The Impact of a Grocery Store Closure in One Rural Highly Obese Appalachian Community on Shopping Behavior and Dietary Intake

Rachel Gillespie, Emily Dewitt, Stacey Slone, Kathryn Cardarelli, Alison Gustafson

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Research has examined how the entry of grocery stores into neighborhoods influences dietary outcomes, yet limited evidence suggests a direct correlation between opening a store and changes in dietary intake. A factor that might influence individuals’ behavior more directly is the closing of a grocery store where residents shop. This study aims to examine how a grocery closure in a rural Appalachian high poverty county is associated with dietary intake. A cohort of n = 152 individuals were recruited to participate in a longitudinal study examining purchasing habits and dietary intake. At time point two, one year later, n = 74 individuals completed the survey via phone. Results indicate those that switched from shopping at a local grocery store to a supercenter significantly increased their dietary intake of fruit (0.2 ± 0.8), fruits and vegetables (1.4 ± 2.7), alcohol (grams) (17.3 ± 54.1), and tomato sauce (0.1 ± 0.3). A local grocery store closure was associated with a change in shopping behavior and dietary intake. Community-level interventions targeting dietary behaviors must account for neighborhood food environment influences, including grocery store availability. Policy aimed at improving food access in rural communities need to consider approaches to improving a variety of food venues with affordable healthy food, while addressing the evolving grocery shopping behaviors of consumers.

Original languageEnglish
Article number3506
JournalInternational Journal of Environmental Research and Public Health
Issue number6
StatePublished - Mar 1 2022

Bibliographical note

Funding Information:
This research was funded by Centers for Disease Control and Prevention (CDC) Division of Nutrition, Physical Activity, and Obesity (DNPAO), Cooperative Agreement number 1NU58DP0065690100.

Funding Information:
As part of a larger multi-year High Obesity Program (HOP) project funded by the Centers for Disease Control and Prevention (CDC), the current study addresses access to nutritious foods among a rural, low-income population in Eastern Kentucky. Martin County, Kentucky, is in the Central Appalachian region of the U.S. and has an adult obesity prevalence greater than 40%. In addition to high obesity prevalence, the county experiences high rates of cancer prevalence and other obesity-related chronic illnesses such as Type II diabetes and heart disease [13,14]. The county also faces persistent poverty [15], with a median household income of approximately $30,320, and 32% of residents currently living in poverty [16]. One in five adults are considered food insecure [17], with 22% participating in the Supplemental Nutrition Assistance Program (SNAP) [18].

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • Behavior change
  • Food environment
  • Grocery shopping
  • Obesity
  • Rural

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


Dive into the research topics of 'The Impact of a Grocery Store Closure in One Rural Highly Obese Appalachian Community on Shopping Behavior and Dietary Intake'. Together they form a unique fingerprint.

Cite this