Coupled with declining rates of physical activity, obstacles to accessing healthy and nutritious food have contributed to rising levels of chronic disease, overweight and obesity. Consumption of foods high in fat and calories has soared while access to quality fresh fruits and vegetables has declined.⁷

Myriad environmental, social, political and economic factors influence food choice. For example, the presence of a full-service grocery store in a neighborhood correlates with higher rates of fruit and vegetable consumption. This in turn helps lower the incidence and severity of disease and hunger.⁸

Urban centers, rural communities and older suburban neighborhoods often lack full-service grocery stores nearby. Their residents must rely on corner markets, convenience stores and fast-food restaurants. These small stores offer limited selections of healthy, fresh foods and cost more than full-service groceries.⁹  The Retail Food Environment Index (RFEI) measures the ratio of these small stores to full-service grocery stores and produce markets.¹⁰  The higher the ratio, the more likely it is that residents are obese and diabetic.¹¹