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Description
Background: The consumer food environment of food stores located within walking distance to low socio-economic status (SES) elementary schools may influence childhood obesity risk by providing children the opportunity to purchase and consume unhealthy foods and beverages. The number of times a product is displayed, the location of a display, and prominence of a display may influence the likelihood of a product's purchase. Little is known about the consumer food environment of stores around low-SES elementary schools. Methods: Forty-six small food stores within walking distance of low-SES elementary schools in San Diego Unified School District were randomly sampled and audited. Data were collected about outside of primary location (OPL) displays containing sugary beverages and diet sodas (SSDSs), salty snacks (SSs), and fresh fruits and vegetables (FVs). OPL displays were any display located outside of the area within the store that contained the majority of a product's brand-flavor variety. Analyses examined how store characteristics (type, size, ethnicity, and distance to the nearest elementary school) were related to the number of displays, their placement, and their prominence. Additional tests were run to examine the relationship between display content and prominence. Results: Store level results indicated that (1) grocery stores versus convenience stores had more OPL displays containing a combination of unhealthy and healthy products, and a higher proportion of front endcaps with SSDSs; and (2) stores closer to elementary schools (<0.5 mile) versus stores further away (0.5-1.0 mile) had fewer healthy OPL displays. Display level results indicated that (1) a greater number of unhealthy OPL displays and fewer healthy OPL displays were located in the area <0.5 mile from an elementary school compared to 0.5-1.0 mile from a school; and (2) there were more healthy OPL displays in high prominence locations than medium prominence locations. Discussion: This study supports other literature about the abundance of unhealthy food and beverage availability in stores. Decreasing the promotion of unhealthy products can include: decreasing the number of unhealthy OPL displays; placing more healthy products in high prominence locations, and adding more combination displays within stores that allow customers to choose between unhealthy and healthy options.
