This study has strengths and weaknesses. This study was an ancillary project of the Strong Heart Study, and we worked through that study’s established channels to maximize the project’s efficiency. All stores were surveyed only once, and we were unable to account for variation in availability and price of foods over time. Although we attempted to survey all stores that sell food within the 90-mile catchment area, 3 convenience stores refused to participate. Finally, the study was designed to better understand the availability and cost of foods, and we did not evaluate other structural barriers (eg, transportation, food quality, travel distance) that may affect a person’s ability to consume a healthy diet, nor did we evaluate individual purchasing behaviors.
This study indicates that healthy food options were available in the community studied, although the price of these foods appeared to be slightly higher than the national averages and varied considerably across stores. Greater efforts are needed to better understand a wider range of contextual and structural factors that influence food-purchasing patterns beyond availability and cost.