H4.03 - Oral: Assessing Dollar Store Food Environments and Alignment with WIC: A Multi-state Pilot Study

Brief Abstract Summary: The surge of dollar stores in the United States has raised concerns among residents, policymakers, and public health professionals regarding their impact on community health, economic development, and household nutrition and food security. Conducting in-store assessments with a common tool is critical for understanding the dollar store food environment and enabling studies of the impact of future healthy food policies and interventions in these stores over time. The aim of this project is to employ the Nutrition Environment Measures Survey for Dollar Stores (NEMS-DS) to assess the capacity of dollar stores to meet federal requirements and become certified by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A random sample of (N=200) dollar stores across nine sites will be assessed with the NEMS-DS tool. Stores readiness for WIC adoption and scores on healthy food availability and community resourcefulness will be shared.

Detailed abstract description:

Background: The surge of dollar stores in the United States, particularly within impoverished communities and communities of color, has raised concerns among residents, policymakers, and public health professionals regarding their impact on community health, economic development, and household nutrition and food security. Conducting in-store assessments with a common tool is critical for understanding the dollar store food environment, establishing common data for evidence-based policy actions, and enabling studies of the impact of future healthy food policies and interventions in these stores over time. This study seeks to address current gaps in dollar store research by assessing the in-store food environment in 200 dollar stores across 10 states and determining how, and in what ways, dollar stores align with the federal WIC food package.

Methods: In August 2024, the research team began using the Nutrition Environment Measures Survey for Dollar Stores (NEMS-DS) to assess dollar store food environments. A random sample of (N=200) dollar stores across ten sites (Atlanta, Baltimore, Buffalo, New Orleans, San Diego County, Rockford (IL), Miami, Beaufort (SC), and multiple counties in Texas and Michigan) were selected for data collection. Site settings include urban, suburban, rural, and Tribal land locations where there is a high prevalence of dollar stores that co-exist with limited healthy food access, household health inequities, and low-income populations. The research team collaboratively developed and piloted the store assessment tool, the NEMS-DS, over the past year. The tool includes measures of availability, affordability, and quality of healthy foods, WIC-approved foods at the federal and state level, availability of non-food items, and the availability and promotion of ultra-processed foods. A cross sectional design is being used to evaluate alignment with the federal minimum WIC stocking standards, NAP eligibility, and availability, quality, price, and marketing of healthy and unhealthy foods. Scores will be created for WIC and SNAP alignment, healthy food availability, ultra-processed foods, and community resourcefulness.

Findings: By the time of presentation we expect data collection to be complete. First, we will present descriptive statistics and the scores mentioned above across the 10 sites to provide an overview of the food environment among the 200-dollar stores assessed. Then, we will discuss how well dollar stores align with federal minimum WIC stocking standards as well as focus in on state-level requirements in 1-2 locations as case examples. The findings from this work will be disseminated to policymakers and dollar store corporations to outline opportunities for stores to align their stocking standards with federal and state WIC guidelines.