Delivering Healthier Options to North Carolina’s Rural Food Deserts

In 2015, the North Carolina legislature passed “The Healthy Food Small Retailer Program” (HFSRP), allocating $750,000 over three years to small food retailers located in USDA-defined food deserts. These funds could be used to purchase and install refrigeration equipment, display shelving, and other equipment necessary for stocking nutrient-dense foods, including fresh vegetables and fruits, whole grains, lean meats, and seafood.

Despite the policy’s potential to improve individuals’ dietary habits, current evaluation efforts are currently limited to impact on sales. To understand the potential of this policy to improve community-level health outcomes, the research team will conduct a rigorous quasi-experimental study to evaluate:

1. The public health impact of the HFSRP on the food retail environment and weight-related dietary outcomes among customers; and,
2. Store and community-level economic impacts, and overall potential for sustainability.

Healthy small store initiatives are one strategy to provide healthy options in underserved areas, including rural communities. Such initiatives could potentially address the obesity epidemic by providing healthier foods and beverages in small food stores where candy, sugary beverages, and processed foods are often purchased. Evidence on these policies’ effectiveness is critical to determine sustainability for future state-level initiatives.