Food environment inequities in urban low-income communities: a novel assessment of small discount stores
1
Global Health Studies & Sociology, University of Miami, Coral Gables, United States
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Urban and suburban low-income areas in the southern United States experience a disproportionate burden of diet-related disorders, driven by limited access to nutritious and affordable foods. Dollar stores have rapidly grown in these regions, often replacing traditional grocers and shaping residents’ nutritional behavior. However, their food environment and their readiness to serve as vendors for the Women, Infants, and Children (WIC) nutrition program remain under-examined. This study addressed this gap using a newly developed Nutrition Environment Measures Survey for Dollar Stores (NEMS-DS). This tool captures dimensions that previous assessments may overlook, mainly because dollar stores rely heavily on ultra-processed foods.
METHODS:
We conducted a quantitative, cross-sectional study in 21-dollar stores across four neighborhoods in Miami-Dade County, Florida. All stores were located in predominantly Hispanic, high-deprivation areas identified by the area deprivation index. Food environments of sampled stores were assessed to capture (1) Healthy Food Availability (HFA); (2) WIC Readiness; (3) Marketing of healthy versus unhealthy items. Descriptive statistics, F-tests, and χ²-tests were employed to compare these stores and 194-dollar stores from a parallel multi-state study.
RESULTS:
The sampled stores demonstrated low HFA scores (mean 25/62) and low WIC readiness (mean 47/190), indicating limited availability of nutritious, WIC-eligible products. Stores devoted only 10% of the total shelf space to healthy items compared to unhealthy snacks. None of the stores marketed healthy foods at checkout, while 100% promoted sugar-sweetened beverages and ultra-processed snacks—no significant differences with other sites.
CONCLUSIONS:
Dollar stores in Miami-Dade County mirrored national patterns of reinforcing unhealthy food environments. Findings provide a policy-actionable framework for expanding WIC vendor eligibility to dollar stores, regulating marketing to improve nutritional behavior, promoting equitable access to nutritious foods, and preventing chronic disease in urban Hispanic communities.
Urban and suburban low-income areas in the southern United States experience a disproportionate burden of diet-related disorders, driven by limited access to nutritious and affordable foods. Dollar stores have rapidly grown in these regions, often replacing traditional grocers and shaping residents’ nutritional behavior. However, their food environment and their readiness to serve as vendors for the Women, Infants, and Children (WIC) nutrition program remain under-examined. This study addressed this gap using a newly developed Nutrition Environment Measures Survey for Dollar Stores (NEMS-DS). This tool captures dimensions that previous assessments may overlook, mainly because dollar stores rely heavily on ultra-processed foods.
METHODS:
We conducted a quantitative, cross-sectional study in 21-dollar stores across four neighborhoods in Miami-Dade County, Florida. All stores were located in predominantly Hispanic, high-deprivation areas identified by the area deprivation index. Food environments of sampled stores were assessed to capture (1) Healthy Food Availability (HFA); (2) WIC Readiness; (3) Marketing of healthy versus unhealthy items. Descriptive statistics, F-tests, and χ²-tests were employed to compare these stores and 194-dollar stores from a parallel multi-state study.
RESULTS:
The sampled stores demonstrated low HFA scores (mean 25/62) and low WIC readiness (mean 47/190), indicating limited availability of nutritious, WIC-eligible products. Stores devoted only 10% of the total shelf space to healthy items compared to unhealthy snacks. None of the stores marketed healthy foods at checkout, while 100% promoted sugar-sweetened beverages and ultra-processed snacks—no significant differences with other sites.
CONCLUSIONS:
Dollar stores in Miami-Dade County mirrored national patterns of reinforcing unhealthy food environments. Findings provide a policy-actionable framework for expanding WIC vendor eligibility to dollar stores, regulating marketing to improve nutritional behavior, promoting equitable access to nutritious foods, and preventing chronic disease in urban Hispanic communities.
| eISSN: | 2654-1459 |
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