The Role of Food Retailers for Integration of Nutrition Security and Planetary Health Promotion in the United States

Abstract

In the United States (U.S.), nutrition security is defined as food security and diet quality across social and economic segments of the population. Achieving nutrition security for all requires a healthy planet that can withstand the shocks and stressors of ahistoric weather patterns. Healthy food retail initiatives in the U.S. promote nutrition security through policy, systems, and environmental changes, but under-emphasize planetary health promotion. The purpose of this dissertation was to explore the role of food retailers in the U.S. to integrate nutrition security and planetary health promotion. Study one examined the applicability of an existing corporate food retail benchmarking tool, the Business Impact Assessment-Obesity and population level nutrition (BIA-Obesity), for monitoring food retailer actions to advance the National Strategy on Hunger, Nutrition, and Health recommendations for nutrition security. Existing BIA-Obesity indicators were broadly applicable for National Strategy recommendations. Additional indicators for local foods, fairness in resource distribution, food waste reduction, and digital food environments would improve applicability of the BIA-Obesity to monitor food retailer actions towards National Strategy recommendations. Study two identified corporate Supplemental Nutrition Assistance Program (SNAP)-authorized food retailer public commitments to environmental sustainability and categorized commitments by domain of environmental sustainability, using relevant Sustainable Development Goals (n=9). Content analysis of commitments showed that 31 of 48 included SNAP-authorized food retailers had commitments across environmental sustainability domains. Results can inform accountability evaluations, partnerships, and policy action. Study three explored the perceptions of 12 independent food retailers in Virginia about planetary health promotion through semi-structured interviews, with questions and coding informed by the inner and outer settings of the Consolidated Framework for Implementation Research. Food retailers were willing to play a role in planetary health promotion and identified cost and customer satisfaction as key determinants of the scope of their role. Planetary health promotion practices of interest varied by store format and community context. Corporate and independent food retailers could support planetary health if support and incentive systems align planetary health promotion with profit potential and customer satisfaction. Healthy food retail researchers and practitioners can use these results to inform expanded nutrition security programming that includes planetary health promotion.