Junk around the corner

When trying to get to the root of a problem, it’s usually best to start at the source. That’s why public health officials across the state joined the American Lung Association and other health-advocacy groups to examine the connection between marketing at community stores and the consumption of alcohol, tobacco and junk food.

Each of California’s 58 counties participated in the project, titled Healthy Stores for a Healthy Community. Survey results came out this month; they show Butte County ranking among the most unhealthful retail environments, with cheap, plentiful tobacco; alcohol ads placed at kid level; sugary drinks at checkout counters in stores near schools; and a far greater promotion of unhealthy foods than healthy foods.

The study also found a marked increase in electronic cigarettes and a proliferation of “alcopops,” alcoholic beverages with bright colors and/or fruity flavors. The number of e-cigarette sellers has nearly quadrupled in two years; alcopops, meanwhile, are so ubiquitous that they’re carried by most every market, pharmacy and convenience store.

Health officials aren’t stunned by the findings, but are nonetheless concerned.

“Anecdotally we knew what we would find,” said Shelly Brantley, the Chico-based advocacy director for the American Lung Association. “It was somewhat disheartening to then quantify that [the preconception] was true.

“The fact that there’s so much more unhealthy product available—alcohol, tobacco, unhealthy snacks, sugary beverages, [and] such a disparity between healthy and unhealthy in what’s available—it really is troubling.”

The connection between stores and health seems intuitive. “If it’s not available,” Brantley said, “then obviously folks can’t purchase it, can’t consume it,” and vice versa. But such a comprehensive study, involving alcohol and nutrition along with tobacco, had not been conducted before. Now public health officials have hard numbers to present to policymakers and community leaders in the hope of inspiring holistic change.

“Stores play an important role in the community,” Brantley said. “They shape economics, quality of life, maybe even safety of our neighborhoods. … They’re absolutely assets to the community, and we need to make sure, then, that they’re healthy assets. This project is one way to do that.”

Officials and volunteers in Butte County surveyed 145 local retailers—markets, pharmacies, convenience stores, liquor stores, tobacco-only stores—selected randomly. From July to October 2013, they looked at inventory, advertising, product placement and promotional displays.

Researchers then incorporated the local data into the regional and statewide analyses. The information is available at www.healthystoreshealthycommunity.com.

“The Survey results as a whole serve as an opportunity to begin a discussion about what can be done to improve the retail environment that makes it easier to be healthy,” said Raul Raygoza, a public health education specialist for the Butte County Department of Public Health, who focuses on tobacco.

In that regard, in addition to the widespread proliferation of e-cigarettes, the survey found that Butte County has some of the lowest cigarette prices in the state. “In a nutshell, that’s a recipe for nicotine addiction that leads to preventable illness and suffering,” Raygoza said.

Also of concern to both Raygoza and colleague Ellen Michels, who specializes in nutrition, are products attractive to young people such as candy and bubble gum in the form of cigarettes and chewing tobacco flavored like candy.

Sweet alcohol falls into the same category. Many parents don’t even know what alcopops are, “but the kids know,” said Michel, “and I think that’s shameful.

“It’s just a logical progression for the kids who are used to drinking sugary beverages to move on to sugary beverages with alcohol, and when you line up these products, it’s hard to even tell which have alcohol in them; they all look alike.”

Sugary drinks contribute to obesity, which affects nearly two-thirds of adults and a third of children in Butte County. The survey found these beverages frequently displayed near cash registers, along with candy, snacks and other impulse items. Fresh milk, fruits and vegetables were harder to find.

“It just seems to be accepted that our convenience stores are just going to sell unhealthy snacks,” Michels said, “and if you want healthy stuff, you have to go to a grocery store—and a lot of neighborhoods don’t have that option.”

Michels is careful about pointing fingers, though. Commerce involves supply, but also demand.

“The retailer isn’t the problem here; the retailer is really just the middleman,” she said. “The companies that produce the unhealthy products and market them, that’s where it originates, and then all of us who purchase all the unhealthy stuff are adding to the problem, too. I think there needs to be change all around.”