If You Build Them… Will it Matter? Food Stores' Presence and Perceived Barriers to Purchasing Healthy Foods in the Northeastern U.S.

Policies incentivizing store entry or store improvements are aimed at increasing access to healthy foods; however, findings about their effectiveness to improve diets are mixed. Similarly, little is known about whether food stores' presence affects consumers' perceived barriers to purchasing healthy foods, which reflect the subjective hardships experienced by shoppers to purchase and consume healthier foods. In this study, we assess the relationship between the two most widely studied perceived barriers to purchasing healthy foods (price and availability) and the local retail food environment using individual-level survey data collected across the northeastern US and census data on the numbers of grocery stores and warehouse clubs and supercenters. Our results indicate that unobserved heterogeneity plays an important role in determining the sign and magnitude of the relationship between store presence and perceptions. The likelihood that an individual cites price or availability as a perceived barrier depends upon the barrier considered, whether respondents live in the zip code where they shop, and the method of controlling for unobserved heterogeneity. Thus, policies focusing on improving access to a given store type may only mitigate some of the negative perceptions associated with one's food environment.