Effect of price, variety, and caloric cost on food purchases in corner stores in NYC Mindy Chang, MPH, DVM City Harvest Evaluation Dept. November 2014 Disclosure I have no relationships to declare 2 Introduction • Obesity – 34.9% (78.6 million) U.S. adults are obese1 – Disproportionately affect groups with the highest poverty rates2 – In NYC, 22% are obese3 • • Rates of obesity increases as poverty increases4 – 15.7% with highest income are obese – 26.8% with lowest income are obese Food environment of low-income neighborhoods – Predominantly corner stores5 • Charge higher prices for healthier food6 • Limited availability of fruits and vegetables7 • Primarily offer inexpensive snack foods8 – Candy, fried snacks – Sugar sweetened beverage – Packaged bakery product – Presence of corner stores associated with increased risk of obesity9 3 Introduction • City Harvest Healthy Corner Store program – Work with corner stores to encourage • Expansion of produce sales • Expansion of healthy choices in stores • Question: What factors will affect customer purchases 4 Methods • Inventory of corner stores (n=29) – List varieties of produce, potato chips and candy – List prices of produce, potato chips and candy – List sizes of potato chips and candy • Customer surveys (n=437) – What do you purchase most often from corner stores – How far is supermarket, corner store and fast food restaurant from where you live – Did you notice food advertisements • Pictures of ads present in 2 block radius around corner store 5 Methods • Data collection – June 2013 to September 2014 • Inventory of corner stores (n=29) – – – – – Bedford-Stuyvesant (n=11) South Bronx (n=9) Long Island City/Astoria (n=4) Stapleton (n=2) Washington Heights/Inwood (n=3) • Customer surveys (n=437) – Gender • Female 45% – Race/ethnicity • Black • Hispanic 41% 36% – Average age 41.3 years old – Average education level: High school graduate/GED 6 What are customers buying-food (n=437) 36% 36% Chips Candy 32% 24% 9% Fresh fruit Fresh vegetable Canned fruit 8% Canned vegetable 7 Factors that may affect corner store purchases • Distance to stores – Supermarket – Corner stores – Fast food restaurants • Quality of produce available in corner stores • Number of varieties available of produce and snack foods at corner stores • Cost of produce and snack foods at corner stores • Advertising Factors that may affect purchases: Distance to stores Store type Range of blocks to store Average number of blocks to store (+/- stdev) Supermarket 0-20 3.17 (+/-3.18) Corner store 0-8 1.36 (+/-0.98) Fast food restaurant 0-25 3.36 (+/-3.35) • Distance to supermarkets, corner stores and fast food restaurants categorized as – Close (less than 3 blocks) – Medium (3 to 6 blocks) – Far (more than 6 blocks) Factors that may affect purchases: Distance to stores % of Customer who Purchase Fruits % of Customers who Purchase Vegetables 40% 33% 36% 32% 31% 27% 33% 31% 29% 26% 26% 24% 23% 24% 26% 20% 17% 16% Corner store Supermarket Close Medium Fast food restaurant Far Corner store Supermarket Close Medium Fast food restaurant Far Factors that may affect purchases: Distance to store % of Customers who Purchase Chips % of Customers who Purchase Candy 42% 42% 38% 36% 42% 38% 33% 36% 32% 33% 27% 21% 20% 0% Corner store 38% 37% 42% 0% Supermarket Close Medium Fast food restaurant Far Corner store Supermarket Close Medium Fast food restaurant Far Factors that may affect purchases: Quality of produce • Quality of produce categorized as – Poor (1) – Fair (2) – Good (3) Average fresh fruit quality 2.4 Average fresh vegetable quality (+/- 0.49) 2.2 (+/- 0.49) Factors that may affect purchases: Quality of produce 40% 31% 24% 24% 24% 15% Fruit quality % Customers who purchase fruits Vegetable quality Poor Fair Good % Customers who purchase vegetables Factors that may affect purchases: Variety Food type Range of variety Average variety (+/- stdev) Fruit 0-16 7.18 (+/-3.92) Vegetable 0-20 9.28 (+/-4.89) Potato chips 0-46 14.14 (+/-11.64) Candy 0-165 38.48 (+/-33.57) • Variety of produce, chips and candy available categorized as (based on tertile) – Low variety – Medium variety – High variety Factors that may affect purchases: Variety 55% * 43% 37% * 34% 30% 30% 13% Fruit % Customers who purchase fruit *p <0.05 41% 29% 31% 31% 13% Vegetable % Customers who purchase vegetable Low variety Potato Chips % Customers who purchase chips Medium variety High variety Candy % Customers who purchase candy Factors that may affect purchases: Cost (per ounce) Food type Range of cost per ounce Average cost per ounce (+/- stdev) Fruit $0.05-$0.34 $0.12* (+/-0.04) Vegetable $0.04-$0.33 $0.12* (+/-0.05) Potato chips $0.17-$1.00 $0.41 (+/-0.12) Candy $0.01-$1.25 $0.47 (+/-0.26) • Candy and potato chips are significantly more expensive – Contradictory to what customers are purchasing • Cost per ounce of produce, chips and candy available categorized as (based on tertile) – Low cost – Medium cost – High cost *p<0.05 significantly different compared to chips or candy Factors that may affect purchases: Cost (per ounce) 50% 43% 45% 40% 35% 34% 41% 37% 36% 32% 30% 28% 26% 23% 25% 20% 15% 17% 14% 10% 7% 5% 0% Fruit % Customers who purchase fruit *p <0.05 Vegetable % Customers who purchase vegetable Low cost Potato Chips % Customers who purchase chips Medium cost High cost Candy % Customers who purchase candy Factors that may affect purchases: Cost (per calorie) Food type Range of cost per calorie Average cost per calorie (+/- stdev) Fruit 0.33¢-7.14¢ 1.76¢ (+/-1.233) Vegetable 0.19¢-3.62¢ 1.11¢* (+/-0.53) Potato chips 0.11¢-0.65¢ 0.27¢ (+/-0.08) Candy 0.09¢-1.15¢ • $0.0043 +/- 0.0024 per calorie 0.43¢ (+/-0.24) • Potato chips and candy is significantly cheaper per calorie • Cost per calorie of produce, chips and candy available categorized as (based on tertile) – Low cost – Medium cost – High cost *p<0.05 significantly different compared to chips or candy Factors that may affect purchasesCost (per calorie) * * 39% 37% 35% 41% 38% 36% 33% * 27% 24% 15% 14% Fruit % Customers who purchase fruit *p <0.1 12% Vegetable % Customers who purchase vegetable Low cost Potato Chips % Customers who purchase chips Medium cost High cost Candy % Customers who purchase candy Factors that may affect purchases: Advertising Ads for type of food Range of number of ads seen Average number of ads seen Fruits and vegetables 0-9 2.71 Fast foods 0-14 5.36 • Number of advertisements of produce and fast foods chips in neighborhood categorized as (based on tertile) – Low number of ads – Medium number of ads – High number of ads Factors that may affect purchases: Advertising 78% 62% 38% 65% 37% 25% Percent of customers who notice produce Percent of customers who notice fast food ads ads Low number of ads Medium number of ads High number of ads 55% * 25% 27% 22% 24% 25% Percent of customers who purchased Percent of customers who purchased chips produce Low number of ads Medium number of ads High number of ads Conclusions • Factors that showed significant association with customer reported purchases from corner stores – Number of varieties available – Cost of produce (per calorie) • Factors that did not show any significant association – Distance to store – Quality – Advertising • Program should focus on availability – Increasing variety of fruits and vegetables sold • Work with suppliers, retailers and policy makers to affect prices – May be difficult to achieve Limitations • Self-report • Sample size – 437 customers – 29 corner stores • Assessment of quality of produce – Subjective process • Number of varieties available of produce – Seasonality not accounted for • Cost of produce at corner stores – Approximation of produce based on average size and calorie content of produce • Advertising – Only print ads present in neighborhood – May not have captured all ads – TV commercial ads not accounted for Works cited 1. 2. 3. 4. 5. 6. 7. 8. 9. Centers for Disease and Prevention. Overweight and Obesity: Adult Obesity Facts. Accessed Nov 11, 2014. www.cdc.gov/obesity/data/adult.html Arfken CL, Houston CA. Obesity in inner-city African Americans. Ethn Healthy. 1996 Dec; 1(4): 317-26. New York City Department of Health and Mental Hygiene. Obesity. Access Nov 11, 2014. www.nyc.gov/html/doh/html/living/obesity.shtml New York City Department of Health and Mental Hygiene. Community Health Survey (2012): public use dataset accessed on Nov 11, 2014. http://www.nyc.gov/html/doh/html/data/chs-data.shtml Cannuscio CC, Tappe K, Hillier A, Buttenheim A, Karpyn A, Glanz K. Urban food environments and residents shopping behaviors. Am J Prev Med. 2013; 45(5):606614. Krukowski RA, West DS, Harvey-Berino J, Elaine Prewitt T. Neighborhood impact on healthy food availability and pricing in food stores. J Community Health. 2010; 35: 315-20. Leone AF, Rigby S, Betterley C, et al. Store type and demographic influence on the availability and price of healthful foods, Leon County, Floriday, 2008. Prev. Chronic Dis.. 2011; 8, A140. Lucan SC, Karpyn A, Sherman S. Storing empty calories and chronic disease risk: Snack-food products, nutritive content and manufacturers in Philadelphia corner stores. J Urban Health. 2010; 287: 394-409. Bodor JN, Rice JC, Farley TA, Swalm CM, Rose D. The association between obesity and urban food environments. J Urban Health. 2010; 87(5):771-81. Special Thanks To Aditi Puri Jennifer McLean Veronica Uzoebo Sally Cooper Sheilah Crowley Raul Barrios Touro Interns Sarah MacLeod CUNY Corp Interns