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Health Disparities

HD: Food Security (2011)


Pothukuchi K. Attracting supermarkets to inner-city neighborhoods: Economic development outside the box. Economic Development Quarterly 2005; 19: 232-244.

Study Design:
Descriptive Study
D - Click here for explanation of classification scheme.
Quality Rating:
Neutral NEUTRAL: See Quality Criteria Checklist below.
Research Purpose:

This study was designed to answer the following questions:

  • Which cities among those studied had in place specific initiatives to attract supermarkets to underserved areas?
  • What explained the existence or absence of these initiatives?
  • What explained the success or failure of these initiatives in producing supermarket developments?
Inclusion Criteria:

Senior urban and economic development planners in 33 cities (all cities from the list developed by Cotterill and Franklin (1995)) with four additional (Dallas, Texas; Milwaukee, Wisconsin; Pittsburgh, Pennsylvania; and Toledo, Ohio) for which the business literature had reported recent efforts at grocery development in underserved areas.

Exclusion Criteria:

Not noted.

Description of Study Protocol:


Senior urban and economic development planners were contacted by a research assistant and the researcher.



Blinding used

Not applicable


Not applicable

Statistical Analysis

No statistical analysis conducted 

Data Collection Summary:

Timing of Measurements

Surveys were conducted between October 1998 and July 1999. The survey asked whether citywide or neighborhood-specific initiatives to attract supermarkets existed, the reasons for the existence or absence of such initiatives succeeded or failed in bringing about supermarket developments and factors explaining success or failure of development efforts. Tools and strategies were documented that planners reported using to recruit supermarket operators and developers as well as the contextual details of particular developments that could offer lessons for other places. A combination of open- and closed-ended questions also assessed participants' perceptions of problems associated with access to grocery outlets in the city and in low-income neighborhoods as well as the extent to which their agencies worked to solve these problems.

Based on analysis of the responses of planners when asked to elaborate on the question "In the past five to seven years, did your city haven an initiative or initiatives to encourage the development of grocery supermarkets in low-income, underserved neighborhoods?", communities were placed in one of two broad categories: a) Those that indicated significant public activism in seeking grocery retail investment and b) those without retail grocery programs or, at best, only case-by-case involvement in particular supermarket development proposals. For those with only case-by-case involvement, a special subcategory was developed in which community-based private, non-profit and public partnerships had resulted in supermarket developments in particular underserved neighborhoods.

Dependent Variables

  • Location
  • Initiatives to attract supermarkets.

Independent Variables

Supermarket developments

Control Variables

Not applicable


Description of Actual Data Sample:
  • Initial N: 33 cities
  • Attrition (final N): 32 cities (Oakland, California dropped due to planners failing to respond to requests)
  • Age: Not applicable
  • Ethnicity: Not applicable
  • Other relevant demographics: Not applicable 
  • Anthropometrics: Most of the cities surveyed were either in an empowerment zone or an enterprise community
  • Location: Survey conducted from Wayne State University in Detroit, Michigan.
Summary of Results:

 Key Findings

  • For 18 of the 32 cities, planners reported responding to projects initiated by developers. Only occasionally did they initiate actions following complaints from residents. Planners in eight cities with some overlap of the 18 above, indicated involvement in projects that were initiated by community-based organizations. Many of those contacted indicated offering or willingness to offer, financial incentives (13 cities) and loss often, negotiating other site related issues, such as parking and increased public safety and facilitating a "fast-track" approval process, including fee waivers (10 cases each). For only seven cities, planners reported conducting or helping non-profits conduct market feasibility studies before discussions with store developers or operators.
  • Of the 19 cities in the study that had empowerment zone-enterprise community (EZ-EC) designations, planners reported involvement in efforts to reintroduce supermarkets in 12 of these; only three efforts fell within designated EZ-EC boundaries
  • The majority of cities in the study lacked programs to encourage any form of food retail specifically in underserved areas, such as farm stands or assistance to neighborhood grocery businesses
  • More than half (19 of 32) also considered themselves and their agencies to be somewhat or very responsive to solving the problems
  • Three cities displayed systematic and citywide efforts to attract grocery supermarkets and succeeded in their efforts: Dallas, Rochester and Chicago
  • Successful citywide initiatives were characterized by political leadership at the highest levels; strong grassroots advocacy; and skilled public agency participation that responded to the regional grocery industry context, assembled appropriate development and financing tools and competitively recruited operators
  • Planners offered a variety of rationales for limited activity in persuading supermarkets to invest in low-income neighborhoods in their cities
  • The typical store-non-profit partnership is an arrangement in which the CDC develops and owns the retail facility, which is leased to the grocery operator
  • City and non-profit roles serve intrinsically different, though complementary, purposes in successful developments. City rolesfiscal, regulatory or site relatedhelp reduce development and setup costs and ultimately may determine whether the project happens. Non-profit involvement in additional to helping reduce costs, promotes ongoing store success by building mutual gains in neighborhoods through increased confidence, connections and loyalty and reduced uncertainty.
  • Across the country, grocery stores are being developed primarily as a result of private initiative and, in at least one case, in opposition to city planners' efforts.
Author Conclusion:
  • Community wide initiatives to attract supermarkets were rated among cities studied. Successful initiatives included activities to assess market demand, identify multiple locations, assemble incentives and other development assistance and recruit multiple operators.
  • Despite widespread acknowledgement of the absence of grocery stores in low-income neighborhoods, city planning and development agencies tended to wait for proposals to be initiated by developers. Planners tended not to perceive "proactive" roles for themselves in designing food retail strategies and tended to believe that their cities offered a friendly environment for retail and to feel good that their agencies at least were not obstructionist. This led to a sense that if developers were not forthcoming with proposals, it was because underlying market conditions were unsuitable. A few who initiated actions gave up after they encountered obstacles because of perceptions that conditions were beyond their control.
  • Community non-profits performed important "community-market" functions for retail developments
  • Attractive market and location conditions were key.
Funding Source:
Reviewer Comments:
  • The study does not indicate that the survey was validated
  • Only select questions from the survey were revealed; the study would not be able to be replicated based on the current information provided
  • No statistical analysis was conducted to determine similarities or difference between locations or initiatives.
Quality Criteria Checklist: Primary Research
Relevance Questions
  1. Would implementing the studied intervention or procedure (if found successful) result in improved outcomes for the patients/clients/population group? (Not Applicable for some epidemiological studies) Yes
  2. Did the authors study an outcome (dependent variable) or topic that the patients/clients/population group would care about? Yes
  3. Is the focus of the intervention or procedure (independent variable) or topic of study a common issue of concern to dieteticspractice? Yes
  4. Is the intervention or procedure feasible? (NA for some epidemiological studies) Yes
Validity Questions
1. Was the research question clearly stated? Yes
  1.1. Was (were) the specific intervention(s) or procedure(s) [independent variable(s)] identified? Yes
  1.2. Was (were) the outcome(s) [dependent variable(s)] clearly indicated? Yes
  1.3. Were the target population and setting specified? Yes
2. Was the selection of study subjects/patients free from bias? ???
  2.1. Were inclusion/exclusion criteria specified (e.g., risk, point in disease progression, diagnostic or prognosis criteria), and with sufficient detail and without omitting criteria critical to the study? Yes
  2.2. Were criteria applied equally to all study groups? Yes
  2.3. Were health, demographics, and other characteristics of subjects described? N/A
  2.4. Were the subjects/patients a representative sample of the relevant population? ???
3. Were study groups comparable? N/A
  3.1. Was the method of assigning subjects/patients to groups described and unbiased? (Method of randomization identified if RCT) N/A
  3.2. Were distribution of disease status, prognostic factors, and other factors (e.g., demographics) similar across study groups at baseline? N/A
  3.3. Were concurrent controls or comparisons used? (Concurrent preferred over historical control or comparison groups.) N/A
  3.4. If cohort study or cross-sectional study, were groups comparable on important confounding factors and/or were preexisting differences accounted for by using appropriate adjustments in statistical analysis? N/A
  3.5. If case control study, were potential confounding factors comparable for cases and controls? (If case series or trial with subjects serving as own control, this criterion is not applicable.) N/A
  3.6. If diagnostic test, was there an independent blind comparison with an appropriate reference standard (e.g., "gold standard")? N/A
4. Was method of handling withdrawals described? Yes
  4.1. Were follow-up methods described and the same for all groups? Yes
  4.2. Was the number, characteristics of withdrawals (i.e., dropouts, lost to follow up, attrition rate) and/or response rate (cross-sectional studies) described for each group? (Follow up goal for a strong study is 80%.) Yes
  4.3. Were all enrolled subjects/patients (in the original sample) accounted for? Yes
  4.4. Were reasons for withdrawals similar across groups? Yes
  4.5. If diagnostic test, was decision to perform reference test not dependent on results of test under study? N/A
5. Was blinding used to prevent introduction of bias? N/A
  5.1. In intervention study, were subjects, clinicians/practitioners, and investigators blinded to treatment group, as appropriate? N/A
  5.2. Were data collectors blinded for outcomes assessment? (If outcome is measured using an objective test, such as a lab value, this criterion is assumed to be met.) N/A
  5.3. In cohort study or cross-sectional study, were measurements of outcomes and risk factors blinded? N/A
  5.4. In case control study, was case definition explicit and case ascertainment not influenced by exposure status? N/A
  5.5. In diagnostic study, were test results blinded to patient history and other test results? N/A
6. Were intervention/therapeutic regimens/exposure factor or procedure and any comparison(s) described in detail? Were interveningfactors described? Yes
  6.1. In RCT or other intervention trial, were protocols described for all regimens studied? N/A
  6.2. In observational study, were interventions, study settings, and clinicians/provider described? Yes
  6.3. Was the intensity and duration of the intervention or exposure factor sufficient to produce a meaningful effect? Yes
  6.4. Was the amount of exposure and, if relevant, subject/patient compliance measured? Yes
  6.5. Were co-interventions (e.g., ancillary treatments, other therapies) described? N/A
  6.6. Were extra or unplanned treatments described? N/A
  6.7. Was the information for 6.4, 6.5, and 6.6 assessed the same way for all groups? Yes
  6.8. In diagnostic study, were details of test administration and replication sufficient? N/A
7. Were outcomes clearly defined and the measurements valid and reliable? ???
  7.1. Were primary and secondary endpoints described and relevant to the question? Yes
  7.2. Were nutrition measures appropriate to question and outcomes of concern? Yes
  7.3. Was the period of follow-up long enough for important outcome(s) to occur? Yes
  7.4. Were the observations and measurements based on standard, valid, and reliable data collection instruments/tests/procedures? ???
  7.5. Was the measurement of effect at an appropriate level of precision? ???
  7.6. Were other factors accounted for (measured) that could affect outcomes? Yes
  7.7. Were the measurements conducted consistently across groups? Yes
8. Was the statistical analysis appropriate for the study design and type of outcome indicators? N/A
  8.1. Were statistical analyses adequately described and the results reported appropriately? N/A
  8.2. Were correct statistical tests used and assumptions of test not violated? N/A
  8.3. Were statistics reported with levels of significance and/or confidence intervals? N/A
  8.4. Was "intent to treat" analysis of outcomes done (and as appropriate, was there an analysis of outcomes for those maximally exposed or a dose-response analysis)? N/A
  8.5. Were adequate adjustments made for effects of confounding factors that might have affected the outcomes (e.g., multivariate analyses)? N/A
  8.6. Was clinical significance as well as statistical significance reported? N/A
  8.7. If negative findings, was a power calculation reported to address type 2 error? N/A
9. Are conclusions supported by results with biases and limitations taken into consideration? Yes
  9.1. Is there a discussion of findings? Yes
  9.2. Are biases and study limitations identified and discussed? Yes
10. Is bias due to study's funding or sponsorship unlikely? ???
  10.1. Were sources of funding and investigators' affiliations described? No
  10.2. Was the study free from apparent conflict of interest? Yes