Healthy food retail during the COVID-19 pandemic: Challenges and future directions

Lucia A. Leone, Sheila Fleischhacker, Betsy Anderson-Steeves, Kaitlyn Harper, Megan Winkler, Elizabeth Racine, Barbara Baquero, Joel Gittelsohn

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Disparities in dietary behaviors have been directly linked to the food environment, including access to retail food outlets. The Coronavirus Disease of 2019 (COVID-19) pandemic has led to major changes in the distribution, sale, purchase, preparation, and consumption of food in the United States (US). This paper reflects on those changes and provides recommendations for research to understand the impact of the pandemic on the retail food environment (RFE) and consumer behavior. Using the Retail Food Environment and Customer Interaction Model, we describe the impact of COVID-19 in four key areas: (1) community, state, tribal, and federal policy; (2) retail actors, business models, and sources; (3) customer experiences; and (4) dietary intake. We discuss how previously existing vulnerabilities and inequalities based on race, ethnicity, class, and geographic location were worsened by the pandemic. We recommend approaches for building a more just and equitable RFE, including understanding the impacts of changing shopping behaviors and adaptations to federal nutrition assistance as well as how small food business can be made more sustainable. By better understanding the RFE adaptations that have characterized the COVID-19 pandemic, we hope to gain greater insight into how our food system can become more resilient in the future.

Original languageEnglish (US)
Article number7397
Pages (from-to)1-14
Number of pages14
JournalInternational journal of environmental research and public health
Issue number20
StatePublished - Oct 2 2020

Bibliographical note

Funding Information:
Funding: All authors are members of the Healthy Food Retail Working Group leadership team, jointly supported by Healthy Eating Research (HER), a national program of the Robert Wood Johnson Foundation, and the Nutrition and Obesity Policy Research and Evaluation Network (NOPREN). NOPREN is supported by Cooperative Agreement No. 5U48DP00498-05 from the Centers for Disease Control and Prevention (CDC), Prevention Research Centers (PRCs) Program. All authors receive a stipend from HER for their leadership role with the working group. Support for MRW’s effort was also provided by the National Heart, Lung, and Blood Institute (NHLBI), grant number K99HL144824 (Principal Investigator: MRW). Publication fees were supported by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation. The findings in this study are solely the responsibility of the authors and do not necessarily represent the official views of CDC, HER, or NOPREN.

Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.


  • COVID-19
  • Dietary intake
  • Federal nutrition assistance
  • Food purchasing
  • Grocery stores
  • Restaurants
  • Retail food environment


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