Taking Stock of New Supermarkets in Food Deserts: Patterns in Development, Financing, and Health Promotion.

Motivated by disparate healthy food access in neighborhoods across the US, federal, state, and local initiatives have emerged to develop supermarkets in "food deserts." Differences in the implementation of these initiatives are evident, including the presence of health programming, yet no comprehensive inventory of projects exists to assess their impact. Using interviews, public databases, and media archives, I collected details (project location, financing, development, health promotion efforts) about all supermarket developments under "fresh food financing" regimes in the US, 2004-2015. In total, I identified 126 projects. Projects have been developed in a majority of states, with concentrations in the mid-Atlantic and Southern California regions. Average store size was approximately 28,100 square feet, and those receiving financial assistance from local sources and New Markets Tax Credits were significantly larger, while those receiving assistance from other federal sources were significantly smaller. About 24 percent included health-oriented features; of these, over 80 percent received federal financing. If new supermarkets alone are insufficient for health behavior change, greater attention to these nuances is needed from program designers, policymakers, and advocates who seek to continue fresh food financing programs. Efforts to reduce rates of diet-related disease by expanding food access can be improved by taking stock of existing efforts.