Understanding the Role of Tiendas (Latino grocery stores) in the Nutritional Habits and Obesity Risk of Latino Families

Guadalupe X. Ayala, San Diego State University, Graduate School of Public Health

Barbara Laraia

India Ornelas

Deanna Kepka, University of North Carolina at Chapel Hill, School of Public Health

Background and Purpose:
Obesity is a serious health problem among Latino men and women who have immigrated to the United States. The age-adjusted prevalence of obesity among adult Latinos in the U.S. is estimated at 28.9% for men and 39.7% for women. As possible evidence of the impact of U.S. lifestyle and environmental factors, Mexican-American women in the U.S. have almost twice the obesity rates found in Mexico and other Latin American countries. There is now a growing body of evidence linking neighborhood environmental factors with risk for obesity and poor diet quality. For example, poorer and predominantly minority areas house significantly more small grocery stores which are far less likely to carry healthy food selections than those in a predominantly white neighborhood. In addition, poor neighborhoods tend to have fewer produce markets and natural food stores.

This study represents a three-county examination of the presence of small Latino-oriented grocery stores ("tiendas") in the community, and their influence on Latino store customers' food purchasing behaviors. Latino immigrants to the Southeastern U.S. represent one of the largest and most rapidly growing new immigrant populations. Several factors have driven this significant in-migration, particularly from Mexico: affordable housing; employment opportunities; and family reunification. Changes in the new immigrant demographic profile have occurred so rapidly that few institutions are equipped to adequately serve this population. As a consequence, other forms of support have developed to meet the needs of the Latino immigrant community. In the Southeastern U.S., tiendas have become an important source of food and other products and services for new immigrant Latinos. The growth in the number of tiendas in these counties suggests that they likely influence dietary behavior.

From among several data sources (i.e., USDA, ReferenceUSA, County Health Department, windshield tours), 43 tiendas were identified. Data were collected from 86% of these tiendas (n=37) which were in operation, including unobtrusive store observations (100%), tienda manager in-depth interviews (81%), and 114 interviews with tienda customers.

Data from the store observations revealed that the tiendas varied on the number of food-related services offered. For example, 19% of the tiendas had an on-site butcher and offered prepared foods to consume on-site or to take home. Sixteen percent of the tiendas had a candy vending machine available, with tiendas located in the rural community having significantly more candy vending machines than tiendas in the suburban and urban communities (p < .05). In terms of availability of healthy and unhealthy food products, 63% and 68% of the tiendas carried a limited supply of fruits and vegetables respectively, 5% of stores sold a lower-fat variety of cheese, and 14% offered a lower fat variety of milk. Unhealthy food products were also observed including Mexican candy (100% of stores), American candy (60%), and regular soda (100%). In terms of location, a majority of the tiendas were located in a residential neighborhood (74%), in a strip mall (60%), near other convenience stores (51%), or near a sit-down restaurant (43%) or fast food restaurant (38%). Significantly more tiendas were located near a fast food restaurant in the urban community as compared with the rural and suburban communities (p<.01).

In-depth interviews with the managers revealed that 57% of the managers were also the owners and a majority (63%) lived in the community where the tienda was located. The average number of years the tiendas were in operation and managed by the respondents was three years. Most of the tienda managers made purchasing decisions alone or in collaboration with the owner. Merchandise and food products were obtained from local vendors catering to these tiendas, including a number of food distributors from Mexico. Stocking decisions were made based on a visual inspection of shelf inventory, seasonality, and customer requests.

Intercept interviews conducted with 114 adult Latino customers found that the customers visit these tiendas on average twice a week for commonly consumed foods and 85% lived in the same community as the tienda. The primary motivators for visiting the tienda were quality of service (68%), familiarity of products (62%), and proximity to home or work (57%). The average amount of money spent on groceries was $120/week. Food prepared at home was the primary source of dietary intake for breakfast (84%), lunch (75%), and dinner (94%). Store customers were asked about the types of food products they most commonly purchased at the tienda where the interview was completed. Tortillas, meat, soda, and vegetables were the most common products purchased by the customers, followed by dairy products, fruits, and breads. We examined whether two characteristics of the tienda was associated with customers' purchasing of fruits and vegetables: location of tienda and availability of fruits and vegetables. We found no association between location of the tienda and purchasing of fruits and vegetables. However, we found a strong association between reported purchasing of fruits and vegetable and availability of fruits and vegetables in the tienda (p<.001).

This study provides a first glimpse at a potential source of influence on Latino's dietary intake at a critical period during the acculturation process. We observed that tiendas offer a variety of products and services that are in demand by new immigrant communities. However, tiendas also influence customers' food purchasing behavior by making healthy and unhealthy food products more accessible. Tiendas serve an important role in the community - as a source of information about community resources, as a place to meet and socialize with similar others, and as a place to purchase commonly consumed foods. We are now using this information to test the efficacy of a tienda-based environmental change intervention to increase frequency of fruit and vegetable purchasing behavior.

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