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USC Study: Stores Offering Healthy, Low-cost Foods Less Plentiful in Rural Areas

People who want to adopt healthy lifestyles often are at a disadvantage if they live in rural areas where stores offering nutritious foods at a lower cost are few and far between.

A study by the University of South Carolina’s Arnold School of Public Health examined the “nutritional environment” of a rural county to determine the number and types of food stores, the availability of stores and the price of a specific list of staple foods representing the main food groups.

Researchers selected Orangeburg County in South Carolina for the study. The rural county, which covers 1,106 square miles, has a population of more than 91,500 people, of whom 63 percent are minority.

“Stores offering more healthful and lower-cost food selections were greatly outnumbered by convenience stores, which offered fewer healthy foods,” said Dr. Angela Liese, an associate professor at the Arnold School and the study’s lead author.

“Very little is known about the nutritional environment of rural areas, but 20 percent of Americans live in rural areas,” she said. “Our findings underscore the challenges that rural residents encounter when they want to adopt healthier lifestyles.”

The study is one of the first in the nation to look at store choices in rural areas. The results are published in the November issue of the Journal of the American Dietetic Association.

Of the 77 stores located in Orangeburg County at the time of the 2004 study, only 16 percent were supermarkets, and 10 percent were grocery stores. The remaining 74 percent of the stores were convenience stores. Supermarkets were defined as stores with more than $2 million in sales annually and usually belonged to large chains; grocery stores were defined as stores having less than $2 million in annual sales and were generally smaller than supermarkets.

The county had seven stores per 100 square miles and eight stores per 10,000 residents. Healthy foods were abundant in the supermarkets and grocery stores if available, were more expensive at the convenience stores.

Among the findings:

Only 4 percent of convenience stores carried high-fiber bread;
Only 28 percent of any of the stores sold any of the fruits or vegetables listed on the survey – apples, cucumbers, oranges and tomatoes;
Only 2 percent of convenience stores carried low-fat or skim milk;
Eggs were available in 29 percent of convenience stores, and none of these stores carried ground beef (lean or high fat), chicken drumsticks or chicken breasts;
98 percent of convenience stores had off-street parking and only 36 percent offered handicap parking;
Food stamps were accepted by all the supermarkets, 63 percent of the grocery stores and 2 percent of the convenience stores.

The Arnold School study follows a report that the Los Angeles City Council, concerned about the possible link between obesity and fast-food restaurants, was considering a moratorium on the building of new restaurants in south Los Angeles while city planners looked at ways of attracting businesses with a greater variety of food choices.

“We clearly are seeing a move in this country to better understand how availability and costs of certain foods affect people’s choices,” Liese said. “Knowing the nutritional environment of a community may be important in how we help the people living there make better choices for their health.”

Although the Dietary Guidelines for Americans are intended for all U.S residents, Liese said that people living in rural areas are at a marked disadvantage in being able to meet these guidelines.

(Images provided by USC.)