The 45-square block area of downtown San Francisco known as the Tenderloin has zero supermarkets. Approximately 83% of the Tenderloin’s residents do not have cars, so most rely on 57 corner stores within walking distance for grocery purchases. These corner stores typically carry tobacco, prepackaged processed foods, snacks, alcohol, and sweetened beverages. Without accessible fresh foods and vegetables, the Tenderloin is a food desert.
The US Department of Agriculture estimates that over 2.3 million Americans live in a food desert. Efforts to improve availability of fresh, nutritious food often include mobile grocery stores, food banks, community gardens, and farmers markets. In the Tenderloin, the Healthy Retail San Francisco initiative moves a step beyond these established interventions by building partnerships between corner stores, the Mayor’s Office of Economic and Workforce Development, and a private architectural firm. The program uses a three-pronged approach that focuses on: redesign of the physical environment, business operations, and community engagement.
Under the redesign and physical environment arm, the architects of Sutti Associates have joined with participating corner stores to redesign storefront layouts. This includes façade improvements, adding free or discounted appliances such as display refrigerators, and replacing tobacco, alcohol, and soda advertisements with artwork.
The business operations component of the initiative, led by the Mayor’s Office of Economic and Workforce Development, assists corner store owners with developing profitable business plans, selling healthy products, and implementing point-of-sale systems. Unlike cash registers, these systems allow store owners to monitor sales and inventory with every retail transaction. The Mayor’s office also assists with access to capital as well as tax and debt planning.
Community engagement focuses on building partnerships between the Tenderloin Healthy Corner Store Coalition (the Coalition), San Francisco’s Department of Public Health, and local universities. Through this partnership, the Coalition trains local residents to become certified Food Justice Leaders who engage with community members and collect data used to evaluate the effectiveness of Healthy Retail San Francisco’s initiatives.
Between 2014 and 2018, the Healthy Retail initiative was implemented in 6 corner stores in the Tenderloin. Data from 4 stores over the first year of the program show a 35% increase in fresh fruit and vegetable sales. Tobacco sales decreased by 35% in 3 out of 4 stores.
The healthy food retail initiative demonstrates how public-private partnerships can drive positive public health outcomes.
Food Justice Leaders rated corner stores from 1 to 4 stars based on types and quality of food sold, product placement, cleanliness and safety, as well as amount and type of advertisements. Prior to the launch of the initiative, 23% of corner stores were three and four stars; by 2017, 51% of stores received these high ratings.
The healthy food retail initiative demonstrates how public-private partnerships can drive positive public health outcomes. In the Tenderloin, convincing store owners to invest in fresh produce was a critical step in launching the program. Many believed selling fruits and vegetables would prove less profitable than alcohol and other unhealthy products. Collaboration between the Mayor’s office, Sutti Associates, and community members provided approximately $24,000 in physical upgrades and in-kind services to offset the startup cost of selling produce and losses in tobacco and alcohol sales. In the six months of the initiative, combined total sales of participating stores increased by 25%.
By addressing the business needs of store owners, the Healthy Retail initiative is able to deliver on public health objectives of tobacco control, alcohol prevention, and healthy nutrition. The initiative accomplishes business goals while also benefiting the overall wellbeing of community members in the Tenderloin.
Beyond San Francisco, healthy retail initiatives have taken shape in Massachusetts, Missouri, New Jersey, and Pennsylvania. Their long-term goal is to reduce chronic conditions like obesity, diabetes, and heart disease associated with unhealthy eating.