The document discusses the challenges and evaluations related to healthy food retail in Toronto, particularly focusing on convenience stores in lower-income areas that struggle to provide healthy food options. It highlights the impact of food environments on dietary choices and health, detailing pilot programs aimed at transitioning corner stores to offer healthier products. The report emphasizes the need for supportive policies and infrastructure to enhance food access and improve overall community health.

1. Healthy Corner Store Toronto Model
Presentation to Sustain Ontario—webinar, March 4, 2015

2. The Problem
 Food retail in general still dominated by less healthy foods
 Many lower income areas of Toronto lack sources of
healthy, affordable, diverse food

3. “Healthfulness” of Toronto’s Food Retail
Darker red = “less healthy” food
retail environments (1 km radius)

4. The Problem
 Public Health’s mantra:
“making the healthy choice the easiest & most appealing”
must be applied to food retailers too
 Currently very little support for independent small retailers

5. Waterloo, ON study found that females of average height
(5’5) weighed15.2lbs less and had 6.4cm smaller waist
circumference for every km increase in distance from their
home to nearest convenience store (adjusted coefficients).
Source: Minaker, L. (2013). Evaluating food environment assessment methodologies: a multi-level examination of associations
between food environments and individual outcomes. University of Alberta, PhD Thesis.

6.  Compared to infrequent HCS shoppers, residents who visited
our HCS pilot store 2+ times/week consumed on a daily basis:
 396 more calories
 852mg more sodium, and
 69% more added sugar
Frequent Convenience Store Shoppers
Notes: Based on pre-intervention survey, self-reported. Feb 2014, (n=194). No significant differences were found in frequent vs
infrequent supermarket shoppers.

7. High profit margin
Strong marketing support
Long shelf life
Free new fridge & displays
Attractive product design
Hassle-free distribution
Low risk
High existing customer demand
Financial incentives to sell more
In line with store’s image
No product training required
Some demand for product
Service to community
X Highly perishable
X Lower profit margins
X Distribution?
X Need training in product
handling
X Store not branded as F&V seller
X Past failed attempts to stock
X Funds to buy new equipment?
X Change management support?
Choices Facing Convenience Store Owners

8. Changes Happening, But No Equity Lens

9. PHAC Funded Food Retail
Evaluation

10.  Growing literature on food environments and how they influence diet
quality and health status over and above individual knowledge and
attitudes
The Context: Food environment research
(Glanz et al. 2005)

11. Key findings in the literature to date—
 Methodological gaps in the literature
 Inconsistency in how food environments are measured
 Poor robustness of outcome measures (e.g., diet assessment)
 Mostly cross-sectional associations
 Few studies include multiple environmental features in the
same study
 Few accompanying municipal policy assessments
 Limited assessments of social context in which interventions are
implemented
The Context: Food environment research
(Minaker 2013; Mah, Minaker, Cook 2014 forthcoming)

12. The Context: Food environment research
• ‘Food deserts’ per se
• Lack of big supermarkets
• Big food retailers ignoring
prime locations in lower
income neighbourhoods
• Insufficient food production,
importation
For Toronto, the problem is NOT
The problem IS
• Poverty!
• Many business model,
infrastructure challenges
for small and medium
stores … enabling policy,
economic viability
• Cities (until recently) don’t
see food as their mandate
• And more …

13.  Research in 3 lower income sites to evaluate
healthier food retail models
 Healthy Corner Store pilot
 Mobile Good Food Market site
 Non-intervention control site for comparison
Pre-survey
Iterative pilot
interventions
Post-survey
Evaluation of
outcomes
PHAC-funded Food Retail Evaluation

14. Assets and strengths of the evaluation
 Pre-post, controlled design
 Mixed methods
 Use of 24h diet recall (ASA24) vs. food frequency
 Objective food environment measurement
 Novel mobile data collection tool (NEMS
smartphone app)
 Proximal metrics (changes in store, point-of-sale)

15.  Shift purchases toward healthier food & displace junk
food sales revenue
 Demonstrate potential for economically viable HCS
model
 Create toolkit of solutions to support HCS transition
citywide
Healthy Corner Store Pilot Objectives

16. Healthy Corner
Pilot Process

17. Typical HCS Project Components
Source: Jessie Azrilian, Allison Kwan, Mark Linthicum & Julia Wolfson (2012). Creating Healthy Corner Stores: An analysis of factors
necessary for effective corner store conversion programs.

18. Store
Owners
Residents’
Association
Project Partners

19. HCS Pilot Site #1
(Before)
“A-Z Variety”

20.  PHAC-funded pilot research

21. Challenges: Little Fresh Produce

22. Challenges: Clutter

23. Challenges: Floor repairs

24. Challenges: Not maximizing shelf space

25. City zoning doesn’t allow door directly
to outside from apt building retail
(but rules in process of changing)
Padlocked!
Challenges:

26. Challenges: No natural light inside

27. City Sign Bylaw doesn’t allow outside sign
Challenges: No outside sign!

28.  74% reported annual income <$30,000
 Average daily sodium intake – 3910mg
 84% born outside Canada
Residents’ Baseline Data

29. HCS Pilot Site
(mid-conversion)
“Lucy’s Fresh Food Market”

30. POS System installed (March 2014):
Still challenging to get timely accurate data

31. North wall
(pre-intervention)

32. North wall
Step 1

33. North wall
Step 2

34. North wall
Step 3

35. Window opened up

37. Price
Labels

40. Participation at
Community events
Community Engagement Work

41. Nearby community agency support:
 Links to resident groups
 Local program connections
 Community outreach workers to
promote store project

42. Initiative to link HCS &
food entrepreneurs
East Scarb Storefront,
Seed to Table
TPH Dietitian & HE
support
EcDev & Enterprise
Toronto

43. Unexpected Links
Landlord runs children’s morning snack program
Worked w TPH Dietitians to improve food quality
AND fruit now purchased through HCS pilot store

44. Marketing Support
 Health Canada funding to bring in marketing consultants

46. Current Challenges
 Consistent high quality, affordable fruit & veg distribution
 Expansion beyond F&V - how to find full inventory of healthier
fresh, prepared or frozen food distributors
 Project currently has limited food retail/marketing expertise
 Limited sales data – relying on 3rd party for POS system,
database management & sharing

47. Comments? Questions?
RESEARCH TEAM
Brian Cook – bcook@toronto.ca
Julie Sommerfreund – jsommer@toronto.ca
Leia Minaker – lminaker@uwaterloo.ca
Catherine Mah – catherine.mah@mun.ca
Margaret de Groh