Skip to main content

Encouraging Food Retailers to Facilitate Healthy, Native North Carolinians!

Your tribe just participated in one of the most rigorous food assessments for an American Indian setting to date!  But why is understanding access to grocery stores important?  While grocery shopping is perceived by some as a minor inconvenience, for many urban and rural settings accessing healthy, affordable foods is becoming a major obstacle.  Explore lessons learned about your tribe’s access through the American Indian Healthy Eating Project and visit the US Department of Agriculture Food Environment Atlas.

What is a Food Desert?

A number of definitions exist but generally a food desert describes a community who has limited access to healthy, affordable food.  Over the last ten years, research illustrates communities in areas with limited access to grocery stores eat less fresh fruits and vegetables and tend to have higher risk for type 2 diabetes, cardiovascular disease, and obesity.  Government, non-for-profit, academic, and community advocacy groups have also contributed to identifying grocery gaps throughout the US.  In addition, the media has helped increase awareness about food access struggles for rural and urban areas, including highlighting the increased number of store closures during this economic down period.  The First Lady Michelle Obama through her Let’s Move! campaign has also increased awareness of opportunities and obstacles for making all communities, healthy communities.  To check out your community’s access, explore the maps created by direct observation posted on, go to US Department of Agriculture Food Environment Atlas or Food Desert Locator, and review Feeding America’s Map the Meal Gap.

Strategies to Open and Sustain Food Retailers in Under-Served Areas

Local, state, tribal, and federal government initiatives have tried to expand the availability of grocery stores in under-served areas, many using healthy food financing initiatives to provide loans and other financial support to help grocery stores overcome the initial costs of opening a grocery store.  The Food Trust has partnered with most of these governments to implement healthy food financing initiatives and is exploring similar approaches in Colorado, Massachusetts, Maryland, Mississippi, Georgia, Tennessee, Texas, Arizona, and Minnesota.  Grocery store case studies are featured in Harnessing the Power of Supermarkets to Help Reverse Childhood Obesity and Healthy Food, Healthy Communities.  The Centers for Disease Control and Prevention have also recently put together a report providing an overview of state initiatives to support healthy food retail.

Selected Local
Chicago, IL Mayor Rahm Emanuel aims to implement new policies, incentives, and permit processes for addressing food deserts in Chicago, through urban agriculture, grocery markets, and food trucks.  He has met with CEOs of area grocery stores during a “Food Desert Summit.”  He has proposed ordiances to expand the size of community gardens to promote urban agriculture and improved regulations to enable urban farms to sell their products at area farmers’ markets.  Along with the City Health Department, he proposed Healthy Chicago, which is a comprehensive plan to improve health throughout the city, across a variety of outcomes, including improved access to healthy, affordable foods.  The square footage of grocery store aisles in the city’s most underserved areas has been increasing over the last few years but there are still many areas underserved by healthy food, affordable retail. On October 25th, 2011, Mayor Emanuel invites the First Lady Michelle Obama to Chicago to kick off a Chicago Food Summit.  Chicago was recently awarded healthy food financing funding to improve access to healthy retailers in underserved areas.
Columbia, MO A City Council member is working with Unite 4 Healthy Neighborhoods to create a food policy council for the city to work on food access issues, particularly for the elderly and people without cars.
Austin and Houston, TX Austin established bus routes from at-risk areas to supermarkets and enacted legislation to support the renovation of a local grocery store.  Houston provided tax incentives to supermarkets to open in or near underserved areas.
Detroit, MI Mayor announced the Green Grocer Project to improve the quality of grocery stores and strengthen neighborhoods.
Nashville, TN Through a grant initiative, twenty-nine stores will be getting healthy corner store makeovers to improve fresh produce offerings.  The state of Tennessee integrates community gardens into their approach to increase access and awareness of obesity prevention.
New Brunswick, NJ Developing the New Brunswick Wellness Plaza, featuring one of the first supermarkets built in the city in decades.  The New Jersey Economic Development Authority received funding from the Robert Wood Johnson Foundation and potentially through the state legislature to create the state of New Jersey’s Food Access Initiative.  This may add $10 million in loans and $2 million from the RWJF grant.  The bill passed the full Senate as of January 2012 and was passed to the Assembly Budget Committee.  Newark has also been funded to build fresh food retailers in underserved communities.  The Robert Wood Johnson Foundation has committed more than $12 million to support access to healthy foods in underserved NJ communities.
New Orleans, LA The Fresh Food Retailer Initiative is investing $14 million in low-interest loans, from federal block grants and private donations, to build grocery stores and supermarkets in under-served areas.  A Central City grocery store is one of the first to receive a loan through the local initiative.  The program is using $7 million in Community Development Block Grant money from the city and $7 million from the Hope Enterprise Corporation, which is a community development financial institution based in Jackson, Mississippi.  The Food Trust, a Robert Wood Johnson Foundation grantee based in Philadelphia, is administering the program with another local group.
New York, NY Created the FRESH Initiative, which includes tax incentives and zoning enhancements to supermarkets investing in under-served communities.
Oakland, CA Built the Mandela Co-Op to help bring under-served communities fresh produce while employing area workers and farmers.
Selected State
District of Columbia Opened a Giant in 2008 in the distressed Anacostia neighborhood.  A number of other urban stores are being built and designed to promote walkers and bikers to feasibly shop at the stores.  DC Central Kitchen is also teaming up with DC Hunger Solutions and the DC Department of Small and Local Business Development to launch a program to deliver fresh fruits and vegetables to approximately 30 stores in Wards 5, 7, and 8.  DC Central Kitchen’s latest program is Healthy Corners, aimed at getting fresh produce and refrigeration units into stores in underserved areas of the city. In addition, the Arcadia Center for Sustainable Food and Agriculture will be launching a Mobile Market.  Using a decommissioned school bus retrofitted as a farmers’ market on wheels, this mobile market will accept Supplemental Nutrition Assistance Program (SNAP) benefits and offer Farm-to-School programs to local DC schools.
Illinois General Assembly approved $10 million in funding for the Illinois Fresh Food Fund, which aims to stimulate supermarket development in under-served areas of the state.
Mississippi Considering legislation to create a committee to study the availability of healthy food within the state.
Nebraska Considering legislation to provide state financing to organizations that provide healthy food in low-income communities.  The state fund and tax credits could be used by grocery stores, farmers’ markets, community gardens, and other food retailers that expand access to nutritious foods.  The bill was reintroduced after the Governor vetoed the bill in 2011.
New York Created a $10 million Healthy Food/Healthy Communities Initiative providing grants and loans to supermarkets to invest in under-served communities throughout the state.  Allocated specific grant resources to New York City to hire a coordinator to provide market research to attract supermarkets to build in the city and to assist supermarkets in understanding the permitting and approval processes.
Pennsylvania Created Fresh Food Financing in 2003 to support the building of 10 new stores in under-served rural and urban communities.  Now, the program has invested over $30 million in over 83 projects, providing more than 400,000 Pennsylvanians with healthier food choices in their communities, as well as establishing or sustaining 5,000 jobs and 1.6 million square feet of food retail space.
President Obama proposed the Healthy Food Financing Initiative in February 2010 to be a part of his 2011 budget.  The initiative linked the US Department of Treasury, US Department of Agriculture, and the US Department of Health and Human Services on efforts to equip grocery stores, small retailers, corner stores, and farmers markets in under-served areas to sell healthy foods.  This Tri-Agency effort would use a blend of federal tax credits, below market-rate loans, loan guarantees and grants to build private-public partnerships.  Until funds were appropriated, the three Agencies were also exploring ways within existing programs to eliminate food deserts.  In May, the program began to accept applications.
Through the American Recovery and Reinvestment Act of 2009, $25 billion in tax-exempt Recovery Zone bonds allowed state and local governments to obtain lower borrowing costs to finance economic development.  As one example, this federal tax-exempt funding enabled the opening of Stop & Shop supermarket in New York City.
Through the 2008 Farm Bill, the US Department of Agriculture’s National Institute for Food and Agriculture granted $900,000 to the Healthy Urban Food Enterprise Development (HUFED) Center at the Wallace Center at Winrock International.   HUFED provides grants and technical assistance to entrepreneurs and communities aiming to bring healthy foods to under-served communities.
The National Healthy Food Financing Initiative was introduced in 111th Congress in both the Senate (S3986) and the House (HR 6462) with bipartisan support.  Through loans and grants, the bill proposes to invest $1 billion to build an estimated 2,100 new grocery stores in areas throughout the country of highest need.  On November 30, 2010 the House version was referred to the House Committee on Agriculture and the Senate version was referred to the Committee on Agriculture, Nutrition, and Forestry.


 More recent initiatives:

  • The Notah Begay III Foundation has partnered with New Mexico Pueblos to address food access through MoGro (mobile grocery).
  • North Carolina state policymakers are considering a bill to offer tax incentives to grocery stores that open in food-desert neighborhoods and help promote sales of locally grown produce.
  • Read about the Shakopee Mdewakanton Sioux Community’s new store, which stocks honey grown from reservation trees and bees, along with other Native products!
  • Recently, the First Lady Michelle Obama announced an expansion of the Healthy Food Financing Initiative, known as California FreshWorks Fund.  Across California’s most in need communities, new and improved food outlets will surface along with the creation or retainment of 6,000 jobs.  FreshWorks is a $200 million public-private partnership, involves partners such as the California Endowment and PolicyLink.  Georgia also recently launched a Georgia Supermarket Access Task Force to make recommendatiosn about underserved areas.
  • Central Maryland has been implementing ways to offer more fresh foods at their food banks through partnerships with local farmers.
  • A coalition has been working in Battle Creek to improve access to healthy, affordable foods across the region.
  • Richmond, VA is launching a six-month pilot program known as RVA Shoppers’ Shuttle to provide a twice-monthly shuttle service to residents in a public apartment complex for the elderly and public housing complexes in under-served areas.
  • The State of Maryland is considering using health enterprise zones to target areas with high prevalence rates similar to approaches taken to target economic development in under-served communities.
  • A co-op effort is addressing access to fresh food challenges in North Chicago and exploring starting a community garden.
  • The New York City Department of Health created toolkits to help groups increase access to healthier foods in their communities.  One is an implementation guide to help other municipalities and community organizations implement a food retail program and another toolkit known as Adopt A Shop provides guidance, tools, and resources for residents and smaller community-based organizations interested in supporting a corner store or supermarket in offering healthier choices and promoting existing healthy food retailers such as farmers’ markets.

Food Access Actions of Grocery Stores & Non-Traditional Food Outlets

Selected Stores Selected Actions
7-Eleven Planning to introduce “signature” items and improve overall quality of food beyond traditional convenience store offerings.
ALDI Opening 100 stores in 2011, particularly in Chicago area.  Also opened a new store in New York City and has plans to open one in the Bronx.  In November 2011, a new store was opened in an under-served DC neighborhood.
CVS Increasingly, these pharmacy outlets are offering fruit, salads, sandwiches, and more packaged and frozen items.  In Chicago, CVS doubled the amount of nonperishable food it sells in 11 stores.  Redesigned CVS stores have also surfaced in urban areas of Boston, Detroit, and New York City.
Kaiser Permante Supports farmers’ markets near their clinics.
Mayberry Foodstuffs A non-chain, urban grocer in Cincinnati offering everyday staples and fresh produce.
Family Dollar Stores Started in Chicago, Detroit, and New York City, offering mostly frozen or packaged foods and is now expanding to offer more grocery options in their urban and rural outlets.
Food 4 Less Opened a store in an under-served area of Chicago.
Food Circus Plans to add three more stores in New Jersey.
Grocery Outlet Plans to open over 15 outlets in 2011.
ShopRite Operates 10 stores in underserved markets.
Safeway Opening six stores in California’s Bay Area and has plans to expand over the coming years.  The Safeway Foundation partnered with the Children’s Hospital & Research Center Oakland to develop community or clinic-based programs designed to reduce the burden of childhood obesity.  Their RFP will support NGOs with innovative applications that address childhood obesity.
Shamrock Foods Opening warehouse retail stores in Albuquerque, New Mexico and Denver, Colorado.  No membership is required.
Supervalu (owns Save-A-Lot) Provides fewer items but aims to expand into under-served communities, particularly in the Chicago area.  Also partners with the University of Chicago to teach customers how to shop for healthy foods in underserved areas using shopping tours.  The St. Louis-based grocery store opened up five new stores in Chicago and has plans to open an additional 30 more stores in Chicago over the next four years.  New Florida locations have opened too.  The new stores have improved access to healthy foods and created 150 new permanent jobs, along with construction jobs during the building phases.
Target Increasing grocery offerings in over 380 stores in 2011 and investing over $500 million on retrofitting its general merchandise stores to offer full food sections.  Canadian stores offer more and more perishable foods.
Walgreens Chicago Mayor Richard Daley asked this Deerfield, IL company to increase its food offerings in under-served communities.  Walgreens has opened pilot stores in under-served Chicago and New York City areas with over 500 expanded food options.
Walmart Launching various initiatives including opening smaller Neighborhood Market and Walmart Express stores with groceries throughout US cities.  Four to five smaller stores may open soon in Reno, Nevada and one may open in Menomonee Falls, Wisconsin.

More recent store initiatives:

  • Stockbox Groceries announced it will use converted shipping containers as mini-outlets in under-served urban areas to sell fresh foods, meats, and dairy.  The first store will open in Seattle, WA.
  • Fresh Grocer in partnership with Partnership for a Healthier America plans to open five full-serve supermarkets in underserved areas in the Philadelphia region in the next five years.
  • Retailers in the Healthy Neighborhood Store program in Douglas County, Nebraska are located in underserved areas and designating one checkout aisle that does not have candy or snack items.
  • Local Food Grocer is creating partnerships in Chicago between chefs and local farmers.

Organizations Working to Improve Food Access in Under-Served Communities*

Selected Organizations Selected Actions
American Planning Association
Working to advance the role of comprehensive plans that address food access, as well as training current and future planners on examining and addressing food access issues.
Colorado Health Foundation Provided a $500,000 grant to the Denver Department of Environmental Health to help finance grocery stores in under-served areas.  Also in Colorado, the Valley Food Partnership facilitates local farmers to bring their produce into area homes, schools, restaurants, and a local hospital cafeteria.
California Endowment Supporting the California Healthy Food Financing Initiative.
Community Food Security Coalition Building awareness of and grassroots support for healthy food financing initiatives.
Community Health Councils Working on promotion and advocacy of strategies to address food access issues.
Center for Closing the Health Gap Advocating for and increasing awareness around food access issues.
DC Hunger Solutions Working to create a hunger-free DC, including various advocacy efforts to address DC grocery gaps.  A DC Hunger Solution report documented grocery gaps in the District and set forth a number of recommendations to increase full-service grocers in under-served areas of the District.
Healthy Corner Store Network Maintaining a large network of stakeholders working to improve access to healthy foods and beverages available at corner stores or smaller store venues
Food Desert Action Launching Fresh Moves, a program using renovated city buses to bring fresh produce to underserved areas of Chicago.
Food Research and Action Center Leading anti-hunger advocacy providing reports and resources to advance legislative initiatives bringing food retail to underserved areas
Jewish communities and organizations Working to address food access issues in at-risk communities in a variety of cities across the country.
Literacy for Environmental Justice Aiming to increase access to healthy foods in under-served areas through their Good Neighbor Program.
National Policy and Legal Network Providing legal guidance and resources on land use and relevant levers for healthy food financing initiatives.
PolicyLink Advocating for healthy food financing initiatives at the local, state, and federal levels. Partnering on a Robert Wood Johnson Foundation funded evaluation of the development of new California-based stores, financed through a state-based financing program.
Robert Wood Johnson Foundation Funding research examining the effects of healthy food financing initiatives.
Sarah Samuels & Associates Partnering on a Robert Wood Johnson Foundation funded evaluation of the development of new California-based stores, financed through a state-based financing program.
Social Compact Partnering on the California FreshWorks Fund.
The Food Trust Leading the way through partnerships and technical assistance for local and state governments to use healthy food financing initiatives to bring supermarkets and other food retail outlets to under-served areas throughout the US and shaping most local, state, and federal healthy food financing initiatives.
The Reinvestment Fund Creating tools and technical assistance to identify communities under-served by food retail.  Providing technical assistance and support for financing food retail in under-served areas.
Unite 4 Healthy Neighborhoods Working in Columbia, MO to address food access issues, particularly for elderly and people without cars.
US Green Building Council Considering and has created food-related retailer benchmarks for green building standards

*Insights on the identification and description of organizations came from Rebecca Flournoy of Policy Link and Latetia Moore at the Centers for Disease Control and Prevention at the US Department of Health and Human Services.

More Recent Initiatives:

  • World Harvest Ministries launched its landmark program of opening a faith-based run food store in an under-served area.  After winning a $3 million federal grant for a revolving loan fund through the Healthy Food Financing Intiative through the US Treasury, the ASI Federal Credit Union will make loans to healthful food businesses in low-income communities.
  • Uncommon Table has emerged to help bring together community members, local farmers, and local retailers to discuss how to bring healthy food to the local food retailers.
  • In November 2011, W.K. Kellogg Foundation committed $3 million in fresh food financing to local food enterprises.  Specifically, the Kellogg Foundation will provide capital for financing retail, product, processing, and distribution of fresh food to reach lower-income communities in Michigan, Mississippi, New Mexico, and New Orleans.  The capital will be provided through Kellogg’s partnership with NCB Capital Impact of Arlington, VA, which is a community development financial institution.

Healthy Corner or Country Stores

Work with your local corner, convenience, or country stores to develop feasible strategies to offer and sell more produce, whole grains, and low-fat dairy options.  Join the Healthy Corner Store Network to learn about a variety of corner store programs happening within North Carolina and across the US!  Explore how research and innovative industry approaches work in a number of cities, including on Indian reservations at the Healthy Store Project.  Contact Diane Beth at the NC Department of Health and Human Services to learn about the state resources available to get healthier foods into North Carolina convenience stores.  Camillia Easley (, 919-707-5207) is currently working on a Corner Store Initiative in Durham, NC.   
Corner stores specific initiatives generally work to help get healthy foods items distributed to the smaller store venues.  Efforts also focus on creating affordable pricing strategies for both the retailer and the customer.  Healthy Food Financing Initiatives have been used to retrofit corner stores to have appropriate storage, refrigeration, and lighting to regularly sell produce, low-fat dairy, and ready-to-eat deli sandwiches and salads.  Promotional materials, tailored to local and Native values, also help ensure foods brought into the store get into the homes!  Simply strategies like moving fruit closer to or on the counter help!  Various initiatives are trying to come up with nutrition standards for corner stores.  One good benchmark to strive for is getting all corner stores WIC eligible retailers!  Often, smaller stores greatly appreciate technical assistance and resources around handling, displaying, and promoting healthy foods.  Google Healthy Foods Here Produce Guide to download user-friendly resources on how to handle, store, and display fruits and vegetables from the US Department of Health and Human Services and Public Health-Seattle & King County.  Another toolkit for healthy corner stores is focused on New Orleans but provides good tips and ideas for North Carolina country stores.  Recently, the Ohio State University Center for Farmland Policy Innovation released a Research Brief compiling best practices for establishing and operating healthy corner stores.
Volunteer-oriented corner store example:  In New Haven, CT, three corner stores are working with volunteers from the Community Alliance for Research and Engagement at Yale University and the New Haven Health Department on a New Haven Healthy Corner Store Initiative.  This volunteer-oriented initiative is using free labor to help rearrange store shelves to feature healthier items and tag healthier items with initiative green stickers.
Other examples:

  • A public-private partnership example:  The Food Trust also has a Healthy Corner Store Initiative in partnership with 580 corner stores and the Philadelphia Department of Public Health.
  • The Greenlight Select Program is a new program in Chicago where patients with diabetes work with registered dietitians on how to eat healthy even if a convenience store is the only grocery option.
  • In New York City, the Healthy Bodegas Initiative has worked with more than 1,000 stores, often helping stores purchase refrigerators to keep more produce for longer.
  • Philadelphia has reported how changes to the WIC food package have improved food offerings in small corner stores.
  • In Los Angeles, corner store makeovers are part of a public health program that is helping supply and promote more fresh produce in smaller retail outlets.

Healthy Stores Project in Indian country

Learn about Apache Healthy Stores and the Healthy Stores program for Navajo Nation at the Healthy Stores Project!  Both programs are using innovative approaches to integrate traditional foods and promotion techniques to improve availability of healthy foods in small and large local stores.  Efforts to link farmers to local stores are being explored!

Online & Mobile Grocery Distribution Options

A growing number of communities and companies are exploring how online ordering and mobile grocery distribution options can help bring fresh food regularly to under-served areas.  Two new tribal initiatives are emerging using mobile grocery options in Santo Domingo Tribe (New Mexico) and White Earth Nation (Minnesota)!  Learn more about the launch of MoGro in April 2011 at Santo Domingo Pueblo, New Mexico.  Contact Shane Plumer, the Wellness Project Coordinator at White Earth Nation, to learn more about White Earth Nation’s initiative at:  218-983-3285, ext. 5855.
Other mobile examples include:

  • The Notah Begay III Foundation has partnered with New Mexico Pueblos to address food access through MoGro (mobile grocery).
  • In Chicago, Peapod and the Neighbor Capital Healthy Families Project have been working together to use online ordering and convenient community pick up sites to offer healthy, discounted fruit to under-served areas.  A Chicago advocacy group also launched Fresh Moves, which uses a renovated city bus to bring fresh produce into under-served communities.
  • In New York, FreshDirect, one of the leading online food brands and grocery providers, picks up seasonal products from local farms and helps deliver them to nearby homes.  Change One Thing Truck also provides low-sugar fruit bars, fresh fruit, and nutrition education to children and adolescents in New York City.
  • In Baltimore, the local government is using federal stimulus money to pilot a Virtual Supermarket Project where computers are available at local libraries to enable online ordering venues for under-served communities who may also have limited internet resources.  Customers have to pick up their order at the library, but are not charged a delivery fee.  The virtual grocery store is known as Baltimarket and is based out of the city’s health department.
  • In Boston, the Greater Boston Food Bank’s Mobile Pantry brings fresh produce, meat, and dairy to under-served areas.
  • Walmart is even testing out delivery services for a $5 fee in selected areas in California.
  • Kings Supermarkets have established an online shopping system for its 24 locations where customers can order online and pick up their orders at designated spots.
  • Harris Teeter has reduced its online shopping fee.
  • In Arizona, old school buses are being used to transport free lunches through the US Department of Agriculture Summer Food Service Program to an underserved area.
  • San Francisco has introduced legislation to ease restrictions on mobile food vending.
  • In Portland, Central City Concern, a nonprofit organization, partnered with My Street Grocery to develop a grocery store on wheels program that could deliver healthful food to area residents
  • Blog discusses online grocery stores in Baltimore and Chicago.
  • A mobile van in Tulsa, OK will aim to sell healthier food options in underserved areas.
  • Through the US Department of Agriculture’s Food Distribution Program on Indian Reservations, tribes such as the Rosebud Sioux Tribe have been creating innovative tailgate strategies to deliver food to communities at more convenient locations.

Street of Dreams documents some of the policy facilitators and barriers across the country for food trucks, particularly those serving hot meals.
Explore online providers or tribal members who can develop online/virtual grocery distribution systems!  Work with local food safety authorities to ensure food trucks and mobile vending are in compliance with local food safety laws, particularly when hot food is served.

Grocery Shopping on a Budget

The cost of food, particularly healthier food options such as whole grain cereals and produce, were identified as a barrier to healthy eating by community members.  The US Department of Agriculture forecasts 3-4% increases in US food prices.  Media outlets continue to report raising commodity prices and food companies, such as General Mills, Kellogg, and Unilever, plan to raise prices.  According to an NPD Group, grocery prices are also increasing at faster rates than restaurant prices.  The 2011 Food and Agriculture Organization of the United Nations food insecurity report also indicates global food prices will continue to rise and be unstable.
Promote Participation in Federal Food Assistance Programs
As a tribal leader, consider promoting awareness and participation among eligible families and children in federal food assistance programs.  To help supplement food purchases in the grocery store, eligible families and children may qualify for the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, or Women, Infants, and Children (WIC).  US Department of Agriculture routinely awards grants to local governments and non-for-profit organizations to develop SNAP application and eligibility systems that encourage participation.  Consider applying!
The USDA is currently implementing initiatives to help improve the quality and affordability of foods for program participants.  Examples include:

Equally as important, ensure all local stores accept WIC and SNAP.  A store must apply to the US Department of Agriculture-Food and Nutrition Service to receive a SNAP permit and must continue to comply with program rules and regulations in order to maintain eligibility and be reauthorized at least once every five years (www.fns.usda/gov/snap).  To be SNAP eligible, a store must offer for sale on a continuous basis at least three varieties of qualifying foods:  bread/cereals, dairy products, fruits and vegetables, and meat, fish, and poultry.  At least two of the three offered categories must be perishable foods.  Alternatively, a store can be eligible if over 50% of its total gross sales in staple foods (not candy, carbonated and noncarbonated drinks, coffee, condiments, prepared, ready-to-eat foods, spices, and tea).  Stores can also not allow customers to purchase beer, wine, liquor, tobacco, cigarettes, foods that are point at the point of sale, foods to be eaten in the store, vitamins, medicines, and non-food items with SNAP benefits.  Stores cannot restrict SNAP customers to shop at certain times or in certain lanes, require customers to make minimum purchases, charge sales tax on SNAP transactions, or give cash in exchange for SNAP benefits.
To become a WIC vendor, a store applies to the North Carolina Department of Health and Human Services.  WIC vendors must stock required levels of WIC approved items at all times and to the terms of agreement set forth by the State.  North Carolina WIC Vendor Connection provides more detail.
Share Cost & Time Saving Shopping Tips
Print and post on your tribal office walls or on your website tips and tricks for purchasing affordable healthy foods.  Here are a few suggestions from the Spend Smart. Eat Smart. to get started:

  • Plan ahead to limit your transportation costs to food outlets and to ensure that you have all items you need to make nutritious, family meals.
  • Use old-fashioned paper and pencil or Smart Phones have applications that will help you save your prior shopping lists.  If using your phone to shop, explore your grocery chain’s website to see if they have mobile applications and features that will allow you to access coupons from their weekly circular.
  • Read food labels, particularly levels of fat, sugar, and sodium.
  • Shop the perimeter of the store.  This approach usually is a good rule of thumb to make sure that you have picked up your produce, lean proteins, low-fat dairy options, and whole grains.
  • Stores are packing the aisles to get you to purchase more.  Be mindful of picking up extra items, even if they are on sale!

Check out this new website that provides guidance on eating healthy on a budget!  Share Our Strength also provides guidance through their Shopping Matters resources.

Store-Level Strategies

Encourage your tribe to build relationships with local grocery stores and suggest strategies to help tribal members purchase healthy, affordable foods and beverages.  Never hurts to ask and sometimes keep asking!
Some innovative store-level approaches US stores are trying are:

  • Albert Hy-Vee, a Midwest chain, started in January 2011, its Blue Zones, which feature healthy snacks, such as dried fruit, string cheese, nuts, carrots, granola bars, and water.  They also started a six-week program called “Fast. Fit. Food!”, which includes nutrition classes and meal plans.  In Austin, Hy-Vee works with local partners to connect kids and employees to community gardens.  The chain also has an online Health and Wellness forum staffed with store and wellness employees to help customers shop healthy on a budget or on a specific diet and generally provide ideas to help customers live healthier lifestyles.  In addition, Hy-Vee has joined Iowa’s Healthiest State Initiative, which aims to transform the state to the healthiest state in the nation in five years by encouraging programs, policies, and partnerships that help Iowans make practical, sustainable lifestyle changes.
  • Walmart has launched a five-year product to reduce the amount of unhealthy salt, fats, and sugars in packaged foods and reduce produce prices. Walmart has also worked to increase local foods in its stores.
  • Whole Foods stores in Florida have worked with farms to arrange for their customers to participate in a community-supported agriculture program.  Whole Foods is also planning to expand using smaller store set ups in urban areas in the United States, Canada, and United Kingdom.  In addition, the company established the Whole Kids Foundation to partner with schools and other community organizations to curb childhood obesity and will start off by helping support “teaching gardens” in selected schools and areas.
  • Various stores will offer cooking demonstrations, free products, health screenings, and weight-management programs.  A Downtown Market in Downers Grove, IL offers workout classes, health screenings, cooking classes, and regular sales on produce.  Work with local stores and see if you can have a Healthy, Native North Carolinians event to highlight traditional, healthy foods and preparation strategies, along with providing local health provider and physical activity options!  Jewel-Osco provides free “Eating Healthy with My Diabetes” grocery tours.
  • Various stores also have recipes with nutrition information or will consider offering recipes to highlight store products.  Ask and see what your local store has and consider ways to get the word out about health promoting options your local stores already have in place or are willing to try!
  • Brian Wansink ( has encouraged several of the small things stores can do that work to improve produce consumption, including using soft, focused lighting, color-packaging, catchy signage, and, if found, even cart prompts to remind you to purchase your produce can work!
  • Some grocery stores have dietitians who are willing to explore lessons outside the store, such as Hy-Vee in Iowa whose two dietitians teach first and second graders how to use their store rating program and eat well.  Marsh Supermarkets in Indiana also employs dietitians who offer nutrition education in schools.
  • H.E. Butt Grocery hosted a Childhood Obesity Summit in Austin, TX in 2011, inviting nutrition educators.
  • Healthy Food Retailers in Hartford Neighborhoods details how stores committed to reduce junk food on store shelves and improved offering and promotion of healthier foods and beverages.
  • Grocery stores have a long tradition of sponsoring local sporting events and teams.
  • Navarro Discount Pharmacies pays a chef to conduct in-store demonstrations promoting healthy foods.
  • Consider working with local stores to maximize store lay out to promote healthy foods.  The old “shop the perimeter” for healthy foods might not work anymore as a healthy way to shop as stores redesign.
  • Through the CDC’s Communities Putting Prevention to Work project, participating store managers re-designed their check-out aisles to promote healthier foods and beverages.  The managers have expressed large sales for their healthier items and moms prefer seeing the healthier items promoted to themselves and their children.
  • BrightFarms in New York City has a rooftop garden that helps supply the store with fresh produce.
  • Dahl’s Food in Iowa is rolling out snack stations for kids featuring various fruit selections.
  • Various stores will offer grocery store tours, including explaining how their own store nutrition labels and price discounts work.  Over twenty stores use some form of shelf tags to try to label foods.  Consider coordinating opportunities for tribal youth, families, and seniors to take grocery store tours in your area.  Also, encourage stores with labels to ensure their labels are consistent with federal dietary guidelines and always focus on the actual food label for the most accurate product reading on calories, fat, sugars, fiber, and sodium.
  • The National Legal and Policy Network provides an objective tool to explain and evaluate various store nutrition rating system.
  • Virgnia stores have reported success using the NuVal scoring system.
  • Apples and Oranges in Baltimore is offering Zumba classes in their parking lot and health screenings for nutrition-related chronic diseases.
  • The Food Depot in Baltimore hired a Registered Dietitian to help customers chose healthier items and allowed researchers from Johns Hopkins to conduct studies within their store aiming to understand how to increase healthier purchases.
  • Three Detroit grocers are working on an incentive program to incentive purchases of locally grown produce using SNAP.
  • Fare for All Express is a non-for-profit grocer in St. Paul, Minnesota that gives a discount of at least 30% to help low-income customers afford healthy food.

Product-Level Strategies

  • Native Air N7, a Nike shoe designed for Native Americans, is a great example of how working with companies can help create culturally relevant products that promote health!
  • A number of food companies are making pledges to create healthier products including reducing trans fat, sugar, and sodium.  As one example, the Milk Processor Education Program has announced its flavored milk cartons will have fewer calories and fewer grans of sugar.
  • Use the Internet to link to product sites or Facebook pages to encourage the promotion and production of healthier items!  A lot of companies also feature recipes using their products that include nutrition information.  Most food recipe sites also include search features to focus on time-saving and low-cost recipes. Companies or their foundations often provide financial support or free products to community events and programs.  Let companies know your tribe is interested in better for you products and as Hudson Institute found…it’s good business too!
  • Goya Foods joined the First Lady Michelle Obama’s Let’s Move campaign and is working to promote MiPlato in Hispanic communities.

Healthy Diner Initiative

Recently, the federal government mandated menu labeling in chain restaurants.  Menu labeling laws at the local, state, and federal levels have sparked some industry changes in product development and promotion.  This law does not apply to many smaller diners, grills, and restaurants.  But it never hurts to ask a restaurant for more healthy food items or cooking approaches.  Don’t forget that many tribal members spend more and more time at hospitals; in turn, hospitals also need to be reminded that their food service options should reflect the dietary advice their doctors are providing to their patients!
Many community restaurants noted that folks don’t ask for grilled or baked meat or produce items, even if they are listed on the menu.  Consider working with local food establishments to help establish connections between local farmers and food producers.
Encourage restaurants to offer and promote healthier foods and preparation styles.  Restaurants could offer type 2 diabetes or heart healthy options.  Help them use traditional and social media strategies to highlight their healthier fare at affordable prices.
Consider example healthy dining programs as food for thought!  The Healthy Dining New Bedford Program has created a decal to help customers eat healthier and encourages participating restaurants to serve smaller portions, tag healthier menu items, and allow for healthy substitutions such as a salad instead of French fries.  In Louisville, KY, over 30 restaurants have voluntarily pledged to post calorie counts and receive financial and technical assistance on recipe analysis.  The program is known as Healthy Hometown menu program.
Encourage tribal youth and families to try to eat at home more often, preparing their own meals and discussing other ways their family and tribe can advance American Indian health!  At restaurants, try to avoid fried foods and heavy sauces.  Substitute French fries for salad or seasonal vegetables.  Aim early to only eat a reasonable portion and take the rest home for another meal!
Explore a local example, known as Feast Down East in southeast North Carolina, trying to connect local farmers with local restaurants.  Whether your a farmer or a restaurant owner, explore ways to increase access to local, healthy foods in your area!
Supermarkets are also increasingly becoming venues for healthy, affordable ready to eat foods.  Work with local grocery stores to promote the accessibility, availability, and affordability of ready to eat options and a community-oriented eating environment within the store setting.
Recent Restaurant Health Initiatives:

  • Chick-fil-A revamped its children’s menu to include healthier options such as grilled chicken nuggets and applesauce.  Chick-fil-A is also exploring food trucks.
  • More than 30 restaurants in Tucson, Arizona joined the Smart Choices for Healthy Dining Program, which requires participating restaurants to offer at least three menu items that have less than 700 calories and are low in sodium and fat.
  • Tanita restaurant is increasing its lighter fare options and offers body composition measures to its customers.
  • More and more restaurants are participating in Meatless Monday menu options.
  • Portland used a CDC Communities Putting Prevention to Work grant to help hire RDs to work with local restaurants on developing and promoting healthier menu items.
  • In Chicago, eateries are improving the offerings for kid’s menus through the Healthy Fare for Kids initiative.  Try to get kid’s menus to provide more than just hamburgers and French fries.
  • More than 30 restaurants in Louisville, Ky., have signed on to the Healthy Hometown menu program to voluntarily post calorie counts.  Restaurants get financial assistance for reprinting menus and help from dietitians and chefs in analyzing recipes.

Evaluate your Efforts

Learn to maximize your resources and share your process and progress with your community and other interested communities!  Work with research partners to help develop a feasible and meaningful evaluation of your food retailer efforts.  Explore the free assessments tools at the National Collaborative on Childhood Obesity Research.  The evidence base is in its infancy around the range of effects food retailer initiatives can have on health, agriculture, economic, and environmental outcomes.

Share your Story

Media buzz attracts customers!  Maximize traditional and social media outlets to ensure all potential consumers know about your area’s healthy food retail initiatives!  Also disseminate your process and progress at various levels, including state (e.g., Unity Conference and Sustainable Agriculture Conference by Carolina Farm Stewards), regional (e.g., Southern Obesity Summit), and national (e.g. American Public Health Association Annual Conference).  Share American Indian initiatives with other American Indian health and agricultural research groups, along with two leading ethnic minority research organizations, African American Collaborative Obesity Research Network and the Salud America!

Getting Started on Strategies to Increase Healthy Food Retailing in your Community

Learn from existing local, state, and national initiatives, contact potential food industry partners, and explore resources from active organizations at the local, state, and national levels.  And, encourage strategies at the local, state, and national level to:

  • Commit sufficient support to helping grocery stores and other food retail vendors to initiate new construction or renovation of existing structures.
  • Craft loans to ensure food retailers can purchase equipment and refrigeration in addition to undergo any necessary retrofitting for adequate storage and lighting of produce.
  • Modify existing incentive, zoning, and permitting processes to attract food retailers to under-served areas using traditional and non-traditional food retailing approaches.
  • Ensure strategies integrate food and agricultural related job training support programs, ranging from loan support to technological infrastructure to enhance on the job continuing education opportunities.
  • Encourage objective and timely market assessments to understand community strengths and opportunities for food retail growth.
  • Balance short-term feasible strategies with long-term community interests and strategies.
  • Plan for placement of food retail outlets that maximize the community’s access while also promoting physical activity and reducing environmental burden.  Specifically, explore local, state, and federal options to support transportation systems by bus, van, bike, and foot to food retail venues.
  • Incentivize all food retailers to become WIC and SNAP retailers or to at least strive towards offering WIC eligible foods.
  • Maximize food hub options!
  • Learn from a recent Public Health Law and Policy report how incentives can help motivate food retailers.
  • Learn from a Seattle Healthy Foods Program how to identify the right store and create effective partnerships.
  • Consider how local and state food policy councils can work to address grocery gaps within American Indian communities.
    • What is a food policy council?  Generally these councils or related coalitions, committees, or task forces provide input to relevant stakeholders on policies and approaches to improve local food systems.  NC has a state food policy council and a number of local and regional groups working together to improve local food systems.
    • Start by ensuring appropriate representation of American Indian tribes and urban organizations on existing and forthcoming councils and task forces and considering your very own tribal food policy council!  The Let’s Move in Indian Country campaign is working on guidance to promote the use of food policy councils within tribes and urban Indian organizations.  Six tribes are currently working with the Indian Health Services on building coalitions to improve access to healthy foods.
    • Example programs:  The Birmingham-Jefferson Food Policy Council is funded by a federal grant to tackle food access issues in Jefferson County.  Another food policy task force in Richmond, VA food access work complements a physical activity committee’s work to improve access to more bicycle and pedestrian friendly paths.