by Alex Smith, Heartland Health Monitor
For customers stepping inside Abarrotes Delicias, the noise, traffic and heat of the surrounding Kansas City, Kan., neighborhood seem to disappear.
The small store offers everything from tacos to snacks to money transfers – or just an air-conditioned place to hang out and watch TV on a lazy afternoon.
Owner Graciela Martinez said she tries to provide a welcoming personal touch when serving her customers, who comprise a diverse sample of nearby residents.
“The clients that come here are mostly Latinos from Central America,” Martinez said. “Workers, mothers with kids, kids.”
In a largely Spanish-speaking part of town where there are few grocery stores, small tiendas like this one are often among the few places people can shop for food – and unfortunately, the food offerings usually are not all that healthy.
“In these communities, it’s easier to get soda or candy or highly preserved foods than it is to get the healthy options,” said Vicki Collie-Akers, a University of Kansas researcher and community health worker.
Collie-Akers leads the Health for All Food Retail and Restaurant Initiative, which aims to improve community health by changing the way small neighborhood stores do business.
Product placement
Whether they are entering a tienda in Kansas City, Kan., a large suburban grocery store in Johnson County or a convenience store in a small town, shoppers typically are greeted by enticing displays of chips, soda and candy. And that is no accident.
Junk-food makers offer big incentives to stores in exchange for prime product placement and promotion.
In many parts of town, health-conscious shoppers can easily bypass the snacks and head for the produce. But in food deserts — areas that lack well-stocked grocery stores — that’s usually not an option.
Collie-Akers is trying to change that dynamic in Latino neighborhoods, where obesity and diabetes are persistent problems.
“We focus on how the environment supports or does not support healthy eating or engagement in physical activity,” she said.
It’s not just a matter of stocking some fruits and vegetables and expecting customers to buy them. Health advocates must contend with the highly savvy marketing techniques that junk food marketers deploy.
So changing how stores operate means thinking not like a high-minded health crusader but like a marketer.
“If you’ve been in a grocery store, you know that the impulse buys are right next to the cash register — the gum and the candy,” Collie-Akers said. “We’re trying to make it such that the avocados are right next to the cash register.”
Following the example of food makers and wholesalers that offer branded coolers, shelving and promotions in exchange for prime shelf space, the Health for All Food Retail and Restaurant Initiative offers its own coolers and fruit baskets plus promotion on social media. In exchange, the stores agree to stock fruits, vegetables and other healthy foods and put them within easy reach of customers.
“We’re trying to make it almost the default behavior to get the healthy options,” Collie-Akers said.
Community-based strategies
But changing how stores operate and customers behave isn’t easy, according to Alex Ortega, a University of California, Los Angeles professor who’s been involved with similar programs in East Los Angeles and nearby Boyle Heights for several years.
“So if you build it, it doesn’t mean they’re going to come, right?” Oretga asked.
He said he’s seen the strategy work well: Some stores he’s worked with have reported a 20 percent increase in profits since introducing healthy foods.
Effecting real change in community health, however, requires more than a one-size-fits-all strategy.
“There’s different cultures, different language, different kinds of foods that are being bought and prepared,” Ortega said. “You really have to know what the needs are of the community and what the perceptions are of corner stores. And that will vary from community to community.”
While many health advocates talk about the problem of food deserts, some studies show that simply providing better food options in many neighborhoods doesn’t change what people buy or eat.
“You have to have health education and community outreach as part of the intervention,” Ortega says.
Healthy foods projects are being undertaken in more areas with large Latino populations. In some of those places, though, the market interventions have been akin to TV makeover shows, with little commitment to the community they’re trying to help.
“They will spend anywhere between a weekend to maybe a month with a store and not doing the kind of back and forth that needs to be involved in terms of tweaking the intervention as the project moves along,” Ortega said.
Seeing a difference
Organizers for the Kansas City, Kan., program say they’ve been working closely with store owners through the first year of the program. And as they expand the program to more stores and into restaurants in the coming year, they plan even more community engagement.
They’re now evaluating the first year’s achievements, though to hear store owner Martinez tell it, the program already has made a difference for her customers.
“At first, they were like, ‘Where are the potato chips?’” she said. “But once they got used to it, instead of buying potato chips, they’ll pick up a banana. And that’s better.”
Collie-Akers hopes that success will prove contagious.
“Our hope is that that information can be used as we go further to expand the number of stores that are engaged and create some champions within the community of business owners that will help us convey information to others stores that tell them, ‘Well, there really is a market for this,’” she said.
The nonprofit KHI News Service is an editorially independent initiative of the Kansas Health Institute and a partner in the Heartland Health Monitor reporting collaboration. All stories and photos may be republished at no cost with proper attribution and a link back to KHI.org when a story is reposted online.
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