Minimum stocking requirements in retail food stores: Updates from the Minneapolis Staple Foods Ordinance Evaluation Study

Transcription

1 Minimum stocking requirements in retail food stores: Updates from the Minneapolis Staple Foods Ordinance Evaluation Study Melissa Laska, PhD, RD University of Minnesota

2 MINIMUM STOCKING REQUIREMENTS On-going local, regional and national interest: RWJF/HER Expert Panel Report: Minimum Stocking Levels and Marketing Strategies of Healthful Foods for Small Retail Food Stores (2016) USDA: Enhancing Retailer Standards in the Supplemental Nutrition Assistance Program (2016) Healthy Food Financing Initiatives Voluntary retailer technical assistance programs

3 MINNEAPOLIS STAPLE FOODS ORDINANCE OVERVIEW First policy of its kind in the country Sets minimum standards for healthy foods sold in more than 200 licensed grocery stores (including corner stores, gas stations, and pharmacies) Does not restrict sales of any food items 3

4 REQUIRED FOOD CATEGORIES Milk Cheese Eggs Meat and vegetable protein sources Fruits and vegetables 100% juice Whole grain cereal Whole grains Canned beans Dried beans, peas and lentils 4

5 ORDINANCE REQUIREMENTS Fruits & Vegetables 30 lbs. or 50 items fresh and/or frozen At least 7 varieties (5 must be fresh) No more than 50% from a single variety

6 ORDINANCE REQUIREMENTS Whole Grains 5 pounds total At least 3 varieties Examples: wheat bread, corn tortillas, brown rice, oatmeal

7 POLICY IMPLEMENTATION Ordinance went into effect April 2015; enforcement began in 2016 Support for Retailers Group trainings, individual coaching Free healthy food merchandising and promotional supplies Connections to model stores/mentors Creation of small-scale fresh produce supplier Access to low-interest loans for refrigeration

8 STORE STUDY: STAPLE FOODS ORDINANCE EVALUATION On-going study examining the impact of the Staple Foods Ordinance on small and nontraditional food stores. We are examining: Healthy and unhealthy food availability in stores. Customer purchasing of healthy and unhealthy foods. Home food availability among customers who frequently shop in these stores. 8

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15 Minneapolis Staple Foods Ordinance STORE Study: Evaluation timeline City Council public hearing and vote. Effective date for ordinance (April); monitoring with no enforcement. Enforcement began (April) Time 1 pre-policy data. Time 2 data. Time 3 data. Time 4 data.

16 Data Collection in Stores Store Assessments Availability of staple foods and other healthy food items Quality, variety and pounds of fruits and vegetables Ads/promotions, product placement and impulse buys Manager Interviews Stocking practices Profitability Distribution and delivery

17 Data Collection with Customers Intercept Surveys Audits of food/beverage purchases Frequency and reasons for shopping at the store Customer demographics and other characteristics Home Visits Frequent small food store shoppers Home food availability Additional behavioral measures

18 Manuscripts: Lack of Healthy Food in Small-Size to Mid-Size Retailers Participating in the Supplemental Nutrition Assistance Program. Prev Chronic Dis, Successful Customer Intercept Interview Recruitment Outside Small and Midsize Urban Food Retailers. BMC Public Health Differences in healthy food supply and stocking practices between small grocery stores, gas-marts, pharmacies and dollar stores. Public Health Nutr Healthfulness of foods advertised in small and non-traditional urban food stores. Prev Chronic Dis Food and beverage purchases in corner stores, gas-marts, pharmacies and dollar stores. Public Health Nutr Association between store food environment and customer purchases in small grocery stores, gas-marts, pharmacies and dollar stores. IJBNPA

19 Manuscripts: 2017 Customer characteristics and shopping patterns associated with healthy and unhealthy purchases at small and nontraditional food stores. J Community Health Pricing of staple foods at supermarkets versus small food stores in an urban area. IJERPH Perceptions of a healthier neighborhood food environment linked to greater fruit and vegetable purchases at small and non-traditional food stores. Under review. Early-stage evaluation of a local staple foods ordinance: Impact on the nutritional quality of small and non-traditional food store offerings and customer purchases. Under review.

20 BASELINE SAMPLE Minneapolis St. Paul P-value Store characteristics % % Store type.49 Corner stores or convenience stores Food-gas marts Dollar stores 9 10 Pharmacies Number of aisles in store Number of cash registers SNAP authorized Neighborhood characteristics Mean Mean % <185% of poverty % Hispanic Non-Hispanic % White % Black % American Indian/Alaskan Native % Asian <.0001 Under review: Laska et al.

21 BASELINE CUSTOMER SAMPLE Minneapolis St. Paul (n=352) (n=316) Age (mean years) 39 (15) 42 (15) a Sex: male 60% 52% Race/ethnicity Hispanic 3% 4% Non-Hispanic White 48% 45% Black 34% 38% American Indian/Alaskan Native 5% 3% Asian 3% 4% Education High school diploma or less 37% 39% Some college 37% 35% Bachelor s degree or higher 26% 25% Employment Employed 62% 65% Unemployed/disability 28% 23% Frequency of shopping at store At least once a day 30% 28% 1-6 times a week 45% 43% Weight status Obese (BMI 30kg/m 2 ) 32% 33% a p<.05 Under review: Laska et al.

22 100 Healthy Eating Index (HEI) Scores Of Store Purchases HEI score of grocery purchases (56) a HEI score of fast food menus (38-56) b a Volpe & Okrent, USDA, 2012 b Hearst et al., Am J Prev Med, 2013 Caspi et al, Public Health Nutrition 2016.

23 Pricing of staple foods at supermarkets versus small food stores Purpose: To assess differences in staple food item prices by: 1. Store type Smaller food stores versus their closest supermarket 2. Store isolation Smaller food stores more isolated (>1 mile) versus less isolated ( 1 mile) from supermarkets 3. Food desert status Isolated smaller food stores inside versus outside of food deserts Caspi et al, IJERPH

24 Methods Used a liberal definition of supermarket Began with business lists in the study area Consulted local experts to add stores that were similar to supermarkets in their overall environment, range of products, and customer use Validated by site visits Matched each small food store to its closest supermarket using ArcGIS Data collectors visited each store to obtain pricing data Recorded prices for 54 food and beverage items Used designated package sizes, or their closest package size if not available Recorded lowest available price in the designated package size Caspi et al, IJERPH

25 Measures and Analysis Prices All prices were standardized by item package size Analysis Unit of analysis was the store-supermarket pair Analysis was limited to items carried by at least 40% of smaller stores In mixed models, we tested the association between store characteristic and price differential for each item Caspi et al, IJERPH

26 Average prices were higher in small stores vs. supermarkets for nearly all items. N (store pairs) Average price at small food store a Average price at nearest supermarket Price differential relative to supermarket price p-value Produce $ $ % Apples (lbs) 56 $1.94 $ % <0.001 Bananas (lbs) 64 $1.18 $ % <0.001 Oranges (lbs) 42 $2.03 $ % <0.001 Milk Skim (gallon) 77 $4.05 $ % < % (gallon) 76 $4.09 $ % < % (gallon) 93 $4.18 $ % <0.001 Whole (gallon) 90 $4.28 $ % <0.001 Protein staples Peanut butter (17 oz) 112 $3.89 $ % <0.001 Eggs (dozen) 87 $2.43 $2.27 7% <0.001 Tuna (5 oz) 105 $1.68 $1.58 6% <0.001 Dry beans (16 oz) 57 $1.86 $ % <0.001 Grain staples Cheerios TM (18 oz) 70 $7.41 $ % <0.001 Rice Krispies TM (18 oz) 51 $7.53 $ % <0.001 White rice (16 oz) 75 $2.02 $ % <0.001 White bread (20 oz) 82 $2.20 $ % <0.001 a Prices were standardized to the size indicated if only another unit or package size was available. Caspi et al, IJERPH

27 For 12/15 items, differences were higher in isolated small stores, though this was only statistically significant for apples

28 Compliance analyses STORE Study Timeline City Council public hearing and vote. Effective date for ordinance (April); monitoring with no enforcement. Enforcement began (April) Time 1 pre-policy data. Time 2 data. Time 3 data. Time 4 data.

29 PERCENT* Early outcomes: Retailer compliance COMPLIANCE OVER TIME PERCENT OF STORES THAT COMPLIED WITH STAPLE FOODS ORDINANCE REQUIREMENTS MET ALL ORDINANCE MET 80% OF ORDINANCE MET 60% OF ORDINANCE STANDARDS (10/10) STANDARDS STANDARDS Time x condition p =.73 p =.42 p =.68 Minneapolis time 1 St. Paul time 1 Minneapolis time 2 St. Paul time 2 Minneapolis time 3 St. Paul time 3 *Models adjusted for neighborhood race/ethnicity. Under review: Laska et al.

30 100" 90" Time"1" Time"2" Time"3" 80" 70" Time"1" Time"2" Time"3" 60" 50" 40" 30" 20" 10" 0" Under review: Laska et al.

31 100" 90" Time"1" Time"2" Time"3" 80" 70" Time"1" Time"2" Time"3" 60" 50" 40" 30" 20" 10" 0" Under review: Laska et al.

32 100" 90" Time"1" Time"2" Time"3" 80" 70" Time"1" Time"2" Time"3" 60" 50" 40" 30" 20" 10" 0" Under review: Laska et al.

33 EXPLORATORY ANALYSES % of stores with ANY food in the 10 required product categories 10-point compliance scale Minneapolis St. Paul Time 1 Time 2 Time 3 Time 1 Time 2 Time 3 Time x city: p = 0.59 Time x city: p = 0.23 Preliminary results: LS means controlling for neighborhood race/ethnicity.

34 EXPLORATORY: MINNEAPOLIS DATA % of stores with ANY food in the 10 required product categories 10-point compliance scale Chain Independent Time 1 Time 2 Time 3 Time x chain/independent: p = Time 1 Time 2 Time 3 Time x chain/independent: p = Preliminary results.

35 EXPLORATORY: MINNEAPOLIS DATA % of stores with ANY food in each of the 10 product categories Food desert Non food desert point compliance scale Time 1 Time 2 Time 3 Time x food desert: p = Time 1 Time 2 Time 3 Time x food desert: p = Preliminary results.

36 SUMMARY OF RESULTS For primary study outcomes: No significant differences at time 3. (Time 4 TBD.) Post hoc testing: Some compliance improvements over time for Minneapolis by time 3. Not significantly different from St. Paul. Does this reflect changes in the overall retail marketplace, and/or spillover effects from the policy? Differences between chain vs. independent stores and location.

37 ONGOING ANALYSES Are manager attributes associated with compliance? Support for food policies and/or government regulation Perceived demand in the store for healthy foods Self-efficacy for making stocking changes Distribution sources and frequency for perishable items Perceived profit of healthy foods

38 ONGOING ANALYSES Latent class analyses Identifying classes of stores meeting each of the 10 required product categories of the ordinance. Latent transition analyses Exploring the movement of stores between classes over time.

39 A MODEL POLICY?

40 SUPPORT Support for early formative work for STORE provided by UMN CURA, Hopkins Global Obesity Prevention Center (NICHD U54HD070725), NCI (5R25CA163184; post doctoral support for Dr. Caspi) and NCATS (UL1TR000114; data management). Primary STORE study funding from NIDDK (R01DK104348) and CDC (U48-DP005022). STORE Study team: Co-investigators: Caitlin Caspi, Lisa Harnack, Darin Erickson. Other contributors: Kristen Klingler, Tim Barnes, Nora Gordon, Megan Winkler. Study staff: Pamela Carr-Manthe, Stacey Moe, William Baker, Kathleen Lenk, Jennifer Pelletier. Large team of data collectors and advisory committee.

41 CONTACT INFORMATION Melissa Laska, University of Minnesota Tenure track Assistant Professor position in Public Health Nutrition open at the UMN School of Public Health! Send me an for more information.