden. Mental health is another issue.

Mary Anne Adams: What we're seeing day-to-day are people really impacted by poverty. They're either unemployed or underemployed, folks who have huge transportation barriers so they have to rely on these corner stores because they don't have the transportation to go to a big-box store nor do they have the resources to do that. A typical customer in a lot of these corner stores goes in for sodas, lottery tickets, tobacco. People are not going in to utilize these stores for groceries.

If you're HIV positive, you have diabetes or cardiovascular disease, you need to be eating nutritional foods. If you don't know what they are or you can't afford them, then you revert back to what's familiar, what you know, and what's cheap.

What work are you doing in the neighborhoods at this point?

MAA: We are giving [store owners] information about health disparities, about who's in their neighborhood, and making them more aware of what these health disparities are and how they can really help by increasing the healthy foods that they carry in their stores. We're not trying to do this on a large scale, but maybe three to four offerings. Maybe if you just carry bananas now. Maybe you can carry some apples, some grapes, low-sodium foods. We're trying to do it in the context of where the store is and who their customer base is and currently what they have. The store owners, by and large, it has not been difficult to enroll them. ... We are very pleased with the owners who have readily enrolled into this program, and who really sincerely want to do something different. They just didn't know how to do it.

RL: When we started this, we didn't envision that this initiative was going to turn food access on its head in these communities. It was: Here's where the community is. What can we do to get the ball rolling? We don't have a lot of money. The resources are limited. Can we look at the existing infrastructure in the communities? These convenience and corner stores are a part of that. Can we leverage them as a part of the effort?

Capitol View's Metro Foods
Photo credit: Eric Cash

Are you working on any partnerships?

MAA: [Wholesome Wave is] very much interested in partnering with us. ... We want to do a neighborhood cleanup. That would be a way to get people invested. And not just one time but hopefully we can build this into the culture. We also are interested in developing recipes and doing workshops with the community residents and having food demonstrations at these stores. I think these are partnerships that we can develop that will be vital, and that will continue to cause awareness, and get people involved and invested.

What are you seeing as some of the source issues for the lack of information about food and how to cook it?

RL: Educating people alone, we've been doing that for decades, and the needle hasn't really moved on nutrition, physical activity. The approach over the last, going on 10 years now, has been to create environments and policies and systems that support healthy choices. If I put people in an environment where it's easier to make a healthy choice, then they're more likely to do that. If people don't have the environments or the access to the healthy products then it's sort of all for naught. That's part of what this effort is. Can we create the environment that at least facilitates healthier behaviors?

People often have a hard time understanding why a mile is far away to travel for food. What you do say to help people understand what a burden a mile really can be?

RL: We often have a hard time understanding things that we take for granted. We take for granted things that are just given in our lives. It's a very different reality to be in a community that's cut off by major interstates, where bus routes may not be as convenient as you would like. The means of transporting your products, if you can even get to them, is not easy. ... There has to be consideration of sidewalks, streets, bus routes, access to transportation of all kinds.

MAA: You see now more seniors who are using electronic motorized wheelchairs. We've seen people using these to go into these corner stores since we've been out doing this. When you're in a chair, and you have a bag, and you're trying to go down the street and the sidewalks are not accessible, that mile seems a long, long way. For the people that we deal with every day, they clearly understand a mile and what a burden a mile is.

RL: All that, and then don't let it be cold or raining.

FRUIT FULL: The team is starting small by educating owners and encouraging manageable changes such as adding bananas near the register.
Photo credit: Eric Cash

Does any of the money go to help fund the store owners or are you working to convince them that this is the right decision for their business?

RL: We've been trying to make a business case. We've been trying to make the case on a number of different fronts with the store owners, but it's not been a, "Hey, we'll give you $500." We haven't had that sort of luxury in this initiative. ... There's a start small sort of approach. It's generally not wise, on any sort of program, to launch it before you have any evidence of feasibility. That's where we are, is launching and establishing feasibility.

What can a corner store add to a culture of a neighborhood?

RL: I think some of the things that we haven't gotten to yet that we still have on our to-do list is outreach. Outreach to logical community organizations and partners to increase awareness of what's going on. I think the NPUs can help us with that, but there'll be some additional outreach. The other thing is connecting things like urban gardening to this movement. There's a lot of it going on here. It says that there is a community of people that have a real interest in sustainable, healthy products and foods. I think to the extent that we can bridge those gaps right now, I think there's a lot of value in that.

What I've seen with gardens is that they are an important source of community cohesion and community social capital. Community building is maybe a better way to say it. I've seen where people have put in gardens, those gardens that then the county says, or the city says, "We're going to invest. We're going to put a pavilion in." People are barbecuing there now. We're going to put signage in. People raise money, and now there's a trail around the community garden so people can get physical activity. Then you get a grant, and there's a manager for the garden, and it's growing. It's sort of something that can build momentum over time.

MAA: When we look at all these potential partners and the possibilities for community gardens and for healthy corner stores and for community partners we're bringing awareness to a generation of young kids who are looking at what we're doing, because these kids also frequent these stores. I think it's important for us to remember that what we're doing now is going to impact them. It's educating them now. It's going to affect them for generations to come.