In summer 2023, a team of 10 American University public health and data science students teamed up to examine access to healthy food for District of Columbia residents.

Funded by DC Health, the project sent the students to visit 128 food retailers across all eight DC Wards to measure the shelf space dedicated to healthy and unhealthy items. The results were striking. For every three feet of shelf space allocated to unhealthy foods, only one foot was dedicated to healthy options in both full-service and small/medium grocery stores. (Full-service grocery stores are chain stores primarily selling food and beverages with more than 10,000 square feet of sales space, while small/medium food stores, which can be independent or chain stores, have less than 10,000 square feet of sales space.) Even worse, other food retail outlets, such as convenience stores, drug stores, and healthy corner stores, offered far less space dedicated to healthy food options. 

This disparity means that customers who must shop at these smaller retail outlets face an overwhelming presence of sugar-sweetened beverages and salty and sweet snacks, with fewer healthy choices available.

A Stark Contrast in Access

Not every ward in DC has an equal number of large, full-service grocery stores, leading to unequal access to healthy food. For instance, according to DC Hunger Solutions’ annual Grocery Gap Report, in 2023, approximately 77,800 residents in DC’s Ward 3 (the ward with the highest median household income) had access to 16 full-service grocery stores. However, the 74,500 residents in DC’s Ward 7 (the ward with the second lowest median household income) had access to only four. This highlights the significant disparities in access to healthy food faced by residents in wards with fewer full-service grocery stores.

"This project has really opened our eyes to the deep-rooted inequities in food access across different neighborhoods," said Brooke Wayne (BS health promotion management and MS nutrition education ’23), a member of the research team. "It changes your outlook to understand that not all neighborhoods have the same resources, and those differences impact the health of residents in direct and indirect ways. We saw firsthand how the environment drives food choices, and access to affordable nutritious foods determines much of our health.”

Complex Methodology, Clear Results

The project was both logistically and technically complex, requiring data teams to visit stores, establish trusting relationships with retail outlets, and collect and interpret data. Wayne and Caroline Krekorian (BS public health ’22), both members of the SNAP-Ed Food Matters team in the Department of Health Studies’ Healthy Schools, Healthy Communities Lab, coordinated every detail of this crossover data and health assessment.

"We wanted to understand the real food landscape that residents encounter daily," said Javad Rajabi (MS computer science ’24), another team member. "By doing this, we could provide tangible data to support policy changes."

Once a comprehensive database of food retail locations was established using DC Health licensing records, the data collection team was assembled. The team, which included Rajabi, Raya Rukab, Ella Miller, Lily Marzano, Farrell Phillips, Akash Agrawal Bejarano, and Murtaza Jawid, set out to visit 25 outlets per ward, including full-service grocery stores, small/medium grocery stores, convenience stores, drug stores, and healthy corner stores. In all, 128 stores were measured.

Towards a Healthier Future

The study results have significant implications for how DC Health and policymakers can collaborate with food retail owners to improve access to healthy foods. Possible policy recommendations include incentivizing more full-service grocery stores to open in underserved wards, offering tax incentives for stores that achieve a better ratio of healthy to unhealthy shelf space, and creating healthy checkout guidelines similar to those in Berkeley, California, in which stores are banned from selling items in checkout aisles that contain more than five grams of added sugars or 200 milligrams of sodium per serving.

Going forward, the Healthy Schools, Healthy Communities Lab is entering phase two of this work, examining the 4 Ps (promotion, product, placement, and price) to understand how these variables further influence the accessibility and affordability of healthy and unhealthy foods.

The Road Ahead

"Our ultimate goal is to present these findings to the DC Food Policy Council this summer," said Stacey Snelling, PI and Director of American University’s Healthy Schools, Healthy Communities Lab. "We believe that our research can inform policy changes that can make healthy food more accessible and equitable for all DC residents."

As the team continues its work, the hope is to inspire other students and researchers to join the fight for food equity, ensuring that every DC resident has the opportunity to make healthy food choices.

For More Information

For more information, visit American University’s Department of Health Studies. And read about the award-winning work of one American University alumna, Ekua Hudson, to fight food deserts in Washington, DC.