title: Healthful Nutrition of Foods in Navajo Nation Stores: Availability and Pricing.
abstract: Low availability and affordability of healthier foods in food stores on the Navajo Nation (NN) may be a community-level risk factor for the high prevalence of obesity among the Navajo people. This study assessed the availability and pricing of foods and beverages in supermarkets and convenience stores throughout the NN.
  
  
  
  Descriptive study design using the Nutrition Environment Measurement Survey in Stores audit tool.
  
  
  
  Supermarkets (n = 13) and convenience stores (n = 50) on NN and border-town supermarkets (n = 9).
  
  
  
  Not applicable.
  
  
  
  Availability and pricing of healthy and less-healthy foods.
  
  
  
  Descriptive and χ(2) analyses.
  
  
  
  Navajo convenience stores offered fewer healthier food options compared to Navajo supermarkets. In Navajo convenience stores, 100% whole grain products, reduced-fat cheese, lean meats, reduced-fat chips, and fat-free or light hot dogs were available in fewer stores than their corresponding less-healthy versions (all with p < .05). In both Navajo supermarkets and convenience stores, 100% whole wheat bread, lean cold cuts, and reduced-fat cheese were all more expensive per unit than their corresponding less-healthy versions (all with p < .05).
  
  
  
  According to this study, healthier foods are not as readily available in Navajo convenience stores as they are in Navajo supermarkets. Improving access to and affordability of healthier foods in reservation stores of all sizes may support healthy eating among Navajo residents.
authors: Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Atlanta, Georgia wiz3@cdc.gov.
authors: Gayathri
authors: G
authors: Kumar
authors: Navajo Division of Health, Window Rock, Arizona.
authors: Sonlatsa
authors: S
authors: Jim-Martin
authors: Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
authors: Emily
authors: E
authors: Piltch
authors: Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Stephen
authors: S
authors: Onufrak
authors: Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Atlanta, Georgia.
authors: Carrie
authors: C
authors: McNeil
authors: Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Atlanta, Georgia.
authors: Laura
authors: L
authors: Adams
authors: Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Nancy
authors: N
authors: Williams
authors: Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Heidi M
authors: HM
authors: Blanck
authors: Navajo Division of Health, Window Rock, Arizona.
authors: Larry
authors: L
authors: Curley
mesh_terms: D003132:Commerce / Q000592:standards* / Q000706:statistics & numerical data*; D057140:Fast Foods / Q000191:economics* / Q000600:supply & distribution*; D005523:Food Supply / Q000191:economics*; D006293:Health Promotion / Q000191:economics* / Q000379:methods*; D006801:Humans; D007198:Indians, North American; D014481:United States
keywords: American Indian; Food Environment; Health focus: nutrition; Healthy Food Access; Healthy Food Availability; Healthy Food Pricing; Manuscript format: research; Native American; Navajo; Nutrition; Nutrition Environment; Outcome measure: other; Prevention Research; Research purpose: descriptive; Setting: local community; Strategy: nutrition environment; Study design: nonexperimental; Target population age: youth/adults/seniors; Target population circumstances: geographic location and race/ethnicity