Availability of Healthy Food, Alcohol, and Tobacco in a Rural Oklahoma Tribal Community

Abstract Background: American Indians experience disproportionally high rates of diet-related metabolic disorders. Suboptimal retail food environments make obtaining healthy food difficult, particularly for rural American Indians, and contribute to ill health. Objective: This project examined food availability in food stores within a tribal community. Design: Audits were conducted of all retail stores that sell food within nine communities within the Cheyenne & Arapaho Tribal Jurisdictional Area.Main Measures: Freedman Grocery Store Survey and the Healthy Food Assessment Survey.Key Results: Local populations were often reliant on convenience and dollar stores that prominently featured alcohol, tobacco, and ultra-processed food—and offered very little fresh produce. Convenience stores comprised more than half of all area food stores and were the only source of food in one-third of the communities. Only larger communities had supermarkets that sold fresh produce as well as ultraprocessed food. Dollar stores stocked primarily alcohol, tobacco, and ultraprocessed foods, and were rapidly displacing local markets that sold fresh produce. In general, alcohol and tobacco were far more available than vegetables and fruits in food stores. Conclusions: The limited availability of healthy food helps to explain our previous findings on dysbiotic microbiomes in Cheyenne & Arapaho individuals. The predominance of convenience stores and the growth of dollar stores in the tribal jurisdictional area contributed to a suboptimal food environment.