The Mississippi Small Business and Grocer Investment Act

Transcription

1 January 2015 The Mississippi Small Business and Grocer Investment Act A Closer Look at the Policies and Issues associated with Making Investments in Underserved Communities in the State of Mississippi An Overview for Decision-Makers Mississippi State Research Team Judith Phillips, M.B.A., ABD, Research Analyst Kayla Lee-Hopkins, M.P.P.A. John Harper, M.P.P.A. Dallas Breen, Ph.D., Assistant Director Philip (Eddie) French, Ph.D., Director

2 Mississippi State University Graduate Students Supported by Funding from The Partnership for a Healthy Mississippi The Partnership for a Healthy Mississippi provided funding to the Stennis Institute of Government and Community Development at Mississippi State University to complete the scope of work presented in this study; this funding is used by the Stennis Institute to provide graduate students with tuition and graduate student stipends, thereby enabling them to pursue graduate level course work at Mississippi State University. These students make a significant and important contribution to all research conducted by the Stennis Institute. John Harper is from Braxton, Mississippi and graduated from Mendenhall High School in He earned an associate s degree in Business Administration from Copiah Lincoln Community College before transferring to Mississippi State University where he received a bachelor s degree in Political Science. He completed his master s degree in Public Policy and Administration program in John is currently pursuing a doctorate degree in Higher Education Leadership to prepare for a career in administration at a college or university. Kayla Lee Hopkins is originally from Brandon, MS and graduated from Northwest Rankin High school in She completed a bachelor s degree in Political Science from Mississippi State University and graduated summa cum laude. Kayla completed her master s degree in Public Policy and Administration in She currently works as a Graduate Research Assistant for the Stennis Institute of Government. Previously, she was a student intern for the Department of Veterans Affairs in Jackson, MS. Kayla is currently working on completing a doctoral degree at Mississippi State University and hopes to continue conducting research related to community and economic development at the state and local level in the future. Jacorius Liner is from Rosedale, MS. He graduated from West Bolivar High School in 2009 and attended Mississippi University for Women (MUW) where he earned a bachelor s degree in Political Science with a minor in Legal Studies. While at MUW, Jacorius was on the President s List and the Dean s List. Jacorius completed his M.P.P.A. in 2014 and is currently pursuing a doctoral degree at Mississippi State University. Adriene Davis is originally from Fort Knox, Kentucky. He graduated from Avon High School in Avon, IN and then received his bachelor s degree in Sociology at Indiana University. Adriene received his master s degree from the University of Memphis. While attending the University of Memphis, he was inducted into Alpha Kappa Delta, the sociology honors society. Adriene began his work as a graduate student assistant at the Stennis Institute in the fall of Adriene is currently a sociology doctoral student at Mississippi State University and intends to pursue a career as a university professor upon completion of his PhD.

3 The Mississippi Small Business and Grocer Investment Act (H.B. 1328) Executive Summary In 2014, the Mississippi Legislature passed, and Governor Phil Bryant signed, House Bill 1328; this bill is entitled the Small Business and Grocer Investment Act. In recognition of the need to increase access to healthy and nutritious food, the purpose of the Mississippi Small Business and Grocer Investment Act is to provide grants, loans, and other incentives to promote access to healthy foods in Mississippi s underserved communities. Investments made to increase access to healthy and affordable food options such as meat and poultry, fresh fruits and vegetables, and milk and dairy products in underserved communities have the potential to improve community health, reduce the risk of obesity, diabetes, and heart disease, promote community revitalization, and create new jobs. At the request of the Partnership for a Healthy Mississippi, a research team at the Stennis Institute of Government at Mississippi State University examined the issues associated with the lack of access to healthy food, the policy initiatives that have been implemented in other states to incentivize investments in underserved communities, and the potential economic and fiscal impact of investments in Mississippi s underserved communities that might be associated with a state healthy food financing initiative; the findings of this analysis are presented in this study. Driven by the obesity epidemic in the United States, policies that reduce obesity, improve health outcomes, and contain the cost of obesity related healthcare have received increasing attention. A large body of scientific and public policy research has found that lack of access to healthy food may be a contributing factor to the high prevalence of obesity, diabetes, and related health problems that are found in the disadvantaged populations that live in underserved communities. In 2010, the federal government introduced the Healthy Food Financing Initiative to provide funding for programs designed to increase the supply of healthy foods in underserved communities. The Healthy Food Financing Initiative is a multi year, interagency collaboration that provides funding and incentives from the U.S. Department of Health and Human Services, the U.S. Department of Agriculture, and the U.S. Department of the Treasury to support investments and programs in eligible census tracts throughout the United States. This study assumes that a Mississippi healthy food financing initiative will provide state funding using taxpayer dollars to incentivize investment in underserved communities in the state of Mississippi; these investments are assumed to use a mix of public and private funding to offset the barriers to entry for food outlets in communities where financing needs cannot be met by conventional financial institutions. Although there are numerous underserved communities throughout the state of Mississippi, census tracts that are eligible for federal grants, loans, and incentives under the federal Healthy Food Financing Initiative will enable the state of Mississippi to significantly leverage and minimize the share of state funding that may be associated with the Mississippi Small Business and Grocer Investment Act; for this reason, HFFI A Closer Look at Underserved Communities in Mississippi

4 The Mississippi Small Business and Grocer Investment Act (H.B. 1328) eligible census tracts are specifically delineated in this study. The development of a Mississippi healthy food financing initiative will require programs that are designed to be flexible to assure that the food retailing format is appropriate to the specific needs of the market within each underserved community. The most common business retail formats used to increase access to healthy food within underserved communities are investments in supermarkets, grocery stores, farmers markets, food cooperatives, or food hubs. The economic, market, and consumer profiles that exist within each underserved community will require appropriately designed retail formats and each retail format will have unique capital requirements, different sources of capital investment, and may use different investment structures; although policies may be adopted to enable making these investments in any geographic location in the state of Mississippi, strategically prioritizing investments in federal HFFI qualifying census tracts will enable multiple sources of funding to be leveraged to capitalize investments in Mississippi s underserved communities. These issues are further discussed in the Policies and Intervention Strategies in Underserved Communities section of this report (beginning on page 58). A comprehensive analysis of the 659 census tracts in 72 counties within the state of Mississippi that are designated as federal HFFI qualifying census tracts to receive funding from the federal Healthy Food Financing Initiative was beyond the scope of this study. The Stennis Research Team selected four counties for inclusion in this study: Lowndes County, Pearl River County, Sunflower County, and Washington County. A socioeconomic profile for all census tracts within each of these four counties is included in this study; importantly, all HFFI qualifying census tracts examined in this study are also eligible to receive federal New Market Tax Credits, as well as other federal funding, to leverage investments made in Mississippi s underserved communities. The total population of these four counties was 194,453. The study found that within these four counties, there were a total of 102,089 people living in HFFI qualifying census tracts this represented 52.5 percent of the total population of the four counties. There were a total of 49,472 children 17 years or younger living in the four counties; 27,160 of these children (54.9 percent) lived in HFFI qualifying census tracts. Of the 25,626 people age 65 and older living in the four counties, 12,200 (47.6 percent) lived in HFFI qualifying census tracts. The total female population of the four counties that were examined in this study was 100,236, representing 51.5 percent of the total population across the four counties; of the total female population in the four counties, 53.7 percent lived in HFFI qualifying census tracts. Female households with children under 18 with no husband present were also found to be disproportionately represented in HFFI qualifying census tracts; across the four counties, there were a total of 8,192 female households with children under 18 with no husband present; 70.6 percent of these households were located in HFFI qualifying census tracts. Although the magnitude of this problem exhibited variation within each county, this research found that HFFI qualifying census tracts generally exhibit a higher percentage of female households with children under 18 with no husband present as compared to other census tracts within each A Closer Look at Underserved Communities in Mississippi

5 The Mississippi Small Business and Grocer Investment Act (H.B. 1328) county. Of particular concern is the extraordinarily high poverty level for female households with children and no husband present; at the county level, poverty rates for these households ranged from a low of 56.6 percent to a high of 66.7 percent. The poverty level for female households with children and no husband present was found to be higher within the majority of the HFFI qualifying census tracts as compared to the county average poverty rate for these households; in many HFFI qualifying census tracts that were examined during this study, the poverty rate for female households with children and no husband present was found to exceed 80 percent. Another indicator of poverty is a household income of less than $15,000. In the state of Mississippi, 19.5 percent of households have incomes of less than $15,000. There were 16,763 households with a household income of less than $15,000 in the four counties that were included in this study, representing 23.9 percent of all households in the four counties; 66.9 percent of all households (11,221 households) with incomes of less than $15,000 were found to live in HFFI qualifying census tracts. This pattern was found to be generally consistent for each county that was included in this study. When compared to other census tracts within each of the four counties examined, HFFI qualifying census tracts were found to be characterized as exhibiting relatively lower educational attainment levels, higher unemployment rates, lower income, and higher poverty. For those who were employed, median income from employment tended to be lower in HFFI qualifying census tracts; for those who were retired, retirement income tended to be lower in HFFI qualifying census tracts; for those who were receiving income from Social Security, Social Security income tended to be lower in HFFI qualifying census tracts. These findings reinforce the delineation of federal HFFI qualifying census tracts as a metric to identify underserved communities in the state of Mississippi. Low educational attainment, unemployment, low income, and poverty walk hand in hand with food insecurity, poor nutrition, obesity, and obesity related healthcare costs. Scientific research has demonstrated the relationship between socioeconomic status and obesity; the prevalence of obesity is disproportionately higher among people with limited resources. Common morbidities associated with obesity include diabetes, coronary heart disease, hypertension, and stroke; the cost of obesity and the treatment of obesity related illnesses has grown exponentially. The economic cost of obesity includes direct medical costs which include diagnosis, treatment, and drug therapies; the indirect cost of obesity includes the value of lost work, decreased productivity at work, and absenteeism. From a public policy perspective, understanding the societal cost and economic burden of obesity related healthcare costs can be valuable in the decision making process when evaluating the cost and benefit of obesityrelated cost containment policies. With an adult obesity rate of 35.1 percent in 2013, Mississippi and West Virginia have the highest obesity rates in the United States. Although there is no reliable data for the obesity rate at the census tract level, the socioeconomic profile of HFFI qualifying census tracts in Mississippi is indicative of obesity rates that are even higher A Closer Look at Underserved Communities in Mississippi

6 The Mississippi Small Business and Grocer Investment Act (H.B. 1328) than 35.1 percent; for example, the obesity rate for females in Mississippi is 36.1 percent, the obesity rate for those with less than a high school diploma is 38.7 percent in Mississippi, and among those with a household income of less than $15,000, the obesity rate in Mississippi is 41.2 percent. The relatively high proportion of females, individuals with low educational attainment levels, and households with incomes of less than $15,000 that were found in HFFI qualifying census tracts reinforces the assumption that obesity rates and obesity related healthcare costs tend to be higher in HFFI qualifying census tracts. The most recently available statistics from the Office of the Actuary at the Centers for Medicare and Medicaid indicate that the average annual growth rate in the cost of healthcare in the state of Mississippi is outpacing the average annual growth rate of the cost of healthcare in the United States; in Mississippi, the per capita healthcare spending for those with publically funded healthcare is more than twice that of those with private healthcare insurance. Within the context of the anticipated growth in the cost of healthcare, population growth, a shift from private insurance to public insurance, and related enrollment increases in public health insurance programs, the burden of these increasing costs and the obesity related cost of healthcare on the state of Mississippi is unsustainable. In the state of Mississippi, approximately 35.7 percent of the civilian non institutionalized population relies upon publically funded health care insurance and approximately 17.5 percent of the population has no healthcare insurance. Within the HFFI census tracts in the four counties that were the focus of this study, 44.1 percent of the population relied upon public health insurance and 22.8 percent of the population had no health care insurance; within these HFFI census tracts, an estimated 42,737 people relied upon public health insurance coverage and 22,100 people had no health insurance coverage. To provide guidelines for decisionmakers to evaluate public investment in underserved communities, the Stennis Research Team developed two relatively conservative estimates of the obesity related healthcare cost associated with each HFFI census tract; these more detailed findings are contained in the body of this study. Across all HFFI census tracts that were examined in this study, the annual obesityrelated healthcare cost associated with those who had public insurance coverage was estimated to range between $10,310,712 and $32,761,240. In addition to the potential obesity related healthcare cost reduction that may be realized by increasing access to healthy foods, investments in underserved communities will create economic and fiscal benefits. The Stennis Research Team used econometric input output modeling to estimate the economic and fiscal impact of investments in the construction or renovation of supermarkets, grocery stores, and the purchase of equipment or fixtures by existing stores to increase the supply of healthy foods in Mississippi s underserved communities. The actual economic and fiscal impact of investments made in Mississippi s underserved communities will be determined by multiple factors that include, but are not limited to: the site selected (which will determine the size of the market served), the amount A Closer Look at Underserved Communities in Mississippi

7 The Mississippi Small Business and Grocer Investment Act (H.B. 1328) and type of construction or renovation investment, the sales associated with the ongoing operations of the business, management, and other micro and macro economic factors that were unknown at the time of this study. To address this information gap, the Stennis Research Team used secondary data derived from the Bureau of Labor Statistics Consumer Expenditure Survey and the Environmental Systems Research Institute to develop estimates of consumer spending on food at home and the food retail sales gap for each HFFI census tract in the four counties examined in this study. Alternative scenarios of investments were then modeled for each of the four counties using econometric input output analysis; the findings of this research are presented in the narrative for each county. Within the context of each investment being unique, the Stennis Research Team modeled three alternative investment scenarios at the state level to provide decision makers with a generalized estimate of the economic and fiscal impact that may be associated with potential investments in Mississippi s underserved communities. Although job creation in the state of Mississippi is an important potential benefit that may be associated with investments made in Mississippi s underserved communities, an important consideration for decision makers is the potential offsetting tax revenue that may be recaptured as a result of the investment of public funds; specifically, potential revenue to state government in the form of sales tax, individual income tax, and corporate income tax. The econometric input output models indicate that an investment of $6,570,000 in a 45,000 square foot supermarket with anticipated annual sales of $5,401,464 would have the economic impact of creating 92.5 full time equivalent jobs during the construction phase of the project and would support approximately 35.1 full time equivalent jobs during the ongoing operations of business activities. The fiscal impact of this investment would be to generate approximately $219,181 in combined sales tax, personal income tax, and corporate income tax during the construction phase of project, and an additional $162,140 annually of combined sales tax, personal income tax, and corporate income tax revenue would be associated with the ongoing operations of the business, upon completion of construction activities. Over a 10 year period, the gross fiscal impact of this investment would be approximately $1,840,581 in tax revenues accruing to the benefit of the state of Mississippi, assuming no sales tax diversions to a municipality, no labor displacement, or substitution effects are associated with the investment. A change in the dollar amount of the initial investment in construction or renovation or a change in the projected sales associated with the ongoing operations of the business will also change the economic and fiscal impact of any state healthy food financing initiative investment made in an underserved community in the state of Mississippi. For example, an initial construction investment of $2,920,000 in a 20,000 square foot grocery store with projected annual sales of $2,000,000 modeled at the state level would have a projected fiscal impact of $97,414 in combined sales tax, personal income tax, and corporate income tax during the construction phase of the project, and an annual fiscal impact of $60,025 in combined sales tax, personal income tax, and corporate income tax during the ongoing operations of the business. Over a 10 year period, the gross A Closer Look at Underserved Communities in Mississippi

8 The Mississippi Small Business and Grocer Investment Act (H.B. 1328) fiscal impact of this investment would be approximately $697,250 in tax revenues accruing to the benefit of the state of Mississippi, assuming no sales tax diversions to a municipality, no labor displacement, or substitution effects are associated with the investment. This smaller investment could be anticipated to create approximately 41.1 full time equivalent jobs during the construction phase of the project, and an additional 13 full time equivalent jobs would be associated with ongoing business operations. The permanent job creation that is associated with the ongoing business operations that result from investments made in Mississippi s underserved communities represents a significant employment and job training opportunity in census tracts characterized by high unemployment and low educational attainment; most supermarket and grocery store jobs are entry level positions and workers are frequently trained on the job; therefore these types of employment opportunities are well matched with the educational and job skills profile that was found to exist within the HFFI census tracts that were examined in this study. Many supermarkets and independent grocers provide employee benefits that include healthcare insurance, retirement programs, and retirement savings plans that would improve the negative income conditions that were found to exist within the majority of the HFFI qualifying census tracts and would further reduce the public burden of obesity related healthcare costs. Investments in Mississippi s underserved communities also represent an opportunity for economic revitalization in these communities by creating an anchor that has the potential to increase retail traffic and attract other services and retail stores into the area. State healthy food financing initiatives are designed to provide initial seed money or tax incentives to support public private programs that aggregate capital from multiple sources to include banks, philanthropic organizations, and other investors to create loan pools that may be further leveraged by equity investment through the use of federal New Market Tax Credits and other sources of federal funding available through the Healthy Food Financing Initiative. For example, healthy food financing models may use a combination of grant funding, debt capital, loan guarantees, tax exempt bond financing, and New Market Tax Credits to fund investments in HFFI qualifying census tracts. A healthy food retail strategy may also focus on farmers markets; this strategy might include supporting the creation of new farmers markets in underserved communities, increasing the capacity of existing farmers markets by providing refrigeration equipment that would expand the types of products available (i.e. eggs, poultry, pork, beef, or lamb), providing more permanent structures to enable the farmers market to increase either the scope of product offerings or its frequency of services, or assuring that all farmers markets are able to accept SNAP payments each strategy would require different levels of investment, and in the case of farmers markets or food hubs, multiple additional sources of capital may be available from grants or low interest loans from the U.S. Department of Agriculture. As a result, the state portion of funding for a healthy food financing initiative to attract investment into underserved communities is anticipated to be significantly leveraged by A Closer Look at Underserved Communities in Mississippi

9 The Mississippi Small Business and Grocer Investment Act (H.B. 1328) private capital. Using the Pennsylvania Fresh Food Financing Initiative as a model, the Stennis Research Team assumed that the state share of a $6,570,000 investment in a 45,000 square foot supermarket would be approximately $1,194,545; the fiscal impact of this investment would be anticipated to yield sufficient sales tax, personal income tax, and corporate income tax revenues to provide a pay back of this investment within approximately six years. This investment recapture period assumes that the state share of the investment is able to be leveraged with additional sources of capital and does not include potential savings associated with any reduction in obesity related healthcare costs that may result from increased access to affordable, healthy foods in Mississippi s underserved communities. To further explore the potential economic and fiscal impacts that may be associated with the Mississippi Small Business and Grocer Investment Act, this study prioritized the analysis of making investments in supermarkets and grocery stores in census tracts in Mississippi that qualify for additional funding under the federal Healthy Food Financing Initiative (HFFI qualifying census tracts). Although not fully explored in this study, the Stennis Research Team found that investment in value added agricultural policies represent a significant economic development opportunity for the state of Mississippi. Mississippians spend an estimated $821,950,189 on fruits and vegetables; in fiscal year 2013, Supplemental Nutrition Assistance Program (SNAP) benefits in the state of Mississippi were $993,077,956; and in 2013, National School Lunch Program payments were $197,659,575 in Mississippi. Direct to consumer agricultural programs that enable agricultural producers in the state to capture a greater share of the farm to retail spread should be considered an important component of a Mississippi healthy food financing initiative. This study focused on the potential economic and fiscal impact of investments directly related to Mississippi s Small Business and Grocer Investment Act; fund management, the ability to leverage equity and debt investment, prevailing interest rates, debt service, store management, site selection, and multiple micro and macro economic factors that impact the business climate and the success of any business operation will also determine the magnitude of the economic and fiscal impact that the program will have in the state of Mississippi. Food retail investments in underserved communities should not be stand alone strategies, they must be integrated with comprehensive community based obesity prevention initiatives and education programs as a major focus of healthcare cost containment policies. To ensure success, a wide range of partners, including health and social service providers, schools, businesses, economic and community developers, and community based organizations must be integrated with Mississippi healthy food financing policy initiatives. As a component of a comprehensive community based obesity prevention initiative, investments made in Mississippi s underserved communities to increase access to affordable, healthy foods present a significant opportunity to create jobs for local residents, increase economic activity, offset the economic cost of obesity, and create healthier communities in the state of Mississippi. A Closer Look at Underserved Communities in Mississippi

10 The Mississippi Small Business and Grocer Investment Act (H.B. 1328) Studies conducted by the Stennis Institute of Government and Community Development at Mississippi State University are intended to inform the public policy decision making process; the Stennis Institute does not advocate for specific public policies and this study is not intended to represent a policy recommendation. A Closer Look at Underserved Communities in Mississippi

11 Table of Contents Introduction General and Limiting Conditions About the Economic Impact Methodology used in this Study Access to Healthy Food in Underserved Communities Underserved Communities and Health The Health Effects of Obesity Obesity among Children Childhood Obesity and Academic Outcomes The Economic Cost of Obesity The Economic Cost of Childhood Obesity Food Insecurity Food Insecurity and Health Policies and Intervention Strategies in Underserved Communities Value Added Agriculture The Local Food Movement Value Added Food Centers (Agribusiness Incubators) Community Supported Agriculture Farmers Markets Farm to Table Centers and Food Hubs Farm to School Programs Scaling Up Local Food Direct to Consumer Sales in the United States Direct to Consumer Sales in Mississippi The Supermarket and Grocery Store Industry Underserved Census Tracts in Four Mississippi Counties Lowndes County, Mississippi Eligible Healthy Food Financing Initiative Census Tracts in Lowndes County Overview of Lowndes County, Mississippi i

12 Lowndes County Income by Source Food Insecurity in Lowndes County The Lowndes County Workforce Health Care Insurance in Lowndes County The Economic Impact of Investments in Lowndes County The Economic Impact of a Supermarket Investment in Lowndes County The Economic Impact of a Grocery Store Investment in Lowndes County Pearl River County, Mississippi Eligible Healthy Food Financing Initiative Census Tracts in Pearl River County Overview of Pearl River County Food Insecurity in Pearl River County Pearl River County Income by Source The Pearl River County Workforce Health Care Insurance in Pearl River County The Economic Impact of Investments in Pearl River County The Economic Impact of a Supermarket Investment in Pearl River County The Economic Impact of a Grocery Store Investment in Pearl River County Investments in Store Renovations, Expansion, and Equipment Purchases in Pearl River County Sunflower County, Mississippi Eligible Healthy Food Financing Initiative Census Tracts in Sunflower County Overview of Sunflower County Food Insecurity in Sunflower County Sunflower County Income by Source The Sunflower County Workforce Health Care Insurance in Sunflower County The Economic Impact of Investments in Sunflower County The Economic Impact of a Supermarket Investment in a Sunflower County The Economic Impact of a Grocery Store Investment in Sunflower County Washington County, Mississippi ii

13 Eligible Healthy Food Financing Initiative Census Tracts in Washington County Overview of Washington County, Mississippi Food Insecurity in Washington County Washington County Income by Source The Washington County Workforce Health Care Insurance in Washington County The Economic Impact of Investments in Washington County The Economic Impact of a Supermarket Investment in Washington County The Economic Impact of a Grocery Store Investment in Washington County Investments in Store Renovations, Expansion, and Equipment Purchases in Washington County Standardizing the Economic Effects of Investments in Underserved Communities in the State of Mississippi The Economic Impact of a Supermarket Investment in Mississippi The Economic Impact of a Grocery Store Investment in Mississippi The Economic Impact of Small Loans of $500,000 for Store Remodels and New Refrigeration Equipment The Cost Benefit of Investments in Mississippi s Underserved Communities Review of the Findings Appendices Appendix A: U.S. Treasury HHFI FA Funding to Community Development Financial Institutions 2011 through CCLXI Appendix B: Limited Supermarket Access Rankings by Area Size... CCLXVII Index of Figures Figure 1: Obesity and Overweight High School Students Figure 2: Obesity and Overweight by Gender Figure 3: Per Capita Additional Cost of Obesity Related Health Care Cost Figure 4: Distribution of Total National Health Care Expenditures by Source of Payment, 2009 Actual and 2020 Projected (in Billions of Dollars) Figure 5: U.S. Per Capita Spending on Health Care 2007 through Figure 6: Total National Health Expenditures Funded from Public Sources, Actual through 2012 and Projected through 2023 (in billions of dollars) iii

14 Figure 7: State of Mississippi Enrollment in Medicaid and State Children's Health Insurance Programs 2003 through Figure 8: Comparative Physician Visits Figure 9: Comparative Hospitalization Rates Figure 10: Comparative Medical and Drug Expenditures Figure 11: Dietary Consumption Patterns of High School Students Figure 12: Number of U.S. Supermarkets and Grocery Stores Figure 13: Supermarkets and Grocery Stores in Mississippi Figure 14: Supermarket Sales by Department as a Percentage of Total Supermarket Sales Figure 15: Comparison of U.S. and Mississippi Distribution of Supermarkets and Grocery Store Establishments by Number of Employees Figure 16: Lowndes County Population Estimates 2010 through Figure 17: Pearl River County Population 2000 through Figure 18: Sunflower County Population 2000 through Figure 19: Washington County Population 2000 through Index of Tables Table 1: Healthy Food Financing Initiative Financial Assistance Awards 2011 through Table 2: New Market Tax Credit Allocatees Domiciled in Mississippi 2002 through Table 3: Comparative Disease Mortality Rates for the United States and Mississippi Table 4: Comparative Prevalence of Health Risk Behaviors and Chronic Conditions in the United States and Mississippi Table 5: Comparative Overweight and Obesity Prevalence by Population Classification Groups Table 6: Personal Health Care Spending by Payer Group for Mississippi and the United States, Comparison of 2004 and Table 7: The Uninsured Adult Population of Mississippi and Obesity Table 8: Population Obesity Estimates for the State of Mississippi Table 9: Obesity Related Health Costs in Mississippi using the Cawley and Meyerhoefer Model Table 10: Direct to Consumer Sales in the U.S. and Mississippi 2007 and Table 11: Direct to Consumer Farm Sales by State 2007 and Table 12: Limited Supermarket Access Rankings by State Table 13: LSA Areas and Rankings by Population for Selected Areas Table 14: U.S. Supermarket and Grocery Store Industry Metrics Table 15: Distribution of Employment and Occupational Wages in the Mississippi Supermarket and Grocery Store Industry Table 16: The U.S. Supermarket and Grocery Store Industry (NAICS 44511) Establishments and Sales Table 17: Distribution of Employment, Stores, and Sales in the U.S. and Mississippi Supermarket and Grocery Store Industry Table 18: Lowndes County Population by Census Tract Table 19: Lowndes County Racial Distribution by Census Tract Table 20: Lowndes County Selected Gender, Age, and Family Population Data by Census Tract iv

15 Table 21: Lowndes County Households and Families by Type Table 22: Poverty Rates for Families and Individuals in Lowndes County Table 23: Lowndes County Educational Attainment for the Population Age 25 and Older Table 24: Lowndes County Comparative Employment and Income Table 25: Lowndes County Comparative Earnings and Income by Source Table 26: Lowndes County Employment by Industry Table 27: Median Earnings for Lowndes County Workers Table 28: Health Insurance Coverage for the Civilian Non Institutionalized Population in Lowndes County Table 29: Lowndes County Estimated Spending on Food Table 30: Lowndes County Household Spending on Food at Home and the Retail Spending Gap Table 31: The Economic Impact of a $6,570,000 Construction Investment in Lowndes County Table 32: The Fiscal Impact of a $6,570,000 Construction Investment in Lowndes County Table 33: The Fiscal Impact of the Ongoing Operations of a Supermarket with Annual Sales of $8,352, Table 34: The Economic Impact of the Ongoing Operations of a Supermarket with Annual Sales of $8,352, Table 35: The Economic Impact of a $2,920,000 Construction Investment in Lowndes County Table 36: The Fiscal Impact of a $2,920,000 Construction Investment in Lowndes County Table 37: The Economic Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,037, Table 38: The Fiscal Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,307, Table 39: Pearl River County Population by Census Tract Table 40: Pearl River Racial Distribution by Census Tract Table 41: Pearl River County Selected Gender, Age, and Family Population Data by Census Tract Table 42: Pearl River County Households and Families by Type Table 43: Poverty Rates for Families and Individuals in Pearl River County Table 44: Pearl River County Educational Attainment for the Population Age 25 and Over Table 45: Pearl River County Comparative Employment and Income Table 46: Pearl River County Comparative Earnings and Income by Source Table 47: Pearl River County Employment by Industry Table 48: Pearl River County Median Earnings for Workers Table 49: Health Insurance Coverage for the Civilian Non Institutionalized Population in Pearl River County Table 50: Pearl River County Estimated Spending on Food Table 51: Pearl River County Household Spending on Food at Home and the Retail Spending Gap Table 52: The Economic Impact of a $6,570,000 Construction Investment in Pearl River County Table 53: The Fiscal Impact of a $6,570,000 Construction Investment in Pearl River County Table 54: The Economic Impact of the Ongoing Operations of a Supermarket with Annual Sales of $8,446, Table 55: The Fiscal Impact of the Ongoing Operations of a Supermarket with Annual Sales of $8,446, v

16 Table 56: The Economic Impact of a $2,920,000 Construction Investment in Pearl River County Table 57: The Fiscal Impact of a $2,920,000 Construction Investment in Pearl River County Table 58: The Economic Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,000, Table 59: The Fiscal Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,000, Table 60: The Economic Impact of a $500,000 Renovation, Expansion, and Equipment Purchase Table 61: The Fiscal Impact of a $500,000 Renovation, Expansion, and Equipment Purchase Table 62: The Economic Impact of the Ongoing Operations of a Small Store with Annual Sales of $500, Table 63: The Fiscal Impact of the Ongoing Operations of a Small Store with Annual Sales of $500, Table 64: Sunflower County Population by Census Tract Table 65: Sunflower County Racial Distribution by Census Tract Table 66: Sunflower County Selected Gender, Age, and Family Population Data by Census Tract Table 67: Percentage of Families and Individuals in Poverty in Sunflower County Table 68: Sunflower County Households and Families by Type Table 69: Sunflower County Educational Attainment for the Population 25 and Older Table 70: Sunflower County Comparative Employment and Income Table 71: Sunflower County Comparative Earnings and Income by Source Table 72: Sunflower County Employment by Industry Table 73: Median Earnings for Workers in Sunflower County Table 74: Health Insurance Coverage for the Civilian Non Institutionalized Population in Sunflower County Table 75: Sunflower County Estimated Household Spending on Food Table 76: Sunflower County Household Spending on Food at Home and the Food Retail Spending Gap Table 77: The Economic Impact of a $6,570,000 Construction Investment in Sunflower County Table 78: The Fiscal Impact of a $6,570,000 Construction Investment in Sunflower County Table 79: The Economic Impact of the Ongoing Operations of a Supermarket with Annual Sales of $4,951, Table 80: The Fiscal Impact of the Ongoing Operations of a Supermarket with Annual Sales of $4,951, Table 81: The Economic Impact of a $2,920,000 Construction Investment in Sunflower County Table 82: The Fiscal Impact of a $2,920,000 Construction Investment in Sunflower County Table 83: The Economic Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,131, Table 84: The Fiscal Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,131, Table 85: Washington County Population by Census Tract Table 86: Washington County Racial Distribution by Census Tract Table 87: Washington County Selected Gender, Age, and Family Population Data by Census Tract Table 88: Washington County Households by Type vi

17 Table 89: Washington County Poverty Rates for Families and Individuals Table 90: Washington County Educational Attainment for the Population 25 Years and Older Table 91: Washington County Comparative Employment and Income Table 92: Washington County Comparative Earnings and Income by Source Table 93: Washington County Employment by Industry Sector Table 94: Washington County Median Earnings for Workers Table 95: Health Insurance Coverage for the Civilian Non Institutionalized Population in Washington County Table 96: Washington County Household Spending on Food Table 97: Washington County Household Spending on Food at Home and the Retail Spending Gap for Food at Home Table 98: The Economic Impact of a $6,570,000 Construction Investment in Washington County Table 99: The Fiscal Impact of a $6,570,000 Construction Investment in Washington County Table 100: The Economic Impact of the Ongoing Operations of a Supermarket with Annual Sales of $5,116, Table 101: The Fiscal Impact of the Ongoing Operations of a Supermarket with Annual Sales of $5,116, Table 102: The Economic Impact of a $2,920,000 Construction Investment in Washington County Table 103: The Fiscal Impact of a $2,920,000 Construction Investment in Washington County Table 104: The Economic Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $3,851, Table 105: The Fiscal Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $3,851, Table 106: The Economic Impact of a $500,000 Construction or Renovation Investment Table 107: The Fiscal Impact of a $500,000 Construction or Renovation Investment Table 108: The Economic Impact of the Ongoing Operations of a Store with $500,000 in Grocery Sales in Washington County Table 109: The Fiscal Impact of the Ongoing Operations of a Store with $500,000 in Grocery Sales in Washington County Table 110: The Economic Impact of a $6,570,000 Construction Investment in a 45,000 Square Foot Supermarket Table 111: The Fiscal Impact of a $6,570,000 Construction Investment in a 45,000 Square Foot Supermarket Table 112: The Economic Impact of the Ongoing Operations of a Supermarket with Annual Sales of $5,402, Table 113: The Fiscal Impact of the Ongoing Operations of a Supermarket with Annual Sales of $5,402, Table 114: The Economic Impact of a $2,920,000 Construction Investment in a Grocery Store in Mississippi Table 115: The Fiscal Impact of a $2,920,000 Construction Investment in a Grocery Store in Mississippi Table 116: The Economic Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,000,000 in Mississippi vii

18 Table 117: The Fiscal Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,000,000 in Mississippi Table 118: The Economic Impact of a $500,000 Investment in a Store Renovation in Mississippi Table 119: The Fiscal Impact of a $500,000 Investment in a Store Renovation in Mississippi Table 120: The Economic Impact of the Ongoing Operations of a Store with Annual Sales of $500, Table 121: The Fiscal Impact of the Ongoing Operations of a Store with Annual Sales of $500, Table 122: Lowndes County Obesity related Healthcare Cost Estimates Table 123: Pearl River County Obesity related Healthcare Cost Estimates Table 124: Sunflower County Obesity related Health Care Cost Estimates Table 125: Comparison of Adult Obesity Rate by County Table 126: Washington County Obesity related Healthcare Cost Estimates Table 127: Estimated Obesity related Healthcare Cost Savings Associated with a One Percent Reduction in the Obesity Rate in Lowndes County Table 128: Estimated Obesity related Healthcare Cost Savings Associated with a One Percent Reduction in the Obesity Rate in Pearl River County Table 129: Estimated Obesity related Healthcare Cost Savings Associated with a One Percent Reduction in the Obesity Rate in Sunflower County Table 130: Estimated Obesity related Healthcare Cost Savings Associated with a One Percent Reduction in the Obesity Rate in Washington County Table 131: Projections of the Economic and Fiscal Impact of a Mississippi Healthy Food Financing Initiative Pilot Project Table 132: The Economic Impact of a $2,000,000 Increase in the Direct to Consumer Agricultural Sales of Fruits and Vegetables Table 133: The Fiscal Impact of a $2,000,000 Increase in Direct to Consumer Agricultural Sales of Fruits and Vegetables Table 134: Overview of County Socio demographic Characteristics of the Population Table 137: Recipients of HFFI FA Funding 2011 through CCLXIII Table 138: U.S. Treasury, CDFI NMTC Data for Washington, Pearl River, Lowndes, and Sunflower Counties... CCLXV Table 139: LSA Rankings for Major Metro Areas with Population Greater than 1,000, CCLXIX Table 140: LSA Rankings for Metro Areas with Population between 500,000 and 1,000, CCLXX Table 141: LSA Rankings for Metro Areas with Population between 250,000 to 500, CCLXXI Table 142: LSA Rankings for Metro Areas with Populations less than 250, CCLXXIII Table 143: LSA Rankings for Micropolitan Areas... CCLXXVI Index of Maps Map 1: Farmers' Markets in Mississippi Map 2: Direct to Consumer Sales Map 3: Direct to Consumer Sales per Farm in Map 4: Direct to Consumer Farm Sales in Mississippi Map 5: Lowndes County HFFI Qualifying Census Tracts Map 6: Lowndes County Reference Map viii

19 Map 7: Pearl River County HFFI Qualifying Census Tracts Map 8: Pearl River County Reference Map Map 9: Sunflower County HFFI Qualifying Census Tracts Map 10: Sunflower County Reference Map Map 11: Washington County HFFI Qualifying Census Tracts Map 12: Washington County Reference Map ix

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21 Introduction In recognition of the need to increase access to healthy and nutritious food, the Mississippi State Legislature passed, and Governor Phil Bryant signed, House Bill 1328 during the 2014 Regular Session; the legislation is entitled as the Small Business and Grocer Investment Act. This legislation is designed to provide grants and loans to promote access to healthy foods in Mississippi s underserved communities. This study provides a background of the issues associated with the lack of access to healthy food and the policy initiatives that have been implemented in other states to provide incentives to expand access to healthy foods. A primary focus of this study is to examine the potential economic benefits that may be associated with investments made in Mississippi s underserved communities. To increase access to healthy foods in Mississippi s underserved communities, incentives provided with taxpayer funding from the state of Mississippi may be leveraged with additional federal funds that are available through the federal Healthy Food Financing Initiative. Investments in underserved communities in Mississippi may take multiple forms; these investments may include new construction or the renovation of existing food retail stores, or they may comprise support for Food Hubs or other Community Supported Agriculture (CSAs) programs. To be eligible for federal funds, investments made in Mississippi s underserved communities must be in qualifying HFFI qualifying census tracts. To develop a multifaceted perspective of the socioeconomic profile of Mississippi s underserved communities, four Mississippi counties were selected for inclusion in this study: Lowndes County, Pearl River County, Sunflower County, and Washington County; each county is examined at the census tract level. A team of researchers at the Stennis Institute of Government and Community Development at Mississippi State University profiled census tracts, developed initial estimates of spending for food at home within each census tract in the four counties included in this study, and then modeled potential demand using econometric input output analysis to project the potential economic impact of investments in these underserved census tracts. The public incentives that may be provided under the Small Business and Grocer Investment Act to expand access to healthy food in Mississippi s underserved communities are anticipated to be predominantly market driven investments made by the private sector; each investment will have unique characteristics that were undetermined at the time of this study. The size of each investment, combined with economic and market conditions, consumer purchasing decisions, and the management of each business will ultimately determine the future magnitude of the economic effects of investments in underserved communities. Within this context, the economic impact models provided in this study are designed to provide decision makers with an initial framework to evaluate the potential cost benefit of making public investments in Mississippi s underserved communities. 11

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23 General and Limiting Conditions Every reasonable effort has been made to ensure that the data and analysis contained is this report are accurate; however, factors exist that are beyond the control of the Stennis Institute and these factors may affect the estimates and projections contained herein. This study is based on assumptions, estimates, and other data developed by the Stennis Institute through independent research efforts, general knowledge of local conditions and the industry, and with data provided by secondary data sources. Every effort is made to use the most recent, accurate, and reliable sources of data. No responsibility is assumed for inaccuracies in or any data source used to prepare this study. Because future events or circumstances (many of which are unknown as of the date of this study) may affect the projections and estimates contained herein, no warranty or representation is made by the Stennis Institute that any of the predicted outcomes or projected results contained in this study will actually be achieved. Possession of this study does not carry with it the right of publication or the right to use the name of the Stennis Institute in any manner without first obtaining the prior written consent of the Stennis Institute. No abstracting, excerption or summarization of this study may be made without first obtaining the prior written consent of the Stennis Institute. This study is not to be used in conjunction with any public or private offering of securities, debt, equity, or other similar purpose where it may be relied upon to any degree by any persons other than the client, nor is any third party entitled to rely upon this report without first obtaining the prior written consent of the Stennis Institute. This study may not be used for purposes other than that for which it is prepared and for which prior written consent has first been obtained from the Stennis Institute. Any changes made to the study, or any use of the study not specifically prescribed in the agreement between the parties or otherwise expressly approved by the Stennis Institute, shall be at the sole risk of the party making such changes or adopting such use. This study is qualified in its entirety, and should be considered in light of these limitations, conditions, and considerations. 13

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25 About the Economic Impact Methodology used in this Study This report evaluates the economic impact during the construction phase and subsequent impact of the ongoing operations of potential investments in underserved census tracts in the state of Mississippi. Economic impact goes beyond simply the number of dollars spent within a defined study area. The term economic impact describes a series of events and changes that occur within an economy as a result of a particular stimulus. In this report, the economic stimulus examined is the two phased economic impact of the construction and then, the subsequent ongoing operations of investments in underserved communities. Construction direct economic and fiscal impacts include: actual project expenses, such as expenditures on architectural and engineering fees, labor costs, and the purchase of construction materials associated with the construction of potential supermarkets, grocery stores, and/or renovations to existing stores. The direct economic and fiscal impact of the ongoing operations of investments in underserved communities may include: new jobs that will be created to manage or staff business enterprises, and the related expenditures that will be required to operate a store. The economic impact of investments in underserved communities is not limited to only the direct economic impact of construction and ongoing operations because economic activity does not end at the first transaction between consumers and businesses. The dynamic nature of the economy is such that the dollars spent reverberate through multiple sectors, generating wages, profits, and subsequent spending on other goods and services. This process continues until all spending is leaked out of the local economy. Economic leakage means that the money has exited the system and is no longer being spent or turned over in the model. In this report, the system is the economy of the state of the state of Mississippi and, specifically, Lowndes County, Pearl River County, Sunflower County, and Washington County. Leakage can take multiple forms. Money spent by Mississippi firms on goods and services produced out of state is a form of leakage, as are dollars that flow out of the country to purchase goods or services overseas. Profits taken by Mississippi owners of capital are also considered leakage, not because they exit the state, but because they exit the system of repeated turnover spending. This reverberation of spending across sectors is the study of economic impact. The Stennis Institute s analysis quantifies the changes in the economy of the four counties that were the focus of this report and in the state of Mississippi that will take place as a result of spending related to investments made in underserved communities to increase access to affordable, healthy foods, and examines the economic effect of the ongoing operations of these business investments. The underlying driver of economic impact analysis is direct spending, with subsequent reverberations estimated by multipliers. Multipliers are usually between 1.0 and 3.0. A multiplier of 1.0 means that there is 100 percent leakage after the first round of spending that all goods and services in the second turnover come from out of the county or 15

26 the state (including overseas), depending upon the level of analysis. High multipliers indicate that local firms are well integrated, and that goods and services are closely linked to other complementary goods and services within an economy. Different industries can have significantly different multipliers. A dollar spent in an industry with a high multiplier has a greater effect on the local economy than a dollar spent in an industry with a low multiplier. The Stennis Institute s examination of the economic impact of investments made in Mississippi s underserved communities included analysis of the following effects: Total Output resulting from on site business activity. This is the overall value of the transactions that result from the economic activities associated with an investment in an underserved community. Total output is similar to gross sales measurements within an industry. Total employment added. This is measured in terms of the total jobs and extends across all industries. Labor Income. This is measured in terms of dollars paid to workers of the businesses contained in this analysis. Indirect Economic Effects. Indirect effects are the summation of changes in the local economy that occur due to spending for inputs by the industry or industries directly impacted. For example, if employment at a supermarket increases by 10 jobs, this implies a corresponding increase in output by the store. As a supermarket or grocery store increases output (serves more customers), it must also purchase more of its inputs, such as supplies, electricity, poultry or produce. As a supermarket or grocery store increases the purchase of these items, its suppliers must also increase their output hire new workers or purchase more supplies, as do suppliers to these suppliers. As these ripples of spending move through the economy, they can be captured and measured; the ripples related to these purchases of goods and services by suppliers to the supermarket or grocery store are indirect impacts. The Stennis Institute uses IMPLAN, a software program first developed by the UDSA Forestry Service to perform impact analysis for planning. IMPLAN s database includes national, state, and county level data for 528 industrial sectors and, critically, the ways in which those sectors interact with each other. The county level data is specific to the economy of individual counties within the state of Mississippi. This national, state, and county level data allows the Stennis Institute to quantify the effects of adding jobs or final demand in any industry, or industry subsector, and to model those changes across all 528 sectors. IMPLAN uses social accounting matrices, or a set of social accounts, to generate multipliers and to describe economic relationships. Social accounts track monetary flows between sectors and institutions in the economy. These monetary flows occur because of final demand for goods 16

27 and services, or producers demand for goods and services. Final demand is consumers demand, whereas, producers demand is the necessary trade that take place in order to meet final demand. IMPLAN s modeling allows researchers to define given trade areas and to model transactions in relevant industries. The IMPLAN multipliers are based on data from the Bureau of Labor Statistics, the U.S. Census Bureau, and other government agencies. IMPLAN is a software and data package that applies the principle of input output models to describe and to quantify changes in an economy. These models quantify the relationships among industries and institutions in a given study area. They include the following: Industrial spending patterns. The model measures in what ways, and in what proportions, each industry distributes expenditures. For example, heavy manufacturing spends money in wholesale trade, retail trade, food and beverage services, truck transportation, and a host of other industries. The input output models measure the proportions of spending in each industry via a series of coefficients. These coefficients (called a production function when grouped together) are the basis for generating economic multipliers to determine the indirect and induced impacts in other industries. Wage and employment distribution. The model measures the proportion of income each industry spends on wages and the distribution of these wages throughout household income brackets. This information is the basis for employment forecasts used to quantify the number of jobs and the level of wages that would be paid to employees as a result of an economic activity. Inter institutional trade flows. Money changes hands between several societal institutions private industries, government entities, and households of varying income levels. These trade flows are modeled in IMPLAN to determine the fiscal impacts (flows from industries and households to government entities) and induced impacts (from households to private industries). All changes are measured in terms of a change in final demand. For example, if salespeople who call upon supermarkets or grocery stores remain in the area to call on other accounts, they may spend $100 per night on a hotel room; if 10 salespeople exhibit this behavior, then the hotel and motel industry would experience a $1,000 positive change in final demand. Given this, the IMPLAN model would evaluate the industrial spending pattern for the hotel and motel industry, and apply the $1,000 spending to all supporting industries in the proper proportion. For example, a portion of the final demand could be spent in other industries, a portion could be paid as wages, and a portion could be distributed as profits to the owners (the latter two could flow to households and ultimately to governments based on inter institutional transfers). 17

28 This social accounting matrix allows researchers to measure the changes in income, employment, and tax revenues (fiscal impacts) in detail. However, it is important to note that IMPLAN, like all economic modeling systems, measures the institutional relationships that currently exist. IMPLAN and the economic impact models contained in this study do not include analysis of the employment and spending substitution effects that may occur within an industry when increased sales at one firm result in decreased sales at another firm resulting in a decrease in employment at the firm that experiences decreased sales; employment and spending substitution effects also affect the fiscal impact. This study examined the economic impact of investments in underserved communities in the state of Mississippi and the effect of the ongoing operations of business firms based upon existing spending on food at home by consumers within underserved census tracts; decision makers should be aware that employment and spending substitution effects may reduce the economic effects reported in this study. 18

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31 Access to Healthy Food in Underserved Communities In recent years, public policy research has begun to focus on issues associated with access to healthy food. The primary policy issue is the concern that there is an insufficient supply of affordable, healthy food in specific geographic areas that are characterized by high poverty and/or have large minority populations; and that, lack of access to healthy food is a significant causal variable in the high prevalence rate of obesity, diabetes, and related health problems in disadvantaged populations. The 2008 Farm Bill defines an area in the United States with limited access to affordable and nutritious food, particularly such an area composed of predominately lower income neighborhoods and communities as a Food Desert. Research has found that there are fewer healthy food options in poor neighborhoods, 1 that poor and minority communities have fewer supermarkets than do more affluent, whiter neighborhoods, 2 and lower access to supermarkets and grocery stores based upon racial and income characteristics. 3 Although there is mixed evidence in the research, many studies have found that there is a relationship between better access to supermarkets or grocery stores and a healthier diet, lower risk of being overweight or obese, lower body mass index, and the negative health outcomes associated with being overweight or obese. 4, 5, 6 Research regarding the difference in defining access based upon the relevant distance for households with and without vehicles or access to transportation, 7, 8 particularly in non metropolitan or rural areas, 9 has found that all individuals living within a specific area do not have similar access to affordable and nutritious food. Access to supermarkets and grocery stores may be measured in terms of travel burden. Travel burden and accessibility have multiple dimensions, to include: the cost of travel (time, distance, monetary); convenience; vehicle ownership; availability, frequency, reliability, and safety of public transportation; mobility impairments associated with poor health, disability, or age; crime and traffic hazards that create barriers to travel; and street connectivity and walkability within a spatial area. 1 Lewis, L.B., D.C. Sloane, L.M. Nascimento, A.L. Diamant, J.J. Guinyard, A.K. Yancey, G. Flynn. (2005). African Americans Access to Healthy Food Options in South Los Angeles Restaurants. American Journal of Public Health 95(4): Powell, L. M., Slater, S., Mirtcheva, D., Bao, Y. and Chaloupka, F. (2007). Food Store Availability and Neighborhood Characteristics in the United States. Preventive Medicine 44: Neckerman, K. M., Bader, M., Purciel, M. and Yousefzadeh, P. (2009). Measuring Food Access in Urban Areas. National Poverty Center Working Paper. access/index.php (accessed November 1, 2013). 4 Horowitz, C. R., Colson, K. A., Hebert, P. L., and Lancaster, K. (2004). Barriers to Buying Healthy Foods for People with Diabetes: Evidence of Environmental Disparities. American Journal of Public Health 94(9): Moore, L. V., Diez Roux, A. V., Nettleton, J. A., Jacobs, D.R. (2008). Associations of the Local Food Environment with Diet Quality A Comparison of Assessments based on Surveys and Geographic Information Systems: The Multi Ethnic Study of Atherosclerosis. American Journal of Epidemiology. 170(1): Pearce, J., Hiscock, R., Blakely, T., and Witten K. (2008). The Contextual Effects of Neighborhood Access to Supermarkets and Convenience Stores on Individual Fruit and Vegetable Consumption. Journal of Epidemiology Community Health; 62(3): Ibid. 8 Rose, D., Bodor, J. N., Swalm, C. M., Rice, J. C., Farley, T. A., and Paul L. Hutchison, P. L. (2009). Deserts in New Orleans? Illustrations of Urban Food Access and Implications for Policy. National Poverty Center Working Paper. (accessed November 1, 2013). 9 Sharkey, J. R., and Scott Horel. (2009). Characteristics of Potential Spatial Access to a Variety of Fruits and Vegetables in a Large Rural Area. National Poverty Center Working Paper. access/index.php (accessed November 1, 2013). 21

32 Distressed areas with low income, low education levels, high unemployment, limited retail traffic, and no economic growth are unattractive markets for supermarkets and grocery stores. In these communities, profit potential for supermarkets and grocery stores may be so limited that additional incentives are required to attract and retain investment in these areas. To address the issues associated with attracting investments in these areas, the Healthy Food Financing Initiative (HFFI) was inaugurated in 2010 to address the epidemic of childhood obesity. The Healthy Food Financing Initiative provides support to projects that increase access to healthy, affordable food in communities that currently do not provide these options. The HFFI is designed to attract investments that bring grocery stores and healthy food options to underserved communities in the United States and expand access to fresh and healthy foods. Investment activities may include development, investment, and equipping supermarkets, grocery stores, small business retailers, corner stores, and farmers markets that sell fresh and healthy food. The HFFI is a multi year, interagency effort that is coordinated through the U.S. Department of Health and Human Services, the U.S. Department of Agriculture, and the U.S. Department of the Treasury; in 2010, the federal government provided $400 million to fund the HFFI. The Department of Health and Human Services (HHS) was allocated $20 million for Community Economic Development programs to support the Healthy Food Financing Initiative. In 2014, the Office of the Administration for Children and Families (HHS) Office of Community Services provided Community Economic Development HFFI awards totaling approximately $9.4 million, with an average award of $670,000. The Department of Agriculture was allocated approximately $50 million to support public and private loans, grants, promotion, and technical assistance to increase access to healthy foods in underserved communities, to expand demand and retail outlets for farm products, and to increase the availability of locally produced foods. There are multiple USDA programs that provide funding in support of the HFFI, including, but not limited to: the Community Facilities Program, the Rural Business Opportunity Grant Program, the Business and Industry Loan Guarantee Program, and the Farmers Market Promotion Program. In 2012, the USDA awarded approximately $10 million in competitive grant funding to agricultural projects that developed producer to consumer farmers markets, roadside stands, and community supported agriculture programs. The Department of the Treasury was provided with authority to provide New Market Tax Credits and to provide assistance to certified community development financial institutions (CDFIs). There was no specific set aside of New Market Tax Credits for healthy food financing in the U.S. Department of the Treasury s Community Development Financial Institutions Fund (CDFI) 2011 NMTC allocation, with the exception that the CDFI Fund added HFFI qualifying census tracts as one of the two secondary criteria which could be used to qualify a site as highly distressed under the Federal New Markets Tax Credit Program. In 2011, the Treasury began collecting information from New Market Tax Credit allocatees regarding the percentage of their allocation that would be devoted to 22

33 HFFI projects and activities. On February 23, 2012, the CDFI announced that 70 communities had been selected to receive $3.623 billion of NMTC allocations from the 2011 round; this report also stated that fifty of the 70 allocatees (or 71 percent) indicated that they intended to devote some portion of their NMTC allocation to Healthy Food Financing investments. 10 On May 17, 2012, the CDFI released a study that found that 24.8 million Americans lived in areas with limited supermarket access. A Census Tract qualifies for HFFI funding if it meets the following low income and low access thresholds: The Census Tract is a low income community based upon having a poverty rate of 20 percent or greater, or a median family income at or below 80 percent of the area s median family income; and is a low access community based upon having at least 500 persons and/or at least 33 percent of the census tract s population living more than one mile from a supermarket or large grocery store (10 miles in the case of non metropolitan census tracts). In 2011, the CDFI expanded its definition of HFFI qualifying census tracts as either: 1. A census tract determined to be a Food Desert by the U.S. Department of Agriculture, as identified in USDA s HFFI census tract Locator Tool; or 2. A census tract that qualifies as a Low Income Community for New Market Tax Credit purposes and has been identified as having low access to a supermarket or grocery store through a methodology that has been adopted for use by another governmental or philanthropic healthy food initiative, to the extent that QLICI activities will increase access to healthy food. In more recent years, there has been increasing emphasis on New Market Tax Credit Investments in HFFI qualifying census tracts. The President s fiscal year 2013 budget designated at least $500 million ($250 million per year over a two year period) in New Market Tax Credit allocations to support financing healthy food options in distressed communities as part of the HFFI. In addition to New Market Tax Credits that may be awarded to Certified Community Development Entities (CDEs) to make HFFI investments, the CDFI Fund also provides supplemental Healthy Food Financing Initiative Financial Assistance (HFFI FA) awards to Certified Table 1: Healthy Food Financing Initiative Financial Assistance Awards 2011 through 2014 CDFI Recipients of HFFI FA Funding 2011 through 2014 Year Amount 2011 $9,500, $17,750, $22,300, $16,650,000 Source: U.S. Treasury, Community Development Financial Institutions Fund, HFFI FA Annual State-level data on CDFI HFFI-FA recipients is provided in Appendix A Community Development Financial Institutions (CDFIs); Financial Assistance awards require dollarfor dollar matching funds and only CDFIs that are eligible to receive Financial Assistance Awards are also eligible to receive HFFI FA awards. 10 U.S. Treasury, Community Development Financial Institutions Fund, Highlights of 2011 Allocation Round. 23

34 New Market Tax Credits are designed to increase the flow of capital and investment into low income areas and rural communities to support business growth and to create jobs by providing private investors with federal tax credits. New Market Tax Credits provide resources that can create a satisfactory loan structure for investments that might otherwise be denied or only offered a loan at a significantly higher rate of interest; NMTCs can also be used with other credit enhancements such as historic rehabilitation tax credits, state New Market Tax Credits, or with other governmental loan programs that reduce risk and enhance the feasibility of a project in a low income community. New Market Tax Credit can increase the return for investors in projects, reduce the interest rate on loans, and/or reduce the risk of an investment; therefore, New Market Tax Credits enable financing for projects that would otherwise not be feasible. The New Market Tax Credits Program was enacted by Congress as an element of the Community Renewal Tax Relief Act of 2000; the program allows individual and corporate taxpayers to receive a credit against federal income taxes for making Qualified Equity Investments (QEI) in Qualified Community Development Entities (CDEs). The tax credit provided to the investor equals 39 percent of the QEI and is claimed over a seven year period; under IRC 45D (a) (2), the applicable credit is five percent for the first three years and six percent for the last four years; NMTC investments made by a CDE cannot be redeemed before the end of the seven year investment period. Until recent years, there have been relatively few Mississippi domiciled Community Development Entities (CDEs) that have received New Market Tax Credits from the U.S. Treasury; since the program s inception, Mississippi domiciled organizations have received less than one percent of the total dollar amount of New Market Tax Credit awards made by the U.S. Treasury. Since the advent of the issuance of $1 billion of Hurricane Katrina New Market Tax Credits for use in the Gulf Opportunity Zone, an increasing number of organizations within the state of Mississippi have applied for and received New Market Tax Credits (Table 2, below). Table 2: New Market Tax Credit Allocatees Domiciled in Mississippi 2002 through 2013 New Market Tax Credit Awardee City Year Amount Enterprise Corporation of the Delta Jackson 2002 $15,000,000 Enterprise Corporation of the Delta Jackson 2006 $15,000,000 MBFC CDE, Inc. Jackson 2007 $20,000,000 Enterprise Corporation of the Delta Jackson 2008 $20,000,000 MuniStrategies, LLC Jackson 2010 $28,000,000 Secde Ventures, LLC. Madison 2010 $53,000,000 Hope Enterprise Corporation Jackson 2012 $25,000,000 MuniStrategies, LLC Jackson 2012 $50,000,000 Southern Community Capital, LLC, Jackson 2012 $50,000,000 MuniStrategies, LLC Jackson 2013 $50,000,000 Source: U.S. Department of the Treasury, Community Development Financial Institutions Fund, Searchable Award Database 24

35 Underserved Communities and Health A lack of access to healthy food has been found to be associated with health disparities. 11 Health disparities refer to differences in the incidence of disease, mortality, and survival rate for one group of people as compared to another. Factors that contribute to health disparities include income, education, behavior, race or ethnicity, and environment. The reduction or elimination of health disparities can produce significant benefits that may include a reduction in morbidity and mortality, improved quality of life, and reduced costs for illness. Living in an environment where there is lack of access to healthy food has been linked to multiple health disparities associated with income, education, and race or ethnicity. For example, failure to consume healthy foods can lead to cardiovascular disease, 12, 13 stroke, 14 and certain forms of cancer, 15 and multiple studies have examined the relationship between limited access to healthy food options and higher rates of obesity. 16 The lack of access to healthy food within underserved communities and the relationship between lack of access and diet and health outcomes has become a major focus of research and public policy due to the epidemic of obesity and related diabetes in the United States. Underserved communities have received increased attention and policy initiatives such as the Healthy Food Financing Initiative have been implemented to make healthy foods more accessible in these areas. According to the Centers for Disease Control (CDC), the prevalence of self reported obesity among U.S. adults in 2013 ranged from a low of 21.3 percent in the state of Colorado to a high of 35.1 percent in the state of Mississippi. In the United States, the prevalence of obesity among adults was highest for Blacks (37.6 percent) as compared to 30.6 percent for Hispanics and 26.6 percent for Whites; in Mississippi, the prevalence of obesity among African American adults was 42.9 percent as compared to 30.7 percent among Whites and 28.2 percent among Hispanics. 17 Research has found that among women, obesity prevalence increases as educational attainment levels decrease, but there does not appear to be a similar linkage between educational attainment and obesity for men; among women, 23.4 percent of those with a college degree are obese and among those with less than a high school education, the obesity rate is 42.1 percent Sharkey, J. R., Johnson, C. M., and Dean, W. R. (2011). Relationship of Household Food Insecurity to Health Related Quality of Life. Women s Health. 51(5): Bazzano, L. A., He, J., Ogden, L. G., Loria, C. M., Vupputuri, S., Myers, L., and Whelton, P. K. (2002). Fruit and Vegetable Intake and Risk of Cardiovascular Disease in U.S. Adults. American Journal of Clinical Nutrition. 76: Ness, A. R., and Powless, J. W. (1997). Fruit and Vegetables and Cardiovascular Disease: A Review. International Journal of Epidemiology. 26: Joshipura, K. J., Ascherio, A., Manson, J.E., Stampher, M. J., and Rimm, E. B. (1999). Fruit and Vegetable Intake in Relation to Risk of Ischemic Stroke. Journal of the American Medical Association. 282: Key, T. J., Schatzkin, A., Willett, W. C., Allen, N., Spencer, E. A. and Travis, R. C. (2004). Diet, Nutrition, and the Prevention of Cancer. Public Health Nutrition. 7: Larson, N., Story, M., and Nelson, M. (2009). Neighborhood Environments: Disparities in Access to Healthy Foods in the U.S. American Journal of Preventive Medicine. 36(1): Centers for Disease Control. Behavioral Risk Factor Surveillance System, 2011 through Ogden, C. L., Lamb, M. M., Carroll, M.D., and Flegal, K. (2010). Obesity and Socioeconomic Status in Adults: United States, NCHS Brief No. 50. Hyattsville, MD: National Center for Health Statistics. 25

36 Table 3: Comparative Disease Mortality Rates for the United States and Mississippi 26

37 The rate of obesity in the United States exhibits a socioeconomic slope with levels of obesity exhibited disproportionately by people with lower educational attainment, those with limited resources, racial and ethnic minorities, and for those living in poverty. Studies on dietary choices that lead to obesity have overwhelmingly found that energy dense diets (foods high in sugars, fats, and refined grains) are less costly than diets that consist of fresh vegetables, lean meats, and fruit juices. Because energy dense food are lower in price, they represent a low cost option for poor people, with 19, 20, 21 income and prices affecting food choices, dietary habits, and dietary quality. The Health Effects of Obesity Common morbidities associated with obesity include hypertension and stroke, coronary heart disease, certain types of cancer, and Type 2 diabetes or non insulin dependent diabetes mellitus and other serious health problems that include sleep apnea, Osteoarthritis, and Gallbladder disease. 22,23,24,25,26 Heart disease is the leading cause of death in the United States; people who are overweight are more likely to exhibit the risk factors for heart disease and stroke, which are high blood pressure, high levels of cholesterol, and blood fats. 27 According to the Mississippi State Department of Health, cardiovascular disease, including heart attack and stroke, is the leading cause of death in Mississippi; in 2011, heart disease accounted for approximately 25.1 percent of all deaths in the state of Mississippi. Mississippi has the highest death rate from heart disease, hypertension, and cerebrovascular disease in the nation (see Table 3, page 26); Mississippi also has the second highest rate of death from diabetes mellitus in the nation. Many of these deaths are preventable; an update of the 1997 American Health Association s Scientific Statement on Obesity and Health Disease found strong evidence that weight loss in overweight and obese individuals reduces risk factors for diabetes and cardiovascular disease Wardle, J. (2002). Sex Differences in Association with SES and Obesity. American Journal of Public Health. 92: Drewnowski, A. and Specter, S., E. (2004). Poverty and Obesity: the Role of Energy Density and Energy Costs. American Journal of Clinical Nutrition. 79 (1): Cook, J. T. (2002). Clinical Implications of Household Food Security: Definitions, Monitoring, and Policy. Nutrition in Clinical Care. 5 (4): Are you Obese? Journal of the American Medical Association, 282 (16) October Additional sources: Centers for Disease Control and Prevention, National Institute of Diabetes and Digestive and Kidney Diseases. 23 Burton, B., T., Foster, W. R., Hirsch, J., and VanItallie, T. B. (1985). Health Implications of Obesity: NIH Consensus Development Conference. International Journal of Obesity. 9 (3): Wienpahl, J., Ragland, D. R., and Sidney, S. (1990). Body Mass Index and 15 year Mortality in a Cohort of Black Men and Women. Journal of Clinical Epidemiology. 43 (9): Stevens, J., Keil, J. E., Rust, P.F., Tyroler, H. A., Davis, C. E., and Gazes, P.C. (1992). Body Mass Index and Body Girths as Predictors of Mortality in Black and White Women. Archives of Internal Medicine. 152: Stevens J., Plankey, M. W., Williamson, D.F., et al. (1998). The Body Mass Index Mortality Relationship in White and African American Women. Obesity Research. 6: Heart and Stroke Facts, American Heart Association. 28 Poirier, P., Giles, T. D., Bray, G. A., Hong, Y., Stern, J., Pi Sunyer, X. and Eckel, R. H. (2006). Obesity and Cadiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss: An Update of the 1997 American Heart Association Scientific Statement on Obesity and Health Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Journal of the American Heart Association. 113:

38 Table 4: Comparative Prevalence of Health Risk Behaviors and Chronic Conditions in the United States and Mississippi Health Risk Behavior or Chronic Condition Variable State of Mississippi United States Range for All States Adults with Good or Better Health to 88.0 Adults between Ages of 18 to 65 who have Healthcare Coverage to 92.3 Adults aged 18 or Older who were Obese to 34.9 Adults with Diagnosed Diabetes to 13.5 Adults having had any type of Cancer to 14.5 Adults with Current Asthma to 12.1 Adults with some form of Arthritis to 35.9 Adults with Hypertension to 41.3 Adults aged 20 or Older having High Blood cholesterol to 42.9 Adults aged 45 or Older who have had Coronary Heart Disease to 16.2 Adults aged 45 or Older who have had a Stroke to 7.2 Adults with Limited Acitivites because of a Physical, Mental, or Emotional Problem to 31.4 Adults using Special Equipment because of any Health Problem to 11.3 Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, United States 2011; Volume 63 (9); October 24, 2014 Author's Note: In 2011, BRFSS adopted a new weighting methodology (iterative proportional fitting); as a result data from 2011 forward may not be compared with previous years. 28

39 Medical research has overwhelmingly demonstrated the linkage between diabetes and being overweight or obese. The medical community has identified obesity and diabetes as an epidemic in the United States, 29 with body mass index and weight gain being major risk factors for diabetes 33 and one of the strongest predictors of diabetes. 34, 35, 36, 37 A thirty year study of 121,700 female registered nurses who did not have diagnosed diabetes mellitus, a coronary heart disease, stroke, or cancer when enrolled in the study found that a weight gain of between 15 and 24 pounds after age 18 was associated with a twofold increase in the risk of diabetes; this study also found that women who lost more than 11 pounds reduced their risk level for diabetes mellitus by 50 percent or more. 38 National mortality statistics have shown an increased risk of death from stroke and a higher prevalence of diabetes mellitus among African Americans; 39, 40, 41 findings indicate the age adjusted diabetes death rates for African Americans in the United States to be approximately twice as high as death rates for Whites 42 and the diabetes death rates among African American youths to be approximately twice as high as that of White youths. 43 The linkage between overweight/obesity and diabetes is a critical issue in the state of Mississippi. According to the Mississippi State Department of Health, over 276,000 adults in Mississippi had type 2 diabetes in 2012, and four of every 1,000 deaths in Mississippi were from diabetes. In Mississippi, 12.4 percent of the adult population has diabetes; this is the second highest rate in the nation (Table 4, page 28). 30, 31, Mokdad A., Serdula M., Dietz W., Bowman B., Marks J., and Koplan, J. (1999). The Spread of the Obesity Epidemic in the United States, Journal of the American Medical Association. 282: American Diabetes Association. Diabetes Facts and Figures. Alexandra, VA; American Diabetes Association; Pi Sunyer, F. X. (1993). Medical Hazards of Obesity. Annals of Internal Medicine. 119 (7): Resnick H., Valsania, P., Halter, J., Lin, X. (2000). Relation of Weight Gain and Weight Loss on Subsequent Diabetes Risk in Overweight Adults. Journal of Epidemiology and Community Health. 54: Ford, E. S., Williamson, D. F., and Liu, S. (1997). Weight Change and Diabetes Incidence: Findings from a National Cohort of U.S. Adults. American Journal of Epidemiology. 146: Holbrook, T. L., Barrett Conor, E., Wingard, D. L. (1989). The Association of Lifetime Weight and Weight Control Patterns with Diabetes among Men and Women in an Adult Community. International Journal of Obesity. 13: Chan, J. M., Stampfer, M. J., Rimm, E. B., et al. (1994). Obesity, Fat Distribution, and Weight Gain as Risk Factors for Clinical Diabetes in Men. Diabetes Care. 17: Colditz, G. A., Willett, W. C., Rotnitzky, A., et al. (1995). Weight Gain as a Risk Factor for Clinical Diabetes in Women. Annals of Internal Medicine. 122: Hanson, R. L., Narayan, K. M., McCance, D. R., et al. (1995). Rate of Weight Gain, Weight Fluctuation, and Incidence of NIDDM. Diabetes. 44: Ibid. 39 Kittner, S. J., White, L. R., Losonczy, K. G., Wolf, P. A., and Hebel, J. R. (1990). Black White Differences in Stroke Incidence in a National Sample: The Contribution of Hypertension and Diabetes Mellitus. Journal of the American Medical Association. 264: Winkleby, M. A., Kraemer, H. C., Ahn, D. K., and Varady, A. N. (1998). Ethnic and Socioeconomic Differences in Cardiovascular Disease Risk Factors. Journal of the American Medical Association. 280: McTigue, K., Larson, J. C., Valoski, A., Burke, G., Kotchen, J., Lewis, C. E., Stefanick, M. L. et al. (2006). Mortality and Cardiac and Vascular Outcomes in Extremely Obese Women. Journal of the American Medical Association. 296: National Center for Health Statistics. Health, United States, Racial Disparities in Diabetes Mortality among Persons Aged 1 19 Years United States, Journal of the American Medical Association, 2008; 299 (10):

40 Table 5: Comparative Overweight and Obesity Prevalence by Population Classification Groups 2013 Percentage Distribution of the Population by Weight Classification by Body Mass Index (BMI): Mississippi and the United States 2013 Weight Classification: Underweight Normal Weight Overweight Obese (bmi ) (bmi ) (bmi ) (bmi ) Mississippi Nationwide Prevalence of Overweight and Obesity by Gender: Mississippi and the United States 2013 Gender and Category: Overweight Males Overweight Females Obese Males Obese Females Mississippi Nationwide Prevalence of Overweight by Race or Ethnicity: Mississippi and the United States 2013 Race or Ethnicity: White Black Hispanic Other Mississippi Nationwide Prevalence of Obesity by Race or Ethnicity: Mississippi and the United States 2013 Race or Ethnicity: White Black Hispanic Other Mississippi Nationwide Prevalence of Overweight by Educational Attainment: Mississippi and the United States 2013 Educational Attainment: Less than H.S. H.S. or G.E.D. Some post H.S. College graduate Mississippi Nationwide Prevalence of Obesity by Educational Attainment: Mississippi and the United States 2013 Educational Attainment: Less than H.S. H.S. or G.E.D. Some post H.S. College graduate Mississippi Nationwide Prevalence of Overweight by Income Group: Mississippi and the United States 2013 Income Group: Less than $15,000 $15,000 24,999 $25,000 34,999 $35,000 49,999 $50,000+ Mississippi Nationwide Prevalence of Obesity by Income Group: Mississippi and the United States 2013 Income Group: Less than $15,000 $15,000 24,999 $25,000 34,999 $35,000 49,999 $50,000+ Mississippi Nationwide Prevalence of Overweight by Age Group: Mississippi and the United States 2013 Age Group: Mississippi Nationwide Prevalence of Obesity by Age Group: Mississippi and the United States 2013 Age Group: Mississippi Nationwide Source: Office of Surveillance, Epidemiology, and Laboratory Services, Behavioral Risk Surveillance System, Centers for Disease Control,

41 Researchers at Johns Hopkins Bloomberg School of Public Health have found a link between obesity and dementia; 44 researchers at the Kaiser Permanente Institute for Health Research in Denver found that obese adults were 4.6 times more likely to be hospitalized for asthma and had significantly worse asthma control. Maternal obesity impacts the health of the mother and the child. Pregnant women who are obese are at risk of hypertensive and thromboembolic disorders, gestational diabetes, increased rates of cesarean delivery, and wound infection. 45,46,47,48,49 Research published in the Journal of the American Medical Association found that congenital abnormalities are more likely to occur in the babies of obese women and found that babies born to an obese mother were more likely to have heart problems, excess fluid build up in the brain, spina bifida, cleft palate or cleft lip, and abnormal development of the rectum or anus. 50 In 2013, 35.1 percent of adults in Mississippi were obese; this was the highest obesity rate in the United States and compared to a U.S. obesity level of 29.4 percent. 51, 52 In Mississippi, 31.1 percent of Whites were obese, 42.5 percent of African Americans were obese, and 35.3 percent of Hispanics were obese; nationwide, 27.4 percent of Whites were obese and 37.9 percent of African Americans were obese. 53 In Mississippi, 37.3 percent of females and 31.8 percent of males were obese as compared to national obesity rates of 28.0 percent for females and 29.1 percent for males; females in Mississippi had the highest obesity rate in the nation Beydoun, M. A., Beydoun, H. A., Wang, Y. (2008). Obesity and Central Obesity as Risk Factors for Incident Dementia and its Subtypes: a Systematic Review. Obesity Reviews. 9(3): Chauhan, S. P., Magann, E. E., Carroll, C. S., Barrilleaux, P. S., Scardo, J. A., and Martin, J.N. Jr. (2001). Mode of Delivery for the Morbidly Obese with Prior Cesarean Delivery: Vaginal versus Repeat Cesarean Section. American Journal of Obstetrics and Gynecology. 185(2): Chu, S. Y., Callaghan, W. M., Kim, S. Y., et al. (2007). Maternal Obesity and Risk of Gestational Diabetes Mellitus. Diabetes Care. 30(8): Usha Kiran, T. S., Hemmadi, S., Bethel, J., and Evans, J. (2005). Outcome of Pregnancy in a Woman with Increased Body Mass Index. BJOG: An International Journal of Obstetrics & Gynacology. 112(6): O Brien, T. E., Ray, J. G., Chan, W. S. (2003). Maternal Body Mass Index and the Risk of Preeclampsia: a Systematic Overview. Epidemiology. 14(3): Sebire, N. J., Jolly, M., Harris, J. R., et al. (2001). Maternal Obesity and Pregnancy Outcome: a Study of 287,213 Pregnancies in London. International Journal of Obesity and Related Metabolic Disorders. 25(8): Katherine J. Stothard, PhD; Peter W. G. Tennant, MSc; Ruth Bell, MD; Judith Rankin, PhD. (2009). Maternal Overweight and Obesity and the Risk of Congenital Anomalies: A Systematic Review and Meta Analysis. Journal of the American Medical Association. 301 (6): Prevalence of Self Reported Obesity among U.S. Adults by State and Territory, Centers for Disease Control and Prevention, Behavioral Risk Surveillance Survey. 52 Author s note: in 2011 the Centers for Disease Control and Prevention initiated changes in its methodology for calculating obesity; as a result, prevalence estimates from 2011 cannot be compared with obesity estimates reported prior to Ibid. 54 Ibid. 31

42 Obesity among Children Obesity and being overweight has increased dramatically among children. Between 1976 and 1990, there was a 40 percent increase in the prevalence of being overweight or obese among youth between the ages of 6 and , 56,57 Research has found that an estimated 22 percent of youth aged 6 to 17 years were overweight in 1995 and 25 percent were overweight in The relatively greater increase in the upper body mass index (BMI) percentiles compared with the lower Figure 1: Obesity and Overweight High School Students suggests the severity of overweight is increasing. 58 The prevalence of overweight has increased over the last 25 years among all 59, 60, 61 American children and adolescents, but particularly among racial/ethnic minorities. According to the CDC s Youth Risk Behavior Survey for 2013, 62 in the U.S., the percentage of high school students who were obese was 12.4 percent; for males, this obesity rate was 15.1 percent and for females, this obesity rate was 9.1 percent. Among high school students in Mississippi, the obesity rate was 15.4 percent for all students; for males in Mississippi high schools, the obesity rate was 19.2 percent and it was 11.7 percent for females. 55 Rosenbaum, M., Leibel, R. L., (1998). The Physiology of Body Weight Regulation: Relevance to the Etiology of Obesity in Children. Pediatrics. 101: Troiano, R. P., Flegal, K. M. (1998). Overweight Children and Adolescents: Description, Epidemiology, and Demographics. Pediatrics. 101: Troiano, R. P., Flegal, K. M., Kuczmarski, R. J., Campbell, S.M., and Johnson, C. L. (1995). Overweight Prevalence and Trends for Children and Adolescents: the National Health and Nutrition Examination Surveys, 1963 to Archives of Pediatrics & Adolescent Medicine. 149: U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, Evidence Syntheses and Systematic Evidence Reviews 2005, Screening and Interventions for Childhood Overweight, prepared by the Oregon Evidencebased Practice Center; Principal Investigators: Evelyn P. Whitlock, MD, MPH; Selvi B. Williams, MD; Rachel Gold, PhD, MPH; Paula Smith, RN, BSN; and Scott Shipman, MD, MPH. 59 Ibid. 60 Ogden, C. L., (2009). Disparities in Obesity Prevalence in the United States: Black Women at Risk; American Journal of Clinical Nutrition. 89(4): Robinson, W. R.; Gordon Larsen, P.; Kaufman, J. S. et al. (2009). The Female Male Disparity in Obesity Prevalence among Black American Young Adults: Contributions of Sociodemographic Characteristics of the Childhood Family; American Journal of Clinical Nutrition. 89 (4): Youth Risk Behavior Surveillance United States, Centers for Disease Control and Prevention, Morbidity and Mortality Week Reports, Surveillance Summaries, 63(4). 32

43 The CDC s Youth Risk Behavior Survey for 2013 found that the percentage of high school students who were overweight was 14.9 percent; for males and females, the percentage of high school students that were overweight was 14.8 percent. Among Mississippi s high school students, 13.2 percent were overweight; 10.0 percent of male high school students were overweight and 16.3 percent of female high school students were overweight. This indicates that approximately 28.7 percent of Mississippi s high school students were either obese or overweight (Figure 2, below). 63 In the United States, the percent of children aged six to 11 years who are considered obese was 17.4 percent; 16.0 percent of females and 18.7 percent of males in this age group were considered obese. Among White children aged six to 11 years, 15.6 percent of children were obese and among African American children, 20.0 percent of children aged six to 11 years were obese. For children age six to 11, the obesity rate for children with health insurance was 16.4 percent as compared to an obesity rate of 26.1 percent for children with no health insurance. Among children aged six to 11 years with health insurance, the obesity rate among children covered by private health insurance was 14.5 percent as compared to 19.8 percent among children who were covered by public health insurance. 64 Based upon data from the 2011 National Survey of Children s Health, the obesity rate among children age 10 to 17 was 21.7 percent in Mississippi; this was the highest level in the United States. 65 Figure 2: Obesity and Overweight by Gender Overweight and obese children have a high probability of becoming obese adults and experiencing a higher incidence of health problems as compared with normal weight children. Studies have found that overweight or obese children have increased blood pressure and glucose intolerance and exhibit psychosocial difficulties and increased risk of the persistence of obesity into adulthood. The high cost of treating diseases and health risks associated with overweight and obese children can be expected to increase significantly as the overweight and 63 Ibid. 64 Centers for Disease Control and Prevention. Percent of Children and Adolescents Aged 6 to 11 Years who are Considered Obese. National Health and Nutrition Examination Survey, National Survey of Children s Health, Health Resources and Services Administration, Maternal and Child Health Bureau. 33

44 obese population ages. Research has found that body fatness is a significant predictor of cardiovascular disease risk factors in children and youth, 66 with the atherosclerotic process beginning in childhood, 67, 68, 69 and that eating habits developed during childhood form the longterm eating patterns of the population. 70 A study conducted by researchers at the Children s Nutrition Research Center at the Baylor College of Medicine found that children who are overweight have a 1.5 to twofold higher risk of being overweight as adults and that overweight youth are 2.4 times as likely to have a high cholesterol level and 43.5 times as likely to have three or more cardiovascular risk factors. 71 Childhood Obesity and Academic Outcomes Causal relationships between student obesity and academic outcomes require more research. One of the difficulties in identifying the cause and effect relationships between obesity and student academic outcomes is due to the autocorrelation that exists between childhood obesity, poverty, race, and parental academic attainment levels. There is significant evidence to suggest that childhood obesity can impact a student s performance in school. Research has established a link between childhood obesity, depression, and low self esteem, which in turn is related to educational attainment. Research has found that obese children in kindergarten score lower on math and reading tests and overweight females have lower scores on academic tests between kindergarten and 3 rd grade. 72, 73 Studies of middle and high school students have found that students at risk of obesity tend to have lower grades and that obese girls perform more poorly on math and reading tests when compared to their normal weight peers. 74 A 1966 study found that overweight students have a lower college acceptance rate to universities as compared to normal weight students with similar test scores. 75 A longitudinal study of 66 Williams, D. P., Going, S. B., Lohman, T. G., Harsha, D. W., Snnivasan, S. R., Webber, L. S., Berenson, G. S, (1993). Body Fatness and Risk for Elevated Blood Pressure, Total Cholesterol, and Serum Lipoprotein Ratios in Children and Adolescents: American Journal of Public Health. 82(3): National Cholesterol Education Program. Highlights of the Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Journal of Pediatrics 1993; 89 (3): Kavey, R. E., Daniels, S. R., Lauer, R. M., et al. (2003). American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation. 107(11): McCrindle, B. W., Urbina, E. M., Dennison, B. A., et al. (2007). Drug Therapy of High risk Lipid Abnormalities in Children and Adolescents: A Scientific Statement from the American heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, with the Council on Cardiovascular Nursing. Circulation. 115: Birch, L. L., Fisher, J. O. (1998). Development of Eating Behaviors among Children and Adolescents. Pediatrics; 101(5): Nicklas, T.A., Baranowski, T., Cullen, K.W., and Berenson, G. (2001). Eating Patterns, Dietary Quality and Obesity; Journal of the American College Nutrition. 20 (6): Datar, A., Sturm, R., and Magnabosco, J. L. (2004). Childhood Overweight and Academic Performance: National Study of Kindergartners and First graders. Obesity Research, 12 (1): Datar, A., and Sturm, R. (2006). Childhood Overweight and Elementary School Outcomes. International Journal of Obesity, 30: Crosnoe, R., and Muller, C. (2004). Body Mass Index, Academic Achievement, and School Context: Examining the Educational Experiences of Adolescents at Risk of Obesity. Journal of Health and Social Behavior, 45(4): Canning, H., Majer, J. (1966). Obesity Its Possible Effect on College Acceptance, New England Journal of Medicine; 275:

45 adolescents and young adults over a seven year period found that women who were overweight in their youth completed less schooling, had higher rates of poverty, and had lower household incomes as adults. 76 A study funded by the Rand Corporation found that female students who transitioned from being not overweight upon entry into kindergarten but became overweight at the end of third grade experienced negative academic achievement and socialbehavioral outcomes by the end of third grade, with findings of significant reductions in test scores. 77 Of particular concern is the association between lower school attendance levels and student obesity. Research has demonstrated the relationship between poor academic outcomes and school attendance 78, 79 and has demonstrated that obesity is a significant contributor to student absenteeism after adjusting for race, ethnicity, and socioeconomic status. 80 The Economic Cost of Obesity The U.S. Department of Health and Human Services has found that overweight and obesity have a significant impact on the health care system in the United States. 81 Longitudinally, the cost of obesity and the treatment of obesity related illnesses has escalated in the United States; the increase in these costs are primarily a function of increased health care costs and increased levels of obesity within the population. Research estimates of the cost of obesity in the United States vary significantly depending upon multiple factors, to include the time frame during which the research is conducted, the methodology that is used to measure these costs, the variables included in the analysis, the population included in the study (i.e. adults, children, or specific sub populations), and the purpose of the study. All estimates of the cost of obesity within the United States (or Mississippi) must be viewed within the context of a degree of uncertainty that begins with the methods and sources used to measure the level of obesity within a population and increases from that starting point. The economic cost of obesity includes direct and indirect costs; some studies expand these categories to include transportation, human capital costs, or productivity costs. The direct medical costs associated with overweight and obesity include diagnosis, treatment, and prevention including outpatient and inpatient health services and drug therapies; indirect costs include the value of lost work and income related to absenteeism and decreased productivity at work (also called 76 Gortmaker, S. L., Must, A., Perrin, J. M., and Sobol, A. M. (1993). Social and Economic Consequences of Overweight in Adolescence and Young Adulthood. New England Journal of Medicine. 328: Datar, A., and Sturm, R. (2006). Childhood Overweight and Elementary School Outcomes. International Journal of Obesity. 30: Dunn, M. C., Kadane, J. B., and Garrow, J. R. (2003). Comparing Harm Done by Mobility and Class Absence: Missing Students and Missing Data. Journal of Education and Behavioral Statistics. 28 (3): Monk, D., Ibrahim, M. (1984). Patterns of Absence and Pupil Achievement. American Educational Research Journal. 21 (2): Geier, A. B., Foster, G. D., Womble, L. G., et al. (2007). The Relationship between Relative Weight and School Attendance among Elementary Schoolchildren. Obesity. 15 (8): The Surgeon General s Call to Action to Prevent and Decrease Overweight and Obesity (2001). U.S. Department of Health and Human Services. 35

46 presenteeism, which is defined as working at less than full capacity), and the value of future income that is lost due to premature death. From a public policy perspective, an understanding of the economic burden of obesity, the negative externalities, and shifting of these cost burdens are useful in the decision making process to evaluate the cost and benefit of policy interventions designed to reduce the prevalence of obesity. Research conducted in that examined state level Medicare and Medicaid spending by state using data from the Centers for Disease Control and Prevention s Behavior Risk Factor Surveillance System found that total U.S. medical spending attributable to adult obesity was approximately $75.1 billion, with $17.7 billion of obesity related health costs being paid by Medicare and $21.3 billion being paid by Medicaid. This would indicate that approximately 23.6 percent of the total cost of obesity related medical spending is absorbed by Medicare and 28.4 percent of the total cost of obesity related medical spending is absorbed by Medicaid. These researchers found that in Mississippi, total aggregate medical spending attributable to obesity in was approximately $757 million (expressed in 2003 dollars); of this amount, $223 million was paid by Medicare and $221 million was paid by Medicaid during the period from 1998 to This estimate ($757 million) of the cost of obesity to the state of Mississippi was also used by the report Obesity in Mississippi compiled by the Mississippi Department of Education s Office of Health Schools for the Preventing Obesity with Every Resource (POWER) Project and Governor Haley Barbour s Obesity Task Force. Subsequent research in estimated that the medical cost of obesity was approximately $147 billion annually in the United States and that obesity related health care costs represented approximately 12.9 percent of private health care spending, 8.5 percent of Medicare spending, and 11.8 percent of Medicaid spending in the U.S. This research also found that the increase in adult per capita medical spending that is attributable to obesity is $1,723 for Medicare beneficiaries, $1,021 for Medicaid beneficiaries, and $1,140 per person for those who are privately insured; across all payers, the per capita medical spending was $1,429 higher for those who were obese as compared to persons of normal weight. A 2009 study conducted by Kenneth E. Thorpe and academic researchers at Emory University used econometric modeling to estimate obesity related direct health care costs in the United States. This report found that obesity was a rapidly growing public health issue in the U.S. and that approximately 103 million adults will be obese by 2018, assuming current growth trends continued. The Emory University study estimated that total obesity related health care costs for adults in the U.S. was between $67.4 and $91.5 billion in 2008 and predicted that these 82 Finkelstein, E. A., Fiebelkorn, I. C., Wang, G. (2004). State level Estimates of Annual Medical Expenditures Attributable to Obesity. Obesity Research. 12 (1): Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., and Dietz, W. (2009). At the Intersection of Health, Health Care and Policy. Health Affairs. 28(5): w822 w

47 costs would increase to approximately $343.8 billion by Using data collected from the National Health and Nutrition Examination Survey (NHANES) and the CDC s Behavior Risk Factor Surveillance System, the obesity rate of the population of Mississippi was projected to increase from 37.7 percent in 2008 to approximately 52.2 percent in In 2008, direct health care costs associated with obesity were estimated to be $441 per capita for adults in Mississippi and Mississippi s obesity related health care spending was projected to increase to $1,757 per adult by More recent research 86 has estimated that the per capita medical spending for obese persons was $2,741 per person higher as compared to non obese persons, $1,152 higher for obese men and $3,613 higher for women. This research also found that the obesity related per capita medical spending for the uninsured was $3, as compared to $2,568 for those with private insurance and $3,674 for those with Figure 3: Per Capita Additional Cost of Obesity Related Health Care Cost Medicaid (Figure 3). This research found that the national health care cost associated with obesity was approximately $209.7 billion; this is higher than any previous estimates and indicates that approximately 20.6 percent of U.S. health care expenditures are related to the cost of treating obesity and its related illnesses Thorpe, K.E., (2009). National and State Estimates of the Impact of Obesity on Direct Health Care Expenses. A Collaborative Report from the United Health Foundation, the American Public Health Association and Partnership for Prevention. 85 Ibid. 86 Cawley, J., and Meyerhoefer, C. (2012). The Medical Care Costs of Obesity: An Instrumental Variables Approach. Journal of Health Economics. 31: Author s note: no data was provided by the Cawley and Meyerhoefer for the estimated cost to 3 rd party payers for the obesity related health care costs for the uninsured. 88 Ibid. 37

48 Figure 4: Distribution of Total National Health Care Expenditures by Source of Payment, 2009 Actual and 2020 Projected (in Billions of Dollars) 38

49 Health care costs are increasing and the rising cost of health care will impact the obesityrelated cost of health care; as health care costs increase, so too will the cost of obesity related health care. Of particular concern is the level of public spending on health care. Public spending on health care represents expenditures by Federal, State, and local governments, private spending on health care is the other component of national health expenditures. In 2012, National Health Care Expenditures were $2.8 trillion, an estimated $8,915 per person and are projected to increase to $14,944 per capita by 2023 (Figure 5). 89 From 2011 to 2012, Medicare spending in the U.S. grew by 4.8 percent to $572.5 billion and represented 21 percent of total National Health Care Expenditures; over the same oneyear period, Medicaid spending increased by 2.2 percent to $917 billion and represented 15 Figure 5: U.S. Per Capita Spending on Health Care 2007 through 2023 percent of total National Health Care Expenditures. 90 In 2012, federal government spending accounted for 26 percent of National Health Care Expenditures, private business spending represented 21 percent of National Health Care Expenditures, and 18 percent of National Health Care Expenditures came from state or local governments. 91 From 2013 through 2023, National Health Care Expenditures are projected to grow at an average annual rate of 5.7 percent and by 2023; health care expenditures paid for by Federal, State, and local governments are projected to account for 48.1 percent of National Health Care Expenditures. In 2013, Medicare, Medicaid, State Children s Health Insurance Programs (SCHIP), and other publically funded health care insurance programs (i.e. Department of Defense and Department of Veteran s Affairs) represented approximately 39.1 percent of total national healthcare expenditures; by 2023, this is projected to increase to 43.1 percent. In 2007, Medicare, Medicaid, and CHIP expended approximately $769.6 billion on health care services; in 2009, this amount was approximately $905 billion and is projected to increase to approximately $2,030 billion by Centers for Medicare and Medicaid Services, Office of the Actuary, U.S. Department of Health & Human Services, 2013 Actuarial Report of the Financial Outlook for Medicaid, Centers for Medicare & Medicaid Services The Office of the Actuary in the Centers for Medicare & Medicaid Services. 91 Ibid. 92 Ibid. 39

50 Table 6: Personal Health Care Spending by Payer Group for Mississippi and the United States, Comparison of 2004 and 2009 All Personal Health Care Spending Average Annual Growth 2001 to 2009 U.S. Spending Per Capita $5,411 $6, % Mississippi Spending Per Capita $5,119 $6, % U.S. Total Spending on Personal Health Care $1,585,019,829,000 $2,089,862,286, % Mississippi Total Spending on Personal Health Care $14,743,145,000 $19,384,199, % U.S. Total Enrollment 292,936, ,656, % Mississippi Total Enrollment 2,884,920 2,949, % Medicaid Average Annual Growth 2001 to 2009 U.S. Spending Per Capita $6,089 $6, % Mississippi Spending Per Capita $5,241 $6, % U.S. Total Spending on Personal Health Care $271,167,541,000 $345,669,140, % Mississippi Total Spending on Personal Health Care $3,426,791,000 $3,628,763, % U.S. Total Enrollment 44,531,327 50,641, % Mississippi Total Enrollment 653, , % Medicare Average Annual Growth 2001 to 2009 U.S. Spending per Enrollee $7,362 $10, % Mississippi Spending per Enrollee $7,521 $10, % U.S. Total Spending on Personal Health Care $300,246,723,000 $471,259,678, % Mississippi Total Spending on Personal Health Care $3,357,358,000 $5,205,279, % U.S. Total Enrollment 40,784,276 45,466, % Mississippi Total Enrollment 446, , % Private Health Insurance Average Annual Growth 2001 to 2009 U.S. Spending per Enrollee $2,878 $3, % Mississippi Spending per Enrollee $2,578 $3, % U.S. Total Spending on Personal Health Care $562,831,000,000 $712,165,000, % Mississippi Total Spending on Personal Health Care $4,250,000,000 $4,954,000, % U.S. Total Enrollment 195,546, ,086, % Mississippi Total Enrollment 1,649,000 1,534, % Source: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group Author's Note: The most recent comparable, longitudinal data for the state of Mississippi is presented in the table above. To provide a frame of reference regarding changing enrollment in publically funded health insurance programs, CMS reported that in August of 2014, total enrollment in Medicaid and CHIP was 637,229 in the state of Mississippi and that over the one year period from 2013 to 2014, enrollment had increased by 52,692 (8.27 percent) in the state of Mississippi. 40

51 The growth in public health spending is projected to outpace the growth of private health care spending as the population ages and becomes eligible for Medicare and as the relatively expensive aged and disabled eligible groups constitute an increased share of Medicaid enrollment. From 2008 through 2017, enrollment in Figure 6: Total National Health Expenditures Funded from Public Sources, Actual through 2012 and Projected through 2023 (in billions of dollars) Medicaid is projected to increase at an average annual rate of 1.2 percent, with a predicted national enrollment of 55.1 million by 2017; public spending on Medicare is projected to increase to 8.1 percent in 2018 and public spending on Medicaid is expected to increase by 8.9 percent by A comparison of Medicare and Medicaid spending in the United States as compared to the state of Mississippi indicates the following (Table 6, page 40): In 2009, total personal health care spending associated with Medicare beneficiaries in the state of Mississippi was $5.2 billion. From 2001 to 2009, total personal health care spending associated with Medicare beneficiaries in the state of Mississippi grew at an average annual rate of 8.5 percent; the average annual growth rate of total personal health care spending for Medicare beneficiaries in the state of Mississippi was higher than that of the United States. 93 Author s note: The Office of the Actuary at the Centers for Medicare and Medicaid Services publishes actual and predicted data for national health care expenditures; at the time of this report, comparable state and national level data was only available through In 2010, the National Health Statistics Group at CMS undertook a comprehensive revision of the data, methodology, processing, and definitions (as well as conceptual changes) in the methodology used for reporting national health care expenditures. For purposes of estimating the economic cost of obesity to the state of Mississippi, this report uses the 2009 data published by the Office of the Actuary for the Centers for Medicare and Medicaid Services. 41

52 In 2009, per capita health care spending for Medicare beneficiaries was $10,667 in Mississippi and grew at an average annual rate of 6.9 percent per enrollee; per capita health care spending for Medicare beneficiaries in the state of Mississippi was higher than that of the United States and grew at a faster rate than that of the United States over the period from 2001 through In 2009, total personal health care spending associated with Medicaid beneficiaries in the state of Mississippi was $3.6 billion. From 2001 to 2009, total personal health care spending associated with Medicaid beneficiaries in the state of Mississippi grew at an average annual rate of 8.6 percent as compared to a growth of 7.8 percent at the national level. In 2009, per capita health care spending for Medicaid beneficiaries in Mississippi was $6,850 and grew at an average annual rate of 6.2 percent over the period from 2001 to In the U.S., per capita health care spending by Medicaid beneficiaries was $6,826 in 2009 and grew at an average annual rate of 3.7 percent from 2001 to The total number of individuals enrolled in Medicaid and CHIP programs in August 2014 for all reporting states in the U.S. (51 states plus the District of Columbia) was 67,931,644; of these, 27,825,231 were children enrolled in CHIP programs in 43 states; based upon this data, it can be estimated that children enrolled in the Medicaid and CHIP programs constitute approximately 55 percent of total Medicaid and CHIP program enrollment nationwide. 94 In 2015, the requested funding for the Mississippi Office of Medicaid was $5,625,510,068; of this amount, approximately $4.1 billion is provided from federal sources, $983,049,485 is provided by state general funds, and the balance is provided by other state agency matching funds (2 percent) and the Provider Tax (7 percent or $420,052,225). 95 In 2014, the budget for the Mississippi Division of Medicaid was $5,359,605,123. In 2013, direct state funding for the Mississippi Office of Medicaid totaled $820,544,336; this amount increased by $162.5 million by 2015, the direct state appropriated funding requested by the Mississippi Office of Medicaid was $983,049, In the state of Mississippi, there were approximately 643,664 Medicaid beneficiaries and 70,020 State Children s Health Insurance Program (CHIP) beneficiaries in 2013; Medicaid enrollment averaged an annual increase of approximately 1.1 percent per year and CHIP enrollment averaged an annual increase of 2.8 percent over the period from 2003 through 2013 (Figure 7, page 43). Within the context of projected increases in enrollment in publically funded health insurance programs, increasing health care costs, the relationship between 94 Medicaid & CHIP: August 2014 Monthly Applications, Eligibility Determinations and Enrollment Report, Department of Health and Human Services, Centers for Medicare & Medicaid Services. 95 Mississippi Division of Medicaid, Fiscal Year 2015 Budget Presentation, September 17, Ibid. 42

53 income and obesity, and the higher cost of obesity related health care for Medicaid beneficiaries as compared to the other segments of the population (Figure 3, page 37 and Figure 10, page 48), there is little question that the cost of obesity related health care represents a looming fiscal crisis for the state of Mississippi. In addition to the economic cost of obesity that falls upon Figure 7: State of Mississippi Enrollment in Medicaid and State Children's Health Insurance Programs 2003 through 2013 state revenue funds, hospitals also share a portion of obesity related health care costs. Generally, Medicare and Medicaid payment rates are set by law, with the exception of managed care plans that are usually established based upon negotiations with the hospital. Currently, the payment rates set by Medicare and Medicaid are below all hospitals cost of providing care, resulting in underpayment. Hospital participation in Medicare and Medicaid is voluntary, but it is a condition for hospitals to receive federal tax exemptions for providing health care to the community; as a result, most hospitals accept Medicare and Medicaid beneficiaries. Hospitals provide an important service to their communities because of the important role they play in bridging the gap created by government underpayments from Medicare and Medicaid. Payments received by hospitals for Medicare and Medicaid services are reported for each hospital in the American Hospital Association s (AHA) annual report. According to the AHA s 2012 report, Medicare and Medicaid underpayments to hospitals were $56 billion nationwide; hospitals received payments of 86 cents for every dollar spent by hospitals caring for Medicare patients and 89 cents for every dollar spent caring for Medicaid patients. 97 In addition to underpayments associated with Medicare and Medicaid, hospitals also bear the burden for uncompensated care associated with charity care and bad debt frequently associated with self paying, uninsured, or underinsured patients. In 2012, U.S. hospitals provided an additional $45.9 billion in uncompensated care related to charity and bad 97 American Hospital Association, Underpayment by Medicare and Medicaid Fact Sheet,

54 debt; this amount increased by $4.8 billion over the one year period from 2011 to In Mississippi, the cost of uncompensated care is estimated to be $525.5 million; of that amount, $315 million was not covered by federal reimbursement programs. 99 The cost of underpayments and uncompensated care is frequently shifted to other payers (i.e. employers and those with private insurance) in the form of a hidden tax. A study in estimated that in Mississippi, the insurance premium cost shift associated with uncompensated care for the uninsured was approximately $320 per individual and $800 per family for those with private insurance. Studies indicate that the majority of the uninsured (61 percent) do not have health insurance because they cannot Table 7: The Uninsured Adult Population of Mississippi and Obesity afford it or because they have lost their jobs; these individuals tend to be lowincome working families and individuals living below 200 percent of poverty. 101, 102 According to data from the U.S. Obesity data from CDC Behavioral Risk Surveillance Survey, 2013 Census Bureau, there Age Group Total Uninsured Obesity Rate for Age Group Obese Persons 18 to 24 years: 93, % 21, to 34 years: 115, % 40, to 44 years: 86, % 33, to 54 years: 83, % 38, to 64 years: 63, % 23, and Over: % 259 Total 443,700 N/A 158,335 Uninsured data from U.S. Census Bureau, 2013 American Community Survey 1 Year Estimates were approximately 443,700 adults age 18 and over in the state of Mississippi that had no health insurance. Based upon estimates of obesity levels by age group from the Centers for Disease Control and Prevention, it can be projected that there are approximately 158,335 uninsured adults in the state of Mississippi that are obese (Table 7, above). This estimate of the number of obese Mississippians with no health insurance is quite conservative because obesity rates are significantly higher for low income adults and range between 40.7 percent and 41.2 percent for individuals with incomes of less than $25,000 (see obesity by income group Table 5, page 30). Based upon prior research on obesity related health care costs discussed in previous sections of this report, obesity related health care costs associated with uninsured adults in Mississippi lie within a range of $158,335,294 and may be as high as $499,231,182 based upon the per capita additional obesity related health care cost estimate of $3,153 for uninsured adults that was found by Cowley and Meyerhoefer in Ibid. 99 American Hospital Association, Uncompensated Hospital Care Cost Fact Sheet, December Furnas, B. and Harbage, P. (2009). The Cost Shift from the Uninsured. Center for American Progress Action Fund (an update of prior 2005 research conducted by Kenneth Thorpe). 101 The Uninsured: A Primer, The Kaiser Commission on Medicaid and the Uninsured, 2013 report. 102 Uninsured Americans: Hearing before the Subcommittee on Health of the Committee on Ways and Means, House of Representatives, One Hundred Sixth Congress, First Session, June 15, Washington: U.S. G.P.O. ISBN: Cawley, J., and Meyerhoefer, C. (2012). The Medical Care Costs of Obesity: An Instrumental Variables Approach. Journal of Health Economics. 31:

55 Given annual changes in adult obesity levels, changes in population size, and escalating health care costs, updated estimates of the cost of obesity within the state of Mississippi are useful for the purpose of evaluating the cost benefit of public policy interventions designed to reduce obesity in the state of Mississippi. Although a comprehensive analysis of the cost of obesity to the state of Mississippi is beyond the scope of this study, data from previous studies on the per capita additional health care cost of obesity that were conducted in prior years when the cost of health care was lower than during the current time period can be applied to current population statistics and current adult obesity rates to generate estimates of the economic cost of obesity within the state of Mississippi. This assumption is further substantiated because, as demonstrated in Table 6 on page 40, per capita health care spending in the state of Mississippi closely approximates U.S. health care spending. Based upon 2013 population data for the state of Mississippi, the total population of Mississippi that was over the age of 18 was estimated to be 2,253,775; there were 1,077,466 males over the age of 18 and 1,176,309 females over the age of Using alternative methods to calculate the estimated adult obese population Table 8: Population Obesity Estimates for the State of Mississippi State of Mississippi Population 2013 Population Obesity Rate Total Obese Population Total Population 18 and Over 2,253, % 791,075 Total White Population 18 and Over 1,393, % 433,465 Total Black Population 18 and Over 770, % 327,461 Total Other Population 18 and Over 89, % 29,356 Total Obese Population Using Race 790,282 Total Male Population 18 and Over 1,077, % 364,184 Total Female Population 18 and Over 1,176, % 428,176 Total Obese Population 18 and Over using Gender 792,360 Age Group Total Population Obesity Rate Total Obese Population 18 to 24 years: 312, % 73, to 34 years: 360, % 126, to 44 years: 369, % 143, to 54 years: 380, % 175, to 64 years: 366, % 134, and Over: 400, % 112,910 Total 2,191,136 N/A 767,004 Source: U.S. Census Bureau, 2013 American Community Survey, 1 Year Estimates in the state of Mississippi, it is projected that there are approximately 767,000 to 790,000 obese adults in the state of Mississippi (Table 8, above); this estimate would include all adults regardless of health insurance status (i.e. insured and uninsured). For purposes of estimating the medical spending associated with obesity in the state of Mississippi, this study uses the low point estimate of 767,000 obese adults in the following paragraph. Using Thorpe s (2009) 105 mid point estimate of obesity attributable health care spending per adult of $761, it may be projected that adult obesity related health care costs in the state of 104 Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto Rico Commonwealth and Municipios: April to July 1, U.S. Census Bureau, Population Estimates. 105 Thorpe, K.E., (2009). National and State Estimates of the Impact of Obesity on Direct Health Care Expenses. A Collaborative Report from the United Health Foundation, the American Public Health Association and Partnership for Prevention. 45

56 Mississippi are approximately $583,687,000; using Thorpe s upper range estimate of obesity attributable health care spending per adult, it can be estimated that adult obesity related health care costs in the state of Mississippi are approximately $687,999,000. Using Finkelstein s (2009) 106 estimate of adult medical spending attributable to obesity of $1,429 per capita, it would be estimated that adult obesity related health care costs in the state of Mississippi approximate $1,096,043,000. Based upon Cawley and Meyerhoefer s (2012) 107 per capita obesity related health care cost point estimate of $2,741 and point estimate of $2,418 to 3 rd party payers (public and private insurers) for all obese persons (Figure 3, page 37), it can be projected that $247,741,000 of the obesity related cost of health care is absorbed by households or represents uncompensated costs to hospitals or physicians, and approximately $1,854,606,000 of the obesity related costs of health care in the state of Mississippi is absorbed by either public or private insurance. The methodology used by Cawley and Meyerhoefer adjusts for the endogeneity and the measurement error in weight found in some research on obesity related health care, and specifically accounts for differences in obesity related health care cost for disadvantaged minorities and those with low socioeconomic status, creating a powerful empirical model; the potential cost of obesity related health care expenditures in the state of Mississippi was further examined using the findings of this research. 108 Table 9, below, applies proportional gender and race or ethnicity distributions to the estimated population of 767,000 adult obese persons in Mississippi and applies subgroup obesity related health care expenditure data from the Cawley and Meyerhoefer model. 109 As shown in Table 9, modeling obesity related health care expenditures for the state of Mississippi using the Cawley and Meyerhoefer methodology produces estimates that range from $1,643,607,756 to $1,868,694,292 for 3 rd party payers; these estimates are significantly higher than previously estimated for the state of Mississippi. As with all statistical models, Table 9: Obesity Related Health Costs in Mississippi using the Cawley and Meyerhoefer Model Mississippi Cost of Obesity based upon projected Obese Population of 767,000 Obese Population Per Capita Obesity Related Health Care Costs Per Capita Cost to 3rd Party Payers Total Obesity Related Health Care Costs Total Obesity Related Health Care Cost to 3rd Party Payers Total Obesity Related Health Care Cost Absorbed Out of Pocket o Total Population 767,000 $2,741 $2,418 $2,102,347,000 $1,854,606,000 $247,741,000 White 474,327 $2,729 $2,502 $1,294,439,139 $1,186,766,847 $107,672,292 Non White 292,673 $2,731 $2,330 $799,289,206 $681,927,444 $117,361,762 Total based upon Race/Ethnicity 767,000 N/A N/A $2,093,728,345 $1,868,694,292 $225,034,054 Male 366,681 $1,152 $967 $422,416,487 $354,580,506 $67,835,981 Female 400,319 $3,613 $3,220 $1,446,352,625 $1,289,027,250 $157,325,376 Total based upon Gender 767,000 N/A N/A $1,868,769,112 $1,643,607,756 $225,161, Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., and Dietz, W. (2009). At the Intersection of Health, Health Care and Policy. Health Affairs. 28(5): w822 w Cawley, J., and Meyerhoefer, C. (2012). The Medical Care Costs of Obesity: An Instrumental Variables Approach. Journal of Health Economics. 31: Ibid. 109 Ibid. 46

57 there are questions regarding the generalizability of the findings and the accuracy of the estimates; however, it is possible that even these extraordinarily high obesity related health care expenditure cost projections may underestimate the actual cost of obesity in the state of Mississippi because health care costs have escalated since Cawley and Meyerhoefer modeled costs using Medical Expenditure Panel Survey (MEPS) data for the period from , and because spending for over the counter medications are excluded from the model. Some research has modeled obesity related health care costs as a percentage of U.S. national health expenditures; a statistic widely quoted by multiple sources, including the Centers for Disease for Control and Prevention, is that 10 percent of U.S. national health expenditures are attributable to obesity from Finkelstein. 110 Other researchers have estimated that 9.1 percent 111 of total U.S. national health expenditures are obesity related, and in some research, this estimate is as high as 20.6 percent. 112 In 2009, total health expenditures in the state of Mississippi were $19,384,199,000 (Table 6, page 40). Assuming 10 percent of these expenditures were attributable to obesity related health care, obesity related health care expenditures in the state of Mississippi can be projected to be approximately $1,938,419,900 for all age groups; this amount would also include the cost of child obesity. As described in the previous paragraphs, the burden of obesity related health care costs in the state of Mississippi is significant regardless of the methodology used to calculate these costs. Within the framework of the anticipated growth in the cost of health care, future population growth, a shift from private insurance to public insurance and related enrollment increases in public health insurance programs, the burden of these increasing costs on the state of Mississippi portend ominous revenue shortfalls for publically funded insurance programs. These increasing obesity related health care costs will result in either a significant increase in the burden of these costs to taxpayers or a significant reduction in the ability of the state to provide services to its citizens. 110 Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., and Dietz, W. (2009). Annual Medical Spending Attributable to Obesity: Payerand Service Specific Estimates. Health Affairs. 28(5): w822 w Thorpe, K.E., (2009). National and State Estimates of the Impact of Obesity on Direct Health Care Expenses. A Collaborative Report from the United Health Foundation, the American Public Health Association and Partnership for Prevention. 112 Cawley, J., and Meyerhoefer, C. (2012). The Medical Care Costs of Obesity: An Instrumental Variables Approach. Journal of Health Economics. 31:

58 Figure 8: Comparative Physician Visits Figure 9: Comparative Hospitalization Rates Figure 10: Comparative Medical and Drug Expenditures 48

59 The Economic Cost of Childhood Obesity The obesity epidemic in the United States has severely impacted children. The national cost of childhood obesity is estimated to be approximately $11 billion for children with private insurance and $3.1 billion for children covered by Medicaid. Research has found that children from low income families who are least able to afford health care are disproportionately impacted by obesity; these are usually children who receive health care through Medicaid or State Children s Health Insurance Programs, or may have no health insurance coverage from any source. Obese children are two to three times more likely to have a hospital stay during a year than all children. Children from low income families who receive Medicaid are less likely to visit a doctor (Figure 8, page 48), and their condition may go undiagnosed and untreated until their health deteriorates to the point where more urgent (and costly) medical treatment is required; a similar situation exists for children who have no health insurance. 113 As a result, they are more likely to enter a hospital than children with private insurance (see Figure 9, page 48). A study conducted by Thomson Medstat found that the rate of children treated for diagnosed obesity that were covered by Medicaid was nearly six times higher than that of privately insured children who were treated for diagnosed obesity. 114 The health care cost of treating children diagnosed with obesity is approximately three times that of non obese children because obese children are more likely to be diagnosed with health conditions that require higher medical costs such as: diabetes, heart disease, bone, joint, and spinal disorders, gastroenteritis, hypertension, and mental disorders. The mean annual healthcare cost for obese children covered by Medicaid has been found to be $4,284 higher (see Figure 10, page 48) than the health care costs for non obese children covered by Medicaid and the mean annual health care cost for obese children covered by private insurance is $2,635 higher than the health care cost for non obese children. 115 Given the obstacles that children from lowincome backgrounds have in accessing the health care system, it is likely that obesity is underdiagnosed and under treated; therefore, the true cost of obesity related health care costs may be underestimated. Childhood obesity represents a major cost to private industry and to state or local government entities that provide health insurance to employees. Reports and surveys conducted by business groups 116, 117 have found that children and adolescent dependents account for approximately 18.5 percent of large employers health care costs (excluding dental care) and 113 Gresenz, C. R., Rogowski, J. and Escarce, J. J. (2006). Dimensions of the Local Health Care Environment and Use of Care by Uninsured Children in Rural and Urban Areas. Pediatrics (117(3): e509 e Marder, W. D., Chang, S.; Childhood Obesity: Costs, Treatment Patterns, Disparities in Care, and Prevalent Medical Conditions, 2005; Thomson Medstat Research Brief. 115 Ibid. 116 National Business Group on Health. Maternal and Child Health Benefits Survey. Washington, D.C.: National Business Group on Health; January Mercer Health and Benefits Consulting. National Survey of Employer Sponsored Health Plans: 2005 Survey Report. Mercer Health & Benefits Consulting:

60 that approximately 33 percent of the beneficiaries of large employers health care coverage are dependents under the age of 25. As demonstrated in the previous paragraphs, the health care related costs for obese children are significantly higher than for non obese children, with obese children visiting physicians at twice the rate of non obese children and having approximately three times the hospitalization rate as other children. Nationally, childhood obesity and overweight has been found to be associated with an additional $14.1 billion in annual health care costs (emergency room and outpatient visits, and additional prescription drug costs). 118 Studies have shown that obese children are absent from school more often than their normal weight peers; 119 working parents with sick children exhibit increased absenteeism, tardiness, and early departure from work either to care for a sick child at home, to pick up sick children from school, or to take their children to appointments with physicians. Because obese children visit physicians more frequently, have increased rates of hospitalization, and are absent from school more often, the high economic cost of childhood obesity manifests itself through increased costs to employers who provide health insurance to their employees families, through increased absenteeism, through the lost productivity of workers, and increased disruptions in the work place. Based upon data from the 2013 American Community Survey, there were 56,149 children under the age of 18 who had no health insurance in the state of Mississippi. The Kaiser Family Foundation estimates that there are 326,981 children under 18 in Mississippi that are covered under employers or private insurance and 331,981 children under 18 who are covered by Medicaid (or State Children s Health Insurance Programs). 120 Statistical data for childhood obesity is reported by multiple federal agencies; this data and reported obesity levels vary based upon source, age group, income, gender, and reporting time frame; for example, in Mississippi, 13.9 percent of low income children between the age of two to four were reported to be obese; percent of children in Mississippi between the age of 10 to 17 were reported to be obese (the highest in the nation); 122 and 15.4 percent of high school students were reported to be obese. 123 The Center for Mississippi Health Policy reported a prevalence of obesity of 22.0 percent for elementary school students, 27.3 percent for middle school students, and 23.5 percent for high school students in 2013; this study 118 Marder, W.D., Chang, S. (2006). Childhood Obesity: Costs, Treatment Patterns, Disparities in Care, and Prevalent Medical Conditions. Thomson Medstat Research Brief. 119 Geier, A.B., Foster, G.D., Womble, L.G., et al; The Relationship between Relative Weight and School Attendance among Elementary Schoolchildren, 2007; Obesity, 15 (8): Kaiser Family Foundation and Uninsured Estimates based on the U.S. Census Bureau s March 2014 Current Population Survey. 121 Centers for Disease Control and Prevention, Obesity among Low Income, Preschool Aged Children United States, Vital Signs, National Survey of Children s Health, Health Resources and Services Administration, Maternal and Child Health Bureau. 123 Youth Risk Behavior Survey 2013, Centers for Disease Control and Surveillance. 50

61 reported an obesity prevalence of 23.6 percent across all Mississippi students in kindergarten through 12 th grade. 124 There are no recent studies that have estimated the cost of child obesity in the state of Mississippi, and a study of these costs is beyond the scope of this report; however, an estimate of child obesity related health care costs is useful for purposes of examining the cost benefit of public policy interventions designed to address issues related to childhood obesity. The Stennis Institute developed an estimate of the cost of childhood obesity in the state of Mississippi using the generalized assumption that 10 percent of all children who received employer provided health insurance or were covered under Medicaid were obese; it was also assumed that 10 percent of all children who had no health insurance were obese. Given that an assumed obesity rate of 10 percent for all children is significantly lower than the estimated obesity rate across all age groups under the age of 18 in the state of Mississippi, a rate of 10 percent will yield very conservative estimates of the cost of child obesity to the state of Mississippi. There are three components to the cost of childhood obesity to the state of Mississippi: 1) the cost of child obesity to employers and private insurers; 2) the cost of childhood obesity associated with public health insurance programs (Medicaid/State Children s Health Insurance Programs (SCHIP); and 3) the individual out of pocket and/or unreimbursed cost of health care to physicians and hospitals associated with childhood obesity for those with no health insurance. With an annual cost of medical and drug expenditures of $3, per obese child covered by private health insurance, it is estimated that the total health care cost for obese children covered by private health insurance is $122,388,988 in the state of Mississippi. These costs are shared between the parent/guardian of the child, the employers, and the insurance providers and vary based upon the co payment and the level of the deductible associated with individual health care insurance policies; for example, a survey conducted by the Agency for Healthcare Research and Quality found that the average family deductible in the U.S. was $1,761. With an annual cost of medical and drug expenditures of $6,730 per obese child covered by Medicaid (or SCHIP), it is estimated that the total health care cost for obese children covered by public insurance in the state of Mississippi is $220,058,213. These costs are borne by taxpayers through the redistribution of income from federal and state sources; for example, in the state of Mississippi, the total cost of the State Children s Health Insurance Program was approximately $650 million over the period from June 2004 through June 2008; the federal government contributed about $505 million of this cost and the state of 124 Zhang, L.; Kolbo, J. R.; Kirkup, M.; Molaison, E. F.; Harbaugh, B. L.; Werle, N.; and Walker, E. (2014). Childhood Obesity Rates in Mississippi (Prevalence and Trends in Overweight and Obesity among Mississippi Public School Students, ). Journal of the Mississippi State Medical Association. 55(3): Marder, W. D., Chang, S. (2006). Childhood Obesity: Costs, Treatment Patterns, Disparities in Care, and Prevalent Medical Conditions, Thomson Medstat Research Brief. 51

62 Mississippi provided approximately $100 million as its share of total cost. 126 Based upon the assumption that 15 percent of the cost of child obesity related health care costs are borne by the state of Mississippi, it can be estimated that Mississippi spends approximately $33.9 million of its revenues from taxpayers annually to absorb the obesity related health care costs for children who receive health care coverage through Medicaid or through the State Children s Health Insurance Program. Although prior research has examined the annual health care costs for the uninsured obese and found the per capita cost of health care for uninsured adults was $3,271 compared to $512 for non obese uninsured adults, no reliable data is available for the health care cost for obese, uninsured children. There are approximately 56,149 uninsured children in the state of Mississippi; assuming that 10 percent of these children are obese, it can be estimated that the annual cost of health care for obese, uninsured children in the state of Mississippi falls within a range of $21.1 million to $37.8 million (these estimates are based upon the research conducted by Marder and Chang in 2005). 127 Theoretically, a one percent reduction in the obesity rate among Mississippi s children could result in a savings of approximately $35.1 million in annual obesity related health care costs. 126 Author s Note: These estimates do not integrate the currently undetermined impact of changes to public health insurance programs associated with the Patient Protection and Affordable Care Act of 2010 (Pub. L ). 127 Marder, W. D., Chang, S.; Childhood Obesity: Costs, Treatment Patterns, Disparities in Care, and Prevalent Medical Conditions, 2005; Thomson Medstat Research Brief. 52

63 Food Insecurity Food security is defined in the literature as existing when all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life. Food security relies upon three factors: 1) food access defined as having sufficient resources to obtain appropriate foods for a nutritious diet; 2) food availability defined as having sufficient quantities of food available on a consistent basis; and 3) food use which is based upon knowledge of basic nutrition. The U.S. Department of Agriculture (USDA) monitors the food security of U.S. households; the USDA defines food insecurity as limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways. Research has found that food insecurity is associated with household poverty, low educational attainment levels, minority status, female household status, disability, unemployment, and the relative price of food. 128, 129, 130, 131 Research has found that a one (1) percentage point increase in the unemployment rate is associated with an increase of 0.5 percentage points in the prevalence of food insecurity and that an increase of one (1) percent in the relative price of food (the ratio of food price to the price of all goods and services) is associated with a 0.6 percentage point increase in the prevalence of food insecurity. 132 Single parents with children have been found to be more likely to be food insecure than other households; single men with children were 3.18 percentage points more likely to be food insecure and single women with children were found to be 9.6 percentage points more likely to be food insecure than other households. 133 By definition, HFFI qualifying census tracts are tracts with no grocery stores or tracts that have only small grocery or convenience stores that carry a limited selection of nutritious food and where food items are more expensive than in larger grocery stores or supermarkets. 134, 135 Research has found that the type of store at which consumers purchase their food has an effect on food insecurity. One study found that for households living in HFFI census tracts with a lack of access to food retail, there is a 5.2 percent greater likelihood of household food insecurity Tapogna, J., Suter, A., Nord, M., and Leachman, M. (2004). Explaining Variations in State Hunger Rates. Family Economics and Nutrition Review. 16(2): Zhang, Q., Jones, S., Ruhm, C. J., and Andrews, M. (2013). Higher Food Prices May Threaten Food Security Status Among American Low Income Households with Children. Journal of Nutrition. 143(10): Nord, M., Andrews, M. and Carlson, S., (2009). Household Food Security in the United States, Measuring Food Security. USDA, Economic Research Service. Economic Research Report Number Bartfeld, J., Dunifon, R., Nord, M., and Carlson, S. (2006). What Factors Account for State to State Differences in Food Security? Economic Information Bulletin No. 20. U.S. Department of Agriculture, Economic Research Service. 132 Nord, M., Coleman Jensen, A., and Gregory, C. (2014). Prevalence of U.S. Food Insecurity is related to Changes in Unemployment, Inflation, and the Price of Food. U.S. Department of Agriculture, Economic Research Service, ERR Ibid. 134 Bitto, E., Morton, L., Oakland, M., and Sand, M. (2003). Grocery Store Access Patterns in Rural Food Deserts. Journal for the Study of Food and Society. 6: Guy, C. M., and David, G. (2004). Measuring Physical Access to healthy foods in Areas of Social Deprivations: A Case Study in Cardiff. International Journal of Consumer Studies. 28: Rice, K. (2010). Measuring the Likelihood of Food Insecurity in Ohio s Food Deserts. Journal of Food Distribution Research, 41(1):

64 Figure 11: Dietary Consumption Patterns of High School Students 2012 Source: Centers for Disease Control, Youth Risk Behavior Survey

65 Although there is no reliable, comparable data for food insecurity rates at the census tract level, the high poverty rates, low educational attainment levels, high unemployment rates, low incomes, and the relatively high percentage of single female households with children that were found in HFFI qualifying census tracts in the state of Mississippi and discussed in subsequent sections of this report indicate support for the assumption that the food insecurity levels that are reported in the following paragraphs for the state of Mississippi are likely to be more severe within qualifying HFFI census tracts within the state of Mississippi. In 2011, approximately 16.4 percent of the U.S. population experienced food insecurity; in 2012, 15.9 percent of the U.S. population was food insecure. 137 Across the United States, the average county level food insecurity rate was 14.7 in 2011 and in In Mississippi, the overall food insecurity rate was 22.3 percent in 2012; Mississippi had the highest overall food insecurity rate in the nation in Child food insecurity rates are substantially higher than the food insecurity rate for all age groups. In the U.S., the child food insecurity rate was 21.6 percent in In 2012, the state level of child food insecurity rate ranged from a low of 10.6 percent in North Dakota to a high of 29.2 percent in New Mexico. Mississippi had the second highest level of child food insecurity in the U.S.; with 28.7 percent of Mississippi s children being food insecure, it is estimated that approximately 214,720 children in Mississippi are food insecure. 140 Food Insecurity and Health Studies have found that food insecurity is associated with multiple health problems in children, adults, and the elderly. Food insecurity is associated with a range of chronic illnesses such as hypertension, hyperlipidemia, and various cardiovascular risk factors. 141 Food insecure adults have a higher risk for developing diabetes. 142, 143 The presence of food insecurity may be associated with increased weight because less expensive food choices are frequently high in calories and low in nutrition and households with constrained incomes have less money to spend on healthy foods that may be more costly. 144, 145 Although food insecurity may have 137 Coleman Jensen, A., Nord, M. and Singh, A. (2013) Household Food Security in the United States in U.S. Department of Agriculture Economic Research Service. 138 Ibid. 139 Ibid. 140 Ibid. 141 Seligman, H. K., Laraia, B. A., and Kushel, M. B. (2010). Food Insecurity is associated with Chronic Disease among Low Income NHANES Participants. The Journal of Nutrition. 140(2): Gucciardi, E., Vahabi, M., Norris, N., Del Monte, J. P., and Farnum, C., (2014). The Intersection between Food Insecurity and Diabetes: A Review. Current Nutrition Reports. 3(4): Seligman, H. K., Jacobs, E. A., Lopez, A., Tschann, J., and Fernandez, A., (2012). Food Insecurity and Glycemic Control among Low Income Patients with Type 2 Diabetes. Diabetes Care. 35(2): Drewnoski, A. and Specter, S. E. (2004). Poverty and Obesity: The Role of Energy Density and Energy Costs. American Journal of Clinical Nutrition. 79(1): Ludwig, D. S. and Pollack, H. A. (2009). Obesity and the Economy: From Crisis to Opportunity. Journal of the American Medical Association. 301(5):

66 negative impacts on individuals of any age, it has been found to be extremely devastating for children. Brain development and cognitive functioning during early childhood can be severely affected by food insecurity; inadequate nutrition can permanently alter a child s cognitive development, impact their intellectual capacity, and affect their future learning. 146, 147 Children who are food insecure may be at higher risk for chronic health conditions, such as anemia or asthma, and are more likely to require hospitalization; food insecurity among children is associated with a poor physical quality of life, which may prevent them from being fully engaged in activities at school and in social interaction with their peers. 148 Children who are food insecure may be at greater risk for increased absenteeism from school and experience an array of behavioral problems which include mood swings, aggression, anxiety, and hyperactivity. 149 The lack of access to affordable nutritious food is of particular concern for families with children, and specifically for female headed households with children and no husband present. Households headed by single mothers have been found to have the highest rates of child food insecurity, 150 with access to adequate food limited by their households lack of money and access to affordable nutritious food; food insecurity represents a serious risk to the health of children in female headed households with no husband present 151 and contributes to negative academic and psychological outcomes in older children and adolescents. 152, 153 Studies have also found that the time cost of travel to a grocery store and the time involved to prepare nutritious food for healthy eating are a particular issue for mothers who worked full time and for single mothers; as mothers spend more time working outside the home, food preparation time declines; single women with children spend less time preparing food than married women. 154 In census tracts with a large percentage of individuals over the age of 65 living alone, there is a concern that transportation may represent a particular problem for these individuals. Aging 146 Winicki, J. and Jemison, K. (2003). Food Insecurity and Hunger in the Kindergarten Classroom: Its Effect on Learning and Growth. Contemporary Economic Policy, 21(2): Casey, P. H, Szeto, K., Lensing, S. (2001). Children in Food Insufficient, Low Income Families: Prevalence, Health, and Nutrition Status. Archives of Pediatrics and Adolescent Medicine. 155(4): Cook, J.T., Frank. D. A., Berkowitz, C. (2004). Food Insecurity Is Associated with Adverse Health Outcomes among Human Infants and Toddlers. Journal of Nutrition. 134(6): Alaimo, K., Olson, C. M., and Frongillo, E. A. (2001). Food Insufficiency and American School Aged Children s Cognitive, Academic, and Psychosocial Development. Pediatrics. 108(1): Coleman Jensen, A., Nord, M., Singh, A.S. (2013) Household Food Insecurity in the United States in U.S. Department of Agriculture, Economic Research Service, Rose Jacobs, R., Black. M. M., Casey, P.H., et al. (2008). Household Food Insecurity: Associations with At risk Infant and Toddler Development. Pediatrics. 121(1): Alaimo, K., Olson, C.M., Frongillo, E.A. Jr. (2001). Food Insufficiency and American School aged Children s Cognitive, Academic, and Psychosocial Development. Pediatrics. 108(1): Jyoti, D.F., Frongillo, E.A., Jones, S.J., (2005). Food Insecurity Affects School Children s Academic Performance, Weight Gain, and Social Skills. Journal of Nutrition. 135(12): Mancino, L., and C. Newman (2007). Who has Time to Cook? How Family Resources Influence Food Preparation. U.S. Department of Agriculture, Economic Research Service, Economic Research Report No

67 populations exhibit lower mobility, isolation, and lower access to food stores; older persons are more likely to be dependent on family, friends, neighbors, or non profit organizations to gain access to food. 155 Research on access to affordable and nutritious food identifies subpopulations that may be highly vulnerable to access barriers; households with no or limited vehicle access and individuals over the age of 65 are considered to be particularly vulnerable to barriers to access to affordable, nutritious foods. 156 Although living in an underserved community may not be the primary cause of food insecurity, the lack of access to affordable, nutritious food frames the conditions under which households must expend greater resources to obtain food from available sources. Lack of access to affordable, nutritious food retail has been shown to increase the likelihood of food insecurity. 157 Research has linked high poverty, low income, and low educational achievement levels to food insecurity and to the probability of living in an area with limited access to affordable, healthy foods. 158 Income and education have been found to be negatively correlated with food insecurity; 159 as educational attainment and income increase, food insecurity decreases. Geographic areas with limited access to affordable, healthy foods have predominantly been found to be home to socioeconomically disadvantaged people relative to other areas; 160 lower income levels indicate that residents in underserved communities have fewer resources available to purchase healthy foods. High poverty and low income walk handin hand with low educational levels; lower education levels may also imply less knowledge about the health effects of poor nutrition. 161 A review of the research on areas with limited access to affordable, healthy foods in the United States generally supports the statement that underserved communities are places where area level deprivation compounds individual disadvantage Bitto, E., Morton, L. Oakland, M. and Sand, M. (2003). Grocery Store Access Patterns in Food Deserts. Journal for the Study of Food and Society, 6(2), V. Breneman, et. al. (2009). Report to Congress: Access to Affordable and Nutritious Food, Measuring and Understanding Food Deserts and Their Consequences. U.S. Department of Agriculture, Economic Research Service, Economic Research Report. 157 Nord, M., Andrews, M., and Carlson, S. (2008). Household Food Security in the United States. U.S. Department of Agriculture, Economic Research Service. Report No Wild, P., Liobrera, J., and Ver Ploeg, M. (2014). Population Density, Poverty, and Food Retail Access in the United States: An Empirical Approach. International Food & Agribusiness Management Review. 17: Rice, K. (2010). Measuring the Likelihood of Food Insecurity in Ohio s Food Deserts. Journal of Food Distribution Research. 41(1): Beaulac, J., Kristjansson, E., Cummins, S. (2009). A Systematic Review of Food Deserts: 1996 to Centers for Disease Control, Preventing Chronic Disease, Public Health Research, Practice, and Policy: 6(3): Dutko, P. (2012). Food Deserts Suffer Persistent Socioeconomic Disadvantages. Choices: The Magazine of Food, Farm, and Resources. 27(3): Beaulac, J., Kristjansson, E., Cummins, S. (2009). A Systematic Review of Food Deserts: 1996 to Centers for Disease Control, Preventing Chronic Disease, Public Health Research, Practice, and Policy: 6(3):

68 Policies and Intervention Strategies in Underserved Communities Individuals living in underserved communities frequently do not have access to affordable, nutritious and healthy food. This lack of access has been associated with diet related health problems, obesity, and obesity related morbidities or mortality. The focus on making affordable, nutritious, and healthy food available within a community has resulted in the development of multiple federal strategic policies that are designed to increase access to affordable and healthy food, and to provide sustainable food delivery options within areas defined as HFFI qualifying census tracts by the federal government. There are multiple factors that impact food purchasing and dietary behavior patterns regarding the consumption of fresh fruits and vegetables; availability and consumer choice will impact consumption and diet. Investments in underserved communities that are designed to make affordable, nutritious food available may need to be supplemented with education and marketing programs that facilitate healthy eating behavioral changes. One focus of this study is to examine potential policy interventions that are designed to create, expand, or preserve access to fresh food retail options in Mississippi s underserved communities. Multiple states have capitalized healthy food retail initiatives to attract investment into underserved communities, these initiatives use strategies that involve state and city governments, private funders, and economic development intermediaries to create a dedicated source of funding to provide financing and grants to incentivize investments in fresh food retail options within underserved communities. The majority of these state healthy food financing initiatives are designed to leverage state investments with Federal funding available through the Healthy Food Financing Initiative; as a result, these programs frequently leverage Federal New Market Tax Credits with additional sources of state funding and are structured as Certified Community Development Financial Institutions (CDFIs) and or Community Development Entities (CDEs) to qualify for Federal New Market Tax Credits and/or to qualify for state level equivalents of New Market Tax Credits. The creation of a properly structured state healthy food retail initiative will enable multiple sources of funding to be leveraged for investments in underserved communities; these sources of funding include, but are not limited to: U.S. Department of the Treasury, Community Development Financial Institutions Fund (CDFI) programs that provide Financial Assistance awards for financing capital, loan loss reserves, capital reserves, and operations; CDFI programs that provide Technical Assistance grant funds for personnel (salary and fringe benefits), training travel, professional services, materials or supplies, equipment, and other service delivery related costs to Certified CDFIs; and the CDFI New Market Tax Credit Program. U.S. Department of Agriculture grant programs, to include the Community Food Projects Grant Program, the Value Added Producer Grant Program, the Farmers Market Promotion Program, the Federal State Marketing Improvement Program, the Rural Micro entrepreneur Assistance Program (grants and loans), the Rural Business Enterprise Grant Program, the 58

69 Rural Business Opportunity Grant Program, the Rural Cooperative Development Grant Program, the Beginning Farmer and Rancher Development Program, the Healthy Urban Food Enterprise Development Center Grant Program, the Hunger Free Communities Program, the Small and Socially Disadvantaged Producer Grant Program, the Outreach and Assistance for Socially Disadvantaged Farmers and Ranchers Grant Program, and the Sustainable Community Innovation Grants Program U.S. Department of Agriculture loan programs, to include the Rural Development Business and Industry Guaranteed Loan Program, the Guaranteed Farm Loan Program, the Community Facilities Program (also has some grants available), the Interest Assistance Program, and the Rural Development Intermediary Relending Program U.S. Department of Commerce grant programs, to include the Economic Development Technical Assistance Program and the Community Economic Development (CED) Program U.S. Department of Health and Human Services grant programs, to include the Community Economic Development Program and the Community Transformation Grant Program U.S. Department of Housing and Urban Development programs, to include the Community Development Block Grant Program, the Rural Innovation Fund (grants), and the Section 108 Loan Guarantee Program U.S. Small Business Administration programs, to include the CDC/504 Loan Program, the Community Advantage 7(A) Loan Program, and the Microloan Program Bank grants, investments, or loans; examples include the Bank of America s investment in the Pennsylvania Fresh Food Financing Initiative, Goldman Sachs $40 million commitment of grants and loans to the New York Healthy Foods & Healthy Communities Fund, JP Morgan Chase s $100 million commitment to CDFIs including the Pennsylvania Fresh Food Financing Initiative; and Wells Fargo s provision of grants and loans to the Pennsylvania Fresh Food Financing Initiative for an undisclosed amount Funds borrowed from a bank for re lending Private philanthropic Program Related Investments (PRIs); examples include the Kresge Foundation, the Mary Reynolds Babcock Foundation, the Rockefeller Foundation, and the W. K. Kellogg Foundation the majority of these PRIs have been associated with grants to CDFIs or CDEs Examples of healthy food financing initiatives that have been established by states include: The California FreshWorks Fund (CAFWF), which is a $200 million fund created to finance grocery stores and other forms of fresh food retail and distribution. CAFWF is a publicprivate partnership fund that provides a combination of grant and loan financing. The Program Administrator for this fund is NCB Capital Impact, a non profit community development organization; the California Endowment (a private, statewide health foundation) has committed up to a $30 million mission related investment for debt and $3 million for grants. Other investors include the California Grocers Association, the Calvert 59

70 Foundation, the Kellogg Foundation, the Bank of America, JP Morgan Chase, Kaiser Permanente, and Morgan Stanley. On July 20, 2011, the creation of CAFWF was announced during a ceremony at the White House in Washington, D.C. The FreshWorks Fund provides loans of up to $8 million to finance projects that create or expand healthy food retail in low access areas; these investments include: Capital investments for building or land acquisition, new construction or expansion, or tenant improvements based on leasehold collateral value Equipment loans for new equipment (up to 100 percent of cost) and for used equipment (up to 60 percent of appraised value) Working capital for inventory (up to 35 percent of gross value) and other working capital based on demonstrated need, ability to repay, and available collateral FreshWorks provides grants from $25,000 to $50,000 for projects with demonstrated need to support priority areas; these include: Innovation projects that demonstrate a high potential to increase food access, innovations in product placement and merchandizing, and write down costs for projects that are otherwise not feasible Workforce development and local hiring programs that may include outreach, recruitment, employee training, and hiring activities associated with local hiring Predevelopment grants for the early costs of capital projects such as market studies or appraisals; some predevelopment grants may be recovered from projects that successfully obtain permanent financing The Calvert Social Investment Foundation is a 501(c) (3) nonprofit organization that offers a Community Investment Note that enables investors (individuals, businesses, and other nonprofits) to make investments in the California FreshWorks Fund Initiative. The most recently available information on the CAFWF that was available at the time of this study indicated that the fund had deployed $19 million in capital to support the following projects: The Northgate Gonzalez Market in San Diego, a 42,625 square foot full service grocery store that created 122 new jobs within the community. The California FreshWorks Fund, LLC. provided $8.5 million in New Market Tax Credit financing for tenant improvements and related costs. The Northgate Gonzalez Market in Inglewood, a renovation of a 20,000 square foot full service grocery store that created 110 new jobs within the community; this investment included $7.6 million in New Market Tax Credit Financing The Mandela Marketplace in West Oakland, a 2,000 square foot neighborhood market with 8 employees. The California FreshWorks Fund, LLC. provided a grant of 60

71 $50,000 to support a comprehensive business analysis of the operations and potential for expansion of the market. The El Rancho Marketplace in Pismo Beach, a 39,498 square foot full service grocery store that created 175 new jobs within the community. The California FreshWorks Fund, LLC provided flexible financing in the amount of $1.7 million to purchase equipment and inventory for a $3.6 million loan for the renovation of an empty grocery store Provided a $105,000 grant to the Certified Growing Experience Farmers Market in North Long Beach Provided a $5,000 grant to the 25 th Street Collective and Oakland Food Policy Council and a $50,000 grant to the Moreno Family Service Association to support the development of pilot projects for a mobile food vending program The H. P. Palomino Grocery Store in Huntington Park, a 6,000 square foot neighborhood superette. The California FreshWorks Fund, LLC provided $651,840 in financing and $15,500 in grants to finance equipment and tenant improvements for the project. Numero Uno Markets in South Los Angeles received $12 million in financing from The California FreshWorks Fund, LLC. to restructure the company s debt, improve its cash flow, and allow it to invest in upgrades and expansion. As part of its agreement with California FreshWorks, Numero Uno discontinued the sale of tobacco, installed at least one junk food free checkout aisle per store, and holds regular health and wellness fairs at each of its eight stores. Pending projects include a commitment of $4.6 million in term financing for the acquisition, construction, equipment, and working capital costs for a 14,000 square foot full service supermarket (Supermercado Murphy s in Bonita) and a $1.2 million commitment in term financing for construction and permanent financing for a new 15,400 square foot full service supermarket (El Toro Loco Market in Lost Hills). The New Orleans Fresh Food Retailer Initiative (FFRI) provides direct financial assistance to retail supermarkets, grocery stores, and other fresh food retailers; it is a partnership between the Food Trust (which co manages the Pennsylvania Fresh Food Financing Initiative) and the Hope Enterprise Corporation. The City of New Orleans approved $7 million of its Disaster Community Development Block Grant funds to implement the program in 2009; in response to a Request for Proposals issued by the City of New Orleans, the Food Trust and Hope Enterprise Corporation were selected to administer the program in April During the transition from the Nagin Administration to the Landrieu Administration, the formation of the Initiative was delayed; after additional contract negotiations between the Landrieu Administration, the Food Trust, and the Hope Enterprise Corporation, the New Orleans Fresh Food Retailer Initiative was formally completed and 61

72 announced in March Under the terms of the agreement, the City of New Orleans $7 million investment is matched dollar for dollar by Hope Enterprise Corporation, creating a $14 million investment fund. In 2013, the New Orleans Fresh Food Retailer Initiative received the Robert Wood Johnson Foundation s Culture of Health Prize, which is awarded to outstanding community partnerships that are helping people live healthier lives. The New Orleans Fresh Food Retailer Initiative (FFRI) provides forgivable and interestbearing loans to support grocery development; eligible activities include: pre development, site assembly and improvement, construction and rehabilitation, equipment installation and upgrades, staff training, security, start up inventory, and working capital. The total amount of CDBG FFRI funding awarded per store may not exceed $1 million, of which the total portion of forgivable loans may not exceed $500,000; additional funding may be provided in the form of market rate, interest bearing loans from private lenders or New Market Tax Credits. Projects funded through the program must dedicate significant shelf space to the sale of fresh fruit and vegetables, defined as 15 percent of the current or future store shelf space or 24 linear feet of shelf space, whichever is greater. Projects funded by the New Orleans Fresh Food Retailer Initiative include: Whole Foods on Broad Street in Mid City which is a 25,000 square foot element of an $18.1 million mixed use development project located at the site of a 60,000 square foot abandoned Schwegmann s supermarket. The project received a $1 million FFRI loan, of which $500,000 is forgivable; the New Orleans Redevelopment Authority also awarded $900,000 in grant funding to the project and additional funding was derived through New Market Tax Credits, Goldman Sachs, and JPMorgan Chase. Additional elements of the project include a Liberty s Kitchen (a full service café and commercial teaching kitchen that provides culinary and life skills training for at risk youth and healthy school meals for public school children) and Tulane University s Goldring Center for Culinary Medicine that is a teaching kitchen for community members, medical students, and practicing medical professionals. The facility will also provide indoor and outdoor space for programs that promote health, wellness, gardening, fitness, and other educational programs. Circle Food Store in the Seventh Ward is a $9.2 million project designed to reopen the store which was damaged during Hurricane Katrina and remained closed through August The project received a $1 million FFRI loan, of which $500,000 is forgivable, and an additional $100,000 grant from the City of New Orleans Economic Development Fund. Aerend s Supermarket on Washington Avenue received $120,000 from FFRI to expand its footprint (from 10,000 to 18,000 square feet) and to purchase new equipment. 62

73 DaFresh Seafood and Produce in Central City is a 1,000 square foot store; it received a $117,000 loan from FFRI, of which $17,550 was forgivable if the store remained open for a five year period. As of December 16, 2013, the store was closed. The Pennsylvania Fresh Food Financing Initiative (PAFFI). The Pennsylvania Fresh Food Financing Initiative is managed by The Reinvestment Fund (TRF), a CDFI established in partnership with the Food Trust, the Greater Philadelphia Urban Affairs Coalition, and the state of Pennsylvania. PAFFI was created in 2004 with an initial investment of $10 million from the Pennsylvania Legislature; the state provided an additional investment of $10 million in 2005 and $10 million in 2006 for a total state investment of $30 million. Over the period from 2004 through 2012, this initial investment of $30 million helped to leverage total investments of $190 million in 88 new or improved grocery stores and fresh food projects in the state of Pennsylvania. PAFFI makes grants and loans to create new grocery stores and to expand existing stores; it funds acquisitions, rehabilitations, major expansions, and equipment for local grocery store operations, to include new and updated display cases and equipment upgrades that enable stores to either expand the amount of product carried and/or to carry new lines of product. PAFFI uses a combination of state funding and partnerships with banks (i.e. JP Morgan Chase) to provide debt capital, funding from philanthropies, and has New Market Tax Credit allocations from the CDFI fund at the U.S. Treasury. The PAFFI model has been used by multiple states to create health food financing initiatives; its model offers grants and loans with the following components: Generally, all projects must be within qualifying HFFI census tracts as defined by the federal government, with some very limited exceptions Two types of grants are available: 1) standard grants provide up to $250,000 per store and $750,000 total for a supermarket operator with multiple stores, and 2) extraordinary grants of up to $1 million may be available for projects that show a high potential to address the lack of fresh food outlets in very low income communities, create a significant number of high quality jobs, or maximize debt and equity financing potential in a manner that demonstrates the efficient use of grant resources Grant funds may be used for pre development costs including project feasibility, market studies, appraisals, and deposits on land and buildings; land assembly and capital for relocation, demolition, environmental remediation, infrastructure improvements, and energy efficiency investments; soft costs and other preopening costs for training, security, and other preopening expenses; and construction, builder overhead, labor, materials, and contingencies funds. PAFFI uses bank syndicated loan funds that combine loan capital from various banks (i.e. JP Morgan Chase) and credit enhancements provided by the Commonwealth of Pennsylvania. The fund provides five year and seven year loan products to finance 63

74 acquisition, construction, renovation, leasehold improvements, and equipment. TRF s Core Loan Fund can provide loans for projects that do not fit the parameters of its bank syndicated loan fund; investments by TRF s Core Loan Fund are mission driven capital sourced from individuals, non profit, and other institutional investors (PRIs). TRF, the managing partner for PAFFI, uses federal New Market Tax Credits (NMTCs) to finance projects. TRF is a major recipient of NMTCs, having received approximately $280 million in NMTC allocations, of which approximately 25 percent have been used to finance healthy food financing initiative related activities. Examples of projects funded through the Pennsylvania Fresh Food Financing Initiative include: Boyer s Family Market, a 17 store chain of supermarkets with stores that range in size from 9,500 square feet to 32,000 square feet. Boyer s received PAFFI funding of $2.75 million in bank syndicated loans, $1 million in Energy funds, and a $500,000 grant; funds were used to purchase energy efficient supermarket equipment, furniture and fixtures, leasehold improvements, and to provide employee training. ShopRite in Philadelphia received $5 million in NMTC financing and $250,000 in grant funding for construction and renovation of a 57,000 square foot supermarket and to provide workforce development training. According to a report by the U.S. Treasury s CDFI, 163 projects funded by PAFFI in urban census tracts range from 17,000 to 69,000 square feet, full service supermarkets employ approximately 150 to 200 full and part time employees, and have average weekly sales of between $200,000 and $500,000. Projects funded in rural census tracts range from 12,000 to 22,000 square feet, have between 10 to 84 full and part time employees, and are predominantly family owned businesses. As demonstrated in the previous paragraphs, the development of programs designed to improve access to fresh, healthy food in an underserved community may take different forms and the food retailing format will need to be appropriate to the needs of the market within the community. The most common business retail formats used to increase access to healthy food within underserved communities are investments in supermarkets, grocery stores, farmers markets, food cooperatives, or food hubs. The economic, market, and consumer profiles of a community will require appropriately designed retail formats, and each retail format will have unique capital requirements, different sources of capital investment, and may use different investment structures. For example, healthy food financing models may use a combination of 163 Healthy Food Retail Financing at Work: Pennsylvania Fresh Food Financing Initiative, Financing Healthy Food Options: Implementation Handbook. The U. S. Treasury, CDFI Fund, Capacity Building Initiative. 64

75 grant funding, debt capital, loan guarantees, tax exempt bond financing, and New Market Tax Credits to fund investments in underserved communities. A healthy food retail strategy may focus on farmers markets; this strategy might include supporting the creation of new farmers markets in underserved communities, increasing the capacity of existing farmers markets by providing refrigeration equipment that would expand the types of products available (i.e. eggs, poultry, pork, beef, or lamb), providing more permanent structures to enable the farmers market to increase either the scope of product offerings or its frequency of services, or assuring that all farmers markets are able to accept SNAP payments each strategy would require different levels of investment, and in the case of farmer s markets or food hubs, additional sources of capital may available from grants or low interest loans from the U.S. Department of Agriculture. Alternatively, a healthy food financing program may invest in the construction of new grocery stores or the expansion of existing stores; the construction of new stores will have completely different investment requirements when compared to the investment that would be required to increase the refrigeration capacity of an existing store to enable it to increase its offerings of fresh fruits and vegetables. In more rural areas, strategies may need to be developed that create one stop shopping retail facilities that co locate multiple services in order to increase foot traffic and to create sufficient demand or to make the delivery of retail combined with services more cost effective. One example of this approach is ShopRite in Philadelphia, Pennsylvania that has built stores within underserved communities that provide affordable, nutritious food combined with banking services, health clinics, and family nutrition and counseling services. Value Added Agriculture There may be multiple opportunities to integrate value added agriculture activities with strategies designed to address issues associated with the lack of access to affordable, healthy food within Mississippi s underserved communities. Value added agricultural businesses include activities engaged in by agricultural producers that increase revenues as a result of: (1) engaging in a new activity that has not previously been performed or (2) engaging in an activity that has traditionally been performed at another stage in the supply chain (i.e. direct marketing of agricultural products to individuals or restaurants) these two approaches to value added agriculture are not mutually exclusive and are frequently practiced concurrently. Engaging in new activities that have not previously been performed generates new revenues from new sources for agricultural producers; engaging in activities that have traditionally been performed at another stage in the supply chain enables agricultural producers to command higher prices for commodities, but does not necessarily create increased cost to consumers and may create an opportunity to lower the cost of fresh fruits, vegetables, and other agricultural products (i.e. farmers markets) as compared to traditional supermarket pricing structures. The U.S. Department of Agriculture defines value added agricultural products as: a change in the physical state or manner in which the agricultural commodity or product is produced and 65

76 segregated that results in the expansion of the customer base for the commodity or product and enables a greater portion of revenue to be derived by the producer from the marketing, processing or physical segregation of the commodity or product. Examples of value added agricultural products include: The production of a product in a manner that enhances its value, such as organically produced products, free range livestock or poultry, or foods produced for specific ethnic markets (i.e. Kosher or Halal certified products) A change in the physical state or form of the product, such as making fruits into jams, jellies, and wines, or milling wheat into flour Direct sales of agricultural products to individuals or retail outlets, such as the production of milk, cheese, and soaps from goats or direct sales of pork, beef, or lamb to individuals, restaurants, local grocery stores, and other institutions (local school districts and hospitals) The physical segregation of an agricultural commodity or product in a manner that results in the enhancement of the value of that commodity or product, such as an identity preserved marketing system that enables consumers to trace food back to where it came from and how it was produced Agricultural producers have faced a long term trend of increasing farm production expenses, a widening farm retail spread (the difference between the prices agricultural producers receive and the retail price consumers pay), and declining net real farm income. For many agricultural producers, engaging in value added activities can increase their share of the retail prices that consumers pay for agricultural products, increase income, and make a significant contribution to the sustainability of agricultural production. While value added agricultural practices may offer opportunities to increase net farm income, these endeavors are not without risk; as with starting any new business, a careful assessment must be made to determine the feasibility of starting a new enterprise, and many agricultural producers may need technical assistance to develop the skills required to enter into value added agricultural activities and they may require continued support during the early years of operations. In addition, the capital investment in the facilities or equipment that is required to engage in value added agricultural production and/or direct to consumer sales may be a significant barrier to market entry. Direct marketing and value added activities require a change of focus for agricultural producers and the acquisition of knowledge about a range of business skills related to starting and operating an entrepreneurial business; these skills include, but are not limited to: Market research Concept assessment, feasibility analysis, and business development Creating a business plan 66

77 Defining target markets and developing a marketing plan to reach that market which may require skills in communication, creativity, writing, advertising, direct selling, branding, electronic commerce, promotion, publicity, and public relations Product development Management and time management Personnel management Finance and budgets Risk Management Networking Pricing Food safety and regulatory compliance The Local Food Movement In May 2010, the U.S. Department of Agriculture published a report Local Food Systems: Concepts, Impacts, and Issues; 164 this report provides a comprehensive review of food systems in the United States, including alternative ways to define local food, estimates of market size, and descriptions of local food consumers and producers; the report also provides preliminary estimates of the economic and health impact of the local food movement. The information presented in the following six paragraphs is sourced from this USDA report. In general, local food is defined as food that is grown and harvested close to consumers homes, then distributed over much shorter distances than is common in the conventional global industrial food system. Federal law defines local as within 400 miles or inside a state, whichever is less. A locavore is defined by the New Oxford American Dictionary as a resident who tries to eat food produced within a 100 mile radius of their residence. The source of the food and the story behind the food is an influential identifier associated with the local food movement. For example, most Farm to Table programs provide the name, location, and an expansive description of the farms and farming practices used by farmers and the personality, ethics, or family traditions of the farmers that grow and provide products for sale through Farm to Table programs these identifiers all contribute to the provenance of local foods. Local food distribution networks include two primary markets: the direct to consumer market and the direct to retail/foodservice market. The direct to consumer market involves transactions that are conducted directly between the farmer and the consumer; examples include: farmers markets, community supported agriculture (CSAs), food hubs, on farm sales, and farm stands. Direct to retail/foodservice markets provide farm products directly to retail, foodservice, and institutions; these transactions may involve direct transactions between the 164 Martinez, Steve; Hand, Michael; Da Pra, Michelle; Pollack, Susan; Ralston, Katherine; Smith, Travis; Vogel, Stephen; Clark, Shellye; Lohr, Luanne; Low, Sarah; and Newman, Constance (May, 2010). Local Food Systems: Concepts, Impacts, and Issues. United States Department of Agriculture, Economic Research Report Number

78 producer and the business purchasing the agricultural output of a single farmer or may be supported through value added food centers, food hubs, or organized Farm to Table programs. These programs eliminate the middlemen involved in storing, processing, and/or transporting food destined for grocery and other retail stores, restaurants, schools, hospitals, and other institutions. Food hubs are centralized locations where farmers drop off their farm products for distribution to multiple establishments. The 2010 USDA report found that local food markets account for a small but increasing share of total U.S. agricultural sales. The 2007 Census of Agriculture indicated that 136,817 farms (6.2 percent of all farms) in the United States engaged in direct to consumer marketing, which accounted for $1.2 billion of sales as compared to $551 million in 1997; this represented 0.4 percent of total agricultural sales in 2007 as compared to 0.3 percent in 1997 according to the report. 165 Based upon research by the Stennis Institute using more recent data from the 2012 Census of Agriculture, the percentage of farms engaged in direct to consumer marketing was lower in the state of Mississippi than in the U.S. and the percentage of direct to consumer sales accounted for a lower percentage of total agricultural sales in Mississippi as compared to the U.S. Table 10: Direct to Consumer Sales in the U.S. and Mississippi 2007 and 2012 United States Mississippi Number of Farms 2,109,303 2,204,792 38,076 41,959 Total Market Value of All Agricultural Products (expressed in $1,000 of dollars) $394,644,481 $297,220,481 $6,441,025 $4,876,781 Average Market Value of All Ag Products per Farm $187,097 $134,807 $169,162 $116,227 Agricultural Products Sold Directly to Individuals for Human Consumption Number of Farms 144, ,817 1,206 1,229 Total Sales (expressed in $1,000 of dollars) $1,309,827 $1,211,270 $4,284 $9,659 Average per farm $9,063 $8,853 $3,552 $7,859 Percent of all Farms 6.85% 6.21% 3.17% 2.93% Percent of Total Sales 0.33% 0.41% 0.07% 0.20% Source: U.S.D.A and 2012 Census of Agriculture Barriers to local food market entry and expansion include: capacity constraints for small farms and lack of distribution systems for moving local food into mainstream markets; limited 165 Martinez, Steve; Hand, Michael; Da Pra, Michelle; Pollack, Susan; Ralston, Katherine; Smith, Travis; Vogel, Stephen; Clark, Shellye; Lohr, Luanne; Low, Sarah; and Newman, Constance (May, 2010). Local Food Systems: Concepts, Impacts, and Issues. United States Department of Agriculture, Economic Research Report Number

79 research, education, and training for marketing local food, and uncertainties related to regulations that may affect local food production, such as food safety requirements. Federal, state, and local government programs increasingly support local food systems and the number of these programs is growing. Federal policies and programs include the Community Food Project Grants Program, the WIC Farmers Market Nutrition Program, Senior Farmers Market Nutrition Program, Federal State Marketing Improvement Program, National Farmers Market Promotion Program, Specialty Crop Block Grant Program, Local Food Promotion Program, and the USDA Community Facilities Program. The 2010 USDA report also found that the number of farmers markets rose to 5,274 in 2009, up from 2,756 in 1998, and that in 2005, there were 1,144 community supported agriculture organizations (CSAs) in operation, up from 400 in More recent data from the USDA s Agricultural Marketing Service indicates that there were 8,144 farmers markets in the U.S. in 2013, an increase of 3.6 percent from 2012 to The number of farm to school programs, which use local farms as food suppliers for school meal programs, increased to 2,095 in 2009, up from 400 in 2003 based upon data from the National Farm to School Network. Data from the 2005 School Nutrition and Dietary Assessment Survey indicates that 16 percent of school districts reported having guidelines for purchasing locally grown produce. The five potential impacts of expanding local food systems include: Economic development, to include increased entrepreneurship and new business formation, job creation, and the economic multiplier effect of retaining consumer expenditure dollars within the local economy combined with import substitution and the localization of processing activities Health and nutrition benefits Increased food security and reduced food safety risks Reduced energy use and greenhouse gas emissions Preserving farmland and sustaining agricultural production The research and publications of USDA and multiple agricultural market researchers overwhelming support the statement that the local food movement presents a significant new business opportunity for farmers and for local economic development. Value Added Food Centers (Agribusiness Incubators) Value added food centers and agribusiness incubators are designed to increase the diversification of the agriculture industry by providing business consulting services to agriculture related businesses to maximize their chance of business viability and success. 69

80 Value added food centers and agribusiness incubators provide business consulting services to include: Market research Analysis of financial and operational performance, processes, and procedures Assist with the development of a strategic plan and with the development and execution of a business plan Provide planning and project management services that define and achieve client goals Build ongoing relationships that foster continual improvement of operations Provide assistance with the development of marketing strategies, branding, and product positioning Starting a value added agricultural business is costly and high risk; this is particularly true for small scale value added agricultural product and food manufacturing operations. To assist new and growing value added agricultural product and food ventures, many value added food centers and agribusiness incubators provide shared use commercial kitchen and food processing facilities; many centers and incubators also provide greenhouse space for growing agricultural produce to include fruits and vegetables, facilities for bottling and labeling value added agricultural products, shelf life testing, low cost office space with additional centralized administrative and marketing services, or retail space for direct to consumer sales. Community Supported Agriculture Community supported agriculture (CSA) is a concept that originated in the 1960s in Japan and Switzerland, during a time when consumers interested in safe food and farmers seeking stable markets for their crops joined together in economic partnerships. 166 CSAs may take many forms, i.e. sole proprietorships, cooperatives, or limited liability corporations; all have a common core of a shared commitment to building local, sustainable agricultural systems with growers and consumers providing mutual support and sharing the risks and benefits of food production. In some CSAs, members become shareholders of the farm and pledge to cover the anticipated costs of the farm operation and the farmer s salary; in return, they receive shares of the farm s output during growing season. By making direct sales to community members, who provide working capital to the farmer in advance, growers receive better prices for their crops, gain a level of financial security, and are relieved of the burden of marketing their products. 167 One variant of CSA is termed subscription farming; these arrangements involve growers directly contracting with customers (members) who have agreed in advance to buy a minimum 166 DeMuth, Suzanne (1993). Community Supported Agriculture: An Annotated Bibliography and Resource Guide, U.S. Department of Agriculture, National Agricultural Library. 167 Ibid. 70

81 amount of produce at a fixed price, but who have no investment in the farm itself. Types of CSA programs include: Farmer managed: the farmer organizes and markets a CSA program, recruits subscribers, and determines all management decisions, including what crops will be grown and the frequency of deliveries Shareholder/subscriber: local residents organize a CSA program and hire a farmer to grow specific crops or other products; the subscribers make the majority of management decisions Farmer cooperative: multiple farmers organize and market a CSA program; this arrangement may enable farmers to offer a wider variety of products to include fruit, eggs, poultry, meat, milk, cheese, vegetables, and other produce Farmer Shareholder cooperative: local residents and nearby farmers jointly own the CSA program s resources and manage all aspects of the program jointly Farmers Markets A major advantage of a farmers market is to provide a direct channel of distribution to the consumer, which enables the producer to receive a higher proportion of the farm retail spread, thereby increasing producer revenues from the sale of commodities. Farmers markets also offer a channel of distribution for local value added agricultural products and help small and medium sized producers incubate their businesses and obtain better prices for high value products and provide a reliable source of farm income. Consumers benefit by receiving fresh, high quality products and direct interaction with producers. Farmers markets also contribute to an enhanced community image, generate local business activity, and increase the multiplier effect of the economic impact associated with consumer expenditures on food purchases by retaining dollars within the community. Farmers markets provide a cost effective marketing outlet for producers to introduce new value added products into the market, thereby acting as an incubator for entrepreneurial business activity within the community. Farmers markets are successful when there is cooperation, involvement, and communication among three key groups: 1) the sponsoring community or organization, 2) the producers or farmers, and 3) the customers and others who support the local farmers market. Successful farmers markets require a good variety or mix of vendors operating side by side in the market and effective marketing, management, and advertising. The farmers market location must be accessible, have adequate parking, and have room for expansion; facilities must be clean with adequate garbage disposal facilities and properly equipped with electricity, water, and equipment for transporting heavy items. Good management, clear regulations, effective signage, and attractive displays all contribute to a positive consumer experience; a successful farmers market can draw customers from a wide geographic area. Problems may arise when the location of the farmers market interferes with public parking in a business area, when the farmers market is viewed as competition with some existing businesses, when management 71

82 Map 1: Farmers' Markets in Mississippi 72

83 fails to promote consistency or to effectively promote and advertise the farmers market, or when disagreements among participants interfere with the continued operation of the farmers market. Consumers perceive that purchasing local foods provides them with the opportunity to: obtain food items with superior quality characteristics, to include freshness, flavor, ripeness, and enhanced shelf life learn about farming practices used by local growers, which engenders trust in the integrity and quality of the food they purchase support local agriculture and small business development in their community preserve local farmland and open space by supporting the economically productive use of land A potential driver of increased demand and revenues for farmers markets is participation in the Supplemental Nutrition Assistance Program (SNAP formerly called food stamps); farmers markets supplying food to local hospitals and health care facilities, and the expansion of farm to school programs that promote the use of locally grown produce in school cafeterias. In many underserved communities in Mississippi, investments to expand the product offerings and increase the days of operation of a farmers market may offer an efficient mechanism to cost effectively expand upon an existing infrastructure to provide affordable, healthy food. Health fairs and nutrition education programs could further augment the services provided at farmers markets. Investments might also be made to expand the scope of farmers markets by integrating them with food hubs or Farm to Table programs. Farm to Table Programs and Food Hubs The Farm to Table concept is based upon building local and regional food systems to retain the economic value of consumer expenditures in food producing communities. Farm to Table programs distribute locally grown farm products to area restaurants, commercial kitchens, school cafeterias, hospitals, and independent grocery stores. Farm to Table programs provide a centralized location for the sale, purchase, and distribution of local agricultural products from multiple local farms to a variety of retail customers; frequently, these programs serve a large geographic area that may have a delivery and pick up radius within a one day drive from the distribution center. Over the past 10 years, the food industry has experienced an increase of store types that have not traditionally been engaged in food sales, generally led by supercenters. This industry change has created the need for competitors to differentiate their product offerings by responding to consumer demand for new, healthy product offerings, including local foods. Increasingly, supermarkets are installing local aisles in their stores and offering an increased 73

84 variety of locally produced food. Leading retailers to include Wal Mart, Kroger, Whole Foods, Safeway, and Publix have announced local food initiatives and launched advertising campaigns to focus on locally grown produce. A survey of professional chefs who are members of the American Culinary Federation was conducted by the National Restaurant Association in 2010, this survey found that 88 percent of chefs ranked locally grown produce as a hot trend and that locally grown produce ranked first in hot trends in Food hubs are defined as a business or organization that actively manages the aggregation, distribution, and marketing of source identified food products primarily from local and regional producers to strengthen their ability to satisfy wholesale, retail, and institutional demand. Food hubs may work on the supply side of agricultural production to support and train producers in sustainable production practices, production planning, packaging, branding, certification, season extension, and food safety to enable producers to access wholesale customers; food hubs may work on the demand side of direct to consumer marketing by coordinating with other distributors, processors, and wholesale or institutional buyers to increase market demand for locally grown products many food hubs provide both supply and demand side services. The core function of a food hub is the coordination of supply chain logistics and a professional business management team. Food hubs may be for profit or nonprofit organizations; nonprofit food hubs have greater access to federal and state grant programs and support from donations. In some cases, nonprofit, governmental organizations own farmers markets and carry out food hub activities. The legal structure of the food hub can influence its operations and functions, specifically in areas such as risk management, capital investment, and liability exposure. Based upon research conducted by the National Food Hub Collaboration (December 2011), of the 168 regional food hubs in the U.S., 40 percent of food hubs are privately held, 32 percent are nonprofit, 21 percent are cooperatives, 5 percent are publicly held, and two percent are informal business organizations. Food hubs are an important element of a growing local food system that lowers entry barriers to local food markets and provides the infrastructure that is required to support direct to retail/restaurant/institutional market sales that support local agricultural production. Research conducted by USDA found that: 91 percent of food hubs are located near major cities and population centers each food hub in the U.S. works with, on average, 80 farms and suppliers food hubs have an average of 19 paid employees the average sales of food hubs exceeded $3.7 million in 2012 A limited number of studies have used econometric Input Output models to examine the economic impact of shifting consumer purchases of fruits and vegetables to local producers; the findings of this research are as follows: 74

85 a total net increase of $200 million within the state and a net increase of approximately 2,000 jobs 168 a total net increase of $430 million of income in Iowa and a net increase of 6,000 jobs 169 a study of Regional Access, LLC., a New York food hub established in 1989, had $6 million in sales in 2011, 32 employees, 9 vehicles, and a 25,000 square foot warehouse that provides over 3,400 products found a net output multiplier of This indicates that for every additional dollar of final demand for food hub products, an additional $0.63 is generated in related sectors. 170 Farm to School Programs Farm to School programs are supported by the U.S. Department of Agriculture (USDA), which provides grants to support efforts to bring local or regionally produced foods into school cafeterias; supports hands on learning activities such as school gardening, farm visits, and culinary classes; and funds programs that integrate food related education into the regular, standards based classroom curriculum. USDA awards up to $5 million in grants to help schools connect with local producers and to teach children where their food comes from; grantees include schools and school districts, producers and producer groups, nonprofit entities, and state and local agencies. Scaling Up Local Food Scaling Up, the local food movement is the process of building the system necessary to make local food available to a wider segment of the population. There are multiple market entry barriers and obstacles to expansion faced by producers of local foods; these challenges include ensuring a sufficient, high quality level of agricultural production, providing efficient storage and transportation, and developing marketing and sales relationships with wholesale buyers, distributors, and brokers. When producers must allocate more time off farm to selling and marketing their products, they have less time to expand and become more efficient producers. Significant costs associated with direct marketing and on farm processing can act as an obstacle to the expansion of local food sales. Marketing risks for farmers when selling to local markets include low sales volume, inability to meet specifications and/or rejection of product based on quality, price competition from multiple sellers, buyers backing out of contracts, and the inability to meet transportation or logistical requirements. Institutional or retail purchasers of local foods (i.e. schools, restaurants, hospitals) face barriers and obstacles that include: difficulty identifying reliable local suppliers, difficulty making purchases due to ordering 168 Cantrell, P, Conner, D.S., Erikcek, G., Hamm, M.S. Eat Fresh Grow Jobs, Michigan. Beula, MI: Michigan Land Use Institute: Swenson, D. The Economic Impacts of Increased Fruit and Vegetable Production and Consumption in Iowa: Phase II. Ames, IA: Regional Food Systems Working Group Leopold Center for Sustainable Agriculture, Iowa State University; May Schmit, T.M., B.B.R. Jablonski, and D. Kay Assessing the Economic Impacts of Regional Food Hubs: The Case of Regional Access. Cornell University, December ( 2013). 75

86 Map 2: Direct to Consumer Sales

87 procedures, the need to deal with multiple suppliers, the need to coordinate pick up or delivery, and lack of knowledge about what products are available locally and during different seasons. The lack of supply chain infrastructure for the distribution of local food has been found to be a significant barrier to the development of the market for local foods; the absence of aggregation and distribution systems to include investments in delivery vehicles, temperature controlled storage facilities, processing and packing facilities, and other equipment or technology represent a significant cost for producers seeking to engage in value added direct to retail/foodservice activities. Value Added Food Centers and agribusiness incubators, Community Supported Agriculture (CSA), Farmers Markets, Food Hubs, and Farmto Table programs can assist in removing the barriers faced by producers and by institutional and retail purchasers by pooling the production of local farmers and can overcome the scale limitations of the direct marketing of local foods by providing centralized purchasing, ordering, packing, distribution, and delivery of local foods. The 2014 Farm Bill provides $30 million annually in funding for the Farmers Market and Local Food Promotion Program, an increase of $20 million annually over prior years; the 2014 Farm Bill also provides $72.5 million annually for the Specialty Crop Block Grant Program to promote fruit and vegetable production an increase from $52 million annually in the prior year. Direct to Consumer Sales in the United States According to the 2012 USDA Census of Agriculture, direct to consumer sales in the United States had a market value of $1,309,827,000 in 2012; from 2007 to 2012, direct to consumer sales in the United States increased by $98,557,000 an increase of 8.14 percent. In 2012, there were 144,530 farms engaged in direct to consumer sales in the United States; from 2007 to 2012, the number of farms engaged in direct to consumer sales increased by 7,713 an increase of 5.6 percent (Table 11, page 78). From 2007 to 2012, the total number of all farms in the United States engaged in agricultural production declined by 4.33 percent; over the same period, the total number of farms engaged in direct to consumer sales increased by 5.6 percent. The increase in the number of farms engaged in direct to consumer sales is not consistent across all states; from 2007 to 2012, there were 17 states (including the state of Mississippi) that experienced a decline in the number of farms engaged in direct to consumer sales. Although the majority of the states (10 states) that experienced a decline in the number of farms engaged in direct to consumer also experienced a decline in the market value of agricultural products sold to individuals for human consumption, there were some states (7 states) that experienced a decline in the number of farms engaged in direct to consumer sales but experienced an increase in the market value of sales. For example, in the state of Wisconsin, the number of farms engaged in direct to consumer sales declined by 395 (a decrease of 6.3 percent) from 2007 to 2012, but the market value of direct to consumer sales increased by $3,458,000 (an increase of 7.9 percent); states with similar outcomes included New Jersey, Maryland, West Virginia, Delaware, Iowa, and Kentucky (Table 11, page 78). 77

88 Table 11: Direct to Consumer Farm Sales by State 2007 and 2012 State Farms with Direct to Consumer Sales 2012 Farms with Direct to Consumer Sales 2007 Value of Direct to Consumer Sales 2012 Market Value of Directto Consumer Sales 2007 Percent Change in the Number of Farms with Direct Sales 2007 to 2012 Change in the Market Value of Direct to Consumer Sales 2007 to 2012 Percent Change in the Market Value of Direct to Consumer Sales 2007 to 2012 Average Directto Consumer Sales per Farm 2012 Percent Change in the Average per Farm Value of Direct to Consumer Sales 2007 to 2012 Farms with Direct to Consumer Sales as a Percent of Total Farms Statewide 2012 United States 144, ,817 $1,309,827,000 $1,211,270, % $98,557, % $9, % 6.9% Alabama 2,196 2,175 $9,183,000 $8,325, % $858, % $4, % 5.1% Alaska $2,227,000 $1,682, % $545, % $9, % 31.6% Arizona 1, $7,963,000 $5,247, % $2,716, % $6, % 6.1% Arkansas 1,391 1,657 $6,369,000 $8,161, % ($1,792,000) 21.96% $4, % 3.1% California 8,588 7,068 $169,915,000 $162,896, % $7,019, % $19, % 11.0% Colorado 2,896 2,777 $19,199,000 $22,584, % ($3,385,000) 14.99% $6, % 8.0% Connecticut 1,420 1,099 $30,439,000 $29,752, % $687, % $21, % 23.8% Delaware $4,302,000 $3,505, % $797, % $24, % 7.3% Florida 3,480 3,181 $19,049,000 $19,363, % ($314,000) 1.62% $5, % 7.3% Georgia 2,177 1,890 $13,197,000 $13,146, % $51, % $6, % 5.2% Hawaii 1,606 1,141 $13,215,000 $8,657, % $4,558, % $8, % 22.9% Idaho 2,420 2,076 $8,523,000 $7,840, % $683, % $3, % 9.8% Illinois 2,981 2,818 $33,009,000 $25,893, % $7,116, % $11, % 4.0% Indiana 3,673 3,576 $26,900,000 $22,268, % $4,632, % $7, % 6.3% Iowa 2,964 2,987 $17,522,000 $16,506, % $1,016, % $5, % 3.3% Kansas 2,044 2,140 $8,957,000 $9,272, % ($315,000) 3.40% $4, % 3.3% Kentucky 3,438 3,445 $16,438,000 $15,173, % $1,265, % $4, % 4.5% Louisiana 1,276 1,276 $7,452,000 $9,175, % ($1,723,000) 18.78% $5, % 4.5% Maine 2,311 1,705 $24,793,000 $18,419, % $6,374, % $10, % 28.3% Maryland 1,276 1,407 $28,038,000 $21,220, % $6,818, % $21, % 10.4% Massachusetts 2,206 1,659 $47,909,000 $42,065, % $5,844, % $21, % 28.4% Michigan 6,243 6,373 $58,793,000 $58,923, % ($130,000) 0.22% $9, % 12.0% Minnesota 4,213 4,293 $33,573,000 $34,667, % ($1,094,000) 3.16% $7, % 5.7% Mississippi 1,206 1,229 $4,284,000 $9,659, % ($5,375,000) 55.65% $3, % 3.2% Missouri 4,096 4,341 $19,664,000 $20,982, % ($1,318,000) 6.28% $4, % 4.1% Montana 1,389 1,287 $9,423,000 $6,321, % $3,102, % $6, % 5.0% Nebraska 1,537 1,288 $8,360,000 $5,902, % $2,458, % $5, % 3.1% Nevada $4,265,000 $1,074, % $3,191, % $10, % 9.6% New Hampshire 1, $20,321,000 $16,021, % $4,300, % $15, % 30.7% New Jersey 1,788 1,931 $33,308,000 $30,106, % $3,202, % $18, % 19.7% New Mexico 1,824 1,529 $8,117,000 $11,193, % ($3,076,000) 27.48% $4, % 7.4% New York 6,342 5,338 $100,646,000 $77,464, % $23,182, % $15, % 17.8% North Carolina 4,475 3,712 $31,826,000 $29,144, % $2,682, % $7, % 8.9% North Dakota $1,936,000 $2,429, % ($493,000) 20.30% $4, % 1.4% Ohio 6,612 6,827 $46,615,000 $54,270, % ($7,655,000) 14.11% $7, % 8.8% Oklahoma 2,376 3,194 $7,640,000 $11,534, % ($3,894,000) 33.76% $3, % 3.0% Oregon 6,680 6,274 $44,177,000 $56,362, % ($12,185,000) 21.62% $6, % 18.8% Pennsylvania 7,577 7,537 $86,030,000 $75,893, % $10,137, % $11, % 12.8% Rhode Island $6,253,000 $6,292, % ($39,000) 0.62% $16, % 30.2% South Carolina 1,581 1,323 $27,375,000 $12,660, % $14,715, % $17, % 6.3% South Dakota $4,349,000 $6,158, % ($1,809,000) 29.38% $5, % 2.5% Tennessee 3,679 3,581 $19,182,000 $15,380, % $3,802, % $5, % 5.4% Texas 7,954 8,619 $27,966,000 $38,696, % ($10,730,000) 27.73% $3, % 3.2% Utah 1,875 1,584 $15,930,000 $10,098, % $5,832, % $8, % 10.4% Vermont 2,071 1,474 $27,430,000 $22,863, % $4,567, % $13, % 28.2% Virginia 3,581 2,855 $41,728,000 $28,878, % $12,850, % $11, % 7.8% Washington 5,640 5,418 $45,124,000 $43,537, % $1,587, % $8, % 15.1% West Virginia 1,926 1,990 $10,950,000 $7,097, % $3,853, % $5, % 9.0% Wisconsin 5,848 6,243 $46,949,000 $43,491, % $3,458, % $8, % 8.4% Wyoming $3,018,000 $3,025, % ($7,000) 0.23% $4, % 5.9% Source: U.S. Department of Agriculture, 2007 and 2012 Census of Agriculture 78

89 Direct to Consumer Sales in Mississippi In 2012, Mississippi ranked as the 8 th lowest state in the nation in terms of the number of farms engaged in direct to consumer sales; with 3.17 percent of total farms engaged in direct toconsumer sales, Mississippi ranked as the 6 th lowest state, and it had the 4 th lowest market value of direct to consumer sales among the 50 states in the United States (Table 11, page 78). In 2012, there were 1,206 farms in the state of Mississippi that sold agricultural products directly to individuals for human consumption with total sales of $4,284,000 (Table 11, page 78). From 2007 to 2012, the number of farms in Mississippi that sold agricultural products directly to individuals for human consumption declined by 1.9 percent; however, the percentage of farms in Mississippi that sold agricultural products directly to individuals for human consumption (expressed as a percentage of all farms in Mississippi) increased by 8.1 percent over the same period. 171 In 2012, farms in Mississippi with total agricultural sales of less than $10,000 annually represented the largest percentage (60%) of the farms that sold agricultural products directly to individuals and represented approximately 22.7 percent of the total value of agricultural products sold directly to individuals for human consumption; in Mississippi, farms with total agricultural sales of less than $50,000 account for approximately 55.4 percent ($2,373,000) of the total value of agricultural products sold directly to individuals for human consumption. In 2012, the average per farm value of agricultural products sold directly to individuals for human consumption was $9,053 in the United States as compared to $3,552 in the state of Mississippi (Table 11, page 78). Perspective on Mississippi s participation in the growing direct to consumer market for agricultural products can be gained through comparisons with these activities in other states. In Mississippi, the number of farms engaged in direct to consumer sales declined from 1,229 in 2007 to 1,206 in 2012 a decrease of 1.9%; during the same period, the market value of direct to consumer sales declined by $5,375,000 a decrease of 55.7 percent. From 2007 to 2012, the state of Minnesota experienced a decline in the percentage in the number of farms engaged in direct to consumer sales (1.9 percent) that was similar to that of Mississippi, however, in Minnesota, direct to consumer sales only declined by $1,094,000 a decrease of 3.16 percent. It is noticeable that in Minnesota, the number of farms engaged in direct toconsumer sales was approximately 3.5 times higher than that of Mississippi in 2012, that the market value of direct to consumer sales in Minnesota was $33.6 million as compared to $4.28 million in the state of Mississippi (7.3 times higher in Minnesota as compared to Mississippi), and that average direct to consumer per farm sales in Minnesota were $7,969 as compared to 171 Author s note: this can be explained because the number of total farms in Mississippi declined from 41,959 in 2007 to 38,076 in 2012 (a decrease of 3,883 farms or approximately 9.3 percent). 79

90 Map 3: Direct to Consumer Sales per Farm in

91 $3,552 in Mississippi during Similar comparisons can also be made with Arizona and Louisiana, which had 1,216 farms and 1,276 farms, respectively that were engaged in direct toconsumer sales in 2012 and not significantly different than the number of farms in Mississippi that were engaged in direct to consumer sales. In 2012, the total value of direct to consumer sales in the state of Arizona was $7,963,000 (an average value of $6,549 per farm) and $7,452,000 in the state of Louisiana (an average value of $5,840 per farm); this compared to 1,206 farms in the state of Mississippi with a total value of direct to consumer sales of $4,284,000 (an average value of $3,552 per farm) in If the state of Mississippi were able to increase average direct to consumer sales per farm to be equivalent to that of Louisiana, even without an increase in the total number of farms engaged in direct to consumer sales, this increase would generate approximately $2.8 million in new direct to consumer sales in the state of Mississippi. Across the United States, the number of farms are declining; faced with ever escalating costs, farmers are increasingly turning to direct to consumer sales to generate additional revenues and the market value of direct to consumer sales is increasing. However, farmers in Mississippi have not benefited from the positive growth of direct to consumer sales to the degree experienced by farmers in other states. Farmers in Mississippi, particularly small farms, face significant barriers to entry into the direct to consumer and the direct to retail/restaurant/ institutional market. There are multiple opportunities that exist within the state of Mississippi to explore a range of facilities, programs, and services that will enhance value added agricultural output and integrate these activities with programs designed to increase consumer access to affordable, nutritious food in Mississippi s underserved communities. These activities may include scaling up local food to table activities with expanded farmers markets, agricultural food centers, agribusiness incubators, food hubs, and farm to school programs. These types of programs would have the combined positive impact of increasing access to affordable, healthy food within underserved communities, magnifying the multiplier of effect of dollars expended to purchase food by retaining an increased share of the farm to retail spread within local communities, and magnify the potential for job creation that would be associated with investments made in Mississippi s underserved communities. 81

92 State of Mississippi: Average Value of Direct-to-Consumer Sales per Farm in 2012 Average Value of Sales to Individuals for Human Consumption per Farm 2012 $ $2, $2, $6, $6, $13, $13, $30, No Data Available State of Mississippi Average Value of Sales to Individuals for Human Consumption per Farm in 2012: $ 3,552 Ü Desoto Marshall $6,583 $2,600 Tippah $1,571 Tishomingo Alcorn Tate $3,125 Benton Prentiss $333 $6,737 $2,000 Tunica $1,000 Union Panola Lafayette $1,588 Lee Itawamba $6,556 Coahoma $1,500 $2,250 Pontotoc $1,667 $1,421 $5,000 Quitman $2,889 Yalobusha Tallahatchie $2,286 Calhoun Chickasaw Monroe Bolivar $8,286 $30,500 $667 Grenada Clay $4,063 Webster Sunflower Leflore Carroll $3,333 Montgomery $500 $2,667 $2,000 Oktibbeha Lowndes $3,000 Choctaw $3,458 Washington $5,700 $4,000 $1,000 Attala Winston Noxubee Humphreys Holmes $2,929 $1,586 $643 Sharkey Issaquena Yazoo $4,800 Madison Leake $1,125 Neshoba $619 Kemper $2,400 $2,875 Warren Scott Newton Lauderdale $636 $10,222 $4,769 $2,412 Hinds $2,810 $2,038 Rankin Jasper Clarke $6,000 Claiborne Smith Copiah Simpson $1,000 $3,895 $625 $938 $13,091 Jefferson Covington Wayne Jones $1,917 Lawrence $6,118 Lincoln $3,000 $1,182 Adams Franklin Jeff Davis $1,286 $2,167 $500 $3,083 Forrest Perry Greene Amite Marion Wilkinson Pike Lamar $3,731 $1,786 $9,619 $2,000 $1,684 $1,000 $2,308 $3,952 $4,762 Walthall George Pearl River Stone $3,500 $2,040 $5,000 Jackson Harrison $1,750 $3,594 $2,500 Hancock Prepared by: J Phillips Data Source: USDA Census of Agriculture 2012 and 2007 Map 4: Direct to Consumer Farm Sales in Mississippi

93 Policies designed to increase access to affordable, healthy food in Mississippi s underserved communities will need to have the flexibility to meet a broad continuum of needs that may vary from one geographic location to another. As discussed in the previous sections of this report, healthy food financing initiatives that are designed to attract investment may take the form of a combination of grants, loans, private and public investment, and other incentives. There are multiple approaches to increasing access to affordable, healthy food, which may include (but are not limited to) financing the expansion of existing grocery stores or the construction of new supermarkets or grocery stores, the expansion of existing farmers markets, the creation of food hubs, and other programs designed to increase direct to consumer agricultural sales. Programs designed to attract or make investments in underserved communities must meet the needs that are specific to the community and be designed to provide appropriate localized interventions; they must also be financially viable and sustainable over time. Due to the rural nature of the state of Mississippi and its relatively low population density, the state of Mississippi faces unique challenges in the design of an effective healthy food financing initiative that will increase access to affordable, healthy food and also be sustainable. The vast majority of the investments that have used grants, loans, and New Market Tax Credits associated with the Federal Healthy Food Financing Initiative have been made in relatively urban areas; distance to a supermarket is a primary determinant used to measure food access. For example, the USDA HFFI Locator identifies census tracts as low access if at least 33 percent of its residents, or 500 residents (whichever is larger) live more than 1 mile from a supermarket or large grocery store in urban areas or 10 miles in rural areas. The Federal use of distance as a measure of food access tends to adversely affect states, such as Mississippi, that are predominantly rural and have a large percentage of their population living in rural areas where residents in underserved communities are faced with no local access to affordable, healthy food within their communities, are further burdened with high poverty rates and have absolutely no access to any public transportation system. Other measures of food access integrate distance with car ownership rates. Not surprisingly, car ownership rates in urban areas tend to be lower than in rural areas because public transportation is available in urban areas, and in many urban areas, having access to a private automobile is considered to be a luxury due to the costs associated car ownership, parking, and fees associated with parking garages. As a result, these measures of food access also tend to obscure the true obstacles to access that exist in rural areas with high poverty rates because they do not measure the realities of rural existence, which may include the extremely limited access to reliable and dependable transportation, the relative cost of transportation for poor families who have to travel longer distances to access food as compared to their urban counterparts, and the limited availability of transportation for one car families living in isolated rural areas. The methodology that is currently used to measure healthy food accessibility by federal agencies may mask the depth of the problem that exists within rural states. For example, The U.S. Treasury s CDFI Fund provided funding for a study to identify areas with Limited Supermarket Access (LSAs) 83

94 Place Total Population Table 12: Limited Supermarket Access Rankings by State Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Composite Rank Pennsylvania 12,698,826 1,528,284 12% 7 54% 4 1 Rhode Island 1,052, ,745 14% 6 53% 9 2 Louisiana 4,532, ,257 15% 4 49% 17 3 Connecticut 3,572, ,595 8% 22 62% 1 4 Illinois 12,827,020 1,048,199 8% 19 53% 6 5 Ohio 11,534, ,126 8% 20 54% 5 6 West Virginia 1,852, ,237 17% 2 46% 24 7 Tennessee 6,344, ,129 7% 25 59% 3 8 New York 19,375,996 1,459,034 8% 18 51% 13 9 Maryland 5,773, ,845 10% 12 48% Wisconsin 5,685, ,420 7% 27 53% 7 11 Massachusetts 6,545, ,880 12% 9 42% Texas 25,141,913 3,427,416 14% 5 39% Michigan 9,883, ,227 8% 21 49% New Jersey 8,789,199 1,024,563 12% 8 40% Missouri 5,987, ,210 7% 26 52% Florida 18,798,030 1,313,487 7% 24 49% Arizona 6,390, ,791 11% 10 40% New Mexico 2,058, ,003 18% 1 30% Georgia 9,686, ,700 6% 31 52% Kansas 2,852, ,043 6% 36 53% 8 21 Mississippi 2,966, ,599 5% 43 60% 2 22 Delaware 897, ,009 11% 11 37% Virginia 7,999, ,048 6% 32 51% North Dakota 672, ,080 17% 3 21% Minnesota 5,302, ,458 9% 16 39% Kentucky 4,338, ,343 7% 28 47% Oklahoma 3,750, ,630 10% 13 33% Wyoming 563,453 43,178 8% 23 42% Nevada 2,700, ,161 10% 14 30% South Carolina 4,624, ,033 6% 35 47% California 37,244,395 1,680,131 5% 38 48% Indiana 6,481, ,779 6% 34 46% Montana 989, ,095 10% 15 27% Arkansas 2,915,160 73,957 3% 46 52% South Dakota 814,114 73,127 9% 17 13% Alabama 4,778, ,031 5% 41 46% North Carolina 9,533, ,802 5% 39 42% Colorado 5,028, ,174 5% 40 43% New Hampshire 1,315,982 88,897 7% 30 35% Utah 2,763, ,993 7% 29 28% Iowa 3,045, ,181 5% 42 40% Washington 6,722, ,135 6% 33 20% Nebraska 1,824, ,008 6% 37 28% Oregon 3,829,991 99,673 3% 45 31% Maine 1,328,022 71,968 5% 44 24% Idaho 1,567,197 39,085 2% 47 10% Vermont 625,574 12,591 2% 48 0% Source: Searching for Markets: The Geography of Inequitable Access to Healthy & Affordable Food in the United States, U.S. Department of the Treasury, CDFI Fund 84

95 and to identify optimal areas for supermarket investment: Searching for Markets: The Geography of Inequitable Access to Healthy & Affordable Food in the United States. This study was conducted by The Reinvestment Fund (TRF), the entity that manages the Pennsylvania Fresh Food Financing Initiative and has been the recipient of approximately $451,865,559 in funding from CDFI, to include approximately $408 million in New Market Tax Credit allocations and $12 million in HFFI FA awards. In 2010, there were approximately 11,155,486 census block groups in the United States and approximately 6.1 million of these census blocks have a population greater than zero; the Searching for Markets study was limited to the examination of 207,608 block groups with an average population of 1,481 people, and the study eliminated block groups with populations of less than 250 people or less than 100 households this process eliminated many rural areas from the study. Searching for Markets identified communities with unmet demand for healthy food retail options and was designed to provide guidelines to identify areas where investments in supermarkets may be a viable intervention strategy; the study used accessibility to large food retail outlets (i.e. supermarkets, chain stores, and other midsized or large stores) as the identifier for availability to affordable, nutritious food and then used distance and automobile ownership (at the census block group level) as measures of access. Searching for Markets evaluated market potential using projections of potential grocery store sales demand (based upon 2009 Bureau of Labor Statistics Consumer Expenditure Survey data for spending on food at home ) as compared to actual sales to measure leakage as a measure of unmet demand within a block group and for aggregated block groups to estimate the magnitude of unmet grocery demand. The TRF study then developed a composite score using an average of the rankings for the percentage of the total population living in an LSA and the percentage of the LSA population living in low income blocks; the outcome of these measures is presented in Table 12 on page 84. The TRF study found that the average state has 8.6 percent of its population living in LSAs, of which, 42 percent live in low income areas; Mississippi s Composite Rank was 22 among the 48 states included in the study, with 5 percent of its population living in LSAs, of which, 60 percent lived in low income areas. The TRF study also provided the following information: among the 51 major metropolitan areas with populations greater than 1 million people, the average area had 9 percent of its population living in LSAs and 52 percent of the LSA population living in low income areas. The Memphis Mississippi Arkansas area, with 12 percent of its population living in LSA areas, ranked first due to the high percentage of the LSA population (75 percent) that lived in low income areas among the 48 metropolitan areas with populations between 500,000 to 1 million people, the average area had 9.5 percent of its population living in LSAs and 49 percent of the LSA population living in low income areas. The only Mississippi area included in this category of the TRF rankings was the City of Jackson, Mississippi, which was evaluated as having 6 percent of its population living in LSAs and 65 percent of the LSA populations living 85

96 Place Table 13: LSA Areas and Rankings by Population for Selected Areas Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Complete tables are provided in Appendix B Rank for % of LSA Population in Low Income Area Composite Rank Jackson, Mississippi 538,923 33,368 6% 34 65% Harrisburg Carlisle, PA 549,353 96,668 18% 4 58% 18 4 Wichita, KS 623,024 60,649 10% 20 75% 4 5 Scranton Wilkes Barre, PA 563,331 41,179 7% 29 61% LSA Figures for Metro Areas with Populations Less Than 250,000 Place Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Gulfport Biloxi, MS 248,763 24,437 10% 55 69% Pascagoula, MS 162,227 11,061 7% 77 14% Panama City Lynn Haven, FL 168,822 17,928 11% 50 13% Altoona, PA 127,041 21,981 17% 19 53% Williamsport, PA 116,079 3,189 3% % Lebanon, PA 133,505 5,084 4% 94 34% Johnstown, PA 143,592 8,394 6% 82 10% Port St. Lucie, FL 423,968 23,743 6% 41 46% LSA Figures for Micropolitan Areas Place LSA Figures for Metro Areas with Populations Between 500,000 and 1,000,000 Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Clarksdale, MS 26,140 9,216 35% 13 48% 47 3 Greenville, MS 51,113 9,441 18% 71 81% Vicksburg, MS 48,760 14,298 29% 24 20% Greenwood, MS 42,899 5,508 13% % Meridian, MS 107,412 11,620 11% % Cleveland, MS 34,134 2,499 7% % Natchez, MS LA 53,103 3,336 6% % McComb, MS 53,517 1,913 4% % Oxford, MS 47,343 1,155 2% % Yazoo City, MS 28,055 1,197 4% 207 0% Fairmont, MN 20,829 1,067 5% 194 0% Lewistown, PA 46,668 13,070 28% 26 0% Hun ngdon, PA 45,887 5,802 13% 99 0% Ardmore, OK 56,967 14,844 26% 33 23% Ardmore, OK 56,967 14,844 26% 33 23% New Castle, PA 91,095 24,911 27% 28 43% Ge ysburg, PA 101,362 10,259 10% 124 0% Source: Searching for Markets: The Geography of Inequitable Access to Healthy & Affordable Food in the United States, U.S. Department of the Treasury, CDFI Fund 86

97 in low income areas; of the 48 metropolitan areas, the City of Jackson has a composite ranking of 24 th (see Appendix B, Table 138 for all rankings) among the 71 metropolitan areas with populations between 250,000 to 500,000, the average area had 8.9 percent of its population living in LSAs and 47 percent of the LSA population living in low income areas. There were no Mississippi areas included in this category in the TRF study among the 130 metropolitan areas with populations of less than 250,000, the average area had 9.6 percent of its population living in LSAs and 38 percent of the LSA population living in low income areas. There were two Mississippi LSAs that were identified by the TRF study; the Gulfport Biloxi area received a composite ranking of 24 and the Pascagoula area received a composite ranking of 94 (Table 13, page 86) among the 257 micropolitan areas included in the TRF study, the average area had 13 percent of its population living in LSAs and 24 percent of the LSA population living in lowincome areas. To be included in the study, micropolitan statistical areas must have had at least one urban cluster of at least 10,000 residents but no more than 50,000 residents. There were 10 Mississippi LSAs identified by the TRF study (Table 13, page 86); Clarksdale and Greenville received a composite ranking of 3 and 11, respectively A comparison of the rankings for Pascagoula, Mississippi and Altoona, Pennsylvania provides an example of the impact that population density, low income levels, and research methodology may have on the analysis of food access and the design of appropriate intervention strategies to address food access. These rankings also illustrate the unique challenges faced by more rural states with lower population density, such as Mississippi. As specified in the TRF study, LSA areas cover vast geographic areas; the population size for all Mississippi designated LSA areas far exceeds the actual population within the municipal boundaries and frequently even exceeds the total county population of the designated LSA areas (Table 13). For example, the total population for the Pascagoula LSA area is specified as 162,227 and the total LSA population is 11,061; in 2010, the total population of the City of Pascagoula was 22,392 and the total population of Jackson County was 139,668, indicating the population for the Pascagoula LSA as specified in the TRF study exceeded the total population of the entire county. In 2010, the total population of the City of Altoona, Pennsylvania was 46,320 and the total population of Blair County, Pennsylvania was 127,089, which is equal to the population size ascribed to the Altoona, Pennsylvania LSA in the TRF study. As shown in Table 13, the aggregated total population for the Pascagoula, Mississippi area included in the TRF study was 162,227 (the denominator/divisor of the equation) and total LSA population for the Pascagoula LSA was specified as 11,061 (the numerator/dividend of the equation), resulting in a quotient of 6.8 percent (this value is rounded up to 7 percent in Table 13). These Pascagoula values compare to a total population of 127,041 and a total LSA population of 21,981 for Altoona, Pennsylvania, which yields a quotient of 17 percent of the total population in the LSA; this is more than twice the percentage of the population in the LSA for Pascagoula, Mississippi. The TRF study then 87

98 ranked each LSA for the total of the population in the LSA, yielding a rank of 77 for the Pascagoula, Mississippi LSA and a rank of 19 for the Altoona, Pennsylvania LSA for the total percentage of the population in the LSA; this advantaged the Altoona, Pennsylvania LSA in its position in the Composite Ranking. Because the TRF study uses the total population as the divisor and the total LSA population as the dividend in the equation to identify the percent of the population in an LSA, geographic areas with larger total populations within an LSA (higher population density) decrease the quotient for the percentage of the population in an LSA, and, as a result, decrease the ranking for the total percentage of the population in the LSA. The ranking for the total percentage of the population in the LSA is then averaged with the LSA s ranking for the percentage of the LSA population living in low income block groups to develop the Composite Rank for each LSA. The scoring for the percentage of the population living in low income block groups in the TRF study is designed to measure the degree to which the burden of low access is felt more strongly in low income areas. The TRF study specified that in Pascagoula, the percent of the LSA population in low income block groups was 14 percent and ranked Pascagoula 88 for the percentage of the LSA population in low income areas; this compared to Altoona s specified percent of the LSA population in low income areas of 53 percent with a ranking of 41. The Stennis Institute examined poverty rates and found that the poverty rate for the City of Pascagoula was 24 percent and the poverty rate for Jackson County was 15.4 percent, as compared to a poverty rate of 18.3 percent in the City of Altoona and poverty rate of 13.3 percent for Blair County. 172 These differences are partially a function of research methodology and also a function of urban density, where concentrations of multitenant, high density housing developments, and the higher concentration of larger numbers of low income persons in urban areas may artificially mask the magnitude of the lack of access to affordable, healthy food in underserved communities that may exist in states that exhibit more rural characteristics, the state of Mississippi being one example of this issue. Issues associated with population density, methods used to determine food access, and methods used to evaluate and prioritize investments in underserved communities present unique challenges for the design and funding of appropriate policy interventions in predominantly rural states. A primary issue in the design of sustainable intervention strategies in underserved communities is sufficiency of the market, which addresses the question of whether there are sufficient resources to sustain an intervention strategy, i.e. is there sufficient spending capacity within an underserved community to support a supermarket, a grocery store, a farmers market, a food hub, or other forms of investments made to increase access to affordable, healthy foods. In areas with high population density, even when the population exhibits high poverty or lowincome, there may be sufficient spending on food to justify investments in supermarkets, grocery stores, or even multiple stores. However, in areas with low population density, there may be insufficient spending to make investments economically viable and sustainable over the 172 U.S. Census Bureau American Community Survey 5 Year Estimates. 88

99 long run, even though these may be areas that have the greatest need. A starting point for evaluating the sufficiency of the market in underserved communities is to examine food spending leakage, which is the current spending on food at home by residents in underserved census tracts that is not currently being spent at retail food stores or markets within the underserved census tract, to determine whether specific intervention strategies have the potential to be financially sustainable over the long run. Although state healthy food financing initiatives may be designed to provide incentives or to create programs designed to increase food access in underserved communities, these interventions must be designed to be sustainable. Local, unmet demand for food (leakage), can assist decision makers to identify what form of food retail intervention is most appropriate for a specific underserved community. Areas with high levels of unmet demand for food may be targeted for the development of full service supermarkets or grocery stores, while areas with lower levels of unmet demand may be more appropriately targeted for the expansion of existing grocery stores, farmers markets, or the development of other direct to consumer agricultural food sales. Although healthy food financing programs should not focus exclusively on supermarkets and grocery stores, a general discussion of the supermarket and grocery store industry is provided in the following section of this report to provide decision makers with a perspective on the industry at the national level and for the state of Mississippi. The Supermarket and Grocery Store Industry The Supermarket and Grocery Store Industry (NAICS 44511) is a subsector of the Retail Trade sector; this industry is comprised of establishments generally known as supermarkets and grocery stores. The industry consists of supermarkets and grocery stores; the size of store determines the nomenclature used to define a specific store; supermarkets may be categorized as hypermarkets (> 100,000 square feet), supermarkets (66,000 to 99,000 square feet), superstores (55,000 to 65,000 square feet), and grocery stores (<55,000 square feet). Grocery stores and supermarkets may be part of a chain ( 11 stores) or they may be independent (< 11 stores). Figure 12: Number of U.S. Supermarkets and Grocery Stores In 2013, there were 61,020 grocery stores and supermarkets in the United States. From 2003 through 2007, the number of grocery stores and supermarkets in the U.S. declined by approximately 2.6 percent; since 2007, the number of stores in the United States has increased by 1,741 (an increase of 2.9 percent). 89

100 Table 14: U.S. Supermarket and Grocery Store Industry Metrics The U.S. Supermarket and Grocery Store Industry (NAICS 44511) U.S. Totals in $ millions Per Store Estimates in Dollars Total Cost of Materials $38, $626, Materials Used $15, $245, Commission Expense $ $9, Contract Work $1, $26, Cost of Fuels $1, $30, Electricity $19, $315, Total Payroll & Benefits $74, $1,198, Payroll $49, $794, HR Benefits $13, $216, Health Insurance $4, $65, Pension Plans $1, $20, Contribution Plans $ $10, Other HR Benefits $5, $91, Total Other Expenses $77, $1,242, Shipping & Storage $4, $71, Expensed Equipment $1, $22, Data Process Services $ $9, Communications Services $1, $26, Repair & Maintenance $4, $78, Waste Removal $3, $49, Advertising Expenses $12, $203, Professional Services $7, $125, Taxes & License Fees $8, $135, All Other Expenses $32, $520, Total Rentals $34, $555, Building Rentals $33, $532, Machinery Rentals $1, $22, Total Capital Expenditures $31, $512, Buildings & Structures $15, $247, Machinery & Equipment $16, $264, Autos & Trucks $ $4, Computer Equipment $1, $23, Other Machinery & Equipment $14, $237, Other Industry Metrics (in dollars) for 2012 Total U.S. Industry Sales $461,275,000,000 Average Sales per Store $7,101, Average Sales per Employee $201, Average Employees per Store 36.5 Source: Adapted from Barnes Reports Supermarket and Grocery Store Industry 2013 Capital and Expense Series 90

101 The industry employed 2,412,256 people in 2013; total wages paid were $54,894,662, and the average annual wage for workers in the industry was $22, In 2013, average sales per establishment were $7.16 million, average sales per employee were $238,928, and the average number of employees per establishment was The average number of employees per establishment has remained constant over the period from 2008 through In 2013, there were 455 grocery stores and supermarkets in the state of Mississippi. Since 2004, the number of grocery stores and supermarkets in the state of Mississippi has declined by 31.6 Figure 13: Supermarkets and Grocery Stores in Mississippi percent a loss of approximately 210 stores. In Mississippi, the industry employed 16,364 people in 2013; total wages paid were $301.6 million and the average annual pay for workers in the industry was $18, Although employees in Mississippi grocery stores and supermarkets have an average annual wage of $18,431 that is lower than the average annual wage of $35,890 for all Mississippi employees across all private industries in the state of Mississippi, the wage disparity for workers in Mississippi grocery stores and supermarkets is not as great as that exhibited when compared to the average annual wage across all private industries. In Mississippi, the average annual wage across all private industries in 2013 was $35,890 as compared to the U.S. average annual wage of $49,701 across all private industries; 178 across all private industries, Mississippi workers have an average annual wage that is 72.2 percent of that for U.S. workers across all private industries; Mississippi workers in the grocery stores and supermarkets have an average annual wage that is 80.9 percent of that for all U.S. workers in grocery stores and supermarkets. This indicates that workers in Mississippi grocery stores and supermarkets exhibit greater wage parity with their U.S. counterparts, as compared to other industry sectors in the state of Mississippi. Employment in the Supermarket and Grocery Store industry in the state of Mississippi is distributed across approximately 48 occupational categories (Table 15, page 92); an estimated 173 U.S. Department of Labor, Bureau of Labor Statistics, Quarterly Employment and Wage Statistics. 174 U.S. Department of Labor, Bureau of Labor Statistics, Quarterly Employment and Wage Statistics. 175 Market Reports, Industry Trends, and Demographic Data. Barnes Reports, Grocery Stores Industry (NAICS 44511). 176 Ibid. 177 U.S. Department of Labor, Bureau of Labor Statistics, Quarterly Employment and Wage Statistics. 178 Ibid. 91

102 Table 15: Distribution of Employment and Occupational Wages in the Mississippi Supermarket and Grocery Store Industry 2012 Mississippi Employment in the Supermarket and Grocery Store Industry (NAICS 44511) by Occupation in 2012 Employment Annual Wage Occupation Description Employment Percent of Total Employment 10 percentile 25 percentile Median 75 percentile 90 percentile Mississippi Total Employment 16, % Management occupations % 25,538 $25,538 $45,350 $60,656 $86,777 General and operations managers % 44,636 $44,636 $78,394 $101,264 $138,230 Sales managers % 27,289 $27,289 $45,766 $62,133 $85,108 Business and financial operations occupations % 17,907 $17,907 $28,161 $37,327 $46,882 Wholesale and retail buyers, except farm products % 16,939 $16,939 $26,137 $34,863 $45,860 Arts, design, entertainment, sports, and media % 14,046 $14,046 $20,425 $25,252 $31,149 Healthcare practitioner and technical occupations % 27,602 $27,602 $50,523 $139,410 $160,745 Pharmacists % 54,398 $54,398 $77,906 $87,723 $94,272 Pharmacy technicians % 15,067 $15,067 $21,936 $25,789 $29,358 Healthcare support occupations % 13,649 $13,649 $18,052 $21,280 $25,253 Pharmacy aides % 14,488 $14,488 $19,165 $22,594 $26,796 Protective service occupations % 15,971 $15,971 $26,228 $35,923 $49,648 Security guards % 15,158 $15,158 $24,771 $35,067 $48,804 Food prepara on and serving related occupa ons 1, % 12,538 $12,538 $16,126 $20,796 $26,460 First line supervisors/man agers of food prep. workers % 16,621 $16,621 $25,067 $31,146 $37,774 Cooks, fast food % 12,820 $12,820 $16,244 $20,655 $24,974 Cooks, short order % 10,901 $10,901 $14,248 $17,418 $21,307 Food preparation workers % 14,836 $14,836 $18,729 $23,317 $29,494 Combined food prep. workers, including fast food % 12,572 $12,572 $15,785 $19,588 $24,191 Counter attendants, food concession, and coffee shop % 12,297 $12,297 $14,951 $17,676 $22,399 Food preparation and serving related workers, all other % 15,007 $15,007 $20,082 $23,930 $27,545 Building and grounds cleaning and maintenance % 13,224 $13,224 $16,448 $20,572 $25,581 Janitors and cleaners, except maids % 12,375 $12,375 $15,384 $19,157 $23,710 Sales and related occupations 6, % 15,311 $15,311 $19,060 $25,058 $36,660 First line supervisors/managers of retail sales workers % 17,981 $17,981 $28,721 $36,565 $45,535 Cashiers 5, % 12,740 $12,740 $15,409 $18,461 $24,631 Counter and rental clerks % 13,279 $13,279 $17,343 $22,200 $28,917 Retail salespersons % 12,798 $12,798 $16,478 $20,967 $26,806 Demonstrators and product promoters % 12,149 $12,149 $15,164 $18,509 $23,721 Sales and related workers, all other % 14,414 $14,414 $24,151 $29,134 $36,246 Office and administrative support occupations 3, % 11,072 $11,072 $14,899 $19,978 $26,224 First line supervisors/managers of admin workers % 18,129 $18,129 $28,898 $36,470 $44,567 Bookkeeping, accounting, and auditing clerks % 11,364 $11,364 $17,750 $22,347 $27,517 Customer service representatives % 13,251 $13,251 $18,012 $23,332 $29,036 Shipping, receiving, and traffic clerks % 14,369 $14,369 $21,794 $26,762 $34,298 Stock clerks and order fillers 2, % 13,096 $13,096 $16,782 $21,580 $28,023 Weighers, checkers, and samplers, recordkeeping % 19,252 $19,252 $29,947 $36,827 $44,546 Office clerks, general % 14,891 $14,891 $19,773 $24,814 $31,427 Installation, maintenance, and repair occupations % 15,310 $15,310 $24,342 $33,383 $42,345 Production occupations 1, % 14,513 $14,513 $22,572 $29,765 $37,388 First line supervisors/man agers of production workers % 21,037 $21,037 $30,370 $38,192 $45,768 Bakers % 12,120 $12,120 $17,303 $21,814 $26,574 Butchers and meat cutters % 13,211 $13,211 $21,870 $28,109 $34,081 Meat, poultry, and fish cutters and trimmers % 14,757 $14,757 $19,484 $25,601 $32,503 Food batchmakers % 12,463 $12,463 $16,272 $19,893 $24,467 Painting, coating, and decorating workers % 15,942 $15,942 $22,460 $26,893 $30,953 Transportation and material moving occupations 1, % 11,468 $11,468 $13,743 $15,700 $20,789 Source: Barnes Reports Grocery Stores Industry (NAICS 44511), 2012 Jobs and Wages Series 92

103 77.6 percent of total employment in the industry occurs within three occupational categories; these are: 1. Sales and Related Occupations (Bureau of Labor Statistics Occupation Code ), which represents approximately 41.7 percent of total employment. In this occupational category, annual wages range from a low of $15,311 to a high of $36,660; the median annual wage is $19,060; 2. Office and Administrative Support Occupations (Bureau of Labor Statistics Occupation Code ), which represents approximately 24.2 percent of total employment. In this occupational category, annual wages range from a low of $11,072 to a high of $26,224; the median annual wage is $14,899; and 3. Food Preparation and Serving Related Occupations (Bureau of Labor Statistics Occupation Code ), which represents approximately 11.7 percent of total employment within the industry. In this occupational category, annual wages range from a low of $12,538 to a high of $26,460, the median annual wage is $16,126. Most grocery store and supermarket jobs are entry level positions and receive on the job training; cashiers, stock clerks, and food preparation workers are trained on the job, and meatcutters and bakers can attend training at the local community college or they can learn the necessary skills on the job. Although some employers seek graduates of community colleges or 4 year colleges to fill many of the marketing and management positions within the industry, many employees in the industry start in entry level positions and advance to positions of greater responsibility over time, this enables them to advance to positions with higher wages and to gain valuable job skills. The jobs created by grocery stores and supermarkets may represent a significant opportunity for employment within Mississippi census tracts that are characterized by relatively low educational achievement and unemployment, and these jobs are well matched with the educational and job skill profile of residents within many of Mississippi s underserved communities. The industry operates in an environment of low margins and depends upon high volume sales and efficiency of operations. The economics that drive site selection in the Supermarket and Grocery Store industry are based on fundamental supply and demand. Demand in the industry is driven by consumer purchasing behavior; food is considered to be a normal good with demand increasing as income increases. Price is also a determinant of demand; the higher the price of a specific food, the lower the quantity demanded, and as prices increase, there is an increasing demand for substitute foods. The budget constraints of lower income consumers will generally lead them to substitute higher priced food with lower priced foods; in many cases, this leads to substituting healthier (more costly foods) with less healthy foods (canned fruits or vegetables replace fresh, or fast foods replace home prepared meals). Consumer demand and purchasing behavior, combined with the budget constraints among lower income consumers, impact industry site selection; supermarkets and grocery stores are normally 93

104 located in geographic areas that are anticipated to maximize sales; this includes locating in close proximity to the largest population of middle to upper income consumers on sites that have high visibility, high traffic counts, and are located in areas that are experiencing economic growth (either residential or business activity). Supply (the number of stores and variety of product offerings) and price are driven by the cost of inputs land, construction costs, fixtures and equipment, labor, food costs, and other fixed and variable operating costs. High fixed costs may require a store to charge a higher price for goods sold or limit the variety of product offerings. The sales volume of a store will affect the magnitude of importance that fixed costs play in determining price; when sales volume is high or when individual consumers spend more (on higher price/higher profit goods or purchase an increased number or variety of goods), the store will be able to spread fixed costs across a larger number of consumers, buy in bulk to reduce the wholesale cost of goods sold, and be able to lower prices while still providing a greater variety of product offerings. Supermarkets and grocery stores compete by offering a greater variety of products, which requires fixed investments in distribution and technology and by differentiating their product offerings through advertising. These fixed costs create barriers to entry for competitors. The supermarket and grocery store industry has transformed over time. Beginning with the increase in chain stores during the 1900 s based upon economies of scale, during the 1960 s, the industry experienced the rise of the supermarket format, driven by consumer demand for Figure 14: Supermarket Sales by Department as a Percentage of Total Supermarket Sales increased variety and achieved through economies of scope, with the adoption of computerized logistic distribution and inventory management systems during the late 1980 s and early 1990 s, supermarket chains were able to efficiently stock, manage, transport, and sell an increasing variety of product offerings. From 1980 to 2004, the number of products offered in the industry increased from 14,145 to over 30,000; in 2012, the average number of items 94

105 carried in a supermarket was 42, As product variety and the number of offerings increased, so too did store size. There is empirical evidence indicating that the consumer demand for an increased variety of product offerings within the supermarket and grocery store industry limits the number of firms that can profitably enter a geographic market. 180 The Supermarket and Grocery Store industry has become increasingly concentrated over time; there are approximately 50 national and regional chains that generate 70 percent of total revenue, and the top five chains control approximately 30 percent of the market. The largest supermarket chains in the United States include Walmart Stores; The Kroger Company; Safeway, Inc.; Albertsons, LLC.; SuperValu, Inc.; Publix Super Markets, Inc.; the Delhaize Group; Aldi; and Whole Foods Market. In 2012, Walmart s revenue from grocery sales was approximately $311 billion, The Kroger Company s sales were $82.2 billion, and Safeway s sales were approximately $41.1 billion. Factors that have led to consolidation within the industry and have driven the industry towards having fewer, but larger stores dominated by large chains include economies of scale, economies of scope, and economies of agglomeration. The cost of operating a store declines as the size of the store increases (economies of scale); the cost decreases as store size increases and the store is able to provide more shelf space for a larger quantity of goods while increasing the variety of offerings (economies of scope); and the cost/benefit of operating a store are lower when a store is located near other stores that attract consumers (economies of agglomeration). In many cases, endogenous fixed costs drive the location decision of firms within the supermarket and grocery store industry; in other cases, response to competition and strategic actions taken by firms include investing in larger stores, offering more and higher quality product variety, and investing in prime retail locations that are proximate to high traffic retail locations. Consolidation within the industry, economies of scale, economies of scope, and economies of agglomeration have all impacted the supply of food access the number of supermarkets or grocery stores within a geographic location and where these stores are located. This economic decision making has resulted in underserved communities with limited or no access to affordable, healthy food. Market Reports for the Supermarket and Grocery Store Industry (NAICS 44511) includes data for 62,143 establishments across 12 sub industries within the Supermarket and Grocery Store 181, 182 Industry, as follows: Frozen food and freezer plans, except meat 179 Food Marketing Institute, Ellickson, P. B. (2005). Does Sutton Apply to Supermarkets? Duke University Economic Department, NBER Summer Institute. 181 Market Reports, Industry Trends, and Demographic Data. Barnes Reports, Grocery Stores Industry (NAICS 44511). 182 Author s note: data sourced from the Bureau of Labor Statistics for supermarkets and grocery stores exhibit slight differences when compared to the data sourced from Market Reports in this section of the report. For example, data from the U.S. Bureau of Labor Statistics reports a total of 455 establishments in the supermarket and grocery store industry in Mississippi with total employment of 16,364 in 2013; this compares to 487 establishments with total employment of 15,899 reported for Mississippi by Barnes Market Reports for These differences may be attributable to the methodology used for gathering and aggregating data, differences in reporting periods, and the variance that exists between sources for statistical data. 95

106 Cooperative food stores Delicatessen stores Independent Grocery Stores Grocery Stores Independent Supermarkets range between 20,000 to 55,000 square feet Supermarkets range between 20,000 to 55,000 square feet Supermarket Chains Superstores supermarkets that are between 55,000 and 65,000 square feet Hypermarkets supermarkets that are greater than 100,000 square feet In 2013, total U.S. sales in the Supermarket and Grocery Store Industry were approximately $ billion; the average sales across all supermarket and grocery store establishments were $7,358,961, regardless of size (Table 16, below). Supermarkets and supermarket chains represent less than 18.8 percent of total establishments within the U.S. Supermarket and Grocery Store Industry, but represent 81.3 percent of total sales within the industry. Supermarkets are generally between 20,000 to 50,000 square feet and offer a full line of groceries, meat, and produce with an average of between 10,000 to 30,000 stock keeping units (SKUs), and have a sales volume above $2 million annually. The median store size for all supermarkets in the U.S. was 46,400 square feet in Grocery stores, independent grocery stores, and chain grocery stores represent 74.6 percent of all establishments within the Supermarket and Grocery Store Industry, but with total sales of approximately $80.3 billion represent only 17.4 percent of total sales (Table 16, below). Grocery stores typically average approximately 20,000 square feet, offer a general line of Table 16: The U.S. Supermarket and Grocery Store Industry (NAICS 44511) Establishments and Sales 2013 The Supermarket and Grocery Store Industry Sub Industries Establishments Total Percent of Total Establishments Sales in $ Millions Percent of Total Sales Grocery stores, independent 7, % $24, % Grocery stores 37, % $47, % Grocery stores, chain 1, % $8, % Supermarkets 4, % $109, % Supermarkets, chain 5, % $246, % Supermarkets, greater than 100,000 square feet % $ % Supermarkets, independent 1, % $12, % Supermarkets, 55,000 65,000 square feet % $6, % Supermarkets, 66,000 99,000 square feet % $ % Cooperative food stores % $ % Delicatessen stores 3, % $4, % Frozen food and freezer plans, except meat % $ % Total 62, % $461, % Source: Market Reports, Industry Trends, and Demographic Data. Barnes Reports, the Supermarket and Grocery Store Industry (NAICS 44511)

107 grocery and perishable products including meat and produce, and offer an average of between 5,000 to 10,000 stock keeping units. Market Reports 183 for the state of Mississippi indicates that there were 487 establishments with a total employment of 15,899 and total sales of $2.631 billion in the Supermarket and Grocery Store industry (NAICS 44511) in 2013 (Table 17, page 98). In addition to the Supermarket and Grocery Store industry (NAICS 44511), there were approximately 16 establishments in the General Line Grocery Wholesale Industry (NAICS 42441) that were located in the state of Mississippi in 2013; these firms employed 2,637 people in 2013 and had sales of approximately $725.3 million. 184 As compared to the United States, the percentage of small grocery stores with less 9 employees is lower in the state of Mississippi; Mississippi also has a lower percentage of very large grocery stores with more than 100 employees as compared to the United States (Figure 15, below). In Mississippi, approximately 25.4 percent of industry employment is in supermarkets or grocery stores with 20 to 49 employees, as compared to 12.8 percent nationwide. In Mississippi, 40.2 percent of workers are employed in supermarkets or grocery stores with 50 to 99 employees as compared to 27.1 percent nationwide. In the United States, approximately 42 percent of workers in the supermarket and grocery store industry work at stores with between 100 to 249 workers; in Mississippi, only 23.6 percent of workers are employed in stores with 100 to 249 workers (Table 17, page 98). Figure 15: Comparison of U.S. and Mississippi Distribution of Supermarkets and Grocery Store Establishments by Number of Employees 183 Market Reports, Industry Trends, and Demographic Data. Barnes Reports, Grocery Stores Industry (NAICS 44511); Ibid. 97

108 Table 17: Distribution of Employment, Stores, and Sales in the U.S. and Mississippi Supermarket and Grocery Store Industry 2013 Category United States 1 4 Employees 5 9 Employees Employees Employees Employees Employees Employees Employees > 1,000 Employees Unknown Total Total Employment 69,988 40,286 86, , , , ,836 25,095 1,237 30,720 2,268,339 Number of Stores 23,329 6,714 6,156 8,524 9,321 7, ,143 Total Sales (in $ Average Sales per $8,826 $4,838 $11,644 $45,298 $104,955 $178,039 $58,668 $24,157 $2,588 $2,292 $441,305 Store (in dollars) $378,327 $720,584 $1,891,488 $5,314,172 $11,260,058 $25,221,561 $112,606,526 $635,710,526 N/A $4,784,969 $7,101,443 Mississippi Total Employment ,038 6,385 3, ,899 Number of Stores Total Sales (in $ Millions) $52 $34 $105 $631 $1,089 $701 $0 $0 $0 $19 $2,631 Average Sales per Store (in dollars) $379,562 $723,404 $1,875,000 $5,302,521 $11,226,804 $25,035,714 N/A N/A N/A $4,750,000 $5,402,464 Columbus, MS Number of Employees Number of Stores Sales (in $ Millions) $1.0 $1.0 $2.0 $10.0 $43.0 $0.0 $0.0 $0.0 $0.0 $0.0 $57.0 Average Sales per Store (in dollars) $500,000 $500,000 $2,000,000 $5,000,000 $10,750,000 N/A N/A N/A N/A N/A $5,181,818 Greenville, MS Number of Employees Number of Stores Sales (in $ Millions) $1.0 $1.0 $0.0 $20.0 $43.0 $0.0 $0.0 $0.0 $0.0 $0.0 $66.0 Average Sales per Store (in dollars) $500,000 $500,000 N/A $5,000,000 $10,750,000 N/A N/A N/A N/A N/A $6,000,000 Indianola, MS Number of Employees Number of Stores Sales (in $ Millions) $1.2 $0.3 $0.0 $9.9 $21.5 $0.0 $0.0 $0.0 $0.0 $32.0 Average Sales per Store (in dollars) $300,000 $300,000 N/A $4,950,000 $21,500,000 N/A N/A N/A N/A $4,112,500 Picayune, MS Number of Employees Number of Stores Sales (in $ Millions) $0.3 $1.0 $2.0 $15.0 $32.0 $0.0 $0.0 $0.0 $0.0 $0.0 $50.0 Average Sales per Store (in dollars) $300,000 $1,000,000 $2,000,000 $5,000,000 $10,666,667 N/A N/A N/A N/A N/A $5,555,556 Source: Market Reports, Industry Trends, and Demographic Data, Barnes Reports, The Supermarket and Grocery Store Industry (NAICS 44511),

109 Underserved Census Tracts in Four Mississippi Counties The following section of this report examines underserved census tracts located in the Mississippi counties of Lowndes, Pearl River, Sunflower, and Washington that qualify for federal new market tax credits and other funding under the guidelines of the federal Healthy Food Financing Initiative (HFFI). An analysis of the socio economic profile for each county is provided at the census tract level to provide a comparative profile for the characteristics of the population living in federal HFFI qualifying census tracts as defined by the U.S. Department of Agriculture and also eligible for grants, loans, and federal New Market Tax Credits through the Federal Healthy Food Financing Initiative. The following section of this study focuses on census tracts that are eligible of funding under the federal Healthy Food Financing Initiative (HFFI census tracts) due to the important opportunities that exist to significantly leverage the state share of investments made in Mississippi s underserved communities with additional federal grants, loans, or tax credits. The four counties (Lowndes, Pearl River, Sunflower, and Washington) that are included in this study were selected to be generally representative of different geographic areas of the state of Mississippi; however, underserved communities exist throughout the state of Mississippi and state healthy food financing programs should be designed to be sufficiently flexible to meet a broad continuum of needs throughout the state of Mississippi. In recognition of the need to increase access to healthy and nutritious food, the Mississippi State Legislature passed, and Governor Phil Bryant signed, House Bill 1328 during the 2014 Regular Session; known as the Small Business and Grocer Investment Act, this legislation is designed to provide grants and loans to promote access to fresh fruits and vegetables and other affordable healthy food in Mississippi s underserved communities. House Bill 1328 makes provisions for the Mississippi Development Authority to contract with non profit organizations or community development financial institutions to administer activities through public private partnerships to provide funding for eligible projects. There are a range of investments that may be made to increase access to affordable, healthy foods in Mississippi s underserved communities; these may include, but are not limited to: The new construction a traditional supermarket, or the renovation of an abandoned supermarket or other existing space to create a new supermarket The construction of a new grocery store, superette, convenience store, or the expansion of an existing grocery store, superette, or convenience store to provide expanded refrigeration and shelf space to increase the offering of an assortment of fresh fruits and vegetables The construction of a farmers market facility or the expansion of an existing farmers market facility to facilitate offering a wider selection of fresh fruits and vegetables The creation of a Food Hub warehousing and distribution facility, to increase direct toconsumer sales by local agricultural producers; these facilities may include direct sales and distribution to individuals or direct sales to institutions to potentially include restaurants, 99

110 schools, and hospitals. Such facilities may either provide for on site pick up of agricultural products or may provide delivery services. The economic and fiscal impact associated with potential investments made in Mississippi s underserved communities in each of the four counties selected to be included in this study are also examined in the following section of this report; hereinafter, the term underserved communities is used interchangeably with the term HFFI qualifying census tracts. The economic impact of each investment in Mississippi s underserved communities are anticipated to occur in two phases. The first phase of economic activity will take place during the construction or renovation phase; the magnitude of the economic impact of construction or renovation activities will be directly related to the size of the investment being made. The second phase of economic activity will occur upon the completion of construction activities and the commencement of ongoing business operations; the magnitude of the economic impact of the ongoing operations of business activity will be dependent upon the type of investment made (i.e. supermarket, grocery store, farmers market, or food hub), the size of the facility, the location and size of the market within which the facility is located, and management experience. Each investment will have unique elements that are not able to be modeled without information that is specific to the investment; for example, site location may determine the market potential for a specific site and within each county examined in this report there are multiple census tracts within which there are a high number of potential sites that may be selected for investment. To address the issues associated with multiple, currently unknown elements of the wide range of potential investments that may be made in underserved communities in the state of Mississippi, economic impact analysis was conducted using the following framework: Construction Impacts. In the United States, the average size of traditional supermarkets is approximately 45,000 square feet, with a selling area of approximately 33,300 square feet; these stores normally have approximately 9 to 10 checkout lanes and employ approximately 66 people. Across the United States, traditional supermarkets, limited assortment supermarkets, or grocery stores may range between 20,000 to 55,000 square feet. Assuming face brick with concrete block backup/steel frame construction, the average cost of constructing a supermarket or grocery store, including furniture, fixtures, and equipment is approximately $146 per square foot in the state of Mississippi. 185 The economic impact analysis presented in this study assumes that for projects that renovate existing stores, the purchase price for the building combined with the purchase of new furniture, fixtures, and equipment will be equivalent to the cost of a new construction; therefore, the assumption of $146 per square foot 185 Source: RS Means Online Construction Estimator 100

111 is assumed to be appropriate renovation projects. Construction phase impacts were modeled based upon the assumption of three levels of investment: 1. A construction or renovation cost of $6,570,000. This assumption is based upon an estimated store size of 45,000 square feet which is appropriate for a traditional, independent supermarket. 2. A construction or renovation cost of $2,920,000. This assumption is based upon an estimated store size of 20,000 square feet which is appropriate for a limited assortment supermarket, grocery store, or convenience store. 3. An investment of $500,000 in store renovations and the purchase of new equipment to enable it to expand its offerings of fruits and vegetables. This assumption is appropriate for multiple investments that may be required to renovate existing facilities for the purpose of increasing refrigeration, cooler, or freezer capacity to expand the offerings of fresh fruits and vegetables; these investments may include renovation and/or new equipment for existing supermarkets, convenience stores, grocery stores, or farmers markets. Ongoing Operations Impact. In the U.S., the average annual sales for supermarkets and grocery stores was $7,101,443; in the state of Mississippi, average supermarket and grocery store sales were $5,402,464 (Table 17, page 98). When a specific retail sales gap in a census tract level was not specifically identified, retail sales associated with the ongoing operations of investments in underserved communities were modeled at three levels, using the following assumptions: 1. Annual sales of approximately $5,000,000; this assumption is based upon estimated store sales in the state of Mississippi for moderately sized traditional, independent supermarkets. Although the assumption of annual sales of $5 million may underestimate the economic impact of supermarkets that are 45,000 square feet, the use of these conservative sales estimates will also yield relatively conservative estimates of the economic impact of the ongoing operations associated with these stores (Table 17, page 98). 2. Annual sales of $2,000,000; this assumption is based upon annual sales associated smaller grocery stores in the state of Mississippi with (Table 17, page 98). 3. Annual sales of $500,000; this assumption is based upon store for relatively small grocery stores in the state of Mississippi (Table 17, page 98) and upon spending on fruits and vegetables in the state of Mississippi. The economic impact of investments for the four counties that are the focus of this study are examined using census tract specific investment scenarios. Economic and fiscal impacts are reported for the construction phase of activity and for the ongoing operations of business activity that are associated with investments made in underserved census tracts in each of the counties. A separate section of this report provides a state level econometric input output analysis of construction impacts and the impact of ongoing business operations that may be associated with the three alternative investment scenarios in any area of the state. 101

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113 Lowndes County, Mississippi ** Denotes HFFI Qualifying Census Tract ** Denotes a Food Desert Census Tract Flint Hill Caledonia Kolola Springs Columbus AFB Woodlawn Wells Steens Artesia Mayhew ** ** ** Columbus ** ** New Hope McCrary McIntyre New Hope Bent Oak Whitebury Penns Crawford ** Trinity Plum Grove Forreston Miles Map 5: Lowndes County HFFI Qualifying Census Tracts 103

114 ** Denotes an HFFI Census Tract ** ** ** ** ** ** Miles Map 6: Lowndes County Reference Map 104

115 Eligible Healthy Food Financing Initiative Census Tracts in Lowndes County Based upon the data from the USDA s HFFI Locator Tool, there are six (6) census tracts located in Lowndes County that are eligible and qualify for funding under the Federal Healthy Food Financing Initiative; these are: Census Tract is designated as a rural tract and is eligible based upon low income and low access using vehicle access. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at 1 and 10 miles, at ½ and 10 miles, and at 1 and 20 miles. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at 1 and 10 miles, at ½ and 10 miles, and at 1 and 20 miles, and low income and low access using vehicle access. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at ½ and 10 miles and low income and low access using vehicle access. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at ½ and 10 miles and low income and low access using vehicle access. Census Tract is designated as a rural tract and is eligible based upon low income and low access using vehicle access. All qualifying HFFI census tracts in Lowndes County are also eligible to receive Federal New Market Tax Credits. There are 26,433 people living in HFFI census tracts in Lowndes County; this represents 44.4 percent of the total county population. An estimated 6,751 children (age 0 to 17 years) and 3,594 seniors (age 65 and over) live in HFFI census tracts in Lowndes County; 44.9 percent of all children and 46.5 percent of all seniors in Lowndes County live in HFFI census tracts Source: U.S. Census Bureau, American Community Survey year Estimates. 105

116 Figure 16: Lowndes County Population Estimates 2010 through

117 Overview of Lowndes County, Mississippi In 2013, Lowndes County, Mississippi s estimated population was 59,922; from 2000 to 2013, the county had a negative growth rate of 2.6 percent and population declined by approximately 1,607 people. Over the period from 2000 through 2008, Lowndes County s population decreased by 2,369 (a decline of 3.85 percent). In recent years, Lowndes County has seen an upward trend in population growth; from 2009 through 2013, the population increased by approximately 259 people (Figure 16, page 106). Among the 82 counties in the state of Mississippi, Lowndes County ranked among the 18 counties experiencing the highest loss in total population over the period from 2000 to According to the 2010 U.S. Census, 187 in the United States, 72.4 percent of the population is White, 12.6 percent of the population is African American, 9.1 percent of the population is Hispanic or Latino, percent of the population is Asian, 1.7 percent of the population is American Indian or Alaska Native, and the balance is some other race; Census Tract Table 18: Lowndes County Population by Census Tract Total Population Percent of County Population , % , % , % , % ** 7, % , % , % , % ** 3, % ** 5, % ** 3, % ** 5, % , % ** 1, % Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract in the U.S., 49.2 percent of the population is male and 50.8 percent of the population is female. In the state of Mississippi, 60.1 percent of the population is White, 37.6 percent of the population is African American, and less than 2 percent of the population is comprised of some other racial group; in Mississippi, 48.3 percent of the population is male and 51.7 percent of the population is female. In Lowndes County, approximately 47.4 percent of the population is male and 52.6 percent of the population is female; this gender distribution is not significantly different than that of the state of Mississippi or the United States. In Lowndes County, 43.7 percent of the population is African American and 54.3 percent of the population is White; American Indians, Asians, and other groups each account for less than one percent of the population. 187 Author s Note: there is variation between the data reported for the 2010 U.S. Census, U.S. Census Population Estimates, and the data from the U.S. Census Bureau American Community Survey year Estimates. Unless specified, this report uses American Community Survey year estimates to make census tract level comparisons percent of the U.S. population is Hispanic or Latino; of these, 8.7 percent are classified as White alone and 6 percent are classified as some other race by the 2010 U.S. Census. 107

118 Table 19: Lowndes County Racial Distribution by Census Tract Census Tract Total Population White Percent White Black or African American alone Percent Black or African American American Indian and Alaska Native Percent American Indian and Alaska Native Asian Percent Asian Some Other Race Percent Some Other Race ,053 5, % % % % % ,854 1, % 1, % % % % ,607 1, % % % % % ,690 5, % 1, % % % % ** 7,122 4, % 2, % % % % ,331 2, % 2, % % % % ,084 3, % % % % % ,295 1, % 2, % % % % ** 3, % 2, % % % % ** 5,124 1, % 3, % % % % ** 3, % 3, % % % % ** 5,725 2, % 3, % % % % ,237 1, % % % % % ** 1, % 1, % % % % Total 59,584 32, % 26, % % % % Source: U.S. Census Bureau, American Community Survey year Estimates ** Denotes HFFI Eligible Census Tract 108

119 Research 189, 190, 191 has found that HFFI census tracts are more likely to be census tracts with higher concentrations of minority populations; a similar pattern is exhibited within the HFFI census tracts in Lowndes County. Overall, Lowndes County s African American population represents a higher percentage of the population as compared to the state of Mississippi and to the United States; the percentage of the population that is African American in HFFI census tracts in Lowndes County is higher than the county level average. For example, in Census Tract , percent of the population is African American and percent of the population in Census Tract is African American (Table 19, page 108). African Americans represent 60.9 percent of the total population living in Lowndes County s six HFFI census tracts. Approximately 46.5 percent of Lowndes County s population age 65 and over live in HFFI census tracts. In Lowndes County, there are approximately 7,733 people age 65 and over, representing 12.9 percent of the population. Two HFFI census tracts in Lowndes County have a relatively high percentage of people age 65 and over; in census tract , 19.6 percent of the population is age 65 and over and in census tract , 16.1 percent of the population is age 65 and over (Table 20, page 110). In Lowndes County, 25.2 percent of the population are children (age 17 and under). There are two HFFI census tracts that exhibit a significantly higher percentage of children than the county average; in census tract , 32 percent of the population are children and in census tract , 27.1 percent of the population are children (Table 20, page 110). In Lowndes County, 44.9 percent of all children live in an HFFI qualified census tract. There are approximately 31,315 females living in Lowndes County; they represent 52.6 percent of the population. Four HFFI census tracts in Lowndes County have the highest percentage of females among the 15 census tracts in the county. In census tract and census tract , females represent 62.7 percent and 57.2 percent of the population, respectively. Approximately 47 percent (14,718 females) of all females in Lowndes County live in HFFI qualified census tracts. HFFI census tracts in Lowndes County contain a high number of female families with children under the age of 18 with no husband present. In Lowndes County, there are approximately 15,628 families; of these, 2,303 (14.74 percent) are single female families with no husband present who have children under the age of 18; in the state of Mississippi, 10.2 percent of 189 Dutko, Paula, Michele Ver Ploeg, and Tracey Farrigan. Characteristics and Influential Factors of Food Deserts, ERR 140, U.S. Department of Agriculture, Economic Research Service, August Duran, A. C., et al. (2013). Neighborhood Socioeconomic Characteristics and Differences in the Availability of Healthy Food Stores and Restaurants in Sao Paulo, Brazil. Health Place 23: Block, J. P., et al. (2004). Fast food, Race/Ethnicity, and Income: A Geographic Analysis. American Journal of Preventive Medicine 27(3):

120 Table 20: Lowndes County Selected Gender, Age, and Family Population Data by Census Tract Census Tract Total Population Female Population Population 17 years and Under Percent of Tract Population 17 and Under Population 65 and Over Percent of Tract Population 65 and Over Number of Families Number of Female Households, No Husband Present, with Children Under 18 Percent of Tract Families with Female Householder, No Husband Present with Children under 18 Years , % 1, % % 1, % , % % % % , % % % % , % 1, % 1, % 2, % ** 7, % 1, % % 2, % , % 1, % % 1, % , % 1, % % 1, % , % % % 1, % ** 3, % 1, % % % ** 5, % 1, % % 1, % ** 3, % % % % ** 5, % 1, % % 1, % , % % % % ** 1, % % % % County Totals 59, % 15, % 7, % 15,628 2, % Source: U.S. Census Bureau, American Community Survey year Estimates * Denotes HFFI Eligible Census Tract 110

121 households are female headed families with children under 18, and no husband present. Three HFFI census tracts that exhibit a significantly large percentage of female households with children under the age of 18 are: census tract , census tract , and census tract , with the percentage rate of female families with children under 18 and no husband present being 27.9 percent, 20.5 percent, and 19.1 percent, respectively (Table 20, page 110). In Lowndes County, approximately 74.9 percent of all female headed families with children under 18 and no husband present live in HFFI census tracts (Table 21, below). In Lowndes County, 46.3 percent of all households live in a HFFI census tract and 42.5 percent of all family households with children under the age of 18 live in HFFI census tracts (Table 21, below). An estimated 59.5 percent of households where a person 65 years and over is living alone are located in HFFI census tracts in Lowndes County and 50.1 percent of households with one or more people 65 years and over are located in HFFI census tracts in the county. The lack of access to affordable, nutritious food is of particular concern for families with children, and specifically for female headed households with children and no husband present. Households headed by single mothers have been found to have the highest rates of child food insecurity, 192 with access to adequate food limited by their households lack of money and Table 21: Lowndes County Households and Families by Type Household by Type Lowndes County Totals Total in Food Deserts Percent in Food Deserts Total households 23,429 10, % Family households (families) 15,628 6, % With own children under 18 years 6,907 2, % Married couple family 10,728 3, % With own children under 18 years 4,111 1, % Male householder, no wife present, family % With own children under 18 years % Female householder, no husband present, family 4,040 2, % With own children under 18 years 2,303 1, % Nonfamily households 7,801 4, % Householder living alone 6,894 3, % 65 years and over 2,046 1, % Households with one or more people under 18 years 8,190 3, % Households with one or more people 65 years and over 5,407 2, % Source: U.S. Census Bureau, American Community Survey year Estimates 192 Coleman Jensen, A., Nord, M., Singh, A.S. (2013). Household Food Insecurity in the United States in U.S. Department of Agriculture, Economic Research Service,

122 ** Denotes HFFI Eligible Census Tract A Closer Look at Underserved Communities in Mississippi Table 22: Poverty Rates for Families and Individuals in Lowndes County 112

123 access to affordable, nutritious food. Inadequate nutrition and poor diet represent a serious risk to the health of children, has been linked to poor health and developmental risks, 193 and to negative academic and psychological outcomes in older children and adolescents. 194, 195 Studies have found that living in an HFFI census tract contributes to food insecurity and may be a principle cause of poor nutrition; although low income families have been found to prefer shopping in supermarkets, they are often forced to shop at smaller food stores or convenience stores due to restricted budgets and limited resources. 196 The large percentage (59.5 percent) of individuals over the age of 65 living alone in HFFI census tracts in Lowndes County is also of concern due to the higher probability that transportation may be a particular problem for these individuals. Aging populations exhibit lower mobility, isolation, and lower access to food stores; older persons are more likely to be dependent on family, friends, neighbors, or non profit organizations to gain access to food. 197 Research on access to affordable and nutritious food identifies subpopulations that may be highly vulnerable to access barriers; households with no, or limited, vehicle access and individuals over the age of 65 are considered to be particularly vulnerable to barriers to access to affordable, nutritious foods. 198 Mississippi is among the states with the highest poverty rates in the U.S. With a poverty rate of 22.7 percent, the state of Mississippi s poverty rate is 7.3 percent higher than the U.S. poverty rate of 15.4 percent. In Lowndes County, the poverty rate is 25.7 percent (Table 22, page 112), indicating that the overall poverty rate for all people living in Lowndes County is 3.0 percent higher than that of the state of Mississippi and 10.3 percent higher than that of the United States. Within five of the six HFFI qualifying census tracts in Lowndes County, the poverty rate for all people is higher than the poverty rate for all census tracts in Lowndes County, ranging from 56.7 percent in census tract to 31.3 percent in census tract (Table 22, page 112). With a poverty rate for all people of 22.7 percent, census tract is the only HFFI qualifying census tract in Lowndes County that does 193 Rose Jacobs, R., Black. M. M., Casey, P.H., et al. (2008). Household Food Insecurity: Associations with At risk Infant and Toddler Development. Pediatrics. 121(1): Alaimo, K., Olson, C.M., Frongillo, E.A. Jr. (2001). Food Insufficiency and American School aged Children s Cognitive, Academic, and Psychosocial Development. Pediatrics. 108(1): Jyoti, D.F., Frongillo, E.A., Jones, S.J., (2005). Food Insecurity Affects School Children s Academic Performance, Weight Gain, and Social Skills. Journal of Nutrition. 135(12): Grief, M. H., and Barrett A. Lee. (2008). Homelessness and Hunger. Journal of Health and Social Behavior. 49(1): Bitto, E., Morton, L. Oakland, M. and Sand, M. (2003). Grocery Store Access Patterns in Food Deserts. Journal for the Study of Food and Society, 6(2), V. Breneman, et. al. (2009). Report to Congress: Access to Affordable and Nutritious Food, Measuring and Understanding Food Deserts and Their Consequences. U.S. Department of Agriculture, Economic Research Service, Economic Research Report. 113

124 **Denote HFFI Eligible Census Tract A Closer Look at Underserved Communities in Mississippi Table 23: Lowndes County Educational Attainment for the Population Age 25 and Older 114

125 not have a poverty rate that is higher than that of Lowndes County; however, even in this census tract, the poverty rate of 35.8 percent for all families with children under 18 is higher than Lowndes County s percentage rate of 33.3 percent and significantly higher that the state average of 27.1 percent and the national average poverty rate of 17.8 percent (Table 22, page 112). The poverty rate for female households with children under 18 and no husband present and the poverty rate for people age 65 and older is pronounced in Lowndes County. In the United States, 40.0 percent of female households with children under 18 and no husband present live in poverty; in Mississippi, 51.8 percent of single females with children under 18 live in poverty, and in Lowndes County, 66.7 percent of single females with children under 18 live in poverty. Similar to the pattern of poverty for all people, five of the six HFFI qualified census tracts in Lowndes County also have the highest percentage of single female households with children under 18 living in poverty; in two HFFI qualifying census tracts, approximately 85 percent of the single female households with children under 18 live in poverty (Census Tracts and ). The burden of poverty falls heavily upon the children in Lowndes County; 44.8 percent of children under the age of five and 32.8 percent of children age five to seventeen live in poverty in Lowndes County. In all six of the HFFI qualifying census tracts, the poverty rate for children under five is higher than the state average of 36.5 percent, and in five of the six HFFI census tracts, the poverty rate for children under five years old is higher than the Lowndes County percentage rate (Table 22, page 112). In census tract and census tract , more than 90 percent of the children under the age of five live in poverty. In Lowndes County, approximately 16.8 percent of the people age 65 and over live in poverty; this is 2.8 percentage points higher than that of Mississippi s senior poverty rate of 14.0 percent, and 7.4 percentage points higher than that of the United States, which has 9.4 percent of the population age 65 and over living in poverty (Table 22, page 112). Among the six HFFI qualifying census tracts in Lowndes County, five of the census tracts have poverty rates that are higher than the average Lowndes County poverty rate for people age 65 and over. In three of the HFFI qualifying census tracts, the poverty rate for people age 65 and over is above 32 percent more than twice that of the average poverty rate across Lowndes County. Lowndes County s educational attainment levels are approximately equivalent to those of the state of Mississippi; approximately 82 percent of the population age 25 and over are high school graduates and 21.4 percent of the population in this age group has a bachelor s degree or higher (Table 23, page 114). With the exception of census tract , all qualifying HFFI census tracts in Lowndes County have a lower percentage of high school graduates than the county average graduation rate for the population age 25 and over. Three of the qualifying HFFI census tracts in Lowndes County have high school graduation rates that are less than

126 Table 24: Lowndes County Comparative Employment and Income Census Tract or Geographic Area Population 16 years and over Number in Civilian Labor Force Percent in Labor Force Percent Unemployed Number not in the Labor Force ,861 3, % 13.9% 1, ,065 1, % 16.2% , % 4.0% ,554 3, % 12.3% 2, ** 5,268 3, % 11.6% 1, ,223 2, % 7.7% 1, ,185 2, % 6.6% 1, ,365 1, % 17.7% 1, ** 2,464 1, % 20.1% 1, ** 3,994 2, % 21.7% 1, ** 2,591 1, % 30.1% 1, ** 4,393 2, % 15.4% 1, ,006 1, % 11.4% ** 1, % 23.6% 664 Lowndes County 46,488 27, % 14.6% 17,397 Mississippi 2,312,959 1,343, % 11.1% 957,272 United States 246,191, ,113, % 9.7% 87,994,377 Source: U.S. Census Bureau, American Community Survey Year Estimates Census Tract or Geographic Area Total Households Percent of Households with Income less than $10,000 Percent of Housholds with Income between $10,000 to $14,999 Median household income (dollars) Percent of Households with Earnings , % 2.9% $54, % % 8.2% $43, % % 2.1% $54, % , % 8.0% $59, % ** 2, % 11.5% $39, % , % 8.4% $41, % , % 2.2% $58, % , % 7.7% $34, % ** 1, % 16.9% $20, % ** 1, % 19.7% $18, % ** 1, % 19.0% $14, % ** 2, % 10.1% $29, % % 4.9% $58, % ** % 15.1% $20, % Lowndes County 23, % 9.8% $37, % Mississippi 1,088, % 8.1% $39, % United States 115,610, % 5.4% $53, % Source: U.S. Census Bureau, American Community Survey Year Estimates **Denotes HFFI Eligible Census Tract 116

127 percent; these are census tracts , , and in census tract , the high school graduation rate for the population age 25 and over is 34.5 percent (Table 23, page 114). In four of the HFFI qualifying census tracts in Lowndes County, 10 percent or more of the population age 25 and over have less than a 9 th grade education (Table 23, page 114); in census tract , 15.1 percent of the population have less than a 9 th grade education, and in census tract , 20.2 percent of the population have less than a 9 th grade education. Lowndes County Income by Source In Lowndes County, the average unemployment rate among the population 16 years and over was 14.6 percent; this unemployment rate was approximately 3.5 percent higher than that of the state of Mississippi and 4.9 percent higher than that of the United States for this age group (Table 24, page 116). The unemployment rate for the population age 16 and over within the HFFI qualifying census tracts in Lowndes County is generally higher than that of the county (with the exception of census tract ). For example, in census tracts , , and , the unemployment rate ranges from 20.1 percent to 30.1 percent (Table 24, page 116); these census tracts also exhibit a significantly high percentage of the population that are not in the labor force, with percentage rates upward of 40 percent of the population not in the labor force. The median household income in Lowndes County is $37,868; median household income in Lowndes County is approximately $1,163 lower than the state of Mississippi s median household income and approximately $15,178 lower than that of the United States (Table 24, page 116). The median household income in HFFI census tracts is lower than that of Lowndes County (with the exception of census tract ); in three of the HFFI census tracts (census tracts , , and ), median household income is approximately 50 percent of Lowndes County s median household income. Of particular concern is the high percentage of households that have household incomes of less than $15,000. In Lowndes County, approximately 22.4 percent of households have incomes of less than $15,000; in the state of Mississippi, 19.5 percent of households have incomes of less than $15,000, and in the U.S., this percentage rate is 12.6 percent (Table 24, page 116). Within Lowndes County, HFFI census tracts have the highest percentage of households with incomes of less than $15,000, and in all of these census tracts, the percentage of households with incomes of less than $15,000 is higher than that of the county. For example, in census tract , 52.9 percent of households earn less than $15,000, and in census tract , 43.0 percent of households earn less than $15,000. Within Lowndes County s HFFI qualifying census tracts, there are 3,590 households with incomes of less than $15,000; this represents 69.0 percent of all households in Lowndes County with incomes of less than $15,000. HFFI census tracts also have a higher percentage of households with incomes of less than $10,000 (Table 24, page 116); these low income levels are indicative of deep poverty. 117

128 Table 25: Lowndes County Comparative Earnings and Income by Source Census Tract or Geographic Area Mean earnings (dollars) for Households Percent of Households with Social Security Mean Social Security income (dollars) Percent of Households with retirement income Mean retirement income (dollars) Percent of Households with Supplemental Security Income Mean Supplemental Security Income (dollars) Percent of Households with cash public assistance income Mean cash public assistance income (dollars) Percent of Households with Food Stamp/SNAP benefits in the past 12 months $62, % $17, % $17, % $11, % $1, % $59, % $12, % $15, % $7, % $7, % $56, % $2, % $51, % 0.0% 2.3% $78, % $18, % $21, % $8, % $4, % ** $45, % $16, % $12, % $8, % $3, % $51, % $15, % $15, % $7, % $1, % $70, % $16, % $17, % $6, % 5.3% $38, % $14, % $18, % $7, % $2, % ** $23, % $13, % $14, % $9, % $2, % ** $34, % $12, % $20, % $7, % $3, % ** $28, % $11, % $15, % $8, % $1, % ** $41, % $16, % $15, % $6, % $2, % $82, % $13, % $28, % $8, % $ % ** $44, % $13, % $10, % $6, % $ % Lowndes County $53, % $15, % $17, % $8, % $2, % Mississippi $56, % $15, % $19, % $8, % $2, % United States $75, % $17, % $23, % $9, % $3, % Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 118

129 Within Lowndes County, approximately 74.6 percent of households have earnings from employment (Table 24, page 116); this percentage rate is higher than that of the state of Mississippi (73.9 percent) and lower than that of the United States (78.2 percent). For households with income from earnings, mean household earnings in Lowndes County are $53,033 (Table 25, page 118). Other sources of household income include Social Security, Retirement Income, Supplemental Security Income, and Cash Public Assistance. In Lowndes County, approximately 30.7 percent of households receive Social Security Income; this is slightly lower than the 32.6 percent of households in the state of Mississippi that receive Social Security Income and slightly higher than the 28.9 percent of households in the U.S. that receive Social Security Income. Four HFFI census tracts have notably higher percentage rates of households receiving Social Security Income; these are census tracts , where 42.7 percent of households have Social Security Income; census tract , where 34.7 percent of households have Social Security Income; and tracts and , where 33.8 percent and 31.5 percent of households have Social Security Income, respectively. In Lowndes County, 19.2 percent of households have retirement income; this reflects a greater percentage of households with retirement income as compared to either the state of Mississippi (17.5 percent) or the United States (17.7 percent). In Lowndes County, the mean retirement income is $17,467; this is $2,272 lower than the mean household retirement income of $19,739 in the state of Mississippi and $6,122 lower than the U.S. mean household retirement income of $23,589 (Table 25, page 118). In all but one of the HFFI census tracts in Lowndes County, the mean household retirement income is significantly lower than that of the county; for example, in census tract , the mean household retirement income is $10,554, which is $6,913 lower than the county level mean retirement income (Table 25, page 118). The average mean retirement income across the six HFFI census tracts in Lowndes County is $14,784, indicating that households in these census tracts have mean household retirement incomes that are $2,682 lower than the mean household retirement income in Lowndes County. Supplemental Security Income (SSI) provides benefits to needy aged, blind, and disabled people; in the U.S., approximately 40 percent of SSI recipients are over the age of 65; the remainder are disabled. Children may qualify for SSI benefits if they are disabled. In Lowndes County, 7.8 percent of households receive SSI income; the percentage of households in Lowndes County receiving SSI is the same as that of the state but is 2.9 percentage points higher than that of the United States. In Lowndes County, there are approximately 1,818 households receiving Supplemental Security Income; 50.6 percent of these households live in HFFI qualifying census tracts. Cash Assistance programs are designed to enable households with limited income to meet the basic needs of living to include shelter, food, utilities, daily living expenses, and child care. In Mississippi, adults who receive Temporary Assistance for Needy Families (TANF) must 119

130 participate in a work program. In Lowndes County, approximately 5.4 percent of households receive Cash Public Assistance; this is almost twice the level of the recipients in the state of Mississippi and in the United States (Table 25, page 118). In all of the six HFFI qualifying census tracts, the percentage of households receiving Cash Public Assistance is higher than that of Lowndes County; in census tracts and tract , 14.3 percent of all households receive Cash Public Assistance. In Lowndes County, there are approximately 1,262 households receiving income from Cash Public Assistance; 70.3 percent of these households live in HFFI qualifying census tracts percent of households in Lowndes County receive SNAP (Food Stamps) benefits; this is approximately 2.4 percent higher than the percentage rate of households in Mississippi that receive SNAP Benefits and 7.4 percent higher than the percentage of households in the United States that receive SNAP benefits. As shown in Table 25 (page 118), the majority of HFFI census tracts in Lowndes County exhibit a higher percentage rate of households receiving SNAP benefits as compared to the county level; in some HFFI census tracts, the percentage of households with SNAP Benefits exceeds 30 percent and is as high as 48.4 percent in census tract Food Insecurity in Lowndes County In 2011, approximately 16.4 percent of all individuals in the U.S. population experienced food insecurity; in 2012, 15.9 percent of all individuals in the United States were food insecure, 199 indicating that food insecurity had declined in the U.S. Across the United States, the average county level food insecurity rate remained stable at 14.7 in 2011 and remained the same in In Mississippi, the overall food insecurity rate was 22.3 percent in 2012; Mississippi had the highest overall food insecurity rate in the nation in In 2012, approximately 22.9 percent of the population in Lowndes County was food insecure (15,029 people). 201 Child food insecurity rates are substantially higher than the overall food insecurity rate. In the U.S., the child food insecurity rate was 21.6 percent in In counties across the United States, the county level of child food insecurity ranged from a low of six percent to a high of 41 percent in 2012; food insecurity rates among households with children have been found to be considerably higher than that in the general population. In 2012, the state level of child food insecurity rate ranged from a low of 10.6 percent in North Dakota to a high of 29.2 percent in New Mexico. Mississippi had the second highest level of child food insecurity in the U.S.; with 28.7 percent of Mississippi s children being food insecure, it is estimated that approximately 199 Coleman Jensen, A., Nord, M. and Singh, A. (2013) Household Food Security in the United States in U.S. Department of Agriculture Economic Research Service. 200 Ibid. 201 Gundersen, C., Waxman, E., Engelhard, E., Satho, A. and Namrita, C. Map the Meal Gap 2013: Food Insecurity Estimates at the County Level. Feeding America, Coleman Jensen, A., Nord, M. and Singh, A. (2013) Household Food Security in the United States in U.S. Department of Agriculture Economic Research Service. 120

131 214,720 children in Mississippi are food insecure. 203 In Lowndes County, it is estimated that 27.4 percent of children are food insecure; research indicates that among the 4,120 children living in Lowndes County that are food insecure, approximately 71 percent are eligible for Federal Nutrition Assistance programs but 29 percent are not eligible. 204 Food insecurity is defined as a continuous lack of access to enough food for an active, healthy life; although living in an underserved community may not be the primary cause of food insecurity, the food environment frames the conditions under which households must expend greater resources to obtain food through available sources. Lack of access to affordable nutritious food retail has been shown to increase the likelihood of food insecurity. 205 Research has linked high poverty, low income, and low educational achievement levels to food security and to the probability of living in an underserved community. 206 Income and education have been found to be negatively correlated with food insecurity; 207 as income and educational attainment increase, food insecurity decreases. HFFI census tracts have predominantly been found to be home to socioeconomically disadvantaged people relative to other areas; 208 lower income levels indicate that residents of underserved communities have fewer resources available to purchase healthy foods. A review of the research on HFFI census tracts in the United States generally supports the statement that these census tracts are places where area level deprivation compounds individual disadvantage Ibid. 204 Gundersen, C., Waxman, E., Engelhard, E., Satho, A. and Namrita, C. Map the Meal Gap 2013: Food Insecurity Estimates at the County Level. Feeding America, Nord, M., Andrews, M., and Carlson, S. (2008). Household Food Security in the United States. U.S. Department of Agriculture, Economic Research Service. Report No Wild, P., Liobrera, J., and Ver Ploeg, M. (2014). Population Density, Poverty, and Food Retail Access in the United States: An Empirical Approach. International Food & Agribusiness Management Review. 17: Rice, K. (2010). Measuring the Likelihood of Food Insecurity in Ohio s Food Deserts. Journal of Food Distribution Research. 41(1): Beaulac, J., Kristjansson, E., Cummins, S. (2009). A Systematic Review of Food Deserts: 1996 to Centers for Disease Control, Preventing Chronic Disease, Public Health Research, Practice, and Policy: 6(3): Ibid. 121

132 Census Tract or Geographic Area Civilian employed population 16 years and over ** Denotes HFFI Eligible Census Tract Table 26: Lowndes County Employment by Industry Agriculture and Mining Construction Manufacturing Wholesale trade Retail trade Transportation/ Warehousing/ Utilities , % 11.2% 13.7% 2.6% 12.9% 13.1% , % 6.2% 19.7% 6.3% 11.0% 3.9% % 2.9% 0.0% 6.1% 7.3% 5.6% , % 8.1% 16.7% 0.0% 14.1% 3.7% ** 3, % 5.3% 11.4% 1.7% 22.3% 8.4% , % 11.7% 14.3% 2.3% 12.5% 7.6% , % 11.9% 21.5% 1.8% 17.2% 5.5% , % 6.4% 15.5% 2.6% 8.7% 5.1% ** 1, % 3.5% 22.9% 1.3% 12.6% 4.8% ** 1, % 5.1% 6.1% 0.7% 20.1% 3.4% ** % 8.4% 12.5% 0.7% 9.9% 4.3% ** 2, % 5.6% 7.3% 5.8% 10.9% 10.4% , % 9.2% 10.6% 3.6% 9.9% 8.2% ** % 7.4% 32.3% 0.7% 14.8% 11.3% Lowndes County 23, % 7.8% 14.2% 2.3% 14.3% 7.0% Lowndes Numeric 23, ,851 3, ,396 1,677 Mississippi 1,194, % 6.9% 12.9% 2.6% 11.8% 5.7% United States 141,864, % 6.2% 10.5% 2.8% 11.6% 4.9% Census Tract or Geographic Area Information Finance/ Insurance/ Real Estate Professional/ Scientific/ Management/ Administrative Educational Services/ Health Care/ Social Assistance Arts/ Entertainment/ Recreation/ Accommodation/ Food Services Other services, except Public Administration Public Administration % 2.5% 2.5% 21.2% 8.4% 2.8% 6.8% % 0.6% 9.7% 19.7% 12.1% 2.7% 2.4% % 4.4% 9.0% 17.3% 7.6% 0.0% 33.2% % 5.0% 9.4% 23.1% 4.9% 3.7% 7.7% ** 1.3% 5.2% 5.1% 21.7% 3.9% 9.8% 1.6% % 4.6% 8.4% 21.7% 2.8% 6.1% 5.8% % 3.1% 6.3% 19.2% 4.5% 3.4% 5.1% % 3.8% 9.1% 18.0% 17.8% 6.9% 4.2% ** 3.7% 1.7% 4.5% 14.4% 22.7% 3.3% 3.3% ** 1.4% 3.3% 3.2% 30.3% 15.3% 7.2% 3.3% ** 0.0% 0.0% 4.0% 33.0% 18.3% 6.2% 1.7% ** 0.8% 6.3% 7.7% 19.9% 19.1% 3.0% 2.6% % 5.0% 5.3% 29.8% 5.9% 5.7% 2.5% ** 1.2% 2.0% 1.5% 16.6% 4.0% 3.4% 2.2% Lowndes County 1.6% 3.8% 6.3% 22.1% 9.7% 5.1% 4.7% Lowndes Numeric ,490 5,256 2,308 1,203 1,129 Mississippi 1.4% 4.9% 6.3% 24.4% 9.4% 5.0% 5.7% United States 2.2% 6.7% 10.8% 23.2% 9.3% 5.0% 5.0% Source: U.S. Census Bureau, American Community Survey Year Estimates 122

133 The Lowndes County Workforce Among the civilian employed population over the age of 16, the largest percentage of the work force in Lowndes County is employed in the Educational Services, Health Care, and Social Assistance sectors of the economy; in Lowndes, employment in these sectors represents approximately 22.1 percent of total employment (Table 26, page 122). 210 There are three HFFI census tracts that exhibit a relatively high employment rate in the Educational Services, Health Care, and Social Assistance sectors; these are: Census tract , with 33.0 percent of the workforce employed in the Educational Services, Health Care, and Social Assistance sector Census tract , with 30.3 percent of the workforce employed in the Educational Services, Health Care, and Social Assistance sector Census tract , with 21.7 percent of the workforce employed in the Educational Services, Health Care, and Social Assistance sector In Lowndes County, approximately 14.3 percent of the population is employed in the Retail Trade sector; the percentage of the workforce that is employed in the Retail Trade sector is higher in Lowndes County than it is in either the state of Mississippi (11.8 percent) or the United States (11.6 percent). There are three HFFI census tracts in Lowndes County where the percentage of the workforce employed in the Retail Trade sector is higher than that of the county, the state, and the nation; these are: Census tract , with 20.1 percent of the workforce employed in the Retail Trade sector Census tract , with 22.3 percent of the workforce employed in the Retail Trade sector Census tract , with 14.8 percent of the workforce employed in the Retail Trade sector; this is only marginally higher than the county s Retail employment rate of 14.3 percent. The Manufacturing sector employs approximately 14.2 percent of Lowndes County s employed civilian population over the age of 16 (Table 26, page 122); the percentage of the workforce employed in the Manufacturing sector is higher in Lowndes County than it is in either the state of Mississippi (12.9 percent) or the U.S. (10.5 percent). There are two qualifying HFFI census 210 Author s note: the data provided in this section of the report uses American Community Survey 5 year estimates to provide valid comparable analysis across census tracts and other geographic areas; subsequent sections of this report will use more recent data that is specific to Lowndes County, but not available at the census tract level of analysis to conduct economic analysis. It is also important to note that ACS 5 year estimate data defines the industry in which the workforce is employed but does not define the location of the industry; for example, a worker who resides in an HFFI census tract in Lowndes County may be employed in the Manufacturing sector in a county or geographic area that may be within Lowndes County or outside of Lowndes County. 123

134 tracts where the percentage of the workforce that is employed in the Manufacturing sector is higher than the percentage rate for Lowndes County, these are: Census tract , where 32.3 percent of the workforce is employed in the Manufacturing sector Census tract , where 22.9 percent of the workforce is employed in the Manufacturing sector In Lowndes County, 9.7 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors; this is slightly higher than the percentage rate for the state of Mississippi (9.4 percent) and that of the United States (9.3 percent) (Table 26, page 122). There are four HFFI census tracts in Lowndes County where the percentage of employment in Arts, Entertainment, Recreation, or Accommodation and Food Services is higher than the average in Lowndes County; these are: Census tract , where 22.7 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors Census tract , where 19.1 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors Census Tract or Geographic Area ** Denotes HFFI Eligible Census Tract Table 27: Median Earnings for Lowndes County Workers Median earnings for workers (dollars) Median earnings for male full time, yearround workers Median earnings for female full time, yearround workers $31,196 $51,140 $37, $23,050 $43,667 $23, $28,750 $41,964 $27, $31,750 $52,639 $32, ** $21,374 $46,579 $32, $29,750 $39,505 $32, $35,481 $60,091 $32, $20,594 $37,105 $23, ** $13,570 $21,909 $18, ** $11,270 $43,350 $28, ** $14,626 $22,177 $18, ** $22,111 $42,444 $21, $31,446 $49,938 $30, ** $19,831 $37,885 $25,263 Lowndes County $23,496 $45,035 $27,534 Mississippi $25,707 $40,742 $30,604 U.S. $30,538 $49,087 $38,635 Source: U.S. Census Bureau, American Community Survey Year Estimates 124

135 Census tract , where 18.3 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors Census tract , where 15.3 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors The median earnings for all workers in Lowndes County was $23,496, as compared to median earnings of $25,707 in the state of Mississippi and median earnings of $30,538 in the United States (Table 27, page 124). In Lowndes County, the median earnings for male full time workers that held steady year round jobs was $45,035; the median earnings for female fulltime workers that held steady year round jobs was $27,534 (Table 27, page 124). In Lowndes County s HFFI census tracts, the mean earnings for all workers was lower than that of Lowndes County; in HFFI census tracts, the mean earnings for all workers ranged from being $1,385 (census tract ) lower than that of Lowndes County to being $12,226 lower (census tract ) than that of Lowndes County. In five of the six HFFI census tracts, the median earnings for male full time workers that held steady year round jobs was lower than Lowndes county s median earnings; this negative male earnings differential ranged from a low of $1,685 in tract to a high of $23,126 in HFFI census tract (Table 27, page 124). In Lowndes County, the median earnings for females who held full time, yearround jobs was $27,534; in HFFI census tracts, the median earnings for female full time workers that held steady year round jobs was lower than that of Lowndes County, with the exception of HFFI census tract For female full time workers that held steady year round jobs, the negative median earnings differential in Lowndes County s HFFI census tracts ranged from a low of $2,271 in census tract to a high of $9,284 in census tract Analysis of employment, age, educational attainment, the percentage of households with earnings from work or retirement income, and household income indicates that the majority of individuals residing in HFFI qualifying census tracts in Lowndes County can be categorized as either the working poor or the elderly poor (persons age 65 and over). HFFI census tracts in Lowndes County were found to have a higher percentage of single female families with children, lower educational attainment, and lower incomes and earnings. The food environment within these census tracts requires special consideration due to the vulnerability of the population to deprivation amplification. Deprivation amplification is described as a process where multiple risk factors are combined within an environment and negative outcomes are augmented; for example, health risk factors associated with low income, such as obesity or food insecurity, may be combined with limited knowledge about nutrition and be intensified by living in a food environment that offers little access to affordable, nutritious food. 125

136 Table 28: Health Insurance Coverage for the Civilian Non Institutionalized Population in Lowndes County Census Tract or Geographic Area With Health With Private Health Insurance Coverage Insurance With Public Health Insurance Coverage With No Health Insurance Coverage Population Under 18 Years with No Health Insurance Coverage ,888 3,839 1,857 1, ,340 1,290 1, ,214 5,237 2,061 1, * 5,815 4,119 2,483 1, ,414 2,755 1, ,457 3, ,163 2,183 1, * 2, , * 3,723 2,106 1,902 1, * 2,601 1,159 1,704 1, * 4,390 2,883 2,236 1, ,917 1, * 1, Lowndes 46,478 32,728 20,454 11,000 1,953 Mississippi 2,392,262 1,667,737 1,035, ,225 68,473 United States 258,778, ,379,999 89,277,994 45,206,153 5,953,533 Census Tract of Geographic Area Percent with Health Insurance Coverage Note: Percentage rates for Private, Public, and No Health Insurance Coverage do not sum to 100 percent due to duplicate insurance coverage. For example, individuals covered by a group health insurance plan may have Medicare as a secondary payer. * Denotes HFFI Eligible Census Tract Percent with Private Health Insurance Percent with Public Health Coverage Percent with No Health Insurance Coverage Percent of Population Under 18 Years with No Health Insurance Coverage % 64.10% 31.00% 18.40% 12.80% % 45.60% 44.30% 17.30% 12.50% % 90.70% 5.00% 9.30% 10.80% % 71.30% 28.10% 15.30% 7.20% * 82.10% 58.20% 35.10% 17.90% 14.30% % 64.00% 25.60% 20.70% 21.80% % 74.20% 20.90% 15.10% 9.90% % 53.70% 41.40% 22.20% 28.50% * 76.40% 30.90% 58.60% 23.60% 7.70% * 78.30% 44.30% 40.00% 21.70% 8.00% * 72.00% 32.10% 47.20% 28.00% 14.30% * 78.90% 51.80% 40.20% 21.10% 17.20% % 70.30% 34.70% 11.60% 10.00% * 80.30% 47.60% 43.20% 19.70% 5.80% Lowndes 80.90% 56.90% 35.60% 19.10% 13.20% Mississippi 82.50% 57.50% 35.70% 17.50% 9.10% United States 85.10% 66.90% 29.40% 14.90% 8.10% Source: U.S. Census Bureau, American Community Survey year Estimates 126

137 Health Care Insurance in Lowndes County In Lowndes County, 80.9 percent of the civilian, non institutionalized population has health insurance coverage and 19.1 percent of the population has no health insurance coverage (approximately 11,000 people); 13.2 percent of children under the age of 18 have no health insurance coverage (Table 28, page 126). Among the population that has health insurance coverage, 56.9 percent of the population has private health insurance coverage and 35.6 percent has public health coverage (approximately 20,454 people). There are 10,844 people living in HFFI census tracts in Lowndes County that have public health insurance coverage; this represents 53.0 percent of the Lowndes County population that has public health insurance coverage. The percentage of the civilian, non institutionalized population in Lowndes County with no health insurance coverage (19.1 percent) is slightly higher than that of the state of Mississippi (17.5 percent), and is 4.2 percentage points higher than the U.S. percentage rate of 14.9 percent (Table 28, page 126). The percentage rate of children under 18 with no health insurance coverage in Lowndes County (13.2 percent) is higher than that of the state of Mississippi (9.1 percent) and is also higher than that of the United States by 5.1 percent (Table 28, page 126). There are approximately 812 children under the age of 18 with no health insurance coverage who live in Lowndes County HFFI census tracts; this represents 41.6 percent of the children under the age of 18 in Lowndes County that have no health insurance coverage. With the exception of census tract , all qualifying HFFI census tracts in Lowndes County have a greater percentage of the population that have no health insurance; in two of the HFFI census tracts, the percentage of the population that has no health insurance is quite substantial; for example, in census tract , 28 percent of the population has no health insurance coverage, and in census tract , 23.6 percent of the population has no health insurance coverage. There are 5,532 people living in Lowndes County HFFI census tracts who have no health insurance coverage; this represents 50.3 percent of all people in Lowndes County who have no health insurance coverage and indicates that a disproportionate number of people living in HFFI census tracts in Lowndes County have no health insurance given that only 44.3 percent of the total population of Lowndes County reside in HFFI census tracts. As discussed in prior sections of this report, the healthcare expenditures associated with recipients of public health insurance are higher than those who are covered by private insurance; these healthcare costs and those of the uninsured are predominantly paid for by federal and state governments or by hospitals and physicians and ultimately paid for by tax revenues or by a hidden tax on the cost of healthcare. Public policies that are designed to increase the affordability and accessibility of healthy food in underserved communities have a primary purpose of improving the nutrition and health of the residents, and specifically to reduce obesity and the related healthcare cost of obesity. 127

138 Table 29: Lowndes County Estimated Spending on Food Census Tract Food at Home Average Household Spending Food at Home Total Spending Food Away from Home Average Household Spending Food Away from Home Total Spending Spending Index Food at Home Spending Index Food Away from Home Total Food Spending $4, $8,925,649 $2, $5,653, $14,578, $3, $3,271,287 $2, $2,069, $5,340, $3, $2,417,100 $2, $1,625, $4,042, $5, $19,408,419 $3, $12,032, $31,440, ** $3, $10,330,570 $2, $6,335, $16,666, $3, $6,733,183 $2, $4,086, $10,819, $4, $7,036,711 $2, $4,304, $11,340, $3, $5,582,451 $2, $3,434, $9,017, ** $1, $2,657,507 $1, $1,575, $4,232, ** $2, $4,277,223 $1, $2,552, $6,829, ** $1, $2,218,161 $ $1,296, $3,514, ** $3, $9,016,852 $2, $5,399, $14,416, $4, $4,595,865 $2, $2,662, $7,258, ** $2, $2,064,156 $1, $1,112, $3,176, Lowndes County $3, $89,270,189 $2, $54,262, $143,532, Source: ESRI Forecasts; Consumer spending data is derived from 2011 and 2012 Bureau of Labor Statistics Consumer Expenditure Surveys The Spending Potential Index is household based and represents the amount spent relative to a national average of 100 The Spending Index measures spending as compared to average spending in the United States which equals 100. A spending index below 100, indicates that average household spending is lower than that of the United States; a spending index above 100, indicates that average household spending is higher than that of the United States. 128

139 The Economic Impact of Investments in Lowndes County The economic return on investments in Lowndes County s underserved communities will vary based upon the type of investment (i.e. supermarket, grocery store, or convenience store), the amount of the investment, and the geographic location of the investment which will determine the size of the market. The size of the potential market for an investment is not limited by the boundaries of a census tract; depending upon site selection, a store may draw customers from more than one census tract. As shown in Table 29 on page 128, household spending for food at home varies by census tract; average household spending for food at home is lower in Lowndes County s HFFI census tracts as compared to the county wide average household spending of $3, on food at home. Table 30, below, provides an estimate of total household spending on food at home within each census tract and also provides an estimate of the supply of food at home that is met by stores within the census tract. The retail gap is an estimate of the unmet demand for food at home within the census tract; positive values indicate that demand for food at home exceeds that which is supplied by stores within the census tract; negative retail gap values indicate that stores within a census tract are meeting demand for food at home by households that do not live within that census tract. With a household fruit and vegetable spending index of 76, all households in Lowndes County exhibit lower spending levels on fruits and vegetables than the average household spending level in the United States (Table 30, at right). In many of Lowndes County s HFFI census tracts, the household fruit and vegetable spending index is extremely low; for example, in HFFI census tract , the household fruit and vegetable spending index is 45 this census tract also indicates a retail gap of approximately $2,037,229, indicating there may be sufficient market demand to support a grocery store. Table 30: Lowndes County Household Spending on Food at Home and the Retail Spending Gap Census Tract or Geographic Area Food at Home Total Spending Estimated Supply Retail Gap Spending on Fruits & Vegetables Fruit & Vegetable Spending Index $8,925,649 $1,238,199 $7,687,450 $1,645, $3,271,287 $2,112,230 $1,159,057 $604, $2,417,100 $3,664,351 $1,247,251 $448, $19,408,419 $8,234,497 $11,173,922 $3,622, ** $10,330,570 $1,977,960 $8,352,610 $1,913, $6,733,183 $3,797,401 $2,935,782 $1,214, $7,036,711 $1,576,143 $5,460,568 $1,296, $5,582,451 $8,951,673 $3,369,222 $1,037, ** $2,657,507 $1,111,700 $1,545,807 $495, ** $4,277,223 $2,239,994 $2,037,229 $792, ** $2,218,161 $2,225,930 $7,769 $405, ** $9,016,852 $39,670,125 $30,653,273 $1,656, $4,595,865 $214,929 $4,380,936 $837, ** $2,064,156 $1,082,561 $981,595 $349, Total $89,270,189 $78,097,693 $10,437,441 $16,319, Source: Consumer Spending data is derived from 2012 Bureau of Labor Statistics Consumer Expenditure Surveys; Estimated supply is from Dunn and Bradstreet, sourced from ESRI Forecasts ** Denotes HFFI Eligible Census Tract 129

140 Table 31: The Economic Impact of a $6,570,000 Construction Investment in Lowndes County Impact Type Employment Labor Income Value Added Output Direct Effect 52.6 $3,266,305 $3,357,436 $6,570,000 Indirect Effect 7.0 $316,097 $502,253 $901,511 Induced Effect 15.7 $568,567 $1,010,595 $1,675,632 Total Effect 75.4 $4,150,969 $4,870,284 $9,147,142 Source: IMPLAN Table 32: The Fiscal Impact of a $6,570,000 Construction Investment in Lowndes County Table 34: The Economic Impact of the Ongoing Operations of a Supermarket with Annual Sales of $8,352,610 Impact Type Employment Labor Income Value Added Output Direct Effect 41.7 $1,226,941 $1,614,462 $2,372,141 Indirect Effect 3.1 $115,723 $193,673 $351,449 Induced Effect 5.9 $213,442 $379,618 $629,371 Total Effect 50.7 $1,556,105 $2,187,753 $3,352,961 Source: IMPLAN Table 33: The Fiscal Impact of the Ongoing Operations of a Supermarket with Annual Sales of $8,352,610 Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $211,048 $119,389 $2,910 $5,786 $17,964 $2,917 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $2,689 $20,297 $3,209 $1,439 $559 $725 Source: IMPLAN 130

141 In HFFI census tract , the household fruit and vegetable spending index is 69; the estimated retail gap in this census tract is approximately $8.3 million, indicating there may be sufficient demand to support a traditional, independent supermarket. Although a store located within an HFFI census tract may not capture all spending on food at home within a census tract, the estimated retail gap was used to evaluate the economic impact of two potential investments made in HFFI census tracts in Lowndes County. Economic input output models were used to evaluate the impact of economic activity during the construction or renovation phase of activity and then to evaluate the impact of economic activity during the ongoing operations of the business upon completion of construction. The Economic Impact of a Supermarket Investment in Lowndes County An initial investment of $6,570,000 in construction or renovation of a 45,000 square foot supermarket with estimated annual sales of $8,352,610 during the ongoing operations of the business; modeled at the county level. Based upon these assumptions, this investment would generate an estimated 75.4 full time equivalent jobs during the construction phase of project activities; approximately 52.6 direct jobs would be created and an additional 22.7 indirect and induced jobs would be created during construction. Total labor income associated with the construction phase of project activities was estimated to be $4,150,969; of this amount, $3,266,305 would be direct labor income (Table 31, page 130). The fiscal impact of construction activities would generate an estimated $285,948 in tax revenues; of these, $124,044 are sales tax and approximately $71,635 are property taxes on personal property or on production and imports (Table 32, page 130). The economic and fiscal impact of construction activities are short term effects that terminate shortly after the completion of construction. A supermarket with annual sales of $8,352,610 would create approximately 50.7 full time equivalent jobs in Lowndes County; of these, approximately 41.7 direct jobs with an average annual income of $29,423 would be created. These direct jobs would create multiple employment opportunities within the underserved community where a new store was located (Table 34, page 130). The annual fiscal impact of the ongoing operations of a supermarket with annual sales of $8.3 million would be approximately $388,932; of this amount, sales tax revenues are estimated to be $211,048 and $139,686 are property taxes on personal property or on production and imports (Table 33, page 130). The economic impact and fiscal effects of the ongoing operations of a business firm are continuous throughout the life of the business, providing employment and tax revenues 131

142 Table 35: The Economic Impact of a $2,920,000 Construction Investment in Lowndes County Impact Type Employment Labor Income Value Added Output Direct Effect 22.3 $1,381,571 $1,412,556 $2,920,000 Indirect Effect 4.2 $188,271 $282,850 $509,018 Induced Effect 6.9 $249,187 $442,937 $734,413 Total Effect 33.4 $1,819,029 $2,138,344 $4,163,431 Source: IMPLAN Table 36: The Fiscal Impact of a $2,920,000 Construction Investment in Lowndes County Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $52,744 $29,837 $727 $1,446 $4,489 $729 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $2,561 $23,328 $3,689 $1,654 $642 $833 Source: IMPLAN Table 37: The Economic Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,037,329 Impact Type Employment Labor Income Value Added Output Direct Effect 10.2 $299,255 $393,773 $578,573 Indirect Effect 0.8 $28,225 $47,237 $85,720 Induced Effect 1.4 $52,059 $92,590 $153,505 Total Effect 12.4 $379,539 $533,600 $817,798 Source: IMPLAN Table 38: The Fiscal Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,307,329 Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $51,475 $29,119 $710 $1,411 $4,381 $711 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $656 $4,950 $783 $351 $136 $177 Source: IMPLAN 132

143 annually. Depending upon the success of the firm and the economic climate, employment and related tax revenues may increase or decline over time. The Economic Impact of a Grocery Store Investment in Lowndes County An initial investment of $2,920,000 in the construction or renovation of a 20,000 square foot grocery store with annual sales of $2,037,329; modeled at the county level. Based upon these assumptions, approximately 33.4 full time equivalent jobs would be supported during the construction phase of project activities; of these 22.3 would be on site direct construction jobs with associated labor income of approximately $1,381,571. An additional 11.1 indirect and induced full time equivalent jobs would be created during the construction phase of project activities (Table 35, page 132). During the construction phase of project activities, the fiscal impact is estimated to be $122,879; of this amount, associated sales tax revenues are estimated to be $52,744 (Table 36, page 132). The ongoing operations of a grocery store located in an underserved community in Lowndes County with estimated annual sales of approximately $2,037,329 would create approximately 12.4 full time equivalent jobs, with associated labor income of $379,539 annually. An estimated 10.2 direct jobs would be associated with the ongoing operations of the store, creating employment opportunities for the low income residents living within the underserved community (Table 37, page 132). The annual fiscal impact of the ongoing operations of the project are estimated to be $94,860; of this amount, sales tax revenues are projected to be $51,475 and property tax revenues are projected to be $29,255 (Table 38, page 132). 133

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145 Pearl River County, Mississippi ** Denotes HFFI a Food Eligible Desert Census Tract Census Tract Lumberton Young Villa Ridge Fords Creek Hillsdale Orvisburg Gum Pond Poplarville ** Crossroads White Sand Derby Nortac Juniper Grove Chinquapin Savannah Silver Run Henleyfield Mill Creek McNeill Hawthorne Barth Cybur Industrial ** Picayune ** Nicholson Nicholson Carriere Ozona Hide-A-Way Lake Richardson Caesar Miles Map 7: Pearl River County HFFI Qualifying Census Tracts 135

146 ** Denotes an HFFI Census Tract ** ** ** Miles Map 8: Pearl River County Reference Map 136

147 Eligible Healthy Food Financing Initiative Census Tracts in Pearl River County Based upon the data from the USDA s HFFI Locator Tool, there are three (3) census tracts located in Pearl River County that are eligible HFFI census tracts and qualify for funding under the Federal Healthy Food Financing Initiative; these are: Census Tract is designated as a rural tract that is eligible based upon low income and low access measured at 1 and 10 miles, low income and low access measured at ½ and 10 miles and low income and low access using vehicle access. Census Tract is designated as an urban tract that is eligible based upon low income and low access measured at ½ and 10 miles. Census Tract is designated as an urban tract that is eligible based upon low income and low access measured at 1 and 10 miles, at ½ and 10 miles, and at 1 and 20 miles, and low income and low access using vehicle access. All eligible HFFI census tracts in Pearl River County are also qualifying census tracts to receive Federal New Market Tax Credits. In Pearl River County, an estimated 18,017 people live in HFFI census tracts; this represents approximately 32.4 percent of the total county population. There are approximately 4,714 children (age 0 to 17 years) and 2,211 seniors (age 65 and over) living in HFFI census tracts in Pearl River County; 34.8 percent of all children and 26.1 percent of all seniors in Pearl River County live in HFFI qualifying census tracts. 137

148 Figure 17: Pearl River County Population 2000 through

149 Overview of Pearl River County In 2013, Pearl River County s estimated population was 55,072; from 2000 to 2013, the county s population increased by 6,451 (an increase of 13.3 percent). During the aftermath of Hurricane Katrina, Pearl River County experienced a surge in population and the population peaked at 56,538 in 2008: between 2008 and 2013, the population of Pearl River County declined by approximately 1,466 people (Figure 17, page 138). Over the period from 2000 to 2013, Pearl River County experienced the 8 th highest growth rate in total population and the 11 th highest percentage increase in population among the 82 counties in the state of Mississippi. According to U.S. Census population estimates, in the United States, 72.4 percent of the population is White, 12.6 percent of the population is African American, 9.1 percent of the population is Hispanic or Latino, percent of the population is Asian, 1.7 percent of the population is American Indian or Alaska Native, and the balance is some other race; in the U.S., 49.2 percent of the population is male and 50.8 percent of the population is female. Table 39: Pearl River County Population by Census Tract Census Tract Total Percent of County Population Population ** 6, % , % , % , % , % , % , % ** 4, % ** 7, % Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Census Tract In the state of Mississippi, 60.1 percent of the population is White, 37.6 percent of the population is African American, and less than 2 percent of the population is comprised of some other racial group; in Mississippi, 48.3 percent of the population is male and 51.7 percent of the population is female. In Pearl River County, 84.5 percent of the population is White and 12.7 percent of the population is African American; American Indians, Asians, and other groups account for approximately 1.3 percent of the population (Table 40, page 140). In Pearl River County, approximately 48.9 percent of the population is male and 50.1 percent of the population is female; this gender distribution is similar to that of the state of Mississippi and to that of the United States percent of the U.S. population is Hispanic or Latino; of these, 8.7 percent are classified as White alone and 6 percent are classified as some other race by the 2010 U.S. Census. 139

150 Table 40: Pearl River Racial Distribution by Census Tract Census Tract Total Population White Percent White Black or African American Percent Black or African American American Indian and Alaska Native alone Percent American Indian and Alaska Native Asian Percent Asian Some other Race Percent Some other Race ** 6,000 5, % % % % % ,992 4, % 1, % % % % ,207 2, % % % % % ,798 5, % % % % % ,971 5, % % % % % ,883 7, % % % % % ,701 6, % % % % % ** 4,212 3, % % % % % ** 7,805 5, % 2, % % % % Total 55,569 46, % 7, % % % % Source: U.S. Census Bureau, American Community Survey Year Estimates **Denotes HFFI Eligible Census Tract 140

151 In Pearl River County, 45.9 percent of the African American population lives in an HFFI census tract. In two of Pearl River County s HFFI census tracts, the percentage of the African American population is higher than the county average of 12.7 percent; in census tract , 13.6 percent of the population is African American and in census tract , 32.7 percent of the population is African American (Table 40, page 140). These two census tracts replicate the pattern found in research on HFFI census tracts, 212, 213, 214 which indicates that HFFI census tracts are more likely to be census tracts with higher concentrations of minority populations. However, in census tract (an HFFI census tract), African Americans represent only 1.9 percent of the census tract population; in census tract , which is not a qualifying HFFI census tract, 23.0 percent of the census tract population is African American (Table 40, page 140). In Pearl River County, there are approximately 8,473 people age 65 and over; these seniors represent 15.2 percent of Pearl River County s total population. An estimated 2,211 seniors live in HFFI census tracts in Pearl River County; they represent 26.1 percent of the total county population age 65 and over (Table 41, page 142). HFFI census tract has a relatively high percentage of people age 65 and over; in this tract, 16.5 percent of the population is 65 or older. The poverty rate for people age 65 and over is 8.5 percent in Pearl River County; this senior poverty rate is lower than that of the state of Mississippi and of the United States (Table 43, page 144). With a poverty rate of 16.8 percent, HFFI census tract has the highest senior poverty rate in Pearl River County. There are approximately 2,183 households in Pearl River County with seniors living alone; in HFFI census tracts, an estimated 717 households are comprised of individuals age 65 and over who live alone (Table 42, page 143). Senior populations face unique food access issues due to the transportation issues faced by this segment of the population; they frequently rely upon family members or friends for transportation, and they frequently have mobility and disability issues; programs to increase senior access to affordable, nutritious food must be designed to meet the special needs of the senior population. There are approximately 28,351 females living in Pearl River County; they represent 51.0 percent of the population. Two HFFI census tracts in Pearl River County have a relatively high percentage of females; in census tract , 58.6 percent of the population is female and in census tract , 55.3 percent of the population is female (Table 41, page 142). Approximately 34.9 percent (9,901 females) of all females in Pearl River County live in HFFI census tracts. 212 Dutko, Paula, Michele Ver Ploeg, and Tracey Farrigan. Characteristics and Influential Factors of Food Deserts, ERR 140, U.S. Department of Agriculture, Economic Research Service, August Duran, A. C., et al. (2013). Neighborhood Socioeconomic Characteristics and Differences in the Availability of Healthy Food Stores and Restaurants in Sao Paulo, Brazil. Health Place 23: Block, J. P., et al. (2004). Fast food, Race/Ethnicity, and Income: A Geographic Analysis. American Journal of Preventive Medicine 27(3):

152 Table 41: Pearl River County Selected Gender, Age, and Family Population Data by Census Tract Census Tract Total Population Percent Female Population 17 years and Under Percent of Tract Population 17 and Under Population 65 and Over Percent of Tract Population 65 and Over Number of Families Number of Female Households, No Husband Present, with Children Under 18 Percent of Tract Families with Female Householder, No Husband Present with Children under 18 Years ** 6, % 1, % % 1, % , % 1, % % 1, % , % % % % , % 1, % 1, % 1, % , % 1, % % 1, % , % 1, % 1, % 2, % , % 1, % 1, % 2, % ** 4, % % % 1, % ** 7, % 2, % % 2, % County Totals 55, % 13, % 8, % 14,958 1, % Source: U.S. Census Bureau, American Community Survey Year Estimates **Denotes HFFI Eligible Census Tract 142

153 In Pearl River County, 24.4 percent of the population are children (age 17 and under). There are two HFFI census tracts that exhibit a higher percentage of children than the county average; in census tract , 30.3 percent of the population are children and in census tract , 25.4 percent of the population are children (Table 41, page 142). In Pearl River County, 34.8 percent of all children live in an HFFI census tract. Although the poverty rate for all people in Pearl River County is approximately the same as that of the state of Mississippi, it is 6.8 percent higher than the U.S. poverty rate of 15.4 percent (Table 43, page 144). Child poverty rates in Pearl River County are higher than those for the state of Mississippi and significantly higher than the U.S. poverty rate for children. Among children under the age of five, the poverty rate in Pearl River County is 40 percent and for children between the age of 5 and 17, the poverty rate is 31.7 percent in Pearl River County (Table 43, page 144). HFFI census tract exhibits a high rate of poverty for older children; 46.8 percent of children age 5 to 17 live in poverty in this tract the magnitude of this issue is of particular concern because this census tract also has the largest population of children (2,362 children) when compared to the other HFFI census tracts in Pearl River County. In HFFI census tract , younger children experience an extremely high poverty rate, with 65.0 percent of all children under the age of five living in poverty. There are a total of 14,958 families living in Pearl River County; 32.6 percent of these families live in HFFI census tracts (Table 42, below). There are 1,834 female headed families with no husband present, that have children under 18 years old in Pearl River County; these single female parents represent 12.3 percent of all families in Pearl River County almost 50 percent of these single female families with children live in HFFI census tracts. Among female Table 42: Pearl River County Households and Families by Type Household by Type Pearl River Total in HFFI Percent in HFFI County Total Census Tracts Census Tracts Total households 20,556 6, % Family households (families) 14,958 4, % With own children under 18 years 6,217 2, % Married couple family 11,095 3, % With own children under 18 years 4,022 1, % Male householder, no wife present, family % With own children under 18 years % Female householder, no husband present, family 3,140 1, % With own children under 18 years 1, % Nonfamily households 5,598 1, % Householder living alone 4,819 1, % 65 years and over 2, % Households with one or more people under 18 years 7,080 2, % Households with one or more people 65 years and over 5,863 1, % Source: U.S. Census Bureau, American Community Survey Year Estimates 143

154 Table 43: Poverty Rates for Families and Individuals in Pearl River County Census Tract of Geographic Area All people All Families All Families with related children under 18 years Female Households, No Husband Present, with related children under 18 years All Children Under 5 All Children 5 to 17 Persons 65 years and older ** 26.10% 18.30% 29.60% 69.50% 65.00% 31.20% 8.10% % 19.00% 28.60% 83.30% 21.30% 39.40% 14.00% % 18.90% 27.90% 50.00% 44.60% 16.10% 13.50% % 16.40% 30.60% 56.70% 74.50% 21.80% 5.90% % 24.40% 44.90% 92.30% 37.00% 55.10% 14.60% % 8.60% 14.30% 91.10% 22.90% 17.00% 5.30% % 9.80% 17.40% 47.90% 16.30% 17.20% 1.60% ** 15.30% 14.70% 14.80% 35.10% 3.60% 20.30% 16.80% ** 33.00% 30.20% 41.80% 63.20% 35.40% 46.80% 7.20% Pearl River County 22.20% 17.50% 28.50% 63.80% 40.00% 31.70% 8.50% State of Mississippi 22.70% 17.80% 27.10% 51.80% 36.50% 30.50% 14.00% United States 15.40% 11.30% 17.80% 40.00% 24.70% 20.00% 9.40% Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 144

155 families with children under the age of 18, with no husband present, the poverty rate is 63.8 percent; this poverty rate is 12.0 percent higher than that of the state of Mississippi and 23.8 percent higher than that of the United States. With 636 single female families with children (Table 41, page 142), representing 31.4 percent of the total number of single female families with children in Pearl River County, HFFI census tract has the highest concentration of single female families with children as compared to all tracts in Pearl River County; 63.2 percent of these families live in poverty (Table 43, page 144). In Pearl River County, 83.2 percent of the population age 25 and over has a high school degree and 13.2 percent of the population has a Bachelor s degree or higher; the percentage of Pearl River County s population 25 and older with a high school degree is 1.7 percent higher than that of the state of Mississippi (Table 44, page 146). Although the percentage of Pearl River County s population age 25 and older with a Bachelor s degree or higher (13.2 percent) is lower than that of the state of Mississippi (20.1 percent), Pearl River County has a higher percentage of people age 25 and older who have completed some college, but have no degree and a higher percentage of people who have completed an Associate s degree as compared to these categories of educational attainment at the state level. For example, in the state of Mississippi, 8.1 percent of the population age 25 and over has an Associate s degree; in Pearl River County, 10.6 percent of the population age 25 and over has an Associate s degree (Table 44, page 146). Generally, the educational attainment level for the population age 25 and over living in Pearl River County s HFFI census tracts is not significantly different than the educational attainment levels for the entire county, but there are a few notable differences. For example, in HFFI census tracts and , the percentage of the population who completed some high school but have no high school degree is 11.8 percent and 12.8 percent, respectively; this compares to 10 percent at the county level (Table 44, page 146). Also, in HFFI census tract , 9.7 percent of the population has a Bachelor s degree or higher and in tract , 9.6 percent of the population age 25 and over have Bachelor s degrees or higher; these educational attainment levels are lower than the Pearl River County average of 13.2 percent. Food Insecurity in Pearl River County In 2011, approximately 16.4 percent of all individuals in the U.S. population experienced food insecurity; in 2012, 15.9 percent of all individuals in the United States were food insecure, 215 indicating that food insecurity had declined in the U.S. Across the United States, the average countylevel food insecurity rate remained stable at 14.7 percent in 2011 and in In Mississippi, the overall food insecurity rate was 22.3 percent in 2012; Mississippi had the highest overall food insecurity rate for individuals in the nation in In 2012, approximately 17.3 percent of all individuals in Pearl River County were food insecure an estimated 9,690 people. 215 Coleman Jensen, A., Nord, M. and Singh, A. (2013) Household Food Security in the United States in U.S. Department of Agriculture Economic Research Service. 145

156 ** Denotes HFFI Eligible Census Tract A Closer Look at Underserved Communities in Mississippi Table 44: Pearl River County Educational Attainment for the Population Age 25 and Over 146

157 Child food insecurity rates are substantially higher than the overall food insecurity rate for all age groups in the entire population. In the U.S., the child food insecurity rate was 21.6 percent in In counties across the United States, the county level of child food insecurity ranged from a low of six percent to a high of 41 percent in 2012; food insecurity rates among households with children have been found to be considerably higher than that in the general population. In 2012, the state level child food insecurity rate ranged from a low of 10.6 percent in North Dakota to a high of 29.2 percent in New Mexico. Mississippi had the second highest level of child food insecurity in the U.S.; with 28.7 percent of Mississippi s children being food insecure, it is estimated that approximately 214,720 children in Mississippi are food insecure. 217 In Pearl River County, it is estimated that 29.9 percent of children are food insecure; research indicates that among the 4,110 children living in Pearl River County that are food insecure, approximately 78 percent are eligible for Federal Nutrition Assistance programs but 22 percent are not eligible for these programs Coleman Jensen, A., Nord, M. and Singh, A. (2013) Household Food Security in the United States in U.S. Department of Agriculture Economic Research Service. 217 Ibid. 218 Gundersen, C., Waxman, E., Engelhard, E., Satho, A. and Namrita, C. Map the Meal Gap 2013: Food Insecurity Estimates at the County Level. Feeding America,

158 Census Tract or Geographic Area ** Denotes HFFI Eligible Census Tract ** Denotes HFFI Eligible Census Tract Table 45: Pearl River County Comparative Employment and Income Population 16 years and over Number in the Civilian Labor Force Percent In the Labor Force Percent Unemployed Number Not in the Labor Force ** 4,716 2, % 13.8% 2, ,849 2, % 13.3% 2, ,547 1, % 2.8% 1, ,546 2, % 13.9% 2, ,469 2, % 13.7% 1, ,418 3, % 11.6% 2, ,992 3, % 7.8% 2, ** 3,462 2, % 11.7% 1, ** 5,830 3, % 9.8% 2,644 Pearl River County 43,829 23, % 11.3% 19,864 Mississippi 2,312,959 1,343, % 11.1% 957,272 United States 246,191, ,113, % 9.7% 87,994,377 Source: U.S. Census Bureau, American Community Survey Year Estimates Census Tract or Geographic Area Total Households Percent of Households with Income less than $10,000 Percent of Housholds with Income between $10,000 to $14,999 Median household income (dollars) Percent of Households with Earnings ** 2, % 14.7% $32, % , % 9.8% $38, % , % 12.2% $36, % , % 8.4% $41, % , % 8.9% $40, % , % 2.3% $51, % , % 4.4% $54, % ** 1, % 10.8% $42, % ** 2, % 13.3% $26, % Pearl River County 20, % 9.0% $42, % Mississippi 1,088, % 8.1% $39, % United States 115,610, % 5.4% $53, % Source: U.S. Census Bureau, American Community Survey Year Estimates 148

159 Pearl River County Income by Source Pearl River County has a population of approximately 43,829 people who are age 16 and over; 54.7 percent of this population is in the civilian labor force. In Pearl River County, the average unemployment rate among the population 16 years and over was 11.3 percent; this unemployment rate was not statistically higher than that of the state of Mississippi (11.1 percent) and 1.6 percent higher than that of the United States for this age group (Table 45, page 148). The unemployment rate for the population age 16 and over within the HFFI qualifying census tracts in Pearl River County is slightly higher in tract than the average unemployment rate in the county, but not significantly different. In HFFI census tract , the unemployment rate is 13.8 percent and approximately 2,074 people in this tract are not in the labor force. In Pearl River County, the labor force participation rate is 54.7 percent; this participation rate is 3.4 percent lower than that of the state of Mississippi and 9.6 percent lower than the U.S. labor force participation rate. In Pearl River County, there are approximately 19,864 people age 16 and over who are not in the labor force; this represents 45.3 percent of the population in this age group (Table 45, page 148). There are an estimated 6,087 people age 16 and over who are not in the labor force who live in HFFI census tracts in Pearl River County, representing 43.5 percent of the total population age 16 and over within these tracts. Non participation in the labor force for individuals age 16 and over may be accounted for by those people who are retired, by those who are enrolled in school and not working, by people who are not able to work due to health or disability, and by those who select not to work due to a variety of reasons. The median household income in Pearl River County is $42,510; median household income in Pearl River County is approximately $3,479 higher than the state of Mississippi s median household income and approximately $10,536 lower than that of the United States (Table 45, page 148). The median household income in two HFFI census tracts is lower than that of Pearl River County; in HFFI census tract , the median household income is $32,188 ($10,322 lower than the county median income) and in HFFI census tract , the median income is $26,793; this is $15,717 lower than the average median income in Pearl River County (Table 45, page 148). Poverty is a function of income, family size, and age. For example, for single persons under 65, the income poverty threshold is $11,945 and for persons over 65, the poverty threshold is $11,011; for two people under the age of 65, the income poverty threshold is $15,450 and for two people over the age of 65, the income poverty threshold is $13,892. For family units consisting of three people or more, the income poverty threshold starts at $18,284 and increases based upon the size of the family. Of particular concern is the percentage of households that have household incomes of less than $15,000 due to the resource constraints that exist for these households. In Pearl River County, approximately 19.8 percent of households have incomes of less than $15,000; in the state of Mississippi, 19.5 percent of 149

160 Table 46: Pearl River County Comparative Earnings and Income by Source Census Tract or Geographic Area Mean earnings (dollars) for Households Percent of Households with Social Security Mean Social Security income (dollars) Percent of Households with retirement income Mean retirement income (dollars) Percent of Households with Supplemental Security Income Mean Supplemental Security Income (dollars) Percent of Households with cash public assistance income Mean cash public assistance income (dollars) Percent of Households with Food Stamp/SNAP benefits in the past 12 months ** $52, % $14, % $18, % $7, % $4, % $55, % $16, % $20, % $5, % $5, % $62, % $16, % $24, % $7, % $3, % $53, % $14, % $23, % $5, % $4, % $62, % $16, % $14, % $8, % $4, % $66, % $16, % $26, % $8, % $5, % $68, % $18, % $24, % $11, % $4, % ** $56, % $15, % $17, % $9, % $3, % ** $39, % $12, % $15, % $8, % $1, % Pearl River County $57, % $15, % $21, % $8, % $4, % Mississippi $56, % $15, % $19, % $8, % $2, % U.S. $75, % $17, % $23, % $9, % $3, % Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 150

161 households have incomes of less than $15,000, and in the U.S., this percentage rate is 12.6 percent (Table 45, page 148). Two of Pearl River County s HFFI census tracts exhibit a relatively high percentage of households with incomes of less than $15,000; in census tract , 28.3 percent of households have incomes less than $15,000, and 23.7 percent of households in census tract have incomes of less than $15,000. Household mean earnings are $57,327 in Pearl River County; household earnings in Pearl River County are slightly higher than those in the state of Mississippi (Table 46, page 150). Although mean household earnings in HFFI census tract are $56,784, this level of annual household earnings is not significantly different than the county average. However, in HFFI census tract , mean household earnings are $4,773 lower than Pearl River County s mean household earnings and in HFFI census tract , mean household earnings are $17,342 lower than Pearl River County s mean household earnings. Additional sources of household income may include Retirement income, Social Security or Supplemental Social Security Income, and some form of public assistance. In Pearl River County, approximately 19.4 percent of households receive income from retirement, and the mean retirement income is $21,043 (Table 46, page 150). The mean household retirement income in all HFFI census tracts in Pearl River County is lower than the county level mean household retirement income; for example, in HFFI census tract , the mean household retirement income is $2,354 lower than that of the county, and in HFFI census tract , the mean household retirement income is $5,839 lower than that of the county. Approximately 7.3 percent of households in Pearl River County receive Supplemental Social Security Income; this is slightly lower than the 7.8 percent of households in the state of Mississippi receiving Supplemental Social Security Income (Table 46, page 150). Supplemental Security Income (SSI) provides benefits to needy aged, blind, and disabled people; in the U.S., approximately 40 percent of SSI recipients are over the age of 65; the remainder are disabled. Children may qualify for SSI benefits if they are disabled. Of the estimated 1,510 households in Pearl River County receiving SSI benefits, 43.6 percent live in the three Pearl River County HFFI census tracts; there are approximately 398 (13.8 percent) households in HFFI census tract receiving Supplemental Social Security Income (Table 46, page 150). In Pearl River County, 2.3 percent of households receive cash public assistance income and 20.4 percent of households receive SNAP benefits. In HFFI census tract , 6.8 percent of households receive cash public assistance income and 17.9 percent of households receive SNAP benefits. In HFFI census tract , 1.9 percent of households receive cash public assistance income and 32.3 percent of households receive food stamp benefits (Table 46, page 150). 151

162 Table 47: Pearl River County Employment by Industry Census Tract or Geographic Area Civilian employed population 16 years and over ** Denotes HFFI Eligible Census Tract Agriculture and Mining Construction Manufacturing Wholesale trade Retail trade Transportation/ Warehousing/ Utilities ** 2, % 9.3% 8.8% 3.5% 12.3% 11.8% , % 8.6% 13.9% 1.8% 16.1% 4.3% , % 6.7% 12.2% 0.3% 16.0% 6.2% , % 10.4% 14.0% 0.0% 3.3% 7.4% , % 20.0% 13.5% 0.0% 9.5% 5.3% , % 18.2% 10.0% 7.1% 10.0% 5.8% , % 3.8% 9.2% 3.3% 19.0% 4.8% ** 1, % 6.8% 9.3% 3.6% 15.3% 1.0% ** 2, % 10.1% 7.7% 2.2% 14.4% 2.9% Pearl River County 21, % 10.6% 10.7% 2.7% 12.8% 5.5% Pearl River Numeric 21, ,256 2, ,723 1,167 Mississippi 1,194, % 6.9% 12.9% 2.6% 11.8% 5.7% United States 141,864, % 6.2% 10.5% 2.8% 11.6% 4.9% Census Tract or Geographic Area Information Finance/ Insurance/ Real Estate Professional/ Scientific/ Management/ Administrative Educational Services/ Health Care/ Social Assistance Arts/ Entertainment/ Recreation/ Accommodation/ Food Services Other services, except Public Administration Public Administration ** 1.9% 2.3% 6.6% 15.9% 9.9% 5.0% 7.3% % 2.0% 9.0% 21.1% 7.0% 4.3% 8.1% % 5.0% 3.0% 25.1% 13.1% 2.4% 2.6% % 8.3% 7.2% 27.4% 4.4% 8.0% 3.5% % 0.6% 8.2% 28.2% 4.7% 4.0% 2.8% % 2.5% 7.6% 18.6% 5.0% 4.3% 7.7% % 9.8% 6.7% 18.6% 6.6% 3.5% 9.1% ** 2.5% 3.9% 10.8% 25.6% 10.9% 3.1% 5.2% ** 0.2% 1.5% 9.9% 22.9% 16.7% 6.3% 3.4% Pearl River County 1.4% 4.1% 7.8% 22.1% 8.4% 4.7% 5.8% Pearl River Numeric ,662 4,684 1, ,239 Mississippi 1.4% 4.9% 6.3% 24.4% 9.4% 5.0% 5.7% United States 2.2% 6.7% 10.8% 23.2% 9.3% 5.0% 5.0% Source: U.S. Census Bureau, American Community Survey Year Estimates 152

163 The Pearl River County Workforce The largest percentage of the work force in Pearl River County is employed in the Educational Services, Health Care, and Social Assistance sectors of the economy; in Pearl River County, employment in these sectors represents approximately 22.1 percent of total employment (Table 47, page 152). In HFFI census tract , 25.6 percent of the population is employed in the Educational Services, Health Care, and Social Assistance sectors. In Pearl River County, approximately 12.8 percent of the population is employed in the Retail Trade sector; the percentage of the workforce that is employed in the Retail Trade sector is higher in Pearl River County than it is in either the state of Mississippi (11.8 percent) or the United States (11.6 percent). There are two HFFI census tracts in Pearl River County where the percentage of the workforce employed in the Retail Trade sector is higher than that of the county, the state, and the nation; these are: Census tract , with 15.3 percent of the workforce employed in the Retail Trade sector Census tract , with 14.4 percent of the workforce employed in the Retail Trade sector The Manufacturing sector employs approximately 10.7 percent of Pearl River County s employed civilian population over the age of 16 (Table 47, page 152); the percentage of the workforce employed in the Manufacturing sector is lower in Pearl River County than it is in the state of Mississippi (12.9 percent), but nominally higher than that of the U.S. (10.5 percent). In Pearl River County, a relatively high percentage (10.6 percent) of the civilian workforce is employed in the Construction industry as compared to the state of Mississippi (6.9 percent) and the United States (6.2 percent). In Pearl River County, 8.4 percent of the workforce is employed in the Arts, Entertainment, Recreation, Accommodation, or Food Services sectors; this is slightly lower than the percentage rate for the state of Mississippi (9.4 percent) and that of the United States (Table 47, page 152). In the three HFFI census tracts in Pearl River County, the percentage of employment in the Arts, Entertainment, Recreation, Accommodation, or Food Services is higher than the average percentage rate of employment in these industries in Pearl River County; as follows: In census tract , 9.9 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors In census tract , 10.9 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors 153

164 In census tract , 16.7 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors The median earnings for all workers in Pearl River County was $27,892 as compared to median earnings of $25,707 in the state of Mississippi and median earnings of $30,538 in the United States (Table 48, below). In Pearl River County, the median earnings for male full time workers that held steady year round jobs was $45,252, and the median earnings for female full time workers that held steady year round jobs was $30,614. In Pearl River County s HFFI census tracts, the mean earnings for all workers was lower than that of Pearl River County; in HFFI census tracts, the mean earnings for all workers ranged from being $2,369 (census tract ) lower than that of Pearl River County to being $8,345 lower (census tract ) than that of Pearl River County. In all three of the Pearl River County HFFI census tracts, the median earnings for male full time workers that held steady year round jobs was lower than Pearl River County s median earnings for male full time workers; this negative male earnings differential ranged from a low of $1,242 in tract to a high of $4,179 in HFFI census tract (Table 48, below). In Pearl River County, the median earnings for females who held full time, year round jobs was $30,614; in two HFFI census tracts, the median earnings for female full time workers that held steady year round jobs was higher than that of Pearl River County significantly so in census tract , where the median earnings for females who held full time, year round jobs was $7,065 higher than that of Pearl River County. In HFFI census tract , females with full time, year round jobs had median earnings that were approximately $4,105 lower than the Pearl River County median earnings of $30,614 for female workers with full time, year round jobs (Table 48, below). Table 48: Pearl River County Median Earnings for Workers Census Tract or Geographic Area Median earnings for workers (dollars) Median earnings for male full time, yearround workers (dollars) Median earnings for female full time, yearround workers (dollars) ** $25,543 $41,406 $30, $28,057 $43,619 $30, $20,000 $51,932 $31, $34,574 $44,167 $41, $29,140 $46,803 $29, $30,264 $42,384 $36, $34,154 $55,000 $31, ** $22,547 $44,010 $37, ** $19,547 $41,073 $26,509 Pearl River County $27,892 $45,252 $30,614 Mississippi $25,707 $40,742 $30,604 United States $30,538 $49,087 $38,635 Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 154

165 Table 49: Health Insurance Coverage for the Civilian Non Institutionalized Population in Pearl River County Census Tract or Geographic Area ** Denotes HFFI Eligible Census Tract Note: Percentage rates for Private, Public, and No Health Insurance Coverage do not sum to 100 percent due to duplicate insurance coverage. For example, individuals covered by a group health insurance plan may have Medicare as a secondary payer. ** Denotes HFFI Eligible Census Tract With health insurance coverage With private health insurance With public coverage No health insurance coverage Population Under 18 Years with No Health Insurance Coverage ** 4,383 2,700 2,347 1, ,474 3,211 1,830 1, ,566 1,758 1, ,392 3,886 2,474 1, ,574 2,941 2,517 1, ,462 4,561 2,826 1, ,749 5,734 2, ** 3,019 2,257 1,311 1, ** 5,663 2,727 3,474 2, Pearl River County 43,282 29,775 19,968 11,553 1,864 Mississippi 2,392,262 1,667,737 1,035, ,225 68,473 United States 258,778, ,379,999 89,277,994 45,206,153 5,953,533 Source: U.S. Census Bureau, American Community Survey year Estimates Census Tract or Geographic Area With health insurance coverage With private health insurance With public coverage No health insurance coverage Population Under 18 Years with No Health Insurance Coverage ** 73.3% 45.1% 39.2% 26.7% 18.4% % 55.6% 31.7% 22.5% 20.7% % 57.6% 36.5% 16.0% 2.3% % 57.2% 36.4% 20.7% 16.7% % 49.3% 42.2% 23.4% 17.5% % 59.6% 36.9% 15.6% 4.8% % 74.5% 27.0% 12.4% 14.2% ** 73.2% 54.7% 31.8% 26.8% 19.8% ** 72.9% 35.1% 44.7% 27.1% 10.2% Pearl River County 78.9% 54.3% 36.4% 21.1% 13.8% Mississippi 82.5% 57.5% 35.7% 17.5% 9.1% United States 85.1% 66.9% 29.4% 14.9% 8.1% Source: U.S. Census Bureau, American Community Survey year Estimates 155

166 Health Care Insurance in Pearl River County In Pearl River County, 78.9 percent of the civilian, non institutionalized population has health insurance coverage and 21.1 percent of the population has no health insurance coverage (approximately 11,553 people); 13.8 percent of children under the age of 18 have no health insurance coverage (Table 49, page 155). Among the population that has health insurance coverage, 54.3 percent of the population has private health insurance coverage and 36.4 percent has public health coverage (approximately 19,968 people). There are 7,132 people living in HFFI census tracts in Pearl River County that have public health insurance coverage; this represents 35.7 percent of the Pearl River County population that has public health insurance coverage. The percentage of the civilian, non institutionalized population in Pearl River County with no health insurance coverage (21.1 percent) is higher than that of the state of Mississippi (17.5 percent), and is 6.2 percentage points higher than the U.S. percentage rate of 14.9 percent (Table 49, page 155). The percentage rate of children under 18 with no health insurance coverage in Pearl River County (13.8 percent) is higher than that of the state of Mississippi (9.1 percent) and is also higher than that of the United States by 5.7 percent (Table 49, page 155). There are approximately 685 children under the age of 18 with no health insurance coverage who live in Pearl River County HFFI census tracts; this represents 36.7 percent of the children under the age of 18 in Pearl River County that have no health insurance coverage. All of the qualifying HFFI census tracts in Pearl River County have a higher percentage of the population that have no health insurance as compared to the county wide average; for example, in census tract , 26.8 percent of the population has no health insurance coverage, and in census tract , 27.1 percent of the population has no health insurance coverage. There are 4,813 people living in Pearl River County HFFI census tracts who have no health insurance coverage; this represents 41.6 percent of all people in Pearl River County who have no health insurance coverage and indicates that a disproportionate number of people living in HFFI census tracts in Pearl River County have no health insurance given that only 32.4 percent of the total population of Pearl River County reside in HFFI census tracts. The healthcare expenditures associated with recipients of public health insurance are higher than those who are covered by private insurance; these healthcare costs and those of the uninsured are predominantly paid for by federal and state governments or by hospitals and physicians and are ultimately paid for by tax revenues or by a hidden tax on the cost of healthcare. Public policies that are designed to increase the affordability and accessibility of healthy food in underserved communities have a primary purpose of improving the nutrition and health of the residents in these communities, and specifically to reduce obesity and the related healthcare cost of obesity. 156

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168 Table 50: Pearl River County Estimated Spending on Food Census Tract Food at Home Average Household Spending Food at Home Total Spending Food Away from Home Average Household Spending Food Away from Home Total Spending Spending Index Food at Home Spending Index Food Away from Home Total Food Spending ** $3, $8,446,478 $2, $4,747, $13,194, $4, $8,839,226 $2, $5,098, $13,937, $3, $3,969,481 $2, $2,205, $6,174, $4, $12,418,980 $2, $6,948, $19,367, $4, $9,936,856 $2, $6,069, $16,005, $4, $12,476,149 $2, $7,619, $20,096, $4, $14,527,406 $3, $9,002, $23,529, ** $3, $5,926,752 $2, $3,593, $9,520, ** $3, $8,732,251 $1, $4,873, $13,605,957 Pearl River County $4, $85,273,579 $2, $50,159, $135,432,752 Source: ESRI Forecasts; Consumer spending data is derived from 2011 and 2012 Bureau of Labor Statistics Consumer Expenditure Surveys The Spending Potential Index is household based and represents the amount spent relative to a national average of 100 ** Denotes HFFI Eligible Census Tract The Spending Index measures spending as compared to average spending in the United States which equals 100. A spending index below 100, indicates that average household spending is lower than that of the United States; a spending index above 100, indicates that average household spending is higher than that of the United States. 158

169 The Economic Impact of Investments in Pearl River County The economic return on investments in underserved communities will vary based upon the type of investment (i.e. supermarket, grocery store, or convenience store), the amount of the investment, and the geographic location of the investment which will determine the size of the market. The size of the potential market for an investment is not limited by the boundaries of a census tract; depending upon site selection, a store may draw customers from more than one census tract. As shown in Table 50 on page 158, household spending for food at home varies by census tract; average household spending for food at home is lower in Pearl River County s HFFI census tracts as compared to the county wide average household spending of $4, on food at home. Table 51, below, provides an estimate of total food spending on food at home by households within each census tract and also provides an estimate of the supply of food at home that is met by stores within the census tract. The retail gap is an estimate of the unmet demand for food at home within the census tract; positive values indicate that demand for food at home exceeds that which is supplied by stores within the census tract; negative retail gap values indicate that stores within a census tract are meeting demand for food at home by households that do not live within that census tract. With a household fruit and vegetable spending index of 75, all households in Pearl River County exhibit lower spending levels on fruits and vegetables than the average household spending level in the United States (Table 51, below). In many of Pearl River County s HFFI census tracts, the household fruit and vegetable spending index is quite low; for example, in HFFI census tract , the household fruit and vegetable spending index is 68 this census tract also indicates a retail gap of approximately $8,446,478, indicating there may be sufficient market demand to support an independent supermarket or multiple small grocery stores within this Census Tract or Geographic Area Table 51: Pearl River County Household Spending on Food at Home and the Retail Spending Gap Food at Home Total Spending Estimated Supply Retail Gap Spending on Fruits & Vegetables Fruit & Vegetable Spending Index ** $8,446,478 $0 $8,446,478 $1,464, $8,839,226 $446,011 $8,393,215 $1,543, $3,969,481 $7,802,316 $3,832,835 $698, $12,418,980 $910,567 $11,508,413 $2,150, $9,936,856 $718,345 $9,218,511 $1,763, $12,476,149 $2,478,681 $9,997,468 $2,214, $14,527,406 $0 $14,527,406 $2,713, ** $5,926,752 $30,106,302 $24,179,550 $1,098, ** $8,732,251 $37,438,545 $28,706,294 $1,533, Pearl River County $85,273,579 $79,900,767 $5,372,812 $15,181, Source: Consumer Spending data is derived from 2012 Bureau of Labor Statistics Consumer Expenditure Surveys; Estimated supply is from Dunn and ** Denotes HFFI Eligible Census Tract 159

170 Table 52: The Economic Impact of a $6,570,000 Construction Investment in Pearl River County Impact Type Employment Labor Income Value Added Output Direct Effect 67.6 $1,861,926 $1,956,032 $6,570,000 Indirect Effect 11.8 $368,248 $601,369 $1,628,918 Induced Effect 7.9 $221,677 $495,962 $859,839 Total Effect 87.3 $2,451,852 $3,053,363 $9,058,756 Source: IMPLAN Tax on Production and Imports: Sales Tax Table 53: The Fiscal Impact of a $6,570,000 Construction Investment in Pearl River County Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Table 54: The Economic Impact of the Ongoing Operations of a Supermarket with Annual Sales of $8,446,478 Table 55: The Fiscal Impact of the Ongoing Operations of a Supermarket with Annual Sales of $8,446,478 Tax on Production and Imports: S/L Non Taxes $106,299 $60,133 $1,466 $2,914 $9,048 $1,469 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $4,744 $30,936 $4,892 $2,193 $852 $1,105 Source: IMPLAN Tax on Production and Imports: Sales Tax Impact Type Employment Labor Income Value Added Output Direct Effect 42.7 $1,227,815 $1,623,977 $2,398,800 Indirect Effect 3.2 $85,865 $164,797 $321,226 Induced Effect 4.6 $129,370 $289,365 $501,881 Total Effect 50.4 $1,443,051 $2,078,139 $3,221,907 Source: IMPLAN Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $219,088 $123,937 $3,021 $6,007 $18,648 $3,028 Corporate Profits Tax Source: IMPLAN Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $2,705 $17,754 $2,807 $1,259 $489 $

171 census tract. In HFFI census tract , the household fruit and vegetable spending index is 55. Initial evaluation of the retail gap in census tract indicates that stores are meeting the existing demand for food at home and also meeting the food demand that exists in other geographic areas; there may be specific communities within this tract that would benefit from a small grocery store or some other source of affordable, healthy food supply. Economic input output models were used to evaluate two levels of investments in Pearl River County s underserved communities; these models evaluated the impact of economic activity during the construction or renovation phase of a project and also evaluated the impact of economic activity during the ongoing operations of the business upon completion of construction. The Economic Impact of a Supermarket Investment in Pearl River County A store located within a census tract may not capture all spending on food at home within the census tract, or it may capture spending on food at home from areas outside of the census tract. To model the economic impact of an initial investment of $6,570,000 in the construction or renovation of a 45,000 square foot supermarket, annual sales were estimated to be $8,446,478 during the ongoing operations of the business; this investment was modeled at the county level. Based upon these assumptions, this investment would generate an estimated 87.3 full time equivalent jobs during the construction phase of project activities; approximately 67.6 direct construction related jobs would be created, and an additional 19.7 indirect and induced jobs would be created during construction. Total labor income associated with the construction phase of project activities was estimated to be $2,451,852; of this amount, $1,861,926 would be direct labor income (Table 52, page 160). The fiscal impact of construction activities would generate an estimated $226,051 in tax revenues; of these, $106,299 are sales tax and approximately $60,985 are property taxes on personal property or on production and imports (Table 53, page 160). The economic and fiscal impact of construction activities are short term effects that terminate shortly after the completion of construction. A supermarket with annual sales of $8,446,478 would create approximately 50.4 full time equivalent jobs in Pearl River County; of these, approximately 42.7 direct jobs with an average annual income of $28,754 would be created. The total labor income associated with all jobs (direct, indirect, and induced) created as a result of the ongoing operations of this investment is estimated to be $1,443,051 annually (Table 54, page 160). 161

172 Table 56: The Economic Impact of a $2,920,000 Construction Investment in Pearl River County Impact Type Employment Labor Income Value Added Output Direct Effect 30 $827,523 $869,348 $2,920,000 Indirect Effect 5.3 $163,666 $267,275 $723,964 Induced Effect 3.5 $98,523 $220,428 $382,151 Total Effect 38.8 $1,089,712 $1,357,050 $4,026,114 Source: IMPLAN Table 57: The Fiscal Impact of a $2,920,000 Construction Investment in Pearl River County Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $47,244 $26,726 $651 $1,295 $4,021 $653 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $2,108 $13,749 $2,174 $975 $379 $491 Source: IMPLAN Table 58: The Economic Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,000,000 Impact Type Employment Labor Income Value Added Output Direct Effect 10.1 $290,728 $384,534 $568,000 Indirect Effect 0.8 $20,332 $39,021 $76,061 Induced Effect 1.1 $30,633 $68,517 $118,838 Total Effect 11.9 $341,693 $492,072 $762,899 Source: IMPLAN Tax on Production and Imports: Sales Tax Table 59: The Fiscal Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,000,000 Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $51,877 $29,346 $715 $1,422 $4,416 $717 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $640 $4,204 $665 $298 $116 $150 Source: IMPLAN 162

173 The annual fiscal impact of the ongoing operations of a supermarket with annual sales of $8.4 million would be approximately $399,377; of this amount, sales tax revenues are estimated to be $219,088 and $124,426 are property taxes on personal property or on production and imports (Table 55, page 160). The Economic Impact of a Grocery Store Investment in Pearl River County An initial investment of $2,920,000 in the construction or renovation of a 20,000 square foot grocery store with annual sales of $2,000,000; modeled at the county level. Based upon these assumptions, approximately 38.8 full time equivalent jobs would be supported during the construction phase of project activities; of these 30 jobs would be on site direct construction jobs with associated labor income of approximately $827,523. An additional 8.8 indirect and induced full time equivalent jobs would be created during the construction phase of project activities (Table 56, page 162). During the construction phase of project activities, the fiscal impact is estimated to be $100,466; of this amount, associated sales tax revenues are estimated to be $47,244 (Table 57, page 162) and property tax revenues are projected to be $27,105. The ongoing operations of a grocery store located in Pearl River County with estimated annual sales of approximately $2 million would create approximately 11.9 full time equivalent jobs, with associated labor income of $290,728 annually. An estimated 10.1 direct jobs, with an average annual wage of $28,784 would be associated with the ongoing operations of the store, creating employment opportunities for the low income residents living within underserved communities in Pearl River County (Table 58, page 162). The annual fiscal impact of the ongoing operations of the project are estimated to be $94,566; of this amount, sales tax revenues are projected to be $51,877 and property tax revenues are projected to be $29,462, including personal property tax and property tax on production and imports (Table 59, page 162). The economic impact and fiscal effects of the ongoing operations of a business firm are continuous throughout the life of the business, providing employment and tax revenues annually. Depending upon the success of the firm and the economic climate, employment and related tax revenues may increase or decline over time. 163

174 Tax on Production and Imports: Sales Tax Table 60: The Economic Impact of a $500,000 Renovation, Expansion, and Equipment Purchase Impact Type Employment Labor Income Value Added Output Direct Effect 2.7 $132,830 $149,768 $293,500 Indirect Effect 0.7 $30,108 $45,784 $97,488 Induced Effect 0.9 $33,112 $60,382 $105,613 Total Effect 4.3 $196,050 $255,934 $496,601 Source: IMPLAN Table 61: The Fiscal Impact of a $500,000 Renovation, Expansion, and Equipment Purchase Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Table 62: The Economic Impact of the Ongoing Operations of a Small Store with Annual Sales of $500,000 Tax on Production and Imports: S/L Non Taxes $11,589 $6,556 $160 $318 $986 $160 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $442 $2,567 $406 $182 $71 $92 Source: IMPLAN Impact Type Employment Labor Income Value Added Output Direct Effect 2.5 $72,682 $96,133 $142,000 Indirect Effect 0.2 $5,083 $9,755 $19,015 Induced Effect 0.3 $7,658 $17,129 $29,709 Total Effect 3.0 $85,423 $123,018 $190,725 Source: IMPLAN Table 63: The Fiscal Impact of the Ongoing Operations of a Small Store with Annual Sales of $500,000 Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $13,470 $7,620 $186 $369 $1,147 $186 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $223 $1,313 $208 $93 $36 $47 Source: IMPLAN 164

175 Investments in Store Renovations, Expansion, and Equipment Purchases in Pearl River County The preliminary analysis of HFFI census tracts and indicates no existing retail sales gap in these two tracts; however, there may exist opportunities to renovate or expand existing stores in specific areas to enable them to offer fresh fruits or vegetables in order to increase access to affordable, nutritious food for community residents. To examine the economic impact of these investments, it was assumed that an initial investment of $500,000 is made in store renovations, expansions, and equipment purchases. It is then assumed that annual sales revenues will be $500,000 during the ongoing operations of the business, upon completion of these investments. These investments and the ongoing impact of business operations are reported the state level; the Stennis Research Team ran individuals models of this investment scenario for each county and found insignificant geographic variation in the economic and fiscal impact associated with these investments, therefore the model provided in this report provides a general guideline for similar investments that may be made in any census tract in the state of Mississippi. An investment of $500,000 in a store renovation or expansion will support a total of approximately 4.3 full time equivalent jobs during the construction phase of project activities; of these, 2.7 jobs will be direct employment and an additional 1.6 jobs will be indirect or induced jobs. The total labor income associated with this investment is predicted to be approximately $196,050 (Table 60, page 164). An investment of $500,000 in store renovation or expansion will generate approximately $23,529 of tax revenue during the construction phase of project activities; of this amount, $11,589 is associated with sales tax revenue (Table 61, page 164). Approximately 3.0 full time equivalent jobs will be associated with the ongoing operations of a store with $500,000 in annual sales; of these, 2.5 direct jobs will be created at the store with an additional 0.5 indirect and induced jobs. The labor income effect of the ongoing operations of the store is projected to be $85,423 annually (Table 62, page 164). The fiscal impact of the ongoing operations of a store with annual sales of $500,000 is predicted to be $24,989 annually; of this amount, $15,006 is associated with sales tax, personal income tax, and corporate income tax revenue (Table 63, page 164). 165

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177 Sunflower County, Mississippi Baltzer ** ** Denotes HFFI Qualifying a Food Desert Census Tract Census Tract Rome Minot Parchman Lombardy Fitzhugh ** Dwiggins Whitney Sandy Bayou Drew Ballaston Brooks Jaquith Dockery Ruleville Halstead White City Cottondale Shaw ** ** Eastland Steiner Blaine Pentecost Roundaway Frazier Dwyer Stephenville Boyer Sunflower Furry Inwood Faisonia McDaniels 1 Holly Ridge ** Moorhead Indianola Baird JohnsonvilleMarkham Woodburn Waco Kinlock Gumwood Elmwood ** InvernessSouthside Bowies Milroy Caile Mattoon New Town Isola Miles Map 9: Sunflower County HFFI Qualifying Census Tracts 167

178 ** Denotes an HFFI Census Tract ** ** ** ** ** Miles Map 10: Sunflower County Reference Map 168

179 Eligible Healthy Food Financing Initiative Census Tracts in Sunflower County Based upon the data from the USDA s HFFI Locator Tool, there are five (5) census tracts located in Sunflower County that are eligible HFFI census tracts and qualify for funding under the Federal Healthy Food Financing Initiative; these are: Census Tract is designated a rural tract and is eligible based upon low income and low access using vehicle access. Census Tract is designated a rural tract and is eligible based upon low income and low access using vehicle access. Census Tract is designated a rural tract and is eligible based upon low income and low access using vehicle access. Census Tract is designated an urban tract and is eligible based upon low income and low access measured at 1 and 10 miles, at ½ and 10 miles, and at 1 and 20 miles, and low income and low access using vehicle access. Census Tract is designated an urban tract and is eligible based upon low income and low access measured at 1 and 10 miles, at ½ and 10 miles, and at 1 and 20 miles, and low income and low access using vehicle access. All eligible HFFI census tracts in Sunflower County also qualify to receive Federal New Market Tax Credits. There are approximately 22,944 people who live in HFFI census tracts in Sunflower County; this represents approximately 79.9 percent of the total county population. There are approximately 5,689 children (age 0 to 17 years) and 2,232 seniors (age 65 and over) living in HFFI census tracts in Sunflower County; this indicates that 82.2 percent of all children and 72.5 percent of all seniors in Sunflower County live in HFFI qualifying census tracts. 169

180 Figure 18: Sunflower County Population 2000 through

181 Overview of Sunflower County Over the 13 year period from 2000 to 2013, Sunflower County s population base has been in steady decline, with an average population loss of slightly less than one percent per year (Figure 18, page 170). In 2013, Sunflower County s estimated population was 27,997; from 2000 to 2013, the county s population decreased by 6,252 (a decline of 18.3). Among the 82 counties in Mississippi, Sunflower County experienced the third highest population loss over the period from 2000 to 2013 and it had the 8 th highest percentage rate of decrease in population. In the United States, 72.4 percent of the population is White, 12.6 percent of the population is African American, 9.1 percent of the population is Hispanic or Latino, percent of the population is Asian, 1.7 percent of the population is American Indian or Alaska Native, and the balance is some other race; in the U.S., 49.2 percent of the population is male and 50.8 percent of the population is female. Table 64: Sunflower County Population by Census Tract Census Tract Total Population ** Denotes HFFI Eligible Census Tract Percent of County Population ** 7, % ** 4, % ** 2, % , % ** 5, % ** 2, % , % Source: U.S. Census Bureau, American Community Survey Year Estimates In the state of Mississippi, 60.1 percent of the population is White, 37.6 percent of the population is African American, and less than 2 percent of the population is comprised of some other racial group; in Mississippi, 48.3 percent of the population is male and 51.7 percent of the population is female. In Sunflower County, 73.1 percent of the population is African American and 25.7 percent of the population is White (Table 65, page 172). U.S. Census data indicates that 1.9 percent of the population in census tract and 3.6 percent of the population in census tracts and is Hispanic or Latino; these three census tracts have the largest Hispanic or Latino populations in Sunflower County. American Indians, Asians, and other groups account for slightly less than one percent of the population. In Sunflower County, approximately 53.1 percent of the population is male and 46.9 percent of the population is female; as compared to the state of Mississippi and the United States, the relatively high percentage of males in Sunflower County s population is due to the inclusion of inmates at Parchman Prison in Census Bureau data for Sunflower County (census tract ). 171

182 Table 65: Sunflower County Racial Distribution by Census Tract Census Tract Total Population White Percent White Black or African American Percent Black or African American American Indian and Alaska Native Percent American Indian and Alaska Native Asian Percent Asian Some other race Percent Some Other Race ** 7,239 2, % 4, % % % % ** 4,697 1, % 3, % % % % ** 2, % 1, % % % % ,538 1, % 1, % % % % ** 5, % 5, % % % % ** 2, % 2, % % % % , % 1, % % % % Total 28,722 7, % 20, % % % % Source: U.S. Census Bureau, American Community Survey Year Estimates **Denotes HFFI Eligible Census Tract 172

183 In Sunflower County, 79.9 percent of the county s total population lives in HFFI qualifying census tracts. There are an estimated 17,614 African Americans living in Sunflower County s HFFI census tracts; this represents 83.9 percent of the total African American population in the county and is significantly higher than the representation of African Americans as a percentage of Sunflower County s total population (73.1 percent). This high concentration of minority populations within Sunflower County s HFFI census tracts is similar to that found in research on HFFI census tracts. 220, 221, 222 There are two HFFI census tracts in Sunflower County where the African American population exceeds 80 percent of the tracts population; these are: census tract and ; in these tracts, the African American population represents 97.4 percent and 83.1 percent of the population, respectively (Table 65, page 172). In Sunflower County, 75.9 percent of all families live in an HFFI census tract. In Sunflower County, there are 1,134 families that are female households with children under 18 that have no husband present; this represents 19.2 percent of all family households in Sunflower County (Table 66, page 174). There are 936 families that are female households with children under 18 and have no husband present who live in HFFI census tracts in Sunflower County; this represents 82.5 percent of all single female households with children in Sunflower County; this indicates that female households with no husband present who have children are concentrated in HFFI census tracts in Sunflower County. Single females with children experience significantly higher poverty as compared to other families with children. In Sunflower County, the poverty rate for all families is 31.3 percent; for female households with no husband present that have children under 18, the poverty rate is 59.5 percent in (Table 67, page 174). As shown in Table 67, the percentage of single female households with children that live in poverty is higher in Sunflower County as compared with the state of Mississippi and is almost 20 percent higher than that of the United States. In Sunflower County, there are an estimated 6,923 children age 17 and under; they represent 24.1 percent of the total population. There are 5,689 children age 17 and under living in HFFI census tracts in Sunflower County; they represent 82.2 percent of all children in Sunflower County. With the exception of the census tract that contains Parchman Prison (census tract ), children represent a higher percentage of the total HFFI census tract population when compared to the county average of 24.1 percent; for example, in HFFI census tract , children age 17 and under represent 32.3 percent of the census tract s population as compared to 24.1 percent of Sunflower County s total population. In 220 Dutko, Paula, Michele Ver Ploeg, and Tracey Farrigan. Characteristics and Influential Factors of Food Deserts, ERR 140, U.S. Department of Agriculture, Economic Research Service, August Duran, A. C., et al. (2013). Neighborhood Socioeconomic Characteristics and Differences in the Availability of Healthy Food Stores and Restaurants in Sao Paulo, Brazil. Health Place 23: Block, J. P., et al. (2004). Fast food, Race/Ethnicity, and Income: A Geographic Analysis. American Journal of Preventive Medicine 27(3):

184 Table 66: Sunflower County Selected Gender, Age, and Family Population Data by Census Tract Census Tract Total Population Percent Female Population 17 years and Under Percent of Tract Population 17 and Under Population 65 and Over Percent of Tract Population 65 and Over Number of Families Number of Female Households, No Husband Present, with Children Under 18 Percent of Tract Families with Female Householder, No Husband Present with Children under 18 Years ** 7, % 1, % % % ** 4, % 1, % % 1, % ** 2, % % % % , % % % % ** 5, % 1, % % 1, % ** 2, % % % % , % % % % Total 28, % 6, % 3, % 5,915 1, % Source: U.S. Census Bureau, American Community Survey Year Estimates **Denotes HFFI Eligible Census Tract Table 67: Percentage of Families and Individuals in Poverty in Sunflower County Census Tract or Geographic Area All people All families All Families with related children under 18 years Female Households, No Husband Present, with related children under 18 years All Children Under 5 All Children 5 to 17 years Persons 65 years and over ** 41.50% 34.80% 53.30% 80.30% 57.90% 69.40% 21.40% ** 28.70% 26.20% 32.30% 34.90% 48.50% 27.80% 18.00% ** 37.00% 31.00% 44.70% 64.80% 42.80% 48.30% 28.30% % 21.00% 31.30% 63.60% 81.30% 11.00% 23.20% ** 41.90% 35.50% 48.10% 52.70% 63.30% 49.80% 24.10% ** 50.80% 47.10% 69.50% 78.30% 62.60% 72.90% 34.80% % 26.50% 33.90% 56.60% 33.70% 52.30% 25.70% Sunflower County 36.10% 31.30% 44.40% 59.50% 56.40% 47.60% 23.90% State of Mississippi 22.70% 17.80% 27.10% 51.80% 36.50% 30.50% 14.00% United States 15.40% 11.30% 17.80% 40.00% 24.70% 20.00% 9.40% Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 174

185 Sunflower County, the percentage of children living in poverty is significant; the poverty rate for children under 5 is 56.4 percent and the poverty rate for children age 5 to 17 is 47.6 percent (Table 67, page 174). The percentage of children under 5 years old that live in poverty in Sunflower County is almost 20 percent higher than that of the state of Mississippi and is more than twice that of the United States ; the percentage of children between the age of 5 and 17 who live in poverty in Sunflower County is 17.1 percent higher than that of the state of Mississippi and 27.6 percent higher than that of the United States. Within the context of the extreme child poverty that exists in Sunflower County, many HFFI census tracts exhibit child poverty levels that are even higher than the county poverty rate for children; for example, in census tract , 62.6 percent of all children under 5 years old live in poverty and 72.9 percent of all children between the age of 5 to 17 live in poverty (Table 67, page 174). Approximately 2,232 people age 65 and over live in HFFI census tracts in Sunflower County; this represents 72.5 percent of the senior population in the county. Among people age 65 and over, 23.9 percent live in poverty in Sunflower County; Sunflower County s poverty rate for seniors is 9.9 percent higher than that of the state of Mississippi and 14.5 percent higher than that of the United States (Table 67, page 174). Approximately 66.4 percent of seniors who live alone reside in HFFI census tracts in Sunflower County (Table 68, below). Faced with limited mobility, increased dependence upon others for transportation, and limited access to affordable, nutritious food, senior populations living in HFFI census tracts are at high risk for food insecurity and the negative health outcomes associated with poor nutrition; this is particularly true for seniors living in poverty because they must expend more income to obtain food from available sources. Table 68: Sunflower County Households and Families by Type Household by Type Sunflower Total in HFFI Percent in HFFI County Total Census Tracts Census Tracts Total households 8,394 6, % Family households (families) 5,915 4, % With own children under 18 years 2,278 1, % Married couple family 2,889 2, % With own children under 18 years % Male householder, no wife present, family % With own children under 18 years % Female householder, no husband present, family 2,464 2, % With own children under 18 years 1, % Nonfamily households 2,479 1, % Householder living alone 2,266 1, % 65 years and over % Households with one or more people under 18 years 3,296 2, % Households with one or more people 65 years and over 2,213 1, % Source: U.S. Census Bureau, American Community Survey Year Estimates 175

186 Table 69: Sunflower County Educational Attainment for the Population 25 and Older Census Tract of Geographic Area Less than 9th grade 9th to 12th grade, no diploma High school graduate (includes equivalency) Some college, no degree Associate's degree Bachelor's degree Graduate or Professional degree Percent high school graduate or higher Percent Bachelor's degree or higher ** 9.4% 26.7% 34.8% 18.6% 5.8% 3.3% 1.4% 63.9% 4.7% ** 14.7% 15.4% 19.0% 27.3% 7.4% 10.4% 5.8% 69.9% 16.1% ** 13.1% 20.4% 25.5% 26.1% 5.3% 6.1% 3.5% 66.5% 9.6% % 5.5% 25.9% 28.3% 2.5% 17.0% 12.9% 86.6% 30.0% ** 14.0% 15.7% 24.8% 27.6% 4.6% 7.8% 5.4% 70.3% 13.2% ** 15.9% 18.4% 29.2% 22.5% 6.9% 4.2% 2.9% 65.7% 7.1% % 11.4% 32.1% 21.5% 4.1% 10.5% 6.3% 74.5% 16.8% Sunflower County 12.1% 17.7% 27.9% 24.1% 5.3% 7.9% 5.0% 70.2% 13.0% State of Mississippi 6.4% 12.1% 30.5% 22.7% 8.1% 12.8% 7.3% 81.5% 20.1% United States 5.9% 8.0% 28.1% 21.2% 7.8% 18.0% 10.8% 86.0% 28.8% Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 176

187 In Sunflower County, 70.2 percent of the population age 25 and over are high school graduates and 13.0 percent of the population has a Bachelor s degree or higher; these educational attainment levels are significantly lower than the educational attainment levels exhibited at the state level and at the national level. For example, in the state of Mississippi, 81.5 percent of the population age 25 and over are high school graduates and at the national level 86.0 percent of the population are high school graduates. Of particular concern is the relatively high percentage of people in Sunflower County that have either less than a 9 th grade level of education or have completed some level of high school, but have no high school diploma. Because of the relationship that exists between educational attainment, income, poverty, obesity, and health outcomes, the probability exists that persons with very low educational attainment will be more likely to live in poverty, are more likely to be obese and to exhibit the negative health outcomes associated with obesity, and are also more likely to be recipients of publicly funded health insurance or to have no health insurance for these individuals, living in an HFFI census tract further compounds the socioeconomic disadvantages they experience. In Sunflower County, the percentage of the population age 25 and over that has less than a 9 th grade education is almost twice that of the state of Mississippi; 12.1 percent in Sunflower County as compared to 6.4 percent at the state level (Table 69, page 176). In some HFFI census tracts, the percent of the population age 25 and over with less than a 9 th grade education is as high as 15.9 percent (census tract ). In Sunflower County, 17.7 percent of the population age 25 and over has completed some level of high school but has no diploma; in HFFI census tracts and , the percent of the population age 25 and over that has completed some level of high school, but has no diploma, is 20.4 percent and 26.7 percent, respectively (Table 69, page 176). Food Insecurity in Sunflower County In 2011, approximately 16.4 percent of all individuals in the U.S. population experienced food insecurity; in 2012, 15.9 percent of all individuals in the United States were food insecure, 223 indicating that food insecurity had declined in the U.S. Across the United States, the average countylevel food insecurity rate remained stable at 14.7 percent in 2011 and in In Mississippi, the overall food insecurity rate was 22.3 percent in 2012; Mississippi had the highest overall food insecurity rate in the nation in In 2012, approximately 30.6 percent of all individuals in Sunflower County were food insecure (8,940 people). Child food insecurity rates are substantially higher than the overall food insecurity rate for the entire population. In the U.S., the child food insecurity rate was 21.6 percent in In counties across the United States, the county level of child food insecurity ranged from a low of six percent to a high of 41 percent in 2012; food insecurity rates among households with children have been found to be considerably higher than that in the general population. In 2012, the state level child food insecurity 223 Coleman Jensen, A., Nord, M. and Singh, A. (2013) Household Food Security in the United States in U.S. Department of Agriculture Economic Research Service. 224 Ibid. 177

188 Census Tract or Geographic Area Population 16 years and over ** Denotes HFFI Eligible Census Tract Table 70: Sunflower County Comparative Employment and Income Number in the Civilian Labor Force Percent In the Labor Force Percent Unemployed Number Not in the Labor Force ** 6,220 1, % 17.3% 4, ** 3,542 1, % 22.2% 1, ** 1,803 1, % 24.3% ,957 1, % 14.9% 1, ** 4,231 2, % 24.4% 1, ** 2,010 1, % 37.5% , % 13.1% 751 Sunflower County 22,505 10, % 21.7% 11,691 Mississippi 2,312,959 1,343, % 11.1% 957,272 United States 246,191, ,113, % 9.7% 87,994,377 Source: U.S. Census Bureau, American Community Survey Year Estimates Census Tract or Geographic Area Total Households Percent of Households with Income less than $10,000 Percent of Housholds with Income between $10,000 to $14,999 Median household income (dollars) Percent of Households with Earnings ** 1, % 15.9% $28, % ** 1, % 12.3% $26, % ** % 15.4% $25, % , % 15.2% $35, % ** 1, % 9.9% $23, % ** % 12.3% $19, % % 6.2% $31, % Sunflower County 8, % 12.5% $26, % Mississippi 1,088, % 8.1% $39, % United States 115,610, % 5.4% $53, % Source: U.S. Census Bureau, American Community Survey Year Estimates 178

189 rate ranged from a low of 10.6 percent in North Dakota to a high of 29.2 percent in New Mexico. Mississippi had the second highest level of child food insecurity in the U.S.; with 28.7 percent of Mississippi s children being food insecure, it is estimated that approximately 214,720 children in Mississippi are food insecure. 225 In Sunflower County, it is estimated that 30.5 percent of children are food insecure; research indicates that among the 2,170 children living in Sunflower County that are food insecure, approximately 69 percent are eligible for Federal Nutrition Assistance programs but 31 percent are not eligible. 226 Sunflower County Income by Source In Sunflower County, the average unemployment rate among the population 16 and over was 21.7 percent; this unemployment rate was approximately 10.6 percent higher than the unemployment rate for the state of Mississippi and 12.0 percent higher than the unemployment rate for the United States (Table 70, page 178). With the exception of HFFI census tract , all HFFI census tracts in Sunflower County exhibit unemployment rates that are higher than 21.7 percent and range as high as 37.5 percent in HFFI census tract With 48 percent of the population age 16 and over in the labor force, Sunflower County exhibits a relatively low labor force participation rate; in the state of Mississippi, 58.1 percent of the population age 16 and over is in the labor force, and in the United States, 64.3 percent of the population in this age group is in the labor force. The median household income in Sunflower County is $26,619; median household income in Sunflower County is approximately $12,619 lower than the state of Mississippi s median household income and approximately $26,427 lower than that of the United States (Table 70, page 178). Within the context of having median household incomes that are pervasively lower throughout the county, the median household income in three of Sunflower County s five HFFI census tracts is lower than that of Sunflower County; for example, in HFFI census tract , the median household income is $19,244 $7,375 lower than the county wide median household income of $26,619. Of particular concern is the high percentage of households that have household incomes of less than $15,000. In Sunflower County, approximately 30.2 percent of households have incomes of less than $15,000; in the state of Mississippi, 19.5 percent of households have incomes of less than $15,000, and in the U.S., this percentage rate is 12.6 percent (Table 70, page 178). Within Sunflower County, HFFI census tracts have the highest percentage of households with incomes of less than $15,000 (with the exception of census tract ); for example, in HFFI census tracts and , the percentage of households with incomes of 225 Ibid. 226 Gundersen, C., Waxman, E., Engelhard, E., Satho, A. and Namrita, C. Map the Meal Gap 2013: Food Insecurity Estimates at the County Level. Feeding America,

190 Table 71: Sunflower County Comparative Earnings and Income by Source Census Tract or Geographic Area Mean earnings (dollars) for Households Percent of Households with Social Security Mean Social Security income (dollars) Percent of Households with retirement income Mean retirement income (dollars) Percent of Households with Supplemental Security Income Mean Supplemental Security Income (dollars) Percent of Households with cash public assistance income Mean cash public assistance income (dollars) Percent of Households with Food Stamp/SNAP benefits in the past 12 months ** $37, % $13, % $14, % $6, % $2, % ** $39, % $13, % $15, % $8, % $1, % ** $36, % $12, % $17, % $7, % $1, % $71, % $14, % $16, % $8, % $8, % ** $33, % $11, % $11, % $10, % $1, % ** $27, % $12, % $10, % $7, % $3, % $44, % $13, % $12, % $8, % $3, % Sunflower County $41, % $13, % $14, % $8, % $2, % Mississippi $56, % $15, % $19, % $8, % $2, % United States $75, % $17, % $23, % $9, % $3, % Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 180

191 less than $15,000 is 38.1 percent and 36.5 percent, respectively. Within Sunflower County s HFFI qualifying census tracts, there are approximately 2,001 households with incomes of less than $15,000; this represents 78.9 percent of all households in Sunflower County with incomes of less than $15,000. There are approximately 1,486 households in Sunflower County with incomes of less than $10,000; 80.9 percent of these households live in Sunflower County s HFFI census tracts. Within Sunflower County, approximately 69.9 percent of households have earnings from employment (Table 70, page 178); this percentage rate is lower than that of the state of Mississippi (73.9 percent) and lower than that of the United States (78.2 percent). For households with income from earnings, mean household earnings in Sunflower County are $41,743 (Table 71, page 180). Other sources of household income include Social Security, Retirement Income, Supplemental Security Income, and Cash Public Assistance. In Sunflower County, approximately 34.0 percent of households receive Social Security Income; this is slightly higher than the 32.6 percent of households in the state of Mississippi that receive Social Security Income and the 28.9 percent of households in the U.S. that receive Social Security Income. In Sunflower County, 18.2 percent of households have retirement income; this reflects a greater percentage of households with retirement income as compared to either the state of Mississippi (17.5 percent) or the United States (17.7 percent). In Sunflower County, the mean retirement income is $14,303; this is $5,436 lower than the mean household retirement income of $19,739 in the state of Mississippi and $9,286 lower than the U.S. mean household retirement income of $23,589 (Table 71, page 180). HFFI census tracts and exhibit an extraordinarily low mean retirement income; these two census tracts have mean retirement incomes of $11,922 and $10,925, respectively. Supplemental Security Income (SSI) provides benefits to needy aged, blind, and disabled people; in the U.S., approximately 40 percent of SSI recipients are over the age of 65; the remainder are disabled. Children may qualify for SSI benefits if they are disabled. In Sunflower County, 15.5 percent of households receive SSI income; this is nearly twice the statewide percentage of 7.8 percent of households that receive Supplemental Security Income. Cash Public Assistance programs are designed to enable households with limited income to meet the basic needs of living to include shelter, food, utilities, daily living expenses, and child care. In Mississippi, adults who receive Temporary Assistance for Needy Families (TANF) must participate in a work program. In Sunflower County, approximately 4.2 percent of households receive Cash Public Assistance; this compares with 2.8 percent of households in the state of Mississippi and the United States (Table 71, page 180). In all of the HFFI qualifying census tracts, the percentage of households receiving Cash Public Assistance is equal to or higher than that of Sunflower County; in HFFI census tract , 7.0 percent of households receive 181

192 Table 72: Sunflower County Employment by Industry Census Tract or Geographic Area Civilian employed population 16 years and over Agriculture and Mining Construction Manufacturing Wholesale trade Retail trade Transportation/ Warehousing/ Utilities ** 1, % 4.2% 7.5% 6.3% 14.7% 2.7% ** 1, % 5.2% 12.1% 0.0% 3.8% 1.4% ** % 5.3% 6.6% 2.8% 15.5% 3.1% , % 8.0% 6.0% 1.9% 10.1% 3.9% ** 1, % 1.7% 16.4% 4.0% 21.5% 8.9% ** % 2.4% 6.3% 17.7% 19.3% 2.7% % 8.2% 9.1% 4.3% 13.0% 10.3% Sunflower County 8, % 4.8% 10.0% 4.3% 13.9% 4.9% Sunflower Numeric 8, , Mississippi 1,194, % 6.9% 12.9% 2.6% 11.8% 5.7% United States 141,864, % 6.2% 10.5% 2.8% 11.6% 4.9% Census Tract or Geographic Area Information ** Denotes HFFI Eligible Census Tract Finance/ Insurance/ Real Estate Professional/ Scientific/ Management/ Administrative Educational Services/ Health Care/ Social Assistance Arts/ Entertainment/ Recreation/ Accommodation/ Food Services Other services, except Public Administration Public Administration ** 0.2% 2.5% 4.3% 20.2% 5.1% 3.6% 17.2% ** 0.0% 3.3% 2.7% 40.2% 2.3% 3.5% 11.4% ** 2.1% 8.1% 0.4% 27.6% 3.2% 4.0% 3.6% % 6.0% 2.1% 27.0% 15.1% 10.9% 6.2% ** 0.0% 2.4% 4.3% 18.9% 10.9% 2.0% 6.9% ** 4.0% 2.8% 1.2% 17.4% 4.0% 3.2% 5.6% % 2.0% 1.3% 21.3% 4.5% 6.6% 8.4% Sunflower County 0.7% 3.7% 2.7% 24.9% 7.4% 4.8% 8.9% Sunflower Numeric , Mississippi 1.4% 4.9% 6.3% 24.4% 9.4% 5.0% 5.7% United States 2.2% 6.7% 10.8% 23.2% 9.3% 5.0% 5.0% Source: U.S. Census Bureau, American Community Survey Year Estimates 182

193 income from Cash Public Assistance programs. In Sunflower County, 36.7 percent of households receive SNAP (Food Stamps) benefits; this is approximately 19.3 percent higher than the percentage rate of households in Mississippi that receive SNAP benefits and 24.3 percent higher than the percentage of households in the United States that receive SNAP benefits. As shown in Table 71 (page 180), the majority of HFFI census tracts in Sunflower County exhibit a higher percentage rate of households receiving SNAP benefits as compared to the county level; in some HFFI census tracts, the percentage of households with SNAP benefits exceeds 40 percent and is as high as 47.1 percent in census tract The Sunflower County Workforce Among the civilian employed population over the age of 16, the largest percentage of the work force in Sunflower County is employed in the Educational Services, Health Care, and Social Assistance sectors of the economy; in Sunflower County, employment in these sectors represents approximately 24.9 percent of total employment (Table 72, page 182). 227 In Sunflower County, approximately 13.9 percent of the population is employed in the Retail Trade sector; the percentage of the workforce that is employed in the Retail Trade sector is higher in Sunflower County than it is in either the state of Mississippi (11.8 percent) or the United States (11.6 percent). There are four HFFI census tracts in Sunflower County where the percentage of the workforce employed in the Retail Trade sector is higher than that of the county, the state, and the nation; these are: Census tract , with 14.7 percent of the workforce employed in the Retail Trade sector Census tract , with 15.5 percent of the workforce employed in the Retail Trade sector Census tract , with 21.5 percent of the workforce employed in the Retail Trade sector Census tract , with 19.3 percent of the workforce employed in the Retail Trade sector The Manufacturing sector employs approximately 10.0 percent of Sunflower County s employed civilian population over the age of 16 (Table 72, page 182); the percentage of the 227 Author s note: the data provided in this section of the report uses American Community Survey 5 year estimates to provide valid comparable analysis across census tracts and other geographic areas; subsequent sections of this report will use more recent data that is specific to Sunflower County, but not available at the census tract level of analysis to conduct economic analysis. It is also important to note that ACS 5 year estimate data defines the industry in which the workforce is employed but does not define the location of the industry; for example a worker who resides in an HFFI census tract in Sunflower County may be employed in the Manufacturing sector in a county or geographic area that may be within Sunflower County or outside of Sunflower County. 183

194 workforce employed in the Manufacturing sector is lower in Sunflower County than it is in either the state of Mississippi (12.9 percent) or the U.S. (10.5 percent). There are two HFFI qualifying census tracts where the percentage of the workforce that is employed in the Manufacturing sector is higher than the percentage rate for Sunflower County; these are: Census tract , where 12.1 percent of the workforce is employed in the Manufacturing sector Census tract , where 16.4 percent of the workforce is employed in the Manufacturing sector The Public Administration sector represents the fourth largest employer in Sunflower County, with 8.9 percent of the civilian employed population age 16 and over working in Public Administration. In Sunflower County, employment in the Public Administration is higher than that of the state of Mississippi (5.7 percent). In two HFFI census tracts, employment in the Public Administration sector is quite high, with 17.2 percent of the civilian employed population age 16 and over working in Public Administration in census tract and 11.4 percent of the civilian employed population age 16 and over working in Public Administration in census tract (Table 72, page 182). In Sunflower County, 8.8 percent of the employed civilian population 16 years and over is employed in Agriculture or Mining; this is 5.8 percent higher than the percentage of this population that is employed in Agriculture or Mining at the state level and 5.9 percent higher than in the United States (Table 72, page 182). The median earnings for all workers in Sunflower County was $19,238, as compared to median earnings of $25,707 in the state of Mississippi and median earnings of $30,538 in the United Table 73: Median Earnings for Workers in Sunflower County ** Denotes HFFI Eligible Census Tract 184

195 States (Table 73, page 184). In Sunflower County, the median earnings for male full time workers that held steady year round jobs was $30,481; the median earnings for female fulltime workers that held steady year round jobs was $26,230. In Sunflower County, the median earnings for male full time, year round workers was $10,261 lower than the median earnings for male full time, year round workers in the state of Mississippi. In Sunflower County, the median earnings for female full time, year round workers was $4,374 lower than the median earnings for female full time, year round workers in the state of Mississippi (Table 73, page 184). 185

196 Census Tract or Geographic Area Table 74: Health Insurance Coverage for the Civilian Non Institutionalized Population in Sunflower County With health insurance coverage With private health insurance With public coverage No health insurance coverage Population Under 18 Years with No Health Insurance Coverage ** 2,964 1,529 1, ** 3,661 1,713 2, ** 1,937 1,000 1, ,934 2,053 1, ** 4,590 1,923 3,075 1, ** 1, , , Sunflower County 19,689 10,012 11,632 5, Mississippi 2,392,262 1,667,737 1,035, ,225 68,473 United States 258,778, ,379,999 89,277,994 45,206,153 5,953,533 Source: U.S. Census Bureau, American Community Survey year Estimates Census Tract or Geographic Area With health insurance coverage With private health insurance With public coverage No health insurance coverage Population Under 18 Years with No Health Insurance Coverage ** 81.0% 41.8% 47.4% 19.0% 6.0% ** 80.8% 37.8% 48.8% 19.2% 6.0% ** 77.9% 40.2% 44.8% 22.1% 15.6% % 60.2% 38.3% 14.0% 5.4% ** 78.8% 33.0% 52.8% 21.2% 5.6% ** 73.1% 31.0% 48.4% 26.9% 6.3% % 43.6% 41.0% 25.1% 18.5% Sunflower County 79.4% 40.4% 46.9% 20.6% 7.9% Mississippi 82.5% 57.5% 35.7% 17.5% 9.1% United States 85.1% 66.9% 29.4% 14.9% 8.1% Source: U.S. Census Bureau, American Community Survey year Estimates Note: Percentage rates for Private, Public, and No Health Insurance Coverage do not sum to 100 percent due to duplicate insurance coverage. For example, individuals covered by a group health insurance plan may have Medicare as a secondary payer. ** Denotes HFFI Eligible Census Tract 186

197 Health Care Insurance in Sunflower County In Sunflower County, 79.4 percent of the civilian, non institutionalized population has health insurance coverage and 20.6 percent of the population has no health insurance coverage (approximately 5,096 people); 7.9 percent of children under the age of 18 have no health insurance coverage (Table 74, page 186). Among the population that has health insurance coverage, 40.4 percent of the population has private health insurance coverage and 46.9 percent has public health insurance coverage (approximately 11,632 people). There are 9,408 people living in HFFI census tracts in Sunflower County that have public health insurance coverage; this represents 80.9 percent of the Sunflower County population that has public health insurance coverage. The percentage of the civilian, non institutionalized population in Sunflower County with no health insurance coverage (20.6 percent) is 3.1 percent higher than that of the state of Mississippi (17.5 percent), and is 5.7 percentage points higher than the U.S. percentage rate of 14.9 percent (Table 74, page 186). The percentage rate of children under 18 with no health insurance coverage in Sunflower County (7.9 percent) is lower than that of the state of Mississippi (9.1 percent) and is also lower than that of the United States. Due to the relatively low income levels and high poverty rates exhibited in Sunflower County, it is likely that a high percentage of children in Sunflower County are eligible for the State Children s Health Insurance Program; this may explain the relatively low percentage of children with no health insurance in Sunflower County. There are approximately 403 children under the age of 18 with no health insurance coverage who live in Sunflower County HFFI census tracts; this represents 73.9 percent of the children under the age of 18 in Sunflower County that have no health insurance coverage. There are 5,096 people living in Sunflower County who have no health insurance coverage; 4,055 of these individuals live in HFFI census tracts and represent 79.6 percent of all people in Sunflower County who have no health insurance coverage. As discussed in prior sections of this report, the healthcare expenditures associated with recipients of public health insurance are higher than those who are covered by private insurance; these healthcare costs and those of the uninsured are predominantly paid for by federal and state governments or by hospitals and physicians and ultimately paid for by tax revenues or by a hidden tax on the cost of healthcare. Public policies that are designed to increase the affordability and accessibility of healthy food in underserved communities have a primary purpose of improving the nutrition and health of the residents in these communities, and specifically, to reduce obesity and the related healthcare cost of obesity. 187

198 Table 75: Sunflower County Estimated Household Spending on Food Census Tract Food at Home Average Household Spending Food at Home Total Spending Food Away from Home Average Household Spending Food Away from Home Total Spending Spending Index Food at Home Spending Index Food Away from Home Total Food Spending ** $2, $3,676,872 $1, $2,067, $5,744, ** $3, $4,660,279 $1, $2,657, $7,317, ** $3, $2,798,836 $1, $1,582, $4,380, $3, $4,359,354 $1, $2,592, $6,952, ** $2, $3,934,195 $1, $2,299, $6,233, ** $2, $2,134,873 $1, $1,247, $3,382, $3, $3,261,703 $2, $1,840, $5,102,462 Sunflower County $2, $24,826,112 $1, $14,287, $39,113,754 Source: ESRI Forecasts; Consumer spending data is derived from 2011 and 2012 Bureau of Labor Statistics Consumer Expenditure Surveys The Spending Potential Index is household based and represents the amount spent relative to a national average of 100 ** Denotes HFFI Eligible Census Tract The Spending Index measures spending as compared to average spending in the United States which equals 100. A spending index below 100, indicates that average household spending is lower than that of the United States; a spending index above 100, indicates that average household spending is higher than that of the United States. 188

199 The Economic Impact of Investments in Sunflower County The economic return on investments in underserved communities will vary based upon the type of investment (i.e. supermarket, grocery store, or convenience store), the amount of the investment, and the geographic location of the investment which will determine the size of the market. The size of the potential market for an investment is not limited by the boundaries of a census tract; depending upon site selection a store may draw customers from more than one census tract. As shown in Table 75 on page 188, household spending for food at home varies by census tract; average household spending for food at home in Sunflower County s HFFI census tracts tends to be lower than the county wide average household spending of $2, Sunflower County s food at home spending index is 56 (Table 75, page 188). Table 76, below, provides an estimate of total food spending on food at home by households within each census tract and also provides an estimate of the supply of food at home that is met by stores within the census tract. The retail gap is an estimate of the unmet demand for food at home within the census tract; positive values indicate that demand for food at home exceeds that which is supplied by stores within the census tract, while negative retail gap dollar values indicate that stores within a census tract are meeting demand for food at home by households that do not live in that census tract. Sunflower County s negative retail gap of approximately $24.5 million indicates that grocery stores in Sunflower County are supplying to consumers who are drawn from outside of the county. Sunflower County s household fruit and vegetable spending index of 55 indicates that households in Sunflower County spend slightly more than one half the amount that U.S. households spend on fruits and vegetables (Table 76, below). In many of Sunflower County s HFFI census tracts, the household fruit and vegetable spending index is extremely low; for example, in HFFI census tract , the household fruit and vegetable spending Table 76: Sunflower County Household Spending on Food at Home and the Food Retail Spending Gap Census Tract or Geographic Area Food at Home Total Spending Estimated Supply Retail Gap Spending on Fruits & Vegetables Food & Vegetable Spending Index ** $3,676,872 $4,473,788 $796,916 $647, ** $4,660,279 $32,918,405 $28,258,126 $831, ** $2,798,836 $667,779 $2,131,057 $495, $4,359,354 $8,484,085 $4,124,731 $800, ** $3,934,195 $2,333,041 $1,601,154 $718, ** $2,134,873 $0 $2,134,873 $389, $3,261,703 $445,186 $2,816,517 $568, Sunflower County $24,826,112 $49,322,284 $24,496,172 $4,453, Source: Consumer Spending data is derived from 2012 Bureau of Labor Statistics Consumer Expenditure Surveys; Estimated supply is from Dunn and Bradstreet, sourced from ESRI Forecasts ** Denotes HFFI Eligible Census Tract 189

200 Table 77: The Economic Impact of a $6,570,000 Construction Investment in Sunflower County Impact Type Employment Labor Income Value Added Output Direct Effect 68.2 $1,818,890 $1,913,838 $6,570,000 Indirect Effect 15.5 $448,892 $686,680 $1,485,944 Induced Effect 7.1 $210,859 $463,049 $766,986 Total Effect 90.7 $2,478,641 $3,063,567 $8,822,929 Source: IMPLAN Tax on Production and Imports: Sales Tax Table 78: The Fiscal Impact of a $6,570,000 Construction Investment in Sunflower County Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Table 79: The Economic Impact of the Ongoing Operations of a Supermarket with Annual Sales of $4,951,290 Table 80: The Fiscal Impact of the Ongoing Operations of a Supermarket with Annual Sales of $4,951,290 Tax on Production and Imports: S/L Non Taxes $118,194 $66,862 $1,630 $3,241 $10,060 $1,634 Corporate Profits Tax Source: IMPLAN Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $4,267 $31,584 $4,994 $2,239 $870 $1,128 Impact Type Employment Labor Income Value Added Output Direct Effect 26.4 $680,958 $926,055 $1,406,166 Indirect Effect 1.6 $54,183 $90,986 $169,456 Induced Effect 2.3 $68,391 $150,188 $248,764 Total Effect 30.3 $803,532 $1,167,229 $1,824,387 Source: IMPLAN Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $132,137 $74,749 $1,822 $3,623 $11,247 $1,826 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) Source: IMPLAN $1,375 $10,256 $1,622 $727 $282 $

201 index is 49 this census tract also indicates a grocery spending retail gap of approximately $2,134,873. This level of spending would be sufficient to support a grocery store; alternatively, a store that is properly located within this census tract might be able to attract grocery spending from census tract , a non qualified HFFI census tract with a retail gap of $2,816,517. The combined food at home spending of census tracts and ($4,951,290) might be sufficient to support an independent supermarket; depending upon site selection, a supermarket in this area might also be able to attract spending from rural areas outside of Sunflower County. In Sunflower County HFFI census tract , the food at home retail spending gap is $2,131,057; this level of spending is sufficient to support a grocery store. These two levels of potential investment in Sunflower County were evaluated using an econometric input output, as follows: The Economic Impact of a Supermarket Investment in a Sunflower County An initial investment of $6,570,000 in the construction or renovation of a 45,000 square foot supermarket with estimated annual sales of $4,951,290 upon the completion of construction and the start up of business operations; modeled at the county level. Based upon these assumptions, the economic effect of this investment would be the generation of approximately 90.7 full time equivalent jobs with associated labor income of $2,478,641. During construction, the direct employment effect is estimated to be 68.2 constructionrelated jobs with associated labor income of $1,818,890; an additional 22.6 indirect and induced full time equivalent jobs would be supported in Sunflower County over the duration of construction activities (Table 77, page 190). The fiscal impact of this investment during the construction phase of project activities is projected to generate an estimated $246,703 in tax revenues (Table 78, page 190); of this amount, sales tax revenues are projected to be $118,194 and property tax revenues are estimated to be $67,732 (combined property tax revenues on production and imports with personal property tax revenues). The economic and fiscal impact of construction activities are one time events and limited to the duration of expenditures associated with construction. Upon the completion of construction activities and the start up of business activities, and assuming annual sales of $4,951,290, the economic effect of a supermarket project in Sunflower County is projected to generate approximately 30.3 jobs in Sunflower County with associated labor income of $803,532. An estimated 26.4 full time equivalent direct jobs would be created at the store, and an additional 3.9 full time equivalent indirect and induced jobs would be created in Sunflower County (Table 79, page 190). 191

202 Table 81: The Economic Impact of a $2,920,000 Construction Investment in Sunflower County Impact Type Employment Labor Income Value Added Output Direct Effect 30.3 $808,396 $850,595 $2,920,000 Indirect Effect 6.9 $199,508 $305,191 $660,419 Induced Effect 3.1 $93,715 $205,799 $340,883 Total Effect 40.3 $1,101,618 $1,361,585 $3,921,302 Source: IMPLAN Table 82: The Fiscal Impact of a $2,920,000 Construction Investment in Sunflower County Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $52,531 $29,717 $724 $1,440 $4,471 $726 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $1,896 $14,037 $2,220 $995 $387 $501 Source: IMPLAN Table 83: The Economic Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,131,057 Impact Type Employment Labor Income Value Added Output Direct Effect 11.4 $293,087 $398,578 $605,220 Indirect Effect 0.7 $23,321 $39,161 $72,935 Induced Effect 1.0 $29,436 $64,642 $107,069 Total Effect 13 $345,844 $502,381 $785,224 Source: IMPLAN Table 84: The Fiscal Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,131,057 Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $56,872 $32,172 $784 $1,559 $4,841 $786 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $592 $4,414 $698 $313 $122 $158 Source: IMPLAN 192

203 The annual fiscal impact of the ongoing operations of a supermarket in Sunflower County with estimated annual sales of $4,951,290 is projected to be $240,032. The annual sales tax revenues associated with this investment are projected to be $132,137 and the personal income tax revenue is estimated to be $10,256 (Table 80, page 190). The Economic Impact of a Grocery Store Investment in Sunflower County An initial investment of $2,920,000 in the construction or renovation of a 20,000 square foot grocery store with annual sales of $2,131,057 was modeled at the county level using econometric input output software. Based upon these assumptions, approximately 40.3 full time equivalent jobs would be supported during the construction phase of project activities; of these, 30.3 would be on site direct construction jobs with associated labor income of approximately $808,396. An additional 10 indirect and induced full time equivalent jobs would be created during the construction phase of project activities (Table 81, page 192). During the construction phase of project activities, the fiscal impact is estimated to be $109,645; of this amount, associated sales tax revenues are estimated to be $52,531 and personal income tax revenues are projected to be $14,037 (Table 82, page 192). The ongoing operations of a grocery store located in Sunflower County with estimated annual sales of approximately $2,131,057 would create approximately 13.0 full time equivalent jobs, with associated labor income of $345,844 annually. An estimated 11.4 direct jobs would be associated with the ongoing operations of the store, creating employment opportunities for the residents living within an underserved community (Table 83, page 192). The annual fiscal impact of the ongoing operations of the project are estimated to be $103,311; of this amount, sales tax revenues are projected to be $56,872 and personal income tax revenues are projected to be $4,414 (Table 84, page 192). 193

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205 ** Denotes HFFI a Food Eligible Desert Census Tract Census Tract Washington County, Mississippi Priscilla Winterville Hunt Brighton Tamburo Nepanee Helm Heads Metcalfe ** Magenta Ingrams StonevilleElizabeth Dunleith ** ** ** Hollyknowe ** ** ** ** Leland Geneill Isenberg Aldridge Greenville BurdetteHays Almy Tribbett Bourbon Refuge Wayside Wilmot Osseola Johnston McGrath Manhattan Tralake Arcola Floyd Avon James ** McCutcheon Estill Empire ** Hollandale Darlove Longwood Overby Chatham Leota Byrne City Erwin Foote Percy Kongo Murphy Marathon Alhambra Hampton WoodsideSpencer Glen Allan Map 11: Washington County HFFI Qualifying Census Tracts Miles 195

206 ** Denotes an HFFI Census Tract ** ** ** ** ** ** ** ** ** ** Miles Map 12: Washington County Reference Map 196

207 Eligible Healthy Food Financing Initiative Census Tracts in Washington County Based upon the data from the USDA s HFFI Locator Tool, there are thirteen (13) census tracts located in Washington County that are eligible and qualify for funding under the Federal Healthy Food Financing Initiative; these are: Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at 1 and 10 miles, at ½ and 10 miles, and at 1 and 20 miles, and low income and low access using vehicle access. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at ½ and 10 miles, and low income and low access using vehicle access. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at ½ and 10 miles, and low income and low access using vehicle access. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at ½ and 10 miles. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at ½ and 10 miles, and low income and low access using vehicle access. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at ½ and 10 miles Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at ½ and 10 miles. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at ½ and 10 miles. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at ½ and 10 miles. Census Tract is designated as a rural tract and is eligible based upon low income and low access measured at 1 and 10 miles, and at ½ and 10 miles Census Tract is designated as a rural tract and is eligible based upon low income and low access measured at ½ and 10 miles. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at 1 and 10 miles, at ½ and 10 miles, and at 1 and 20 miles, and low income and low access using vehicle access. Census Tract is designated as an urban tract and is eligible based upon low income and low access measured at 1 and 10 miles, at ½ and 10 miles, and at 1 and 20 miles. 197

208 In Washington County, an estimated 34,695 people live in qualifying HFFI census tracts; this represents approximately 49.1 percent of the total county population. There are approximately 10,006 children (age 0 to 17 years) and 4,163 seniors (age 65 and over) living in HFFI census tracts in Washington County; 71.6 percent of all children and 65.7 percent of all seniors in Washington County live in qualifying HFFI census tracts (Table 87, page 204) Source: U.S. Census Bureau, American Community Survey Year Estimates. 198

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210 Figure 19: Washington County Population 2000 through

211 Overview of Washington County, Mississippi In 2013, Washington County had a population of 49,688 (Figure 19, page 200). Although population decline has slowed in recent years, Washington County s population has experienced an average annual decrease of 1.8 percent over the period from 2000 to 2013 (Figure 19, page 200), and with a population loss of 12,969 people, it had the largest population decline among the 82 counties in the state of Mississippi. Despite this population loss, Washington County had the 15 th largest population among the 82 counties in the state of Mississippi in Table 85: Washington County Population by Census Tract According to the 2010 U.S. Census, 229 in the United States, 72.4 percent of the population is White, 12.6 percent of the population is African American, 9.1 percent of the population is Hispanic or Latino, percent of the population is Asian, 1.7 percent of the population is American Indian or Alaska Native, and the balance is some other race; in the U.S., 49.2 percent of the population is male and 50.8 percent of the population is female. Census Tract Total Population In the state of Mississippi, 60.1 percent of the population is White, 37.6 percent of the population is African American, and less than 2 percent of the population is comprised of some other racial group; in Mississippi, 48.3 percent of the population is male and 51.7 percent of the population is female. Percent of County Population , % , % ** 3, % ** 3, % ** 2, % , % , % , % ** 2, % ** 1, % ** 1, % ** 2, % ** 2, % ** 3, % ** 4, % ** 2, % ** 2, % , % ** 1, % Source: U.S. Census Bureau, American Community Survey Year Estimates **Denotes HFFI Eligible Census Tract In Washington County, 70.9 percent of the population is African American and 26.9 percent of the population is White (Table 86, page 202). 229 Author s Note: there is variation between the data reported for the 2010 U.S. Census, U.S. Census Population Estimates and the data from the U.S. Census Bureau American Community Survey year Estimates. Unless specified, this report uses American Community Survey year estimates to make census tract level comparisons. When not provided within the body of this report, supporting tables and documentation are provided in the appendices of this report. 201

212 Table 86: Washington County Racial Distribution by Census Tract Census Tract Total Population White Percent White Black or African American Percent Black or African American American Indian and Alaska Native alone Percent American Indian and Alaska Native alone Asian Percent Asian Some other Race Percent Some other Race , % % % % % , % 1, % % % % ** 3, % 3, % % % % ** 3, % 3, % % % % * 2, % 2, % % % % ,512 1, % 2, % % % % ,080 2, % 1, % % % % ,439 1, % 1, % % % % ** 2, % 2, % % % % ** 1, % 1, % % % % ** 1, % 1, % % % % ** 2, % 2, % % % % ** 2, % 2, % % % % ** 3,812 1, % 2, % % % % ** 4,315 3, % 1, % % % % ** 2, % 1, % % % % ** 2, % 2, % % % % , % 1, % % % % ** 1, % 1, % % % % Total 50,578 13, % 35, % % % % Source: U.S. Census Bureau, American Community Survey Year Estimates **Denotes HFFI Eligible Census Tract 202

213 In Washington County, 68.6 percent of the total population lives in HFFI census tracts. Approximately 27,637 African Americans live in Washington County s HFFI census tracts, representing 77.0 percent of the total African American population in the county; this is statistically higher than the representation of African Americans in Washington County s total population (70.9 percent). The higher concentration of minority populations within Washington County s HFFI census tracts repeats the pattern found in other research on HFFI census tracts. 231, 232, 233 There are eight HFFI census tracts in Washington County where the African American population exceeds 90 percent of the tract s population; these are: Census Tract , Census Tract , Census Tract , Census Tract , Census Tract , Census Tract , Census Tract , and Census Tract (Table 86, page 202). Women are disproportionally represented in Washington County s HFFI census tracts. There are approximately 27,007 females living in Washington County; they represent 53.4 percent of the county s population. Approximately 18,989 females live in HFFI census tracts in Washington County; this represents 70.3 percent of Washington County s female population. In some of Washington County s HFFI census tracts, women represent a significantly higher percentage of the census tract s population as compared to the county average; for example, in census tract and in census tract , females represent 62.8 percent and 58.2 percent of the total population, respectively (Table 87, page 204). In Washington County, there are 2,921 families that are female households with children under 18 and no husband present; this represents 23.5 percent of all family households in Washington County. There are 2,206 families that are female households with children under 18 and have no husband present who live in HFFI census tracts in Washington County; this represents 75.5 percent of all single female households with children in Washington County (Table 88, page 205). These families and their children are at the highest risk of poverty, at the highest risk for food insecurity, and are the most likely to be detrimentally impacted by poor nutrition and the negative health outcomes that have been found to be associated with living in an underserved community, as reported in prior sections of this report. Of the 12,412 families in Washington County, 66.7 percent live in HFFI census tracts (Table 88, page 205). In Washington County, 27.6 percent of the population are children (age 17 and under) an estimated 13,973 children. There are many HFFI qualifying census tracts in 231 Dutko, Paula, Michele Ver Ploeg, and Tracey Farrigan. Characteristics and Influential Factors of Food Deserts, ERR 140, U.S. Department of Agriculture, Economic Research Service, August Duran, A. C., et al. (2013). Neighborhood Socioeconomic Characteristics and Differences in the Availability of Healthy Food Stores and Restaurants in Sao Paulo, Brazil. Health Place 23: Block, J. P., et al. (2004). Fast food, Race/Ethnicity, and Income: A Geographic Analysis. American Journal of Preventive Medicine 27(3):

214 Table 87: Washington County Selected Gender, Age, and Family Population Data by Census Tract Census Tract Total Population Percent Female Population 17 years and Under Percent of Tract Population 17 and Under Population 65 and Over Percent of Tract Population 65 and Over Number of Families Number of Female Households, No Husband Present, with Children Under 18 Percent of Tract Families with Female Householder, No Husband Present with Children under 18 Years , % % % % , % % % % ** 3, % 1, % % % ** 3, % % % % ** 2, % % % % , % % % % , % % % 1, % , % % % % ** 2, % % % % ** 1, % % % % ** 1, % % % % ** 2, % % % % ** 2, % % % % ** 3, % 1, % % % ** 4, % 1, % % 1, % ** 2, % % % % ** 2, % % % % , % % % % ** 1, % % % % Total 50, % 13, % 6, % 12,412 2, % Source: U.S. Census Bureau, American Community Survey Year Estimates **Denotes HFFI Eligible Census Tract 204

215 Washington County that exhibit an extraordinarily high number and percentage of children, these include, but are not limited to: 963 children in census tract , representing 39.1 percent of the tract s total population; 1,283 children in census tract , representing 34.5 percent of the tract s total population; and 1,316 children in census tract , representing 34.5 percent of the tract s total population. An estimated 10,006 children live in Washington County s HFFI qualifying census tracts; this represents 71.6 percent of all children in Washington County. Lack of access to affordable, nutritious food is of particular concern for children due to the negative impact that inadequate nutrition may have on child brain development, cognitive functioning, and the potential detrimental effects on 234, 235, 236 their health and on future learning. In Washington County, there are approximately 6,340 people aged 65 and older; they represent approximately 12.5 percent of the total population. There are 4,163 people aged 65 and older living in Washington County s HFFI qualifying census tracts; this represent 65.7 percent of Washington County s population aged 65 and older (Table 87, page 204). Two HFFI census tracts in Washington County exhibit a relatively high number and high percentage of seniors; approximately 659 seniors live in census tract , representing 15.3 percent of the tract s total population, and 613 seniors live in census tract , representing 27.5 percent of the tract s total population (Table 87, page 204). Among the 4,822 households in Washington County that have one or more people age 65 and older, 66.1 percent of these households are located in HFFI census tracts and 67.9 percent of all nonfamily households with people age 65 and older living alone reside in HFFI qualifying census tracts in Washington County (Table 88, at right). Table 88: Washington County Households by Type Household by Type Washington Total in HFFI Percent in HFFI County Total Census Tracts Census Tracts Total households 18,123 12, % Family households (families) 12,412 8, % With own children under 18 years 5,259 3, % Married couple family 5,993 3, % With own children under 18 years 1,987 1, % Male householder, no wife present, family % With own children under 18 years % Female householder, no husband present, family 5,550 4, % With own children under 18 years 2,921 2, % Nonfamily households 5,711 3, % Householder living alone 5,161 3, % 65 years and over 1,905 1, % Households with one or more people under 18 years 6,658 4, % Households with one or more people 65 years and over 4,822 3, % Source: U.S. Census Bureau, American Community Survey Year Estimates 234 Winicki, J. and Jemison, K. (2003). Food Insecurity and Hunger in the Kindergarten Classroom: Its Effect on Learning and Growth. Contemporary Economic Policy, 21(2): Casey, P. H, Szeto, K., Lensing, S. (2001). Children in Food Insufficient, Low Income Families: Prevalence, Health, and Nutrition Status. Archives of Pediatrics and Adolescent Medicine. 155(4): Alaimo, K., Olson, C. M., and Frongillo, E. A. (2001). Food Insufficiency and American School Aged Children s Cognitive, Academic, and Psychosocial Development. Pediatrics. 108(1):

216 Table 89: Washington County Poverty Rates for Families and Individuals Census Tract or Geographic Area All people All families All Families with related children under 18 years Female Households, No Husband Present, with related children under 18 years All Children Under 5 All Children 5 to 17 years Persons 65 and over % 13.10% 17.10% 40.30% 8.90% 20.40% 14.30% % 34.00% 42.40% 52.60% 74.10% 45.20% 22.50% ** 49.50% 40.90% 52.20% 62.20% 85.40% 63.00% 32.10% ** 54.80% 47.80% 69.50% 66.90% 84.90% 63.40% 20.80% ** 46.10% 37.60% 42.30% 67.80% 49.20% 57.20% 38.60% % 16.90% 29.40% 19.10% 35.20% 42.20% 13.80% % 0.70% 1.50% 5.60% 7.00% 0.00% 1.00% % 16.90% 32.60% 44.60% 82.10% 32.20% 13.90% ** 45.90% 32.90% 58.80% 72.10% 60.60% 81.60% 6.90% ** 39.80% 29.30% 36.20% 33.90% 46.00% 34.60% 21.10% ** 50.90% 44.50% 63.20% 72.00% 49.00% 67.30% 19.50% ** 39.60% 36.50% 54.30% 65.80% 44.90% 65.70% 18.00% ** 57.10% 50.80% 73.00% 84.00% 82.00% 84.50% 11.80% ** 33.40% 30.50% 41.20% 53.80% 57.50% 53.50% 14.10% ** 35.60% 25.40% 40.20% 50.00% 75.10% 34.80% 21.40% ** 44.20% 44.60% 57.30% 63.90% 63.40% 57.20% 16.60% ** 41.70% 34.90% 43.60% 58.50% 58.80% 45.00% 39.00% % 36.30% 45.20% 46.30% 93.30% 54.40% 33.90% ** 58.10% 56.00% 68.50% 76.40% % 61.50% 19.40% Washington County 37.30% 30.30% 43.90% 56.60% 60.30% 51.70% 18.70% State of Mississippi 22.70% 17.80% 27.10% 51.80% 36.50% 30.50% 14.00% United States 15.40% 11.30% 17.80% 40.00% 24.70% 20.00% 9.40% Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 206

217 Mississippi has one of the highest poverty rates in the United States. With a poverty rate of 22.7 percent, the state of Mississippi s poverty rate is 7.3 percent higher than the U.S. poverty rate of 15.4 percent. In Washington County, the poverty rate is 37.3 percent (Table 89, page 206), indicating that the overall poverty rate for all people living in Washington County is 14.6 percent higher than that of the state of Mississippi and 21.9 percent higher than that of the United States (more than twice that of the nation). In Washington County, 60.3 percent of all children under the age of 5 and 51.7 percent of all children between the ages of 5 to 17 live in poverty. In Washington County, the poverty rate among children under the age of 5 is 23.8 percent higher than the state of Mississippi s poverty rate for children in this age group and is 35.6 percent higher than the United States poverty rate for children under the age of 5 (Table 89, page 206). For children between the age of 5 and 17, the poverty rate for children in Washington County is 21.2 percent higher than the state of Mississippi s poverty rate of 30.5 percent for children age 5 to 17 and 31.7 percent higher than the U.S. poverty rate for children in this age group (Table 89, page 206). Although any level of poverty for children in the United States is unacceptable, the poverty rate for children under 5 in all of Washington County s HFFI census tracts is more than twice that of the United States poverty rate for children under 5. There are five HFFI census tracts in Washington County that have more than 75 percent of all children under five living in poverty; for example, in census tract , all (100 percent) children under five live in poverty and in census tract , an estimated 84.4 percent of all young children live in poverty (Table 89, page 206). In ten of Washington County s HFFI census tracts, the poverty rate for children between the age of 5 and 17 is higher than the county s poverty rate of 51.7 percent for children in this age group; in HFFI census tracts and , the poverty rate for children age 5 to 17 is 84.5 percent and 81.6 percent, respectively. The burden of poverty falls heavily upon children in female households with no husband present; in Washington County, the poverty rate for female households with no husband present who have children under 18 years is 56.6 percent and this poverty rate is approximately 12.7 percent higher when compared to the poverty rate for all families with children under 18 (Table 89, page 206). Replicating the pattern of poverty for children age 5 to 17, ten of the HFFI census tracts in Washington County exhibit poverty rates that exceed the county poverty rate for female households with no husband present who have children under 18 years. Of the estimated 1,650 female households with no husband present who have children under 18 and are living in poverty, 84.4 percent of these households live in HFFI qualifying census tracts in Washington County. The poverty rate of seniors in Washington County is 18.7 percent; this is 4.7 percent higher than the state of Mississippi s poverty rate of 14 percent and 9.3 percent higher than the United States poverty rate for people in this age group (Table 89, page 206). 207

218 Table 90: Washington County Educational Attainment for the Population 25 Years and Older Census Tract or Geographic Area Less than 9th grade 9th to 12th grade, no diploma High school graduate (includes equivalency) Some college, no degree Associate's degree Bachelor's degree Graduate or.professiona l degree Percent high school graduate or higher % 7.9% 22.6% 23.1% 7.4% 16.2% 9.3% 78.4% 25.4% % 25.2% 29.7% 16.9% 6.4% 8.6% 3.7% 65.3% 12.2% ** 7.0% 20.0% 36.6% 19.9% 4.6% 6.6% 5.3% 72.9% 11.9% ** 14.2% 26.5% 28.0% 22.7% 1.8% 6.8% 0.0% 59.3% 6.8% ** 10.2% 18.6% 39.6% 21.5% 2.9% 7.3% 0.0% 71.2% 7.3% % 10.9% 26.3% 24.5% 8.4% 14.6% 7.9% 81.7% 22.5% % 7.8% 17.5% 22.7% 10.2% 26.0% 13.3% 89.8% 39.3% % 8.8% 26.9% 26.3% 8.4% 18.4% 7.7% 87.8% 26.2% ** 9.4% 10.5% 29.0% 15.3% 6.8% 18.2% 10.8% 80.1% 29.0% ** 21.3% 15.9% 23.7% 23.7% 9.5% 5.7% 0.3% 62.9% 6.0% ** 12.1% 30.1% 27.7% 17.0% 5.9% 5.8% 1.4% 57.8% 7.2% ** 11.8% 13.1% 24.9% 24.1% 6.8% 10.8% 8.6% 75.1% 19.3% ** 8.4% 18.9% 34.1% 21.3% 6.8% 7.5% 3.0% 72.7% 10.5% ** 2.6% 19.7% 34.0% 20.3% 6.9% 13.2% 3.4% 77.7% 16.6% ** 9.6% 16.1% 33.7% 20.6% 5.2% 9.3% 5.5% 74.3% 14.8% ** 7.0% 20.0% 22.7% 23.9% 5.2% 14.4% 6.9% 73.1% 21.3% ** 19.0% 8.4% 27.8% 17.4% 7.3% 16.1% 4.1% 72.6% 20.2% % 11.7% 26.7% 23.9% 6.6% 16.7% 5.8% 79.8% 22.5% ** 16.4% 10.9% 37.7% 19.1% 5.0% 9.8% 1.0% 72.7% 10.8% Washington County 9.0% 15.4% 28.8% 21.5% 6.5% 13.0% 5.8% 75.5% 18.7% State of Mississippi 6.4% 12.1% 30.5% 22.7% 8.1% 12.8% 7.3% 81.5% 20.1% United States 5.9% 8.0% 28.1% 21.2% 7.8% 18.0% 10.8% 86.0% 28.8% Source: U.S. Census Bureau, American Community Survey Year Estimates Percent Bachelor's degree or higher ** Denotes HFFI Eligible Census Tract 208

219 As shown in Table 89 on page 206, there are eight HFFI census tracts in Washington County that exhibit a higher percentage of seniors living in poverty as compared to the county poverty rate of 18.7 percent for people age 65 and over. In some Washington County HFFI census tracts, almost 40 percent of the senior population lives in poverty (i.e. census tract ). Seniors face significant transportation and mobility barriers when access to nutritious food is limited; poverty further exacerbates these mobility barriers because they must expend greater resources to obtain food from available sources. These individual disadvantages are further compounded when there is lack of access to affordable, nutritious foods. In Washington County, approximately 75.5 percent of the population age 25 and older have a high school degree and 18.7 percent of the population in this age group has a Bachelor s degree or higher; these educational attainment levels are lower than those of the general population age 25 and older in the state of Mississippi (Table 90, page 208). In the majority (11 out of 13, or 84.6 percent) of Washington County s HFFI census tracts, the percent of the tracts population with a high school degree is lower than the county average high school graduation rate of 75.5 percent for the population 25 years and older. Because there is a high correlation between educational attainment, income, poverty, obesity, and negative health outcomes, the relatively large percentage of people age 25 and older who do not have a high school diploma in Washington County is of specific concern. In the U.S., approximately 8.8 percent of the population age 25 and older do not have a high school diploma; in the state of Mississippi, approximately 12.1 percent of those age 25 and older do not have a high school diploma, and in Washington County, 15.4 percent of the population 25 and older do not have a high school diploma. In many of Washington County s HFFI qualifying census tracts, the percent of the population age 25 and older that do not have a high school diploma exceeds 18 percent; for example, in census tract , 26.5 percent of the population have no high school diploma and in census tract , 20 percent of the population age 25 and older have no high school degree (Table 90, page 208). Food Insecurity in Washington County In 2011, approximately 16.4 percent of all individuals in the U.S. experienced food insecurity; in 2012, 15.9 percent of all individuals in the United States were food insecure, 237 indicating that food insecurity had declined in the U.S. Across the United States, the average county level food insecurity rate remained stable at 14.7 percent in 2011 and in In Mississippi, the overall food insecurity rate was 22.3 percent in 2012; Mississippi had the highest overall food insecurity rate in the nation in In 2012, approximately 31.0 percent of all individuals in Washington County were food insecure (15,810 people). 237 Coleman Jensen, A., Nord, M. and Singh, A. (2013) Household Food Security in the United States in U.S. Department of Agriculture Economic Research Service. 209

220 Table 91: Washington County Comparative Employment and Income Census Tract of Geographic Area Population 16 years and over Number in the Civilian Labor Force Percent in the Labor Force Percent Unemployed Number Not in the Labor Force Total Households Percent of Households with Income less than $10,000 Percent of Households with Income between $10,000 to $14,999 Median Household Income (dollars) Percent of Households with Earnings , % 15.8% % 12.4% $46, % , % 31.2% % 13.5% $26, % ** 2,484 1, % 33.7% 1,109 1, % 10.5% $21, % ** 2,462 1, % 37.0% 1,281 1, % 28.2% $14, % ** 2, % 23.4% 1,406 1, % 20.4% $16, % ,671 1, % 20.0% 845 1, % 9.1% $44, % ,269 2, % 8.1% 949 1, % 3.8% $63, % ,700 1, % 13.9% 848 1, % 5.4% $47, % ** 2,047 1, % 22.0% % 8.2% $32, % ** % 38.4% % 9.7% $22, % ** 1, % 20.5% % 14.0% $18, % ** 1, % 30.0% 1, % 19.6% $22, % ** 1, % 21.9% % 21.3% $19, % ** 2,593 1, % 18.2% 845 1, % 12.2% $31, % ** 3,330 1, % 14.9% 1,456 1, % 10.4% $29, % ** 1, % 20.4% % 6.4% $26, % ** 2,272 1, % 23.0% 1,085 1, % 6.6% $25, % , % 19.3% % 9.9% $28, % ** % 37.9% % 15.9% $18, % Washington County 38,228 21, % 21.4% 16,332 18, % 11.9% $28, % Mississippi 2,312,959 1,343, % 11.1% 957,272 1,088, % 8.1% $39, % United States 246,191, ,113, % 9.7% 87,994, ,610, % 5.4% $53, % Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 210

221 Child food insecurity rates are substantially higher than the overall food insecurity rate for the entire population. In the U.S., the child food insecurity rate was 21.6 percent in In counties across the United States, the county level of child food insecurity ranged from a low of six percent to a high of 41 percent in In 2012, the state level child food insecurity rate ranged from a low of 10.6 percent in North Dakota to a high of 29.2 percent in New Mexico. Mississippi had the second highest level of child food insecurity in the U.S.; with 28.7 percent of Mississippi s children being food insecure, it is estimated that approximately 214,720 children in Mississippi are food insecure. 239 In Washington County, it is estimated that 32.5 percent of children are food insecure; research indicates that among the 4,670 children living in Washington County that are food insecure, approximately 68 percent are eligible for Federal Nutrition Assistance programs but 32 percent are not eligible for these assistance programs. 240 Washington County Income by Source In Washington County, the labor force participation rate is 57.3 percent and the unemployment rate for those in the civilian labor force is 21.4 percent; this unemployment rate is 10.3 percent higher than Mississippi s unemployment rate of 11.1 percent and 11.7 percent higher than the U.S. unemployment rate of 9.7 percent (Table 91, page 210). In Washington County, many HFFI census tracts exhibit extremely elevated unemployment rates; for example, in census tracts and , the unemployment rates are 38.4 percent and 37.9 percent, respectively (Table 91, page 210). In Washington County, the median household income is $28,093; median household income in Washington County is $10,938 lower than Mississippi s median household income and $24,953 lower than the median household income in the United States (Table 91, page 210). Households with incomes of $15,000 or less are more likely to live in poverty and are at a higher risk for food insecurity and related negative health outcomes, to include obesity and diabetes. As a result, these low income households are also more likely to have high health care costs associated with obesity. Living in an underserved community, with limited access to affordable, nutritious food may exacerbate these risk factors and further compound the individual effects of low household income. In Washington County, 27.4 percent of all households have incomes of $15,000 or less; this compares to an estimated 19.5 percent of all households in the state of Mississippi with incomes of $15,000 or less. In ten of Washington County s HFFI census tracts, the percentage of households with incomes of $15,000 or less equals or exceeds 30 percent. For example, in census tract and census tract 238 Ibid. 239 Ibid. 240 Gundersen, C., Waxman, E., Engelhard, E., Satho, A. and Namrita, C. Map the Meal Gap 2013: Food Insecurity Estimates at the County Level. Feeding America,

222 Table 92: Washington County Comparative Earnings and Income by Source Census Tract or Geographic Area Mean earnings (dollars) for Workers Percent of Households with Social Security Mean Social Security income (dollars) Percent of Households with retirement income Mean retirement income (dollars) Percent of Households with Supplemental Security Income Mean Supplemental Security Income (dollars) Percent of Households with cash public assistance income Mean cash public assistance income (dollars) Percent of Households with Food Stamp/SNAP benefits in the past 12 months $57, % $12, % $14, % $8, % $2, % $59, % $15, % $13, % $6, % $1, % ** $33, % $13, % $25, % $8, % $ % ** $19, % $10, % $6, % $7, % $2, % ** $25, % $11, % $7, % $7, % $2, % $56, % $16, % $17, % $8, % $2, % $86, % $19, % $17, % $7, % $1, % $57, % $14, % $25, % $7, % $1, % ** $40, % $14, % $8, % $7, % $1, % ** $34, % $9, % $12, % $8, % $1, % ** $24, % $9, % $13, % $8, % $2, % ** $26, % $14, % $17, % $8, % $5, % ** $29, % $13, % $23, % $10, % $5, % ** $41, % $14, % $16, % $8, % $5, % ** $51, % $16, % $12, % $9, % $ % ** $46, % $14, % $16, % $11, % $ % ** $52, % $11, % $7, % $8, % $1, % $37, % $10, % $14, % $10, % $1, % ** $28, % $11, % $15, % $8, % $1, % Washington County $47, % $14, % $15, % $8, % $2, % Mississippi $56, % $15, % $19, % $8, % $2, % United States $75, % $17, % $23, % $9, % $3, % Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 212

223 , the percentage of households with incomes of $15,000 or less is 51.7 percent and 47.8 percent, respectively in these two census tracts, more than 20 percent of households have incomes of less than $10,000 (Table 91, page 210). Of the estimated 4,966 households with incomes of $15,000 or less, 80.1 percent live in HFFI census tracts in Washington County. In Washington County, 68.8 percent of households have earnings from work (Table 91, page 210); mean income for households with earnings from work is $47,489 in Washington County (Table 92, page 212). In addition to earnings from work, households may have income from Social Security or Supplemental Security, Retirement, and from other forms of public assistance. In Washington County, 37 percent of households have Social Security income, with a mean Social Security income of $14,034; the percentage of households with Social Security income is 5.6 percent higher in Washington County as compared to the state of Mississippi and these households mean Social Security income is approximately $1,639 lower than the mean Social Security income in the state of Mississippi given an average household spending on food at home of $3,054 annually in Washington County, this difference is not insignificant. Of the estimated 6,705 households with Social Security income in Washington County, 67.9 percent live in HFFI qualifying census tracts. Supplemental Security Income (SSI) provides benefits to needy aged, blind, and disabled people; in the U.S., approximately 40 percent of SSI recipients are over the age of 65; the remainder are disabled. Children may qualify for SSI benefits if they are disabled. In Washington County, 14 percent of households receive SSI; this is slightly lower than the percentage of households in the state of Mississippi that receive SSI (15.5 percent). In Washington County, there are approximately 2,537 households that receive SSI income; 82.6 percent of these households live in HFFI census tracts (Table 92, page 212). Approximately 14.8 percent of households in Washington County receive retirement income; the mean retirement income is $15,857 (Table 92, page 212). As compared to the state of Mississippi, 2.7 percent fewer households receive retirement income, and among those that do, their mean retirement income is approximately $3,882 lower than the mean retirement income of the state. Among the estimated 2,681 households in Washington County that receive retirement income, 1,633 (60.9 percent) live in HFFI census tracts. There are approximately 701 households in Washington County that receive income from Cash Public Assistance; 84.1 percent of these households live in HFFI census tracts. Approximately 33.4 percent of households in Washington County receive SNAP benefits; this is almost twice the percentage rate for the state of Mississippi (Table 92, page 212). In the majority (85 percent) of Washington County s HFFI eligible census tracts, the percentage of households receiving SNAP benefits is higher than the county average. In HFFI eligible census tracts , , , , and , the 213

224 Table 93: Washington County Employment by Industry Sector Census Tract or Geographic Area Civilian employed population 16 years and over Agriculture and Mining Construction Manufacturing Wholesale trade Retail trade Transportation/ Warehousing/ Utilities % 7.5% 3.4% 3.3% 4.6% 15.4% % 4.6% 7.6% 3.6% 5.8% 7.4% ** % 6.7% 17.1% 1.5% 9.9% 1.4% ** % 0.0% 7.9% 2.3% 21.5% 6.7% ** % 0.0% 7.6% 0.0% 13.0% 4.9% , % 0.7% 3.1% 0.8% 16.6% 6.6% , % 9.0% 7.5% 0.5% 9.8% 4.6% , % 4.8% 10.2% 1.5% 16.7% 2.0% ** 1, % 6.3% 7.8% 0.8% 10.9% 0.0% ** % 0.0% 11.6% 6.9% 13.2% 0.0% ** % 7.0% 0.7% 1.8% 12.5% 7.2% ** % 1.6% 6.3% 1.4% 11.1% 0.7% ** % 8.3% 8.5% 1.3% 19.9% 4.2% ** 1, % 2.4% 10.1% 6.2% 7.8% 8.2% ** 1, % 7.8% 8.9% 3.7% 13.5% 5.5% ** % 2.8% 7.9% 0.0% 14.2% 4.3% ** % 1.0% 5.7% 0.5% 19.0% 9.0% % 0.0% 13.4% 7.2% 5.7% 11.3% ** % 4.0% 7.3% 2.4% 15.5% 9.1% Washington County 17, % 4.5% 8.1% 2.1% 12.8% 5.4% Washington Numeric 17, , , Mississippi 1,194, % 6.9% 12.9% 2.6% 11.8% 5.7% United States 141,864, % 6.2% 10.5% 2.8% 11.6% 4.9% Census Tract or Geographic Area Information Finance/ Insurance/ Real Estate Professional/ Scientific/ Management/ Administrative Educational Services/ Health Care/ Social Assistance Arts/ Entertainment/ Recreation/ Accommodation/ Food Services Other services, except Public Administration Public Administration % 6.2% 9.2% 13.5% 5.9% 10.2% 8.6% % 7.6% 5.6% 23.6% 9.2% 3.4% 7.0% ** 0.0% 2.4% 1.1% 41.6% 7.7% 1.1% 6.0% ** 0.0% 1.1% 4.4% 20.2% 20.4% 13.2% 2.3% ** 1.2% 3.7% 3.2% 30.7% 19.1% 1.7% 11.1% % 7.3% 5.6% 25.1% 7.0% 3.0% 13.2% % 9.2% 7.6% 30.3% 7.5% 6.5% 6.6% % 2.9% 10.1% 25.6% 7.0% 3.4% 9.7% ** 2.7% 5.8% 8.9% 28.3% 13.8% 5.6% 6.9% ** 0.0% 0.0% 0.0% 37.6% 15.2% 0.0% 9.2% ** 0.0% 0.0% 13.4% 12.5% 37.6% 2.2% 5.0% ** 0.0% 3.7% 6.7% 47.8% 7.4% 6.7% 6.0% ** 0.0% 1.8% 1.6% 22.4% 18.3% 4.2% 5.2% ** 7.7% 1.0% 2.0% 16.4% 18.0% 10.0% 10.1% ** 0.6% 3.1% 12.3% 11.2% 6.5% 14.0% 4.3% ** 0.0% 3.2% 12.0% 29.3% 8.1% 4.0% 7.0% ** 8.0% 5.0% 4.2% 25.1% 10.0% 3.0% 9.0% % 1.5% 5.7% 32.5% 1.3% 8.7% 3.0% ** 8.2% 2.7% 0.0% 20.7% 16.8% 1.5% 8.8% Washington County 1.8% 4.2% 6.7% 25.1% 11.2% 6.1% 7.6% Washington Numeric ,149 4,313 1,929 1,043 1,307 Mississippi 1.4% 4.9% 6.3% 24.4% 9.4% 5.0% 5.7% United States 2.2% 6.7% 10.8% 23.2% 9.3% 5.0% 5.0% Source: U.S. Census Bureau, American Community Survey Year Estimates ** Denotes HFFI Eligible Census Tract 214

225 percentage of households receiving food stamp benefits exceeds 50 percent. Among the 6,059 households receiving SNAP benefits In Washington County, 80.9 percent live in HFFI qualifying census tracts (Table 92, page 212). The Washington County Workforce Among the civilian employed population over the age of 16, the largest percentage of the work force in Washington County is employed in the Educational Services, Health Care, and Social Assistance sectors of the economy; in Washington County, these industry sectors employ approximately 4,313 people and represent approximately 25.1 percent of total county employment (Table 93, page 214). The percentage of Washington County s workforce that is employed in the Educational Services, Health Care, and Social Assistance sectors of the economy is higher than it is in either the state of Mississippi (24.4 percent) or the United States (23.2 percent). There are three HFFI census tracts that exhibit a relatively high employment rate in the Educational Services, Health Care, and Social Assistance sectors; these are: Census tract , with 47.8 percent of the workforce employed in the Educational Services, Health Care, and Social Assistance sector Census tract , with 41.6 percent of the workforce employed in the Educational Services, Health Care, and Social Assistance sector Census tract , with 37.6 percent of the workforce employed in the Educational Services, Health Care, and Social Assistance sector In Washington County, approximately 12.8 percent of the population is employed in the Retail Trade sector; with approximately 2,197 people working in Retail Trade, this sector is the second largest employer in Washington County (Table 93, page 214). There are three HFFI qualifying census tracts in Washington County where the percentage of the workforce employed in the Retail Trade sector approaches 20 percent or higher and is significantly higher than that of the county, the state, and the nation; these are: Census tract , with 21.5 percent of the workforce employed in the Retail Trade sector Census tract , with 19.9 percent of the workforce employed in the Retail Trade sector Census tract , with 19.0 percent of the workforce employed in the Retail Trade sector The Manufacturing sector employs approximately 8.1 percent of Washington County s employed civilian population over the age of 16 (Table 93, page 214); the percentage of the workforce employed in the Manufacturing sector is significantly lower in Washington County 215

226 than it is in either the state of Mississippi (12.9 percent) or the U.S. (10.5 percent). There are three qualifying HFFI census tracts where the percentage of the workforce that is employed in the Manufacturing sector is higher than the percentage rate for Washington County; these are: Census tract , where 17.1 percent of the workforce is employed in the Manufacturing sector Census tract , where 11.6 percent of the workforce is employed in the Manufacturing sector Census tract , where 10.1 percent of the workforce is employed in the Manufacturing sector In Washington County, 11.2 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors; this is higher than the percentage rate for the state of Mississippi (9.4 percent) and that of the United States (Table 93, page 214). In eight of Washington County s thirteen HFFI census tracts, the percentage of employment in Arts, Entertainment, Recreation, or Accommodation and Food Services sectors is higher than the average in Washington County; examples include: Census tract , where 37.6 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors Census tract , where 20.4 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors Census tract , where 19.1 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors Census tract , where 18.3 percent of the workforce is employed in the Arts, Entertainment, Recreation, or Accommodation and Food Services sectors The median earnings for all workers in Washington County was $21,545 as compared to median earnings of $25,707 in the state of Mississippi, and median earnings of $30,538 in the United States (Table 94, page 217). In Washington County, the median earnings for male full time workers that held steady year round jobs was $34,399 and the median earnings for female fulltime workers that held steady year round jobs was $27,330 (Table 94, page 217). Within 10 of Washington County s HFFI census tracts, the mean earnings for all workers ranged from being $2,175 (census tract ) lower than the mean earnings for workers of $21,545 for Washington County to being $7,922 lower (census tract ) than the mean for Washington County. In the majority of Washington County s HFFI census tracts, the median earnings for male and female full time workers that held steady year round jobs was lower than Washington County s median earnings for workers in this category. For men, this negative earnings differential ranged from a low of $588 (tract ) to a high of $20,144 (tract ); for women, this negative earnings differential ranged from a low of $792 (tract 216

227 ) to a high of $9,552 (tract ). In Washington County, the median earnings for all workers is approximately $4,162 lower than the median earnings for all workers in Mississippi; male full time workers have median earnings that are $6,343 lower and female full time workers have median earnings that are approximately $3,274 lower than median earning in the state of Mississippi in these classes of workers (Table 94, below). Table 94: Washington County Median Earnings for Workers Census Tract or Geographic Area ** Denotes HFFI Eligible Census Tract Median earnings for workers (dollars) Median earnings for male full time, yearround workers (dollars) Median earnings for female full time, year round workers (dollars) $27,411 $47,321 $27, $20,208 $44,231 $24, ** $19,087 $30,711 $22, ** $13,623 $23,906 $18, ** $15,493 $27,083 $24, $24,349 $30,639 $42, $29,937 $53,534 $29, $29,675 $50,694 $37, ** $23,851 $31,230 $18, ** $14,974 $26,944 $20, ** $13,790 $14,255 $17, ** $15,931 $23,750 $22, ** $16,574 $29,917 $21, ** $19,370 $28,242 $28, ** $22,068 $33,811 $23, ** $17,566 $35,789 $26, ** $35,215 $37,700 $39, $14,631 $31,019 $36, ** $14,049 $30,865 $18,750 Washington County $21,545 $34,399 $27,330 Mississippi $25,707 $40,742 $30,604 United States $30,538 $49,087 $38,635 Source: U.S. Census Bureau, American Community Survey Year Estimates 217

228 Table 95: Health Insurance Coverage for the Civilian Non Institutionalized Population in Washington County Census Tract or Geographic Area With health insurance coverage % 57.7% 33.7% 17.4% 11.7% % 34.8% 51.7% 21.1% 4.9% ** 66.7% 22.0% 50.6% 33.3% 29.7% ** 71.4% 17.7% 59.5% 28.6% 8.7% * 78.0% 26.3% 56.1% 22.0% 11.4% % 50.2% 40.5% 19.7% 7.1% % 66.7% 32.5% 13.8% 6.4% % 55.5% 37.6% 16.2% 1.1% ** 75.7% 37.2% 49.4% 24.3% 19.9% ** 78.4% 26.8% 53.2% 21.6% 0.8% ** 74.9% 24.5% 61.3% 25.1% 3.7% ** 79.3% 35.7% 60.7% 20.7% 2.9% ** 77.2% 23.9% 59.1% 22.8% 9.9% ** 86.7% 46.1% 46.1% 13.3% 6.2% ** 86.5% 50.3% 47.7% 13.5% 2.3% ** 70.8% 42.4% 40.2% 29.2% 14.1% ** 77.6% 38.6% 46.2% 22.4% 8.5% % 35.5% 48.7% 23.0% 9.2% ** 77.9% 28.6% 58.1% 22.1% 7.8% Washington County 79.0% 39.8% 48.0% 21.0% 9.7% Mississippi 82.5% 57.5% 35.7% 17.5% 9.1% United States 85.1% 66.9% 29.4% 14.9% 8.1% Source: U.S. Census Bureau, American Community Survey year Estimates Note: Percentage rates for Private, Public, and No Health Insurance Coverage do not sum to 100 percent due to duplicate insurance coverage. For example, individuals covered by a group health insurance plan may have Medicare as a secondary payer. ** Denotes HFFI Eligible Census Tract With private health insurance With public coverage No health Population Under 18 Years with No insurance coverage Health Insurance Coverage , , ** 2, ,782 1, ** 2, , * 2, , ,811 1,755 1, ,493 2,701 1, ,881 1,908 1, ** 2,206 1,083 1, ** ** 1, , ** 1, , ** 1, , ** 3,304 1,757 1, ** 3,727 2,168 2, ** 1, ** 2,305 1,146 1, , ** 1, Washington County 39,486 19,908 23,968 10,488 1,346 Mississippi 2,392,262 1,667,737 1,035, ,225 68,473 United States 258,778, ,379,999 89,277,994 45,206,153 5,953,533 Source: U.S. Census Bureau, American Community Survey year Estimates Census Tract or Geographic Area With health insurance coverage With private health insurance With public coverage No health insurance coverage Population Under 18 Years with No Health Insurance Coverage 218

229 Health Care Insurance in Washington County In Washington County, 79.0 percent of the civilian, non institutionalized population has health insurance coverage and 21.0 percent of the population has no health insurance coverage (approximately 10,488 people); 9.7 percent of children under the age of 18 have no health insurance coverage (Table 95, page 218). Among the population that has health insurance coverage, 39.8 percent of the population has private health insurance coverage and 48.0 percent has public health coverage (approximately 23,968 people). There are 17,779 people living in HFFI census tracts in Washington County that have public health insurance coverage; this represents 74.2 percent of the Washington County population that has public health insurance coverage. The percentage of the civilian, non institutionalized population in Washington County with no health insurance coverage (21.0 percent) is 3.5 percent higher than that of the state of Mississippi (17.5 percent) and is 6.1 percentage points higher than the U.S. percentage rate of 14.9 percent (Table 95, page 218). The percentage rate of children under 18 with no health insurance coverage in Washington County (9.7 percent) is higher than that of the state of Mississippi (9.1 percent) and is also higher than that of the United States. Due to the relatively low income levels and high poverty rates exhibited in Washington County, it is likely that a high percentage of children in Washington County are eligible for the State Children s Health Insurance Program; this may explain the relatively low percentage of children with no health insurance in Washington County. There are approximately 1,071 children under the age of 18 with no health insurance coverage who live in Washington County HFFI qualifying census tracts; this represents 79.6 percent of the children under the age of 18 in Washington County that have no health insurance coverage. There are 10,488 people living in Washington County who have no health insurance coverage; 7,700 of these individuals live in HFFI qualifying census tracts and they represent 73.4 percent of all people in Washington County who have no health insurance coverage. 219

230 Table 96: Washington County Household Spending on Food Census Tract Food at Home Average Household Spending Food at Home Total Spending Food Away from Home Average Household Spending Food Away from Home Total Spending Spending Index Food at Home Spending Index Food Away from Home Total Food Spending $4, $2,364,776 $2, $1,331, $3,696, $3, $2,224,641 $1, $1,263, $3,488, ** $2, $2,503,609 $1, $1,463, $3,966, ** $1, $1,874,543 $1, $1,095, $2,970, ** $1, $1,765,790 $ $1,032, $2,797, $3, $5,427,044 $2, $3,201, $8,628, $4, $7,440,477 $2, $4,703, $12,144, $4, $5,508,704 $2, $3,277, $8,786, ** $3, $4,368,587 $2, $2,667, $7,035, ** $2, $801,315 $1, $468, $1,269, ** $1, $1,222,670 $1, $714, $1,937, ** $1, $1,743,216 $1, $1,018, $2,762, ** $1, $1,536,663 $1, $898, $2,435, ** $3, $4,326,514 $1, $2,662, $6,988, ** $3, $6,233,479 $2, $3,608, $9,842, ** $2, $2,244,883 $1, $1,347, $3,592, ** $2, $2,581,043 $1, $1,493, $4,074, $2, $1,337,369 $1, $770, $2,108, ** $1, $995,306 $1, $581, $1,577,074 Washington County $3, $56,730,340 $1, $33,555, $90,285,550 Source: ESRI Forecasts; Consumer spending data is derived from 2011 and 2012 Bureau of Labor Statistics Consumer Expenditure Surveys The Spending Potential Index is household based and represents the amount spent relative to a national average of

231 The Economic Impact of Investments in Washington County The economic return on investments in underserved communities will vary based upon the type of investment (i.e. supermarket, grocery store, or convenience store), the amount of the investment, and the geographic location of the investment, which will determine the size of the market. The size of the potential market for an investment is not limited by the boundaries of a census tract; depending upon site selection and multiple other factors to include management, marketing, and consumer decision making, a store may draw customers from more than one census tract. Customer spending on food will determine the total sales for a supermarket, grocery store, or any other type of food retail format; total sales will determine the economic impact of the ongoing operations of investments made in underserved communities. The household spending index for food at home in the state of Mississippi is 78 as compared to a U.S. spending index of 100, indicating that Mississippi households in general spend less on food at home as compared to households across the United States (Table 96, page 220). The Table 97: Washington County Household Spending on Food at Home and the Retail Spending Gap for Food at Home Census Tract or Geographic Area Food at Home Total Spending Estimated Supply Retail Gap Spending on Fruits & Vegetables Fruit & Vegetable Spending Index $2,364,776 $222,593 $2,142,183 $411, $2,224,641 $222,593 $2,002,048 $396, ** $2,503,609 $4,211,461 $1,707,852 $457, ** $1,874,543 $1,335,558 $538,985 $343, * $1,765,790 $3,269,240 $1,503,450 $322, $5,427,044 $423,078 $5,003,966 $991, $7,440,477 $1,112,965 $6,327,512 $1,408, $5,508,704 $7,157,623 $1,648,919 $1,009, ** $4,368,587 $2,999,086 $1,369,501 $810, ** $801,315 $222,593 $578,722 $146, ** $1,222,670 $1,890,828 $668,158 $223, ** $1,743,216 $1,199,084 $544,132 $318, ** $1,536,663 $29,263,994 $27,727,331 $281, ** $4,326,514 $475,369 $3,851,145 $802, ** $6,233,479 $1,762,788 $4,470,691 $1,083, ** $2,244,883 $1,455,224 $789,659 $415, ** $2,581,043 $1,112,964 $1,468,079 $467, $1,337,369 $2,188,798 $851,429 $241, ** $995,306 $349,241 $646,065 $181, Washington County $56,730,340 $60,875,080 $4,144,740 $10,313, Source: Consumer Spending data is derived from 2012 Bureau of Labor Statistics Consumer Expenditure Surveys; Estimated supply is from Dunn and Bradstreet, sourced from ESRI Forecasts ** Denotes HFFI Eligible Census Tract 221

232 household food at home spending index for Washington County is 60; this indicates that household spending on food at home is approximately 10 percent lower than that of the average household in the state of Mississippi and 40 percent lower than that of the average household in the United States. For example, in the state of Mississippi, the average household spends approximately $3, on food at home; 241 in Washington County, the average household spends $3, on food at home (Table 96, page 220). In Washington County, household spending for food at home varies by census tract; in 10 of Washington County s HFFI census tracts, the average household spending on food at home is lower than the county wide average household spending of $3, on food at home. In many of Washington County s HFFI census tracts, the average household spending on food at home is more than $1,000 lower than the county average; examples include HFFI census tracts and , where average household spending on food at home is $1, and $1, lower, respectively, than the county wide average (Table 96, page 220). Table 97 on page 221 provides an estimate of total spending on food at home by households within each census tract and also provides an estimate of the supply of food at home that is met by stores within the census tract. The retail gap is an estimate of the unmet demand for food at home within the census tract; positive values indicate that demand for food at home exceeds that which is supplied by stores within the census tract, while negative retail gap values indicate that stores within a census tract are meeting demand for food at home by households that do not live in that census tract. The state of Mississippi household spending index for fruits and vegetables is 76; with a household fruit and vegetable spending index of 58, all households in Washington County exhibit lower spending levels on fruits and vegetables than the average household spending level in the state of Mississippi, and spending on fruits and vegetables by households in Washington County is approximately 42 percent lower than that of the United States (Table 97, page 221). In many of Washington County s HFFI census tracts, the household fruit and vegetable spending index is extremely low; for example, in HFFI census tract , the household fruit and vegetable spending index is 38 this census tract indicates a retail food at home spending gap of approximately $646,065, indicating there may be sufficient market demand to support the renovation and the purchase of refrigeration equipment to provide shelf space to increase the supply of fresh produce and fruits that are currently being supplied at the existing store within this census tract. In Washington County HFFI census tract , the fruit and vegetable spending index is 70; this is one of the highest fruit and vegetable spending indices in Washington County the food at home spending retail gap in this census tract is $4,470,691. An examination of Map 11 on page 195 indicates that HFFI census tracts and are contiguous geographic areas and are also 241 Consumer spending data is derived from the 2012 Consumer Expenditure Surveys of the Bureau of Labor Statistics and from ESRI Forecast for

233 located in a highly rural area with the potential to draw customers from the rural areas in the adjacent county; as a result, there may exist sufficient demand for a supermarket or for a grocery store within these census tracts. The combined food at home retail spending gap for HFFI census tracts and is estimated to be $5,116,756. Multiple similar investment scenarios exist throughout Washington County. The economic effect of construction activities are short term in nature, and normally decline rapidly upon the completion of construction. The economic effect of the ongoing operations of a business are long term and continuous throughout the life of the business; the business continuously maintains a workforce to support ongoing operations and tax revenues are generated on an annual basis. The economic effect of the ongoing operations of a business are difficult to accurately predict and are unique to each firm; management decisions and market conditions will determine the actual economic effect of a business. Site location, decisions regarding the number of employees to hire and wage levels, marketing and advertising strategies, and consumer decision making are currently unknown variables that will impact the variability of the reliability and validity of econometric models used in this study to model investments in underserved communities. To examine the economic impact of investments made in Washington County s HFFI census tracts, the Stennis Research Team used three potential investment scenarios and used econometric input output software modeling to develop projections of the potential job creations and related tax revenues that would be associated with these investments. The economic effects of these investments are modeled at two stages; the first stage is the economic effect of an investment during the construction phase of a project, the second stage is the economic effect of an investment upon completion of construction activities and upon the start up of business activity. These findings are presented on the following pages. 223

234 Table 98: The Economic Impact of a $6,570,000 Construction Investment in Washington County Impact Type Employment Labor Income Value Added Output Direct Effect 64.6 $2,075,392 $2,165,321 $6,570,000 Indirect Effect 14 $587,682 $831,659 $1,499,565 Induced Effect 12.9 $401,183 $759,171 $1,264,608 Total Effect 91.5 $3,064,257 $3,756,151 $9,334,172 Source: IMPLAN Tax on Production and Imports: Sales Tax Table 99: The Fiscal Impact of a $6,570,000 Construction Investment in Washington County Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Table 100: The Economic Impact of the Ongoing Operations of a Supermarket with Annual Sales of $5,116,756 Table 101: The Fiscal Impact of the Ongoing Operations of a Supermarket with Annual Sales of $5,116,756 Tax on Production and Imports: S/L Non Taxes $132,473 $74,940 $1,826 $3,632 $11,276 $1,831 Personal Tax: Personal Tax: Corporate Profits Personal Tax: Personal Tax: Motor Personal Tax: NonTaxes (Fines Other Tax Tax Income Tax Vehicle License Property Taxes Fees) (Fish/Hunt) $5,149 $41,469 $6,557 $2,940 $1,142 $1,481 Source: IMPLAN Impact Type Employment Labor Income Value Added Output Direct Effect 25.1 $763,337 $996,841 $1,453,159 Indirect Effect 2.2 $78,076 $124,560 $236,916 Induced Effect 4.1 $126,750 $239,848 $399,521 Total Effect 31.4 $968,163 $1,361,249 $2,089,596 Source: IMPLAN Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $131,186 $74,211 $1,809 $3,597 $11,166 $1,813 Personal Tax: Personal Tax: Corporate Profits Personal Tax: Personal Tax: Motor Personal Tax: NonTaxes (Fines Other Tax Tax Income Tax Vehicle License Property Taxes Fees) (Fish/Hunt) $1,682 $13,023 $2,059 $923 $359 $465 Source: IMPLAN 224

235 The Economic Impact of a Supermarket Investment in Washington County An initial investment of $6,570,000 in the construction or renovation of a 45,000 square foot supermarket with estimated annual sales of $5,116,756 upon the completion of construction and the start up of business operations was modeled at the county level. Based upon these assumptions, the economic effect of this investment would be the generation of approximately 91.5 full time equivalent jobs with associated labor income of $3,064,257. During construction, the direct employment effect is estimated to be 64.6 construction related jobs with associated labor income of $2,075,392; the average annual wage associated with construction employment is project to be $32,127. An additional 26.9 indirect and induced full time equivalent jobs would be supported in Washington County over the duration of construction activities (Table 98, page 224). The fiscal impact of this investment during the construction phase of project activities is projected to generate an estimated $284,716 in tax revenues (Table 99, page 224). Sales tax revenues are projected to be $132,473, personal income tax revenues are estimated to be $41,469, and property tax revenues are estimated to be $76,082 (combined property tax revenues on production and imports with personal property tax revenues). Upon the completion of construction activities and the start up of business activities, assuming annual sales of $5,116,756, the economic effect of a supermarket project in Washington County is projected to generate approximately 31.4 jobs with associated labor income of $968,163. An estimated 25.1 full time equivalent direct jobs would be created at the store, and an additional 6.3 full time equivalent indirect and induced jobs would be created in Washington County (Table 100, page 224). The creation of employment opportunities for residents of underserved communities in Washington County would contribute to addressing the high unemployment, poverty, and low incomes that were found to exist throughout underserved communities within the county. The annual fiscal impact of the ongoing operations of a supermarket in Washington County with estimated annual sales of $5,116,756 is projected to be $242,293. The annual sales tax revenues associated with this investment are projected to be $131,186, personal income tax revenues are predicted to be $13,023, and corporate income tax is estimated to be $1,682 (Table 101, page 224). 225

236 Table 102: The Economic Impact of a $2,920,000 Construction Investment in Washington County Impact Type Employment Labor Income Value Added Output Direct Effect 28.7 $922,396 $962,365 $2,920,000 Indirect Effect 6.2 $261,192 $369,626 $666,473 Induced Effect 5.7 $178,303 $337,409 $562,048 Total Effect 40.7 $1,361,892 $1,669,401 $4,148,521 Source: IMPLAN Tax on Production and Imports: Sales Tax Corporate Profits Tax Table 103: The Fiscal Impact of a $2,920,000 Construction Investment in Washington County Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $58,877 $33,306 $812 $1,614 $5,011 $814 Personal Tax: Personal Tax: Personal Tax: Personal Tax: NonTaxes (Fines Motor Vehicle Income Tax Property Taxes Fees) License Personal Tax: Other Tax (Fish/Hunt) $2,288 $18,431 $2,914 $1,307 $508 $658 Source: IMPLAN Table 104: The Economic Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $3,851,145 Impact Type Employment Labor Income Value Added Output Direct Effect 18.9 $574,528 $750,276 $1,093,725 Indirect Effect 1.7 $58,764 $93,750 $178,316 Induced Effect 3.1 $95,399 $180,522 $300,701 Total Effect 23.6 $728,692 $1,024,549 $1,572,742 Source: IMPLAN Table 105: The Fiscal Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $3,851,145 Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $98,737 $55,855 $1,361 $2,707 $8,404 $1,365 Personal Tax: Personal Tax: Personal Tax: Corporate Profits Personal Tax: Personal Tax: NonTaxes (Fines Motor Vehicle Other Tax Tax Income Tax Property Taxes Fees) License (Fish/Hunt) $1,266 $9,801 $1,550 $695 $270 $350 Source: IMPLAN 226

237 The Economic Impact of a Grocery Store Investment in Washington County An initial investment of $2,920,000 in the construction or renovation of a 20,000 square foot grocery store with annual sales of $3,851,145, based upon the retail gap in HFFI census tract , was modeled at the county level using econometric input output software. Based upon these assumptions, approximately 40.7 full time equivalent jobs would be supported during the construction phase of project activities; of these 28.7 would be on site direct construction jobs with associated labor income of approximately $922,396. An additional 11.9 indirect and induced full time equivalent jobs would be created during the construction phase of project activities (Table 102, page 226). During the construction phase of project activities, the fiscal impact is estimated to be $126,540; of this amount, associated sales tax revenues are estimated to be $58,877 and personal income tax revenues are projected to be $18,431 (Table 103, page 226). The ongoing operations of a grocery store located in an underserved community in Washington County with estimated annual sales of approximately $3,851,145 would create approximately 23.6 full time equivalent jobs, with associated labor income of $728,692 annually. An estimated 18.9 direct jobs would be associated with the ongoing operations of the store, creating employment opportunities for the low income residents living within the community; the annual labor income of these jobs is estimated to be $574,528 (Table 104, page 226). The annual fiscal impact of the ongoing operations of the project are estimated to be $182,361; of this amount, sales tax revenues are projected to be $98,737 and personal income tax revenues are projected to be $9,801 (Table 105, page 226). Investments in Store Renovations, Expansion, and Equipment Purchases in Washington County The preliminary analysis of HFFI census tracts in Washington County found multiple tracts with a food at home spending gap of $500,000 or more; therefore, multiple opportunities may exist to renovate or expand existing stores in specific areas to enable them to increase their offerings of fresh fruits or vegetables to community residents. To examine the economic impact of these investments, it was assumed that an initial investment of $500,000 is made in store renovations, expansions, and equipment purchases. Upon completion of construction activities, it is then assumed that annual sales revenues will be $500,000 during the ongoing operations of the business. The Stennis Research Team ran individual models of this investment scenario for each county and found relatively insignificant geographic variation in the economic and fiscal impact associated with the economic impact of investments; therefore, the economic effect of investments made during the construction phase of project activities are modeled at the state level. To provide a point of comparison, the economic effects of the ongoing operations of a store with annual sales of $500,000 were modeled at the county level. 227

238 Table 106: The Economic Impact of a $500,000 Construction or Renovation Investment Impact Type Employment Labor Income Value Added Output Direct Effect 2.7 $132,830 $149,768 $293,500 Indirect Effect 0.7 $30,108 $45,784 $97,488 Induced Effect 0.9 $33,112 $60,382 $105,613 Total Effect 4.3 $196,050 $255,934 $496,601 Source: IMPLAN Tax on Production and Imports: Sales Tax Table 107: The Fiscal Impact of a $500,000 Construction or Renovation Investment Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $11,589 $6,556 $160 $318 $986 $160 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $442 $2,567 $406 $182 $71 $92 Source: IMPLAN Table 108: The Economic Impact of the Ongoing Operations of a Store with $500,000 in Grocery Sales in Washington County Impact Type Employment Labor Income Value Added Output Direct Effect 2.5 $74,592 $97,409 $142,000 Indirect Effect 0.2 $7,629 $12,172 $23,151 Induced Effect 0.4 $12,386 $23,437 $39,040 Total Effect 3.1 $94,607 $133,019 $204,192 Source: IMPLAN Table 109: The Fiscal Impact of the Ongoing Operations of a Store with $500,000 in Grocery Sales in Washington County Tax on Production and Imports: Sales Tax Corporate Profits Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $12,819 $7,252 $177 $351 $1,091 $177 Personal Tax: Personal Tax: Personal Tax: Personal Tax: NonTaxes (Fines Motor Vehicle Income Tax Property Taxes Fees) License Personal Tax: Other Tax (Fish/Hunt) $164 $1,273 $201 $90 $35 $45 Source: IMPLAN 228

239 An investment of $500,000 in a store renovation or expansion will support a total of approximately 4.3 full time equivalent jobs during the construction phase of project activities; of these, 2.7 jobs will be direct employment and an additional 1.6 jobs will be indirect or induced jobs. The total labor income associated with this investment is predicted to be approximately $196,050 (Table 106, page 228). An investment of $500,000 in store renovation or expansion will generate approximately $23,529 of tax revenue during the construction phase of project activities; of this amount, $11,589 is associated with sales tax revenue and $2,567 is associated with personal income tax revenue (Table 107, page 228). Approximately 3.1 full time equivalent jobs will be associated with the ongoing operations of a store in Washington County with $500,000 in annual sales; of these, 2.5 direct jobs will be created at the store with an additional 0.6 indirect and induced jobs. The labor income effect of the ongoing operations of the store is projected to be $94,607 annually (Table 108, page 228). The fiscal impact of the ongoing operations of a store with annual sales of $500,000 is predicted to be $23,675 annually; of this amount, $12,819 is associated with sales tax revenue and personal income tax revenues are projected to be $1,273 (Table 109, page 228). 229

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241 Standardizing the Economic Effects of Investments in Underserved Communities in the State of Mississippi The prior sections of this report examined investments made in underserved communities in four Mississippi counties; the economic effects of these investments were predominantly modeled at the county level, using food at home retail spending gap analysis to provide specific examples of potential investments within each county and to examine the impact that these investments would have on job creation in qualifying HFFI census tracts. As a result, the economic impact of these investments, as discussed in prior sections of this report, may not be generalizable and also do not fully capture the total impact of economic activity state wide. For example, construction equipment and supplies may be purchased outside of the county, and the sales tax revenues associated with these sales will not be captured by county level models; also, workers may commute from outside of a county and the personal income taxes they pay will not be included in county level econometric models. A standardized investment scenario modeled at the state level will also enable decision makers to examine the cost benefit of potential investments in Mississippi s underserved communities that are made in locations outside of the four counties that were the focus of this report. To provide this information, the Stennis Research Team modeled three levels of potential investments in underserved communities at the state level, as follows: 1. The construction or renovation of a 45,000 square foot supermarket with a construction investment of $6,570,000 (assuming a construction cost of $124 per square foot) and annual store sales of $5,402, The construction or renovation of a 20,000 square foot grocery store with a construction investment of $2,920,000 (assuming a construction cost of $124 per square foot) and annual store sales of $2,000, An investment of $500,000 in store renovations and new equipment and annual store sales of $500,000; this level of investment would also be appropriate for upgrading a farmers market. It is important to note that the Agriculture Act of 2014 (the Farm Bill) has multiple provisions to increase access to healthy foods that are not addressed in the three investment scenarios described above; examples include programs that allow SNAP benefits to purchase shares in Community Supported Agriculture (CSAs) programs and Double Value Coupon programs that provide monetary incentives to SNAP beneficiaries when they purchase food at participating farmers markets. 231

242 Table 110: The Economic Impact of a $6,570,000 Construction Investment in a 45,000 Square Foot Supermarket Impact Type Employment Labor Income Value Added Output Direct Effect 56.5 $2,648,466 $2,727,184 $6,570,000 Indirect Effect 16.6 $785,078 $1,167,733 $2,558,955 Induced Effect 19.3 $697,312 $1,271,567 $2,224,021 Total Effect 92.5 $4,130,857 $5,166,484 $11,352,976 Source: IMPLAN Table 111: The Fiscal Impact of a $6,570,000 Construction Investment in a 45,000 Square Foot Supermarket Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $156,266 $88,399 $2,155 $4,284 $13,301 $2,160 Personal Tax: Personal Tax: Personal Tax: Corporate Profits Personal Tax: Personal Tax: NonTaxes (Fines Motor Vehicle Other Tax Tax Income Tax Property Taxes Fees) License (Fish/Hunt) $8,631 $54,284 $8,584 $3,848 $1,495 $1,939 Source: IMPLAN Table 112: The Economic Impact of the Ongoing Operations of a Supermarket with Annual Sales of $5,402,464 Impact Type Employment Labor Income Value Added Output Direct Effect 27.0 $792,126 $1,043,259 $1,534,300 Indirect Effect 3.0 $109,660 $191,360 $345,523 Induced Effect 5.1 $183,284 $334,234 $584,603 Total Effect 35.1 $1,085,070 $1,568,853 $2,464,426 Source: IMPLAN Table 113: The Fiscal Impact of the Ongoing Operations of a Supermarket with Annual Sales of $5,402,464 Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $145,542 $82,333 $2,007 $3,990 $12,388 $2,011 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $2,415 $14,184 $2,243 $1,005 $391 $507 Source: IMPLAN 232

243 The Economic Impact of a Supermarket Investment in Mississippi An initial investment of $6,570,000 in the construction or renovation of a 45,000 square foot supermarket with estimated annual sales of $5,402,464 upon the completion of construction and the start up of business operations was modeled at the state level. Based upon these assumptions, the economic effect of this investment would be the generation of approximately 92.5 full time equivalent jobs with associated labor income of $4,130,857. During construction, the direct employment effect is estimated to be 56.5 constructionrelated jobs with associated labor income of $2,648,466. An additional 35.9 indirect and induced full time equivalent jobs would be supported in the state of Mississippi over the duration of construction activities (Table 110, page 232). The fiscal impact of this investment during the construction phase of project activities is projected to generate an estimated $345,346 in tax revenues (Table 111, page 232). Sales tax revenues are projected to be $156,266, personal income tax revenues are estimated to be $54,284, and corporate profits tax revenues are projected to be $8,631. Upon the completion of construction activities and the start up of business activities, assuming annual sales of $5,402,464, the economic effect of a supermarket project in the state of Mississippi is projected to generate approximately 35.1 jobs with associated labor income of $1,085,070. An estimated 27 full time equivalent direct jobs would be created at the store, and an additional 8.1 full time equivalent indirect and induced jobs would be created within the state (Table 112, page 232). The annual fiscal impact of the ongoing operations of a supermarket in the state of Mississippi with estimated annual sales of $5,402,464 is projected to be $269,016. The annual sales tax revenues associated with this investment are projected to be $145,542, personal income tax revenues are predicted to be $14,184, and corporate profits tax revenues are estimated to be $2,415 (Table 113, page 232). 233

244 Table 114: The Economic Impact of a $2,920,000 Construction Investment in a Grocery Store in Mississippi Impact Type Employment Labor Income Value Added Output Direct Effect 25.1 $1,177,096 $1,212,082 $2,920,000 Indirect Effect 7.4 $348,924 $518,992 $1,137,313 Induced Effect 8.6 $309,917 $565,141 $988,454 Total Effect 41.1 $1,835,936 $2,296,215 $5,045,767 Source: IMPLAN Table 115: The Fiscal Impact of a $2,920,000 Construction Investment in a Grocery Store in Mississippi Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $69,452 $39,289 $958 $1,904 $5,912 $960 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $3,836 $24,126 $3,815 $1,710 $664 $862 Source: IMPLAN Table 116: The Economic Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,000,000 in Mississippi Impact Type Employment Labor Income Value Added Output Direct Effect 10.0 $293,246 $386,216 $568,000 Indirect Effect 1.1 $40,596 $70,842 $127,913 Induced Effect 1.9 $67,852 $123,734 $216,421 Total Effect 13.0 $401,694 $580,792 $912,334 Source: IMPLAN Table 117: The Fiscal Impact of the Ongoing Operations of a Grocery Store with Annual Sales of $2,000,000 in Mississippi Tax on Production and Imports: Sales Tax Corporate Profits Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $53,880 $30,480 $743 $1,477 $4,586 $745 Personal Tax: Personal Tax: Personal Tax: Motor Personal Tax: NonTaxes (Fines Income Tax Vehicle License Property Taxes Fees) Source: IMPLAN Personal Tax: Other Tax (Fish/Hunt) $894 $5,251 $830 $372 $145 $

245 The Economic Impact of a Grocery Store Investment in Mississippi Based upon the assumption of an initial investment of $2,920,000 in the construction or renovation of a 20,000 square foot grocery store with annual sales of $2,000,000, an estimated 41.1 full time equivalent jobs would be supported during the construction phase of project activities; of these, 25.1 would be on site direct construction jobs with associated labor income of approximately $1,177,096. An additional 16 indirect and induced full time equivalent jobs would be created during the construction phase of project activities Table 114, page 234). During the construction phase of project activities, the fiscal impact is estimated to be $153,488; of this amount, associated sales tax revenues are estimated to be $69,452, corporate profits tax is projected to be $3,836, and personal income tax is predicted to be $24,126 (Table 115, page 234). The ongoing operations of a grocery store with estimated annual sales of approximately $2,000,000 would create approximately 13 full time equivalent jobs, with associated labor income of $401,694 annually. An estimated 10 direct jobs with labor income of $293,246 would be associated with the ongoing operations of the store (Table 116, page 234). The annual fiscal impact of the ongoing operations of the project are estimated to be $99,591. Sales tax revenues are projected to be $53,880, personal income tax revenues are anticipated to be $5,251, and corporate profits taxes will be approximately $894 (Table 117, page 234). 235

246 Tax on Production and Imports: Sales Tax Corporate Profits Tax Table 118: The Economic Impact of a $500,000 Investment in a Store Renovation in Mississippi Impact Type Employment Labor Income Value Added Output Direct Effect 2.7 $132,830 $149,768 $293,500 Indirect Effect 0.7 $30,108 $45,784 $97,488 Induced Effect 0.9 $33,112 $60,382 $105,613 Total Effect 4.3 $196,050 $255,934 $496,601 Source: IMPLAN Table 119: The Fiscal Impact of a $500,000 Investment in a Store Renovation in Mississippi Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Table 120: The Economic Impact of the Ongoing Operations of a Store with Annual Sales of $500,000 Table 121: The Fiscal Impact of the Ongoing Operations of a Store with Annual Sales of $500,000 Tax on Production and Imports: S/L Non Taxes $11,589 $6,556 $160 $318 $986 $160 Personal Tax: Personal Tax: Personal Tax: Motor Personal Tax: NonTaxes (Fines Income Tax Vehicle License Property Taxes Fees) Personal Tax: Other Tax (Fish/Hunt) $442 $2,567 $406 $182 $71 $92 Source: IMPLAN Impact Type Employment Labor Income Value Added Output Direct Effect 2.5 $73,312 $96,554 $142,000 Indirect Effect 0.3 $10,149 $17,710 $31,978 Induced Effect 0.5 $16,963 $30,933 $54,105 Total Effect 3.2 $100,424 $145,198 $228,083 Source: IMPLAN Tax on Production and Imports: Sales Tax Corporate Profits Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $13,470 $7,620 $186 $369 $1,147 $186 Personal Tax: Personal Tax: Personal Tax: Motor Personal Tax: NonTaxes (Fines Income Tax Vehicle License Property Taxes Fees) Personal Tax: Other Tax (Fish/Hunt) $223 $1,313 $208 $93 $36 $47 Source: IMPLAN 236

247 The Economic Impact of Small Loans of $500,000 for Store Remodels and New Refrigeration Equipment This investment scenario assumes a small loan or grant in the amount of $500,000 is provided to existing stores to enable them to create additional space and to purchase refrigeration equipment to increase the supply of fruits, vegetables, and other nutritious food to community residents. This scenario assumes that upon completion of construction related activities, the annual sales of the store will be $500,000. During the construction/renovation phase of project activities, it is estimated that a total of 4.3 fulltime equivalent jobs with associated labor income of $196,050 will be created. Approximately 2.7 full time equivalent direct jobs in the construction trades with associated labor income of $132,830 will be created by this investment (Table 118, page 236). During the construction phase of project activities, the fiscal impact is estimated to be $23,529; of this amount, associated sales tax revenues are estimated to be $11,589, corporate profits tax is projected to be $442, and personal income tax revenue is predicted to be $2,567 (Table 119, page 236). The ongoing operations of a store with estimated annual sales of approximately $500,000 would create approximately 3.2 full time equivalent jobs, with associated labor income of $100,424 annually. An estimated 2.5 direct jobs with labor income of approximately $73,312 would be associated with the ongoing operations of the store (Table 120, page 236). The annual fiscal impact of the ongoing operations of the project are estimated to be $24,898. Sales tax revenues are projected to be $13,470, personal income tax revenues are anticipated to be $1,313, and corporate profits taxes will be approximately $223 (Table 121, page 236). 237

248 Table 122: Lowndes County Obesity related Healthcare Cost Estimates Estimated Obesity Related 3rd Party Healthcare Cost based upon Thorpe's (2009) Point Estimate of $761 per Obese Adult Census Tract or Geographic Area Cost for Privately Insured Cost for Public Insurance Coverage Cost for Those with No Insurance Total Estimated Obesity Related 3rd Party Healthcare Cost based upon Cawley and Meyerhoefer's (2012) Point Estimate of $2,418 per Obese Adult Cost for Privately Insured Cost for Public Insurance Coverage Cost for Those with No Insurance $876,444 $423,953 $251,358 $1,551,755 $2,784,811 $1,347,068 $798,665 $4,930, $294,507 $286,288 $111,639 $692,434 $935,766 $909,652 $354,721 $2,200, $204,785 $11,187 $21,004 $236,975 $650,684 $35,545 $66,737 $752, $1,195,607 $470,526 $257,066 $1,923,199 $3,798,920 $1,495,049 $816,800 $6,110, ** $940,368 $566,869 $288,800 $1,796,036 $2,987,923 $1,801,168 $917,631 $5,706, $628,967 $251,358 $203,415 $1,083,740 $1,998,477 $798,665 $646,331 $3,443, $689,238 $194,512 $139,948 $1,023,697 $2,189,983 $618,041 $444,670 $3,252, $498,379 $384,229 $206,612 $1,089,219 $1,583,548 $1,220,848 $656,487 $3,460, ** $221,451 $420,529 $169,627 $811,607 $703,638 $1,336,187 $538,972 $2,578, ** $480,800 $434,227 $235,149 $1,150,175 $1,527,692 $1,379,711 $747,162 $3,654, ** $264,600 $389,023 $230,355 $883,978 $840,739 $1,236,082 $731,929 $2,808, ** $658,189 $510,479 $268,481 $1,437,149 $2,091,328 $1,621,994 $853,070 $4,566, $348,158 $171,910 $57,303 $577,371 $1,106,235 $546,226 $182,075 $1,834, ** $170,312 $154,559 $70,545 $395,416 $541,148 $491,096 $224,149 $1,256,393 Lowndes County $7,471,802 $4,669,648 $2,511,300 $14,652,751 $23,740,891 $14,837,332 $7,979,400 $46,557,623 Sources: Insurance Coverage sourced from U.S. Census Bureau, American Community Survey 2012, 5 Year Estimates; obesity rates calculated at 30 percent for each insurance population sub group Total Table 123: Pearl River County Obesity related Healthcare Cost Estimates Estimated Obesity Related 3rd Party Healthcare Cost based upon Thorpe's (2009) Point Estimate of $761 per Obese Adult Estimated Obesity Related 3rd Party Healthcare Cost based upon Cawley and Meyerhoefer's (2012) Point Estimate of $2,418 per Obese Adult Census Tract or Geographic Area Cost for Privately Insured Cost for Public Insurance Coverage Cost for Those with No Insurance Total Cost for Privately Insured Cost for Public Insurance Coverage Cost for Those with No Insurance ** $616,410 $535,820 $364,823 $1,517,054 $1,958,580 $1,702,514 $1,159,189 $4,820, $733,071 $417,789 $297,018 $1,447,879 $2,329,259 $1,327,482 $943,745 $4,600, $401,351 $254,098 $111,182 $766,631 $1,275,253 $807,370 $353,270 $2,435, $887,174 $564,814 $320,990 $1,772,978 $2,818,904 $1,794,640 $1,019,912 $5,633, $671,430 $574,631 $318,935 $1,564,997 $2,133,401 $1,825,832 $1,013,384 $4,972, $1,041,276 $645,176 $273,275 $1,959,727 $3,308,549 $2,049,980 $868,304 $6,226, $1,309,072 $473,951 $217,342 $2,000,365 $4,159,444 $1,505,930 $690,581 $6,355, ** $515,273 $299,301 $252,728 $1,067,303 $1,637,228 $950,999 $803,018 $3,391, ** $622,574 $793,114 $481,256 $1,896,945 $1,978,166 $2,520,040 $1,529,143 $6,027,349 Pearl River County $6,797,633 $4,558,694 $2,637,550 $13,993,877 $21,598,785 $14,484,787 $8,380,546 $44,464,118 Sources: Insurance Coverage sourced from U.S. Census Bureau, American Community Survey 2012, 5 Year Estimates; obesity rates calculated at 30 percent for each insurance population sub group Total ** Denotes HFFI Eligible Census Tract 238

249 The Cost Benefit of Investments in Mississippi s Underserved Communities Public policy designed to increase the supply of affordable, healthy food in underserved communities is based upon the body of research that supports the relationship between better access to affordable, healthy food and a healthier diet, a lower risk of obesity, and a reduction in the negative health outcomes associated with being overweight or obese. Multiple states have adopted policies designed to improve the retail food environment to make healthier food more easily accessible to underserved populations; these state healthy food financing initiatives are designed to incentivize private sector investments into HFFI qualifying census tracts for the purpose of increasing the supply of affordable, healthy food. State healthy food financing initiatives typically provide legislative appropriations for grants, loans, or tax incentives to support investments in supermarkets, grocery stores, convenience stores, farmers markets, and other direct to consumer agricultural sales activities, including Food Hubs or Community Supported Agricultural (CSAs) programs. Typically, state healthy food financing initiatives provide a share of the cost for investments made in HFFI census tracts by the private sector, but may also support investments made by non profit entities. The costs associated with state healthy food financing initiative investments may include: Pre development costs, which may include appraisals, feasibility analysis, or market studies Land acquisition Store construction or renovation Equipment, furnishings, or fixtures Technical assistance Job training Program evaluation The potential benefits associated with state healthy food financing initiatives include an improved retail food environment, increased consumption of fruits and vegetables, healthier diets, and lower levels of obesity. One possible benefit of improving the retail food environment in Mississippi s underserved communities includes the potential to reduce obesity related healthcare costs in the state. As discussed in prior sections of this report, obesity related healthcare costs are a significant financial burden on the state of Mississippi. The obesity related healthcare costs of recipients of public health insurance and for those who have no healthcare insurance are higher than for those who are covered by private insurance. The obesity related healthcare costs for recipients of public health insurance and for the uninsured are predominantly paid for by federal and state governments, or by hospitals and physicians; ultimately, these costs are paid for by tax revenues or are passed through as a 239

250 Table 124: Sunflower County Obesity related Health Care Cost Estimates Estimated Obesity Related 3rd Party Healthcare Cost based upon Thorpe's (2009) Point Estimate of $761 per Obese Adult Estimated Obesity Related 3rd Party Healthcare Cost based upon Cawley and Meyerhoefer's (2012) Point Estimate of $2,418 per Obese Adult Census Tract or Geographic Area Cost for Privately Insured Cost for Public Insurance Coverage Cost for Those with No Insurance Total Cost for Privately Insured Cost for Public Insurance Coverage Cost for those with No Insurance Total ** $349,071 $396,101 $158,440 $903,611 $1,109,137 $1,258,569 $503,428 $2,871, ** $391,078 $504,543 $198,393 $1,094,014 $1,242,610 $1,603,134 $630,373 $3,476, ** $228,300 $254,098 $125,337 $607,735 $725,400 $807,370 $398,245 $1,931, $468,700 $298,160 $109,127 $875,987 $1,489,246 $947,372 $346,741 $2,783, ** $439,021 $702,023 $282,179 $1,423,222 $1,394,944 $2,230,605 $896,594 $4,522, ** $186,521 $291,083 $161,408 $639,012 $592,652 $924,885 $512,858 $2,030, $223,049 $209,579 $128,533 $561,161 $708,716 $665,917 $408,400 $1,783,033 Sunflower County $2,285,740 $2,655,586 $1,163,417 $6,104,742 $7,262,705 $8,437,853 $3,696,638 $19,397,196 Sources: Insurance Coverage sourced from U.S. Census Bureau, American Community Survey 2012, 5 Year Estimates; obesity rates calculated at 30 percent for each insurance population sub group ** Denotes HFFI Eligible Census Tract 240

251 hidden tax on the cost of healthcare. A potential reduction in obesity related healthcare costs also represents a potential savings in state expenditures related to these healthcare costs; this is particularly true for the obesity related healthcare costs that may be associated with those with public health insurance coverage. Within the context of the variability that is inherent in estimates of population obesity rates and the obesity related cost of healthcare, it may be useful for decision makers to evaluate the cost benefit of investments made in Mississippi s underserved communities from the perspective of improving health outcomes in these communities and the potential to reduce obesity related healthcare costs within Mississippi s underserved communities. These metrics may also be useful for the purpose of prioritizing the cost benefit of making investments in specific HFFI qualifying census tracts. With an adult obesity rate of 35.1 percent in 2013, Mississippi and West Virginia had the highest obesity rates in the United States. 242 According to the Robert Woods Johnson Foundation s County Health Rankings and Roadmaps, adult obesity and diabetes rates in the four counties examined in this study were as follows: County Table 125: Comparison of Adult Obesity Rate by County Percent of Adults that were Obese Percent of Adults Diagnosed with Diabetes Average Health Care Costs Lowndes County 37% 14% $9,140 Pearl River County 33% 13% $10,688 Sunflower County 42% 14% $12,438 Washington County 38% 13% $9,606 State of Mississippi 35% 13% $10,688 Source: Robert Woods Johnson Foundation, County Health Rankings and Roadmaps, 2013 Obesity rates exhibit variability based upon gender, race or ethnicity, age, and other socioeconomic characteristics of the population and of the individual (see Table 5, page 30). In addition, there is inherent variability in the statistical methods used to estimate obesity rates and the accuracy of predicted confidence intervals (variance around the mean). As previously discussed in this study, there is also variability in the findings of prior research that has examined obesity related healthcare costs. As a result, estimates of the percentage of the population that is obese and estimates of the healthcare costs associated with obesity also exhibit significant variability. For example, conservative estimates of obesity related healthcare costs indicate that the increase in adult per capita medical spending that is attributable to obesity is $1,140 per person for those who are privately insured, $1,021 for those who are 242 Mississippi State Department of Health website: (accessed November 20, 2014). 241

252 Table 126: Washington County Obesity related Healthcare Cost Estimates Estimated Obesity Related 3rd Party Healthcare Cost based upon Thorpe's (2009) Point Estimate of $761 per Obese Adult Census Tract or Geographic Area Cost for Privately Insured Cost for Public Insurance Coverage Cost for Those with No Insurance Total Estimated Obesity Related 3rd Party Healthcare Cost based upon Cawley and Meyerhoefer's (2012) Point Estimate of $2,418 per Obese Adult Cost for Privately Insured Cost for Public Insurance Coverage Cost for Those with No Insurance $212,547 $124,195 $63,924 $400,667 $675,347 $394,618 $203,112 $1,273, $144,057 $214,145 $87,211 $445,413 $457,727 $680,425 $277,103 $1,415, ** $176,933 $406,831 $268,024 $851,787 $562,185 $1,292,663 $851,620 $2,706, ** $134,012 $449,751 $216,428 $800,192 $425,810 $1,429,038 $687,679 $2,542, * $154,331 $328,524 $129,218 $612,072 $490,370 $1,043,851 $410,576 $1,944, $400,667 $323,273 $157,070 $881,010 $1,273,077 $1,027,166 $499,075 $2,799, $616,638 $300,443 $127,391 $1,044,473 $1,959,305 $954,626 $404,773 $3,318, $435,596 $295,192 $127,391 $858,180 $1,384,063 $937,942 $404,773 $2,726, ** $247,249 $328,295 $161,408 $736,952 $785,608 $1,043,125 $512,858 $2,341, ** $73,284 $145,655 $59,130 $278,069 $232,853 $462,805 $187,879 $883, ** $97,712 $244,053 $99,767 $441,532 $310,471 $775,453 $317,000 $1,402, ** $170,540 $290,169 $99,082 $559,792 $541,874 $921,983 $314,824 $1,778, ** $132,186 $327,611 $126,250 $586,046 $420,007 $1,040,949 $401,146 $1,862, ** $401,123 $401,123 $115,976 $918,223 $1,274,528 $1,274,528 $368,503 $2,917, ** $494,954 $469,157 $132,414 $1,096,525 $1,572,667 $1,490,697 $420,732 $3,484, ** $193,598 $183,553 $133,556 $510,707 $615,139 $583,222 $424,359 $1,622, ** $261,632 $312,999 $151,591 $726,222 $831,308 $994,523 $481,666 $2,307, $113,693 $155,701 $73,513 $342,907 $361,249 $494,723 $233,579 $1,089, ** $84,243 $171,225 $65,066 $320,533 $267,673 $544,050 $206,739 $1,018,462 Washington County $4,544,996 $5,471,894 $2,394,410 $12,411,301 $14,441,263 $17,386,387 $7,607,995 $39,435,646 Sources: Insurance Coverage sourced from U.S. Census Bureau, American Community Survey 2012, 5 Year Estimates; obesity rates calculated at 30 percent for each insurance population sub group Total ** Denotes HFFI Eligible Census Tract 242

253 insured through Medicaid, and $1,723 per person for those who are insured through Medicare. More recent estimates of obesity related healthcare costs indicate that the per capita additional 3 rd party cost of obesity related health care is $2,346 for those who are privately insured, $3,521 for those who are publically insured, and $3,153 for obese persons who have no insurance. 243 The modeling of highly specific, census tract level obesity related healthcare costs was beyond the scope of this study; therefore, the Stennis Research Team selected to develop conservative estimates for a range of obesity related healthcare costs. To develop a generalized guideline for the potential obesity related healthcare costs in Mississippi s HFFI census tracts, the Stennis Research Team used two estimates of potential obesity related healthcare costs: 1) a conservative estimate based upon Thorpe s (2009) 244 mid point estimate of obesity attributable health care spending per adult of $761, and 2) an estimate based upon Cawley and Meyerhoefer s (2012) 245 per capita point estimate of a 3 rd party (public and private insurers, or uncompensated costs to hospitals or physicians) obesity related healthcare cost of $2,418; for both of these estimates, the model assumed an adult obesity rate of 30 percent. The results of these estimates are shown in Table 122 and Table 123 on page 238, in Table 124 on page 240, and in Table 126 on page 242. To further examine the potential cost benefit of using taxpayer funds to make investments in Mississippi s underserved communities, the Stennis Research Team calculated the potential savings that might be associated with a reduction in the obesity rate in each census tract within the four counties that were the focus of this study; these estimates were based upon the assumption that the obesity rate declined from 30 percent to 29 percent of the population in each census tract an assumption of a one percent (1%) reduction in the obesity rate. The obesity related healthcare cost savings were calculated at two levels; one level of cost reduction was estimated based upon Thorpe s (2009) 246 mid point estimate of obesity attributable health care spending per adult of $761, and a second level of cost reduction was estimated based upon Cawley and Meyerhoefer s (2012) 247 per capita point estimate of a 3 rd party (public and private insurers, or uncompensated costs to hospitals or physicians) obesity related healthcare cost of $2,418. The estimated potential savings in obesity related healthcare cost associated with a one percent (1%) reduction in the obesity rate 243 Cawley, J., and Meyerhoefer, C. (2012). The Medical Care Costs of Obesity: An Instrumental Variables Approach. Journal of Health Economics. 31: Thorpe, K.E., (2009). National and State Estimates of the Impact of Obesity on Direct Health Care Expenses. A Collaborative Report from the United Health Foundation, the American Public Health Association and Partnership for Prevention. 245 Cawley, J., and Meyerhoefer, C. (2012). The Medical Care Costs of Obesity: An Instrumental Variables Approach. Journal of Health Economics. 31: Thorpe, K.E., (2009). National and State Estimates of the Impact of Obesity on Direct Health Care Expenses. A Collaborative Report from the United Health Foundation, the American Public Health Association and Partnership for Prevention. 247 Cawley, J., and Meyerhoefer, C. (2012). The Medical Care Costs of Obesity: An Instrumental Variables Approach. Journal of Health Economics. 31:

254 Table 127: Estimated Obesity related Healthcare Cost Savings Associated with a One Percent Reduction in the Obesity Rate in Lowndes County Census Tract or Geographic Area Estimated Obesity Related 3rd Party Cost Savings Assuming a One (1%) Percent Reduction in the Obesity Rate Savings Based on Thorpe's (2009) Point Estimate of $761 per Savings Based on Cawley and Meyerhoefer's Point Estimate of Obese Adult $2,418 per Obese Adult Private Insurance Public Insurance No Insurance Total Private Insurance Public Insurance No Insurance Total $29,215 $14,132 $8,379 $51,725 $92,827 $44,902 $26,622 $164, $9,817 $9,543 $3,721 $23,081 $31,192 $30,322 $11,824 $73, $6,826 $373 $700 $7,899 $21,689 $1,185 $2,225 $25, $39,854 $15,684 $8,569 $64,107 $126,631 $49,835 $27,227 $203, ** $31,346 $18,896 $9,627 $59,868 $99,597 $60,039 $30,588 $190, $20,966 $8,379 $6,781 $36,125 $66,616 $26,622 $21,544 $114, $22,975 $6,484 $4,665 $34,123 $72,999 $20,601 $14,822 $108, $16,613 $12,808 $6,887 $36,307 $52,785 $40,695 $21,883 $115, ** $7,382 $14,018 $5,654 $27,054 $23,455 $44,540 $17,966 $85, ** $16,027 $14,474 $7,838 $38,339 $50,923 $45,990 $24,905 $121, ** $8,820 $12,967 $7,678 $29,466 $28,025 $41,203 $24,398 $93, ** $21,940 $17,016 $8,949 $47,905 $69,711 $54,066 $28,436 $152, $11,605 $5,730 $1,910 $19,246 $36,875 $18,208 $6,069 $61, ** $5,677 $5,152 $2,351 $13,181 $18,038 $16,370 $7,472 $41,880 Lowndes County $249,060 $155,655 $83,710 $488,425 $791,363 $494,578 $265,980 $1,551,921 Source: Insurance Coverage sourced from U.S. Census Bureau, American Community Survey Year Estimates; obesity rates calculated at 29 percent for each population sub group ** Denotes HFFI Eligible Census Tract 244

255 in the counties examined in this study are presented in Table 127, Table 128, Table 129, and Table 130 on pages 244, 246, 246, and 248. The true obesity related healthcare costs are likely to be higher in the state of Mississippi than those presented in this study and the true obesityrelated healthcare costs associated with the populations living in Mississippi s underserved communities are likely to be extraordinarily expensive due to the high poverty rates and lowincome levels that were found to exist in Mississippi s HFFI census tracts. For example, in Sunflower County, the adult obesity rate is 42 percent, and in Washington County, the adult obesity rate is 38 percent (Table 125, page 241). In Lowndes County, 22.4 percent of households have incomes of less than $15,000, and in many of Lowndes County s HFFI census tracts, the percentage of households with incomes of less than $15,000 approaches 50 percent (Table 24, page 116); in Mississippi, the obesity rate among those with incomes of less than $15,000 is 41.2 percent (Table 5, page 30). Because the Stennis Research Team selected to develop conservative estimates for use in this study and used the generalized assumption of an adult obesity rate of 30 percent to develop obesity related healthcare cost estimates, the obesity related healthcare cost estimates associated with those who have public insurance are most likely underestimated due to the low income eligibility levels that are associated with public insurance programs. Within this context, decision makers conducting a cost benefit analysis of the investment of public dollars to provide grants, loans, or tax incentives to support a state healthy food financing initiative in the state of Mississippi should integrate the potential savings that may be associated with any reductions in the state s share of obesity related healthcare costs; this is specifically true for the obesity related healthcare costs that are associated with public insurance because a share of these costs are paid for with taxpayer funds that are appropriated by the Mississippi Legislature to support public insurance programs, and any cost savings associated with a reduction in obesity will accrue to the benefit of the General Fund on an annual basis. For example, as shown in Table 127 on page 244, assuming an obesity related healthcare cost of $2,418 per obese adult, the potential public insurance obesity related healthcare savings associated with a one percent reduction in the adult obesity level in Lowndes County s HFFI census tract is projected to be $54,066. If Mississippi s Federal Medical Assistance Percentage (FMAP) for Medicaid is percent, then the annual healthcare cost savings to the state of Mississippi associated with a one percent reduction in the obesity rate in HFFI census tract would be approximately $13,976 annually, or $139,652 over a 10 year period. These potential savings should be included in the cost benefit analysis for a healthy food financing initiative investment. In addition to the potential health benefits and potential obesity related healthcare cost savings associated with a state healthy food financing initiative, investments in underserved communities generate economic activity, job creation, and employment opportunities, and may serve as anchors to attract other types of commercial or retail activity. The economic benefits associated with these investments will occur in two phases; a first phase of economic impact 245

256 Table 128: Estimated Obesity related Healthcare Cost Savings Associated with a One Percent Reduction in the Obesity Rate in Pearl River County Census Tract or Geographic Area Estimated Obesity Related 3rd Party Cost Savings Assuming a One (1%) Percent Reduction in the Obesity Rate Savings Based on Thorpe's (2009) Point Estimate of $761 per Obese Adult Savings Based on Cawley and Meyerhoefer's Point Estimate of $2,418 per Obese Adult Private Insurance Public Insurance No Insurance Total Private Insurance Public Insurance No Insurance Total ** $20,547 $17,861 $12,161 $50,568 $65,286 $56,750 $38,640 $160, $24,436 $13,926 $9,901 $48,263 $77,642 $44,249 $31,458 $153, $13,378 $8,470 $3,706 $25,554 $42,508 $26,912 $11,776 $81, $29,572 $18,827 $10,700 $59,099 $93,963 $59,821 $33,997 $187, $22,381 $19,154 $10,631 $52,167 $71,113 $60,861 $33,779 $165, $34,709 $21,506 $9,109 $65,324 $110,285 $68,333 $28,943 $207, $43,636 $15,798 $7,245 $66,679 $138,648 $50,198 $23,019 $211, ** $17,176 $9,977 $8,424 $35,577 $54,574 $31,700 $26,767 $113, ** $20,752 $26,437 $16,042 $63,231 $65,939 $84,001 $50,971 $200,912 Pearl River County $226,588 $151,956 $87,918 $466,463 $719,960 $482,826 $279,352 $1,482,137 Source: Insurance Coverage sourced from U.S. Census Bureau, American Community Survey Year Estimates; obesity rates calculated at 29 percent for each population sub group Table 129: Estimated Obesity related Healthcare Cost Savings Associated with a One Percent Reduction in the Obesity Rate in Sunflower County Census Tract or Geographic Area Estimated Obesity Related 3rd Party Cost Savings Assuming a One (1%) Percent Reduction in the Obesity Rate Savings Based on Thorpe's (2009) Point Estimate of $761 per Obese Adult Savings Based on Cawley and Meyerhoefer's Point Estimate of $2,418 per Obese Adult Private Insurance Public Insurance No Insurance Total Private Insurance Public Insurance No Insurance Total ** $11,636 $13,203 $5,281 $30,120 $36,971 $41,952 $16,781 $95, ** $13,036 $16,818 $6,613 $36,467 $41,420 $53,438 $21,012 $115, ** $7,610 $8,470 $4,178 $20,258 $24,180 $26,912 $13,275 $64, $15,623 $9,939 $3,638 $29,200 $49,642 $31,579 $11,558 $92, ** $14,634 $23,401 $9,406 $47,441 $46,498 $74,354 $29,886 $150, ** $6,217 $9,703 $5,380 $21,300 $19,755 $30,830 $17,095 $67, $7,435 $6,986 $4,284 $18,705 $23,624 $22,197 $13,613 $59,434 Sunflower County $76,191 $88,520 $38,781 $203,491 $242,090 $281,262 $123,221 $646,573 Source: Insurance Coverage sourced from U.S. Census Bureau, American Community Survey Year Estimates; obesity rates calculated at 29 percent for each population sub group ** Denotes HFFI Eligible Census Tract 246

257 will occur during the construction or renovation phase of the project and a second phase of economic impact will occur during the ongoing operations of the business. Construction economic impacts are relatively short term in nature, generally lasting through the duration of construction related spending. The economic impact of ongoing business operations is long term in nature, and continuous throughout the life of the business. For example, during the construction or renovation phase of a project, labor will be hired and will spend their wages to make purchases; this spending will support employment at the businesses and suppliers to the businesses from which labor makes purchases. When construction is completed, labor is no longer receiving wages and the economic activity associated with their expenditures ends. Alternatively, the economic impact of the ongoing operations of the business continues from year to year; the firm employs labor (direct employment) and makes purchases from suppliers on a continuous basis; the spending associated with labor income and business purchases supports other jobs (indirect and induced employment) with related additional spending within the economy. The fiscal impact of this economic activity is also continuous; firms and individuals pay income taxes on an annual basis and sales tax revenues associated with the ongoing operations of the business are continuously generated. When examining the cost benefit of making public investments in a state healthy food financing initiatives using taxpayer funds, the primary consideration for elected decision makers is the fiscal effect of these investments. At the state level, tax revenues associated with sales tax, personal income tax, and corporate income taxes represent the greatest potential for generating increased revenue to offset the cost of making public investments in underserved communities. At the county level, property tax represents the greatest potential for generating increased revenue associated with making a public investment in an underserved community; at the municipal level, property taxes and the municipal sales tax diversions represent the greatest potential to offset the cost of making a public investment in an underserved community, assuming the investment is made within the municipal boundaries. As demonstrated in previous sections of this study, the magnitude of the economic and fiscal effects of investments in underserved communities are directly related to the size of the investment, the sales associated with the ongoing operations of the business upon completion of construction or renovation, and the geographic location of the investment. For example, when modeled at the state level, an investment of $6,570,000 in a 45,000 square foot supermarket with anticipated annual sales of $5,402,464 would have the economic impact of creating approximately 92.5 full time equivalent jobs during the construction phase of project activities, and then would have the economic impact of creating approximately 35.1 full time equivalent jobs during the ongoing operations of business activity upon completion of construction (Table 110 and Table 112, page 232). The fiscal impact of this investment would be to generate approximately $219,181 in combined sales tax, personal income tax, and 247

258 Table 130: Estimated Obesity related Healthcare Cost Savings Associated with a One Percent Reduction in the Obesity Rate in Washington County Census Tract or Geographic Area Estimated Obesity Related 3rd Party Cost Savings Assuming a One (1%) Percent Reduction in the Obesity Rate Savings Based on Thorpe's (2009) Point Estimate of $761 per Obese Adult Savings Based on Cawley and Meyerhoefer's Point Estimate of $2,418 per Obese Adult Private Insurance Public Insurance No Insurance Total Private Insurance Public Insurance No Insurance Total $7,085 $4,140 $2,131 $13,356 $22,512 $13,154 $6,770 $42, $4,802 $7,138 $2,907 $14,847 $15,258 $22,681 $9,237 $47, ** $5,898 $13,561 $8,934 $28,393 $18,740 $43,089 $28,387 $90, ** $4,467 $14,992 $7,214 $26,673 $14,194 $47,635 $22,923 $84, * $5,144 $10,951 $4,307 $20,402 $16,346 $34,795 $13,686 $64, $13,356 $10,776 $5,236 $29,367 $42,436 $34,239 $16,636 $93, $20,555 $10,015 $4,246 $34,816 $65,310 $31,821 $13,492 $110, $14,520 $9,840 $4,246 $28,606 $46,135 $31,265 $13,492 $90, ** $8,242 $10,943 $5,380 $24,565 $26,187 $34,771 $17,095 $78, ** $2,443 $4,855 $1,971 $9,269 $7,762 $15,427 $6,263 $29, ** $3,257 $8,135 $3,326 $14,718 $10,349 $25,848 $10,567 $46, ** $5,685 $9,672 $3,303 $18,660 $18,062 $30,733 $10,494 $59, ** $4,406 $10,920 $4,208 $19,535 $14,000 $34,698 $13,372 $62, ** $13,371 $13,371 $3,866 $30,607 $42,484 $42,484 $12,283 $97, ** $16,498 $15,639 $4,414 $36,551 $52,422 $49,690 $14,024 $116, ** $6,453 $6,118 $4,452 $17,024 $20,505 $19,441 $14,145 $54, ** $8,721 $10,433 $5,053 $24,207 $27,710 $33,151 $16,056 $76, $3,790 $5,190 $2,450 $11,430 $12,042 $16,491 $7,786 $36, ** $2,808 $5,708 $2,169 $10,684 $8,922 $18,135 $6,891 $33,949 Washington County $151,500 $182,396 $79,814 $413,710 $481,375 $579,546 $253,600 $1,314,522 Source: Insurance Coverage sourced from U.S. Census Bureau, American Community Survey Year Estimates; obesity rates calculated at 29 percent for each population sub group ** Denotes HFFI Eligible Census Tract 248

259 corporate income tax during the construction phase of project, and an additional $162,140 annually of combined sales tax, personal income tax, and corporate income tax revenue would be associated with the ongoing operations of the business upon completion of construction activities (Table 111 and Table 113, page 232). Over a 10 year period, the gross fiscal impact of this investment would be approximately $1,840,581 in tax revenues accruing to the benefit of the state of Mississippi, assuming no sales tax diversions to a municipality, no labor displacement, or substitution effects are associated with the investment. A change in the dollar amount of the initial investment in construction or renovation, or a change in the projected sales associated with the ongoing operations of the business, will also change the economic and fiscal impact of any healthy food financing initiative investment made in underserved communities within the state of Mississippi. For example, an initial construction investment of $2,920,000 in a 20,000 square foot grocery store with projected annual sales of $2,000,000 modeled at the state level, would have a projected fiscal impact of $97,414 in combined sales tax, personal income tax, and corporate income tax during the construction phase of the project, and an annual fiscal impact of $60,025 in combined sales tax, personal income tax, and corporate income tax during the ongoing operations of the business (Table 115 and Table 117, page 234). Over a 10 year period, the gross fiscal impact of this investment would be approximately $697,250 in tax revenues accruing to the benefit of the state of Mississippi, assuming no sales tax diversions to a municipality, no labor displacement, or substitution effects are associated with the investment. State healthy food financing initiatives are designed to stimulate private investment by leveraging private capital with state funding to meet the financing needs of business operators who are currently located in or planning to open retail food outlets in communities where credit needs cannot be met by conventional financial institutions. Healthy food financing initiatives assist developers and business operators to overcome many of the higher start up costs and other barriers to making investments in retail food outlets in low income areas; this assistance may include flexible construction lending standards, financing at lower interest rates, and other flexible debt terms. Typically, state healthy food financing initiatives provide initial seed money or tax incentives to support public private programs that aggregate capital from multiple sources to include banks, philanthropic organizations, and other investors to create loan pools that are further leveraged by equity investment through the use of federal New Market Tax Credits and other sources of federal funding available through the Healthy Food Financing Initiative. As a result, the state portion of funding for a healthy food financing initiative to attract investment into HFFI census tracts is significantly leveraged by private capital; for example, in the state of Pennsylvania, $30 million in state funding was leveraged to generate $165 million in total investment, 248 indicating that the state share of the total 248 HR 728, Fresh Food Financing Initiative, enacted 2010, Pennsylvania Legislature. 249

260 Table 131: Projections of the Economic and Fiscal Impact of a Mississippi Healthy Food Financing Initiative Pilot Project Lowndes County Full time Equivalent Employment Combined Sales Tax, Personal Income Tax, and Corporate Income Construction of a 45,000 square foot supermarket with Annual Sales of $8,352,601 Construction Impact 75.4 $182,856 Ongoing Operations Impact 50.7 $213,442 Constructon of a 20,000 square foot grocery store with Annual Sales of $2,037,329 Construction Impact 33.4 $78,633 Ongoing Operations Impact 12.4 $57,081 Pearl River County Full time Equivalent Employment Combined Sales Tax, Personal Income Tax, and Corporate Income Tax Construction of 45,000 square foot supermarket with Annual Sales of $8,446,478 Construction Impact 87.3 $141, Ongoing Operations Impact 50.4 $239, Construction of 20,000 square foot grocery store with Annual Sales of $2,000,000 Construction Impact 38.8 $63,101 Ongoing Operations Impact 11.9 $56,721 Sunflower County Full time Equivalent Employment Combined Sales Tax, Personal Income Tax, and Corporate Income Tax Construction of a 45,000 square foot supermarket with Annual Sales of $4,951,290 Construction Impact 90.7 $154,045 Ongoing Operations Impact 30.3 $143,768 Construction of a 20,000 square foot grocery store with Annual Sales of $2,131,057 Construction Impact 40.3 $68,464 Ongoing Operations Impact 13 $61,878 Washington County Full time Equivalent Employment Combined Sales Tax, Personal Income Tax, and Corporate Income Tax Construction of a 45,000 square foot supermarket with Annual Sales of $5,116,756 Construction Impact 91.5 $141,771 Ongoing Operations Impact 31.4 $145,891 Construction of a 20,000 square foot grocery store with Annual Sales of $3,851,145 Construction Impact 40.7 $79,596 Ongoing Operations Impact 23.6 $109,804 Four $500,000 Store Remodels and Equipment Purchases Full time Equivalent Employment Combined Sales Tax, Personal Income Tax, and Corporate Income Tax Four $500,000 Store Remodels and Equipment Purchases with Annual Sales of $500,000 Construction Impact 17.2 $14,598 Ongoing Operations 12.8 $15,006 Summary of All Economic and Fiscal Impacts Full time Equivalent Employment Combined Sales Tax, Personal Income Tax, and Corporate Income Tax Total Construction Impacts $925,043 Annual Total Ongoing Operations Impact $1,043,

261 investment associated with the Pennsylvania Fresh Food Financing Initiative was approximately 18.2 percent. It is important to note that this magnitude of leveraging investments will only be possible in census tracts that are eligible for federal Healthy Food Financing Initiative incentives. Using a similar metric for the investment of $6,570,000 in a 45,000 square foot supermarket as described on page 247, the state share of the investment would be approximately $1,194,545. This investment would generate approximately $219,181 in combined sales tax, personal income tax, and corporate income tax during the construction phase of project (Table 111, page 232), and approximately $162,140 annually of combined sales tax, personal income tax, and corporate income tax revenue (Table 113, page 232). This would indicate that within approximately six years the state would receive sufficient revenue from the fiscal impact (combined sales tax, personal income tax, and corporate income tax) of the investment to significantly offset the state s contribution of approximately $1,194,545. If the investment contributes to a reduction in obesity and obesity related healthcare costs to the state, the payback on this investment could be accelerated. At the time of this study, there are multiple unknown factors associated with the creation of a state healthy food financing initiative in Mississippi; these factors include fund management, the ability to leverage equity and debt investment, prevailing interest rates, debt service, success in securing federal grant funding to leverage investments, store management, site selection, store sales, consumer purchasing behavior, and multiple micro and macro economic factors that impact the business climate and the success of any business operation. Within the context of this uncertainty, the Stennis Research Team modeled a scenario for a Mississippi Healthy Food Financing Pilot Program, using the county level investment scenarios presented in previous sections of this report and using the following assumptions: The construction related cost for a 45,000 square foot supermarket and a 20,000 square foot grocery store was standardized at $6,570,000 and $2,920,000, respectively. The state share of these investments was assumed to be 18.2 percent; $1,195,740 for an investment of $6,570,000 and $531,440 for an investment of $2,920,000. The scenario assumes that one 45,000 square foot supermarket and one 20,000 square foot grocery store will be constructed or renovated in each of the four counties examined in this study, using the potential annual sales that were modeled for each county (Table 131, page 250). One investment of $500,000 in store renovation to provide space and purchase new equipment to increase shelf space for healthy food will be made in each of the four counties, and that annual sales associated with these investments will be $500,000 at each of the four stores; these impacts are modeled at the state level. It is assumed that the state share of these investments is 50 percent ($1,000,000). The Pilot Program scenario assumes that an additional $1,000,000 of state funding will be for technical assistance, education programs, implementation, and program evaluation. The Pilot Program scenario assumes a state cost for administrative fees of 15 percent ($1,336,308). 251

262 Table 132: The Economic Impact of a $2,000,000 Increase in the Direct to Consumer Agricultural Sales of Fruits and Vegetables Impact Type Employment Labor Income Value Added Output Direct Effect 8.6 $1,104,281 $1,083,704 $2,000,000 Indirect Effect 7.6 $265,092 $362,470 $802,665 Induced Effect 7.7 $276,492 $504,072 $881,493 Total Effect 23.9 $1,645,866 $1,950,245 $3,684,158 Source: IMPLAN Table 133: The Fiscal Impact of a $2,000,000 Increase in Direct to Consumer Agricultural Sales of Fruits and Vegetables Tax on Production and Imports: Sales Tax Tax on Production and Imports: Property Tax Tax on Production and Imports: Motor Vehicle Licenses Tax on Production and Imports: Severance Tax Tax on Production and Imports: Other Taxes Tax on Production and Imports: S/L Non Taxes $62,293 $35,239 $859 $1,708 $5,302 $861 Corporate Profits Tax Personal Tax: Income Tax Personal Tax: NonTaxes (Fines Fees) Personal Tax: Motor Vehicle License Personal Tax: Property Taxes Personal Tax: Other Tax (Fish/Hunt) $2,172 $22,398 $3,542 $1,588 $617 $800 Source: IMPLAN 252

263 Based upon these assumptions, a Mississippi Healthy Food Financing Initiative would require a state investment of $10,245,028 to leverage $39,960,000 of public and private investments in the new construction and renovation of existing supermarkets, grocery stores, and other existing food retail formats. This magnitude of private investment leveraging may only be possible for investments made in census tracts that qualify under the federal guidelines for the Healthy Food Financing Initiative or the federal New Market Tax Credit program. The economic impact of these investments would be to create full time equivalent jobs and an estimated $925,043 of fiscal impact would be associated with the combined sales tax, personal income tax, and corporate income tax during the construction phase of project activities. Upon completion of construction activities, an estimated full time equivalent jobs would be associated with the ongoing operations of business activities and the annual fiscal impact associated with ongoing operations is projected to be $1,043,138 in combined sales tax, personal income tax, and corporate income tax (Table 131, page 250). Based upon the assumptions used to model a Mississippi Healthy Food Financing Initiative Pilot Program, it is estimated that it would take approximately 8.9 years for the state to recapture its initial investment of $10,245,028 from the combined sales tax, personal income tax, and corporate income tax that would be associated with the fiscal effects of investments in Mississippi s underserved communities, assuming no sales tax diversions to municipalities, no labor displacement, or substitution effects are associated with these investments. In addition to making investments in supermarkets, grocery stores, and other traditional food retail formats, value added agricultural and direct to consumer agricultural sales represent a significant economic growth opportunity for the state of Mississippi. Investments and policies designed to support farmers markets, food hubs, farm to school programs, and Community Supported Agricultural programs (CSAs) represent an additional strategy for increasing access to affordable, healthy foods in Mississippi s underserved communities that has extraordinary potential. The magnitude of the economic and fiscal impact of investments that enable the state of Mississippi to capture a larger share of the farm to retail price spread within the state s agricultural economy, to retain expenditures associated with existing food spending, while offering fresh food at an affordable price have the potential to be quite significant. In 2013, Mississippians spent an estimated $821,950,189 on fruits and vegetables; in 2013, National School Lunch Program payments to the state of Mississippi were $197,659,575, and Supplemental Nutrition Assistance Program (SNAP/Food Stamp) expenditures in the state of Mississippi were $993,077,956. Capturing just a small percentage of this spending within Mississippi s agricultural economy would create significant economic and fiscal impact. For example, a $2,000,000 increase in the sale of Mississippi produced fruits and vegetables would create approximately 23.9 full time equivalents jobs in the state of Mississippi and would have an annual fiscal impact of $137,379; of this amount, $86,863 is associated with sales tax, personal income tax, and corporate income tax revenue (Table 132 and Table 133, page 252). 253

264 Table 134: Overview of County Socio demographic Characteristics of the Population Socio demographic Characteristic Lowndes County Pearl River County Sunflower County Washington County All Four Counties Total Population 59,584 55,569 28,722 50, ,453 Population Living in HFFI Census Tracts 26,433 18,017 22,944 34, ,089 Percent of Total Population Living in HFFI Census Tracts 44.4% 32.4% 79.9% 68.6% 52.5% Total White Population 32,362 46,980 7,368 13, ,357 White Population Living in HFFI Census Tracts 10,004 14,270 5,054 6,694 36,022 Percent of White Population Living in HFFI Census Tracts 30.9% 30.4% 68.6% 49.1% 35.9% Total African American Population 26,040 7,065 20,997 35,879 89,981 African American Population Living in HFFI Census Tracts 16,117 3,247 17,614 27,637 64,615 Percent of African American Population Living in HFFI Census Tracts 61.9% 46.0% 83.9% 77.0% 71.8% Percent of Total Population that is White 54.3% 84.5% 25.7% 27.0% 51.6% Percent of Total Population that is African American 43.7% 12.7% 73.1% 70.9% 46.3% Total Female Population 31,315 28,351 13,563 27, ,237 Female Population Living in HFFI Census Tracts 14,718 9,901 10,227 18,989 53,835 Percent of Total Female Population Living in HFFI Census Tracts 47.0% 34.9% 75.4% 70.3% 53.7% Percent of Total Population that is Female 52.6% 51.0% 47.2% 53.4% 51.5% Total Population 17 Years and Under 15,029 13,547 6,923 13,973 49,472 Population 17 Years and Under Living in HFFI Census Tracts 6,751 4,714 5,689 10,006 27,160 Percent of Total Population 17 and Under Living in HFFI Census Tracts 44.9% 34.8% 82.2% 71.6% 54.9% Percent of Total Population that is 17 and Under 25.2% 24.4% 24.1% 27.6% 25.4% Total Population 65 and Over 7,733 8,473 3,080 6,340 25,626 Population 65 and Over Living in HFFI Census Tracts 3,594 2,211 2,232 4,163 12,200 Percent of the Population 65 and Over Living in HFFI Census Tracts 46.5% 26.1% 72.5% 65.7% 47.6% Percent of Total Population that is 65 and Over 13.0% 15.2% 10.7% 12.5% 13.2% Source: U.S. Census Bureau, American Community Survey, Year Estimates Authors Note: total population estimates provided in Table 134 above is sourced from 2012 American Community Survey 5 Year Estimates, population totals presented in Figure 16 (page 106), Figure 17 (page 138), Figure 18 (page 170), and Figure 19 (page 200) are sourced from 2014 U.S. Census Bureau, Population Estimates. The use of different data sources results in minor variation in reported population totals. 254

265 Review of the Findings The federal government has defined specific census tracts as geographic areas with limited access to affordable and nutritious food; these census tracts are designated as eligible for federal funding under the Healthy Food Financing Initiative; these HFFI eligible census tracts are low income areas with a poverty rate of 20 percent or greater, or a median family income at or below 80 percent of the area s median income. Research has linked food access, nutritious diets, and public health. Obesity, diabetes, cardiovascular disease, and premature death from diet related disease has been found to be higher in populations living in HFFI census tracts; the medical treatment of obesity related diseases is costly. The state of Mississippi has the highest prevalence of health risk behaviors, chronic conditions, and the highest death rate from heart disease, cerebrovascular disease, hypertension, and hypertensive renal disease in the United States (Table 3, page 26 and Table 4, page 28); there is a significant need in the state of Mississippi for public policy interventions designed to improve public health outcomes, to reduce obesity related disease, and to contain the healthcare costs associated with obesity. This study examined Lowndes County, Pearl River County, Sunflower County, and Washington County at the census tract level to develop a comparative analysis of the characteristics found in HFFI census tracts in the state of Mississippi. Although each county and census tract was found to exhibit unique socio economic characteristics, the HFFI census tracts examined in this study can be generally characterized as having low income, low educational attainment levels, and relatively high unemployment. Women, children, and the elderly were found to be disproportionately represented in HFFI census tracts (Table 134, page 254). The predominant economic determinates of site selection in the Supermarket and Grocery Store Industry include locating in proximity to areas with high population density, close proximity to a large population of middle to upper income consumers, high traffic counts, and location in areas exhibiting strong economic growth; these determinants combined with industry trends towards an increase in the variety of product offerings and increased store size create significant barriers to improving access to healthy food in underserved communities. The absence of supermarkets and grocery stores in underserved communities is further exacerbated by small markets and stores that offer few affordable, healthy food options. This is particularly true in rural areas in the state of Mississippi. The primary purpose of a state healthy food financing initiative is to provide incentives to reduce the risk associated with making investments in supermarkets and grocery stores in underserved communities by providing technical and financial assistance through an array of funding options that may include grants, loans, and tax credits through leveraged public private partnerships. Many state healthy food financing initiatives also provide grants and loans to smaller existing stores or to farmers markets to make renovations and equipment purchases to expand their offering of healthier food options and to enable these stores and farmers markets to promote the use of SNAP benefits to purchase healthy food. 255

266 Based upon consumer expenditures for food at home combined with a retail food purchasing gap analysis at the census tract level, this study found sufficient market potential to exist within a number of HFFI census tracts examined in this study. At the time of this study, multiple factors associated with potential investments in Mississippi s underserved communities were unknown due to the unique funding mechanisms (i.e. debt, equity, bonds, loans, tax credits or grants) that may be used to structure each investment; each investment will differ depending upon site location, market size, the magnitude of the investment, potential sales, the retail format of a future store, and other micro and macro economic variables that will impact the future sustainability and economic impact of these investments. Within this context, the Stennis Research Team developed three healthy food financing scenarios for use in modeling the economic and fiscal impact of investments in underserved communities at the county level for each of the four counties included in this study; these models are discussed in the body of this study. A potential scenario for a Mississippi Healthy Food Financing Pilot Program was also developed; this scenario assumed a state investment of $10,245,028 to leverage $39,960,000 of public and private investments in the new construction and renovation of existing supermarkets, grocery stores, and other existing food retail formats; this degree of leveraging may only be feasible for investments made in census tracts that qualify for federal Healthy Food Financing Initiative funding and incentives. The construction impact of this investment was found to be associated with the creation of full time equivalent jobs with a one time fiscal impact of $925,043 in combined sales tax, personal income tax, and corporate income tax; upon the commencement of business activities, these investments would support an estimated full time equivalent jobs and the annual fiscal impact associated was projected to be $1,043,138 in combined sales tax, personal income tax, and corporate income tax (Table 131, page 250). Based upon the assumptions used to model a Mississippi Healthy Food Financing Initiative Pilot Program, it was estimated that it would take approximately 8.9 years for the state to recapture its initial investment of $10,245,028 from the combined sales tax, personal income tax, and corporate income tax that would be associated with the fiscal effects of investments in Mississippi s underserved communities, assuming no sales tax diversions to municipalities, no labor displacement, or substitution effects are associated with these investments, and that investments are made in HFFI qualifying census tracts. An extensive infrastructure of existing farmers markets was found to exist throughout the state of Mississippi (Map 1, page 72); significant opportunities exist to make investments in this existing infrastructure to increase access to affordable, healthy foods and the economic potential of increased direct to consumer agricultural sales through food hubs is virtually untapped in the state. A critical issue in the success of a healthy food financing initiative in the state of Mississippi will be fund management, experience in structuring leveraged equity and debt investments with tax credits, capacity to attract investment from the private and philanthropic sectors, the ability to 256

267 secure federal grant funding to further leverage state funds, and expertise in evaluating and managing risk; providing technical assistance, partnering with community organizations, the delivery of education programs, and objective program evaluation are strongly recommended. Investments made to increase access to affordable, healthy foods in Mississippi s underserved communities will provide jobs for community residents and also have the potential to revitalize communities by acting as an anchor to attract other investments. In more rural areas, strategies that co locate services to create one stop shopping that may include banking services, dry cleaning, family nutrition, childcare, and other educational programs, or health clinics will provide new services to the community, create additional jobs, and increase retail traffic. The majority of the jobs that are created through investments in grocery stores and supermarkets will be entry level positions and receive on the job training; cashiers, stock clerks, and food preparation workers are trained on the job, and meat cutters and bakers can attend training at the local community college or they can learn the necessary skills on the job. This study found that educational attainment levels for the populations living in HFFI qualifying census tracts is relatively low; in HFFI census tracts, the percentage of the population without a high school degree ranges from 17.0 percent to 32.9 percent of the population age 25 and over; the entry level jobs created by investments in underserved communities will provide residents with employment opportunities, the chance to gain valuable job skills, and to advance to positions with greater responsibility and higher wages over time. Flexible work schedules and part time employment opportunities may also provide new income opportunities, particularly for the high percentage of females and for female households with children and no husband present that were found in HFFI qualifying census tracts. A Mississippi healthy food financing initiative may be viewed as a policy intervention strategy designed to increase access to affordable, healthy foods in Mississippi s underserved communities with the objective of increasing the consumption of healthy food, improving the diet of residents within these communities, and reducing obesity and obesity related illnesses. An important potential benefit associated with this policy is the containment of obesity related healthcare costs. The economic cost of obesity includes medical costs, lost worker productivity, absenteeism from work, and the future value of income that is lost due to illness and premature death. The majority of the economic costs of obesity are negative externalities that shift the burden of the cost of obesity to other parties; for those who are employed and privately insured, the majority of the burden of obesity related healthcare cost is shared by employers and health insurance companies; for those who are covered by public health insurance, the burden of obesity related healthcare cost is predominantly paid for by federal and state governments; and for those who have no health insurance, the cost of uncompensated healthcare is shifted to others in the form of higher healthcare costs. A potential reduction in obesity related healthcare costs also represents a potential savings in state expenditures, specifically those related to those who are covered by public health 257

268 insurance. In all four counties that were examined during this study, the percentage of the population that was covered by public health insurance was higher than the state average of 43.3 percent; among the 27 HFFI qualifying census tracts that were examined in this study, the percentage of the population with public health insurance was generally found to be higher than the county wide and the state wide average (the exceptions to this statement were Lowndes County HFFI census tract , Pearl River County HFFI census tract , Sunflower County HFFI census tract , and Washington County HFFI census tracts and ). To assist decision makers to formulate an appropriate Mississippi healthy food financing initiative policy, estimates of obesity related healthcare costs at the census tract level are included in this study; the annual obesity related healthcare costs associated with the populations living in HFFI census tracts and covered by public health insurance was estimated to range between $10,310,712 and $32,761,240 (Tables 127 through 130, pages 244 to 248). This study was designed to assist decision makers to evaluate policy intervention strategies associated with a future Mississippi Healthy Food Financing Initiative that is aligned with the purpose of H.B the Small Business and Grocer Investment Act of This study focused on evaluating census tracts that qualify for additional loans, grants, tax credits and other incentives under the federal Health Food Financing Initiative; although numerous underserved communities exist throughout the state of Mississippi, investments made in HFFI eligible census tracts will create opportunities to significantly leverage the use of any future state funding that may be provided to meet the objectives of the Mississippi Small Business and Grocer Investment Act of The assumptions, projections, cost estimates, and methodology used in this study are fully described for the purpose of transparency and are based upon the best information that was available at the time the study was conducted. Studies conducted by the Stennis Institute are intended to inform the public policy decision making process; the Stennis Institute does not support specific public policies, nor is this study intended to be a policy recommendation. 258

269 Appendices 259

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271 Appendix A: U.S. Treasury HHFI FA Funding to Community Development Financial Institutions 2011 through 2014 CCLXI

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273 Table 135: Recipients of HFFI FA Funding 2011 through 2014 CDFI Recipients of HFFI FA Funding 2011 through 2014 California Awardee City Year Amount Low Income Investment Fund San Francisco 2011 $3,000,000 Low Income Investment Fund San Francisco 2013 $3,000,000 Low Income Investment Fund San Francisco 2014 $3,000,000 Total California: 3 Colorado Colorado Enterprise Fund Denver 2012 $750,000 Colorado Enterprise Fund Denver 2013 $800,000 First Nations Oweesta Corporation Longmont 2014 $500,000 Total Colorado: 3 Georgia Appalachian Community Enterprises Cleveland 2011 $500,000 Total Georgia: 1 Illinois Chicago Community Loan Fund Chicago 2012 $3,000,000 IFF Chicago 2011 $3,000,000 IFF Chicago 2012 $3,000,000 IFF Chicago 2013 $3,000,000 Total Illinois: 4 Kentucky Community Ventures Corporation, Inc. Lexington 2012 $2,000,000 Community Ventures Corporation, Inc. Lexington 2013 $1,500,000 Total Kentucky: 2 Louisiana ASI Federal Credit Union Harahan 2011 $3,000,000 ASI Federal Credit Union Harahan 2012 $2,000,000 Total Louisiana: 2 Massachusetts Boston Community Loan Fund Boston 2013 $500,000 Boston Community Loan Fund Boston 2014 $2,750,000 Common Capital, Inc. Holyoke 2011 $500,000 Common Capital, Inc. Holyoke 2014 $500,000 Cooperative Fund of New England Amherst 2011 $2,000,000 Cooperative Fund of New England Amherst 2012 $1,000,000 Local Enterprise Assistance Fund Brookline 2011 $500,000 Local Enterprise Assistance Fund Brookline 2014 $400,000 Total Massachusetts: 8 Table continued on next page CCLXIII

274 Recipients of HFFI FA 2011 through 2014 continued CCLXIV

275 Table 136: U.S. Treasury, CDFI NMTC Data for Washington, Pearl River, Lowndes, and Sunflower Counties Census Tract NMTC Eligible Poverty Rate Median Income Unemployment Rate Metro Designation ACS Population for which Poverty is determined Stennis Area Description Washington Yes 20.10% % non 1,718 Arcola Area Yes 36.40% % non 1,558 Metcalfe Area/Mid Delta Airport Yes 54.20% % non 4, Yes 50.90% % non 3, Yes 48.60% % non 2, No 14.30% % non 3,532 Greenville No 10.80% % non 4,174 Greenville No 12.80% % non 3,016 Greenville Yes 31.60% % non 3, Yes 52.60% % non 1, Yes 54.50% % non 1, Yes 36.50% % non 2,683 Delta Regional Medical Center Area Yes non Yes 21.30% % non Yes 30.10% % non 4,867 Chatham/Avon/Wayside/Glen Allan Yes 57.40% % non 2,140 Leland Yes 36.30% % non 2,968 Leland Yes 35.40% % non 1,338 Hollandale Yes 44.20% % non 1,465 Hollandale Sunflower Yes 33.00% % non 3,508 Drew Area Yes 27.60% % non 4,707 Ruleville Area Yes 28.70% % non 2,621 Sunflower Area No 12.70% % non 3,585 Indianola North of RR and Pollock Road Yes 46.00% % non 6,195 Indianola South of RR and Pollock Road Yes 48.40% % non 2,514 Moorhead Yes 32.00% % non 2,779 Inverness area Pearl River Yes 23.40% % non 6, Yes 20.20% % non 5,567 Poplarville Yes 34.40% % non 2, No 17.10% % non 7, No 15.80% % non 5, No 15.60% % non 7, No 9.40% % non 6,759 Carrier Yes 20.10% % non 4,671 Picayunne Yes 32.80% % non 7,641 Nicholson Lowndes No 14.70% % non 5,536 Caledonia Area No 13.60% % non 2, No 8.30% % non 1,419 Columbus AFB Area No 92.00% % non 7,374 Pennington Lake Area Yes 20.50% % non 7,255 Steens Area No 17.10% % non 4,187 Lowndes County Airport Area No 10.70% % non 3,872 Lake Lowndes State Park Area No 14.40% % non 4,055 Gardner Blvd/Warpath Road Yes 43.70% % non 2, Yes 45.70% % non 4,554 Lexapallila Creek Recreation Area (slightly north of) Yes 50.70% % non 3,578 Area Around Union Cemetary Yes 24.60% % non 6,094 Plymouth Road/Wilkins Wise Road Area No 16.00% % non 2,058 Artesia Yes 36.60% % non 1,729 Crawford Source: U.S. Treasury Department, CDFI, Qualifying NMTC Census Tracts CCLXV

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277 Appendix B: Limited Supermarket Access Rankings by Area Size CCLXVII

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279 Table 137: LSA Rankings for Major Metro Areas with Population Greater than 1,000,000 Place Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Memphis, TN MS AR 1,315, ,419 12% 14 75% 5 1 Pittsburgh, PA 2,355, ,513 18% 5 57% 18 2 Richmond, VA 1,257, ,662 10% 20 84% 3 3 New Orleans Metairie Kenner, LA 1,167, ,172 21% 3 56% 20 4 Philadelphia Camden Wilmington, PA NJ DE MD 5,964, ,746 13% 8 57% 17 5 Milwaukee Waukesha West Allis, WI 1,555, ,167 11% 17 71% 8 6 St. Louis, MO IL 2,836, ,039 14% 6 50% 25 7 Bal more Towson, MD 2,710, ,267 13% 10 55% 22 8 Cleveland Elyria Mentor, OH 2,076, ,908 10% 19 61% 15 9 Bu alo Niagara Falls, NY 1,135, ,555 19% 4 46% Rochester, NY 1,054, ,498 14% 7 48% Cincinnati Middletown, OH KY IN 2,129, ,398 13% 11 49% Providence New Bedford Fall River, RI MA 1,600, ,940 12% 13 50% Tampa St. Petersburg Clearwater, FL 2,782, ,775 7% 29 64% Chicago Naperville Joliet, IL IN WI 9,458, ,637 8% 23 56% Kansas City, MO KS 2,035,230 73,929 4% 42 87% 2 16 Miami Fort Lauderdale Miami Beach, FL 5,563, ,392 8% 24 55% San Antonio, TX 2,141, ,912 24% 1 35% Washington Arlington Alexandria, DC VA MD WV 5,581, ,925 6% 33 62% Detroit Warren Livonia, MI 4,296, ,681 10% 18 48% Houston Baytown Sugar Land, TX 5,945, ,656 13% 9 39% Jacksonville, FL 1,345,526 58,822 4% 45 75% 4 22 Dallas Fort Worth Arlington, TX 6,371, ,864 11% 15 44% Minneapolis St. Paul Bloomington, MN WI 3,279, ,762 12% 12 40% Columbus, OH 1,836, ,760 8% 27 54% Aus n Round Rock, TX 1,716, ,195 23% 2 28% Virginia Beach Norfolk Newport News, VA NC 1,671, ,962 6% 37 63% Raleigh Cary, NC 1,130,501 25,155 2% 49 92% 1 28 Birmingham Hoover, AL 1,127, ,552 10% 21 49% Los Angeles Long Beach Santa Ana, CA 12,825, ,523 4% 41 67% Nashville Davidson Murfreesboro, TN 1,589,709 70,446 4% 44 71% 7 31 Boston Cambridge Quincy, MA NH 4,550, ,617 11% 16 42% Har ord West Harford East Har ord, CT 1,211,964 51,401 4% 46 74% 6 33 Louisville, KY IN 1,283,234 81,679 6% 38 59% Charlotte Gastonia Concord, NC SC 1,757,665 74,306 4% 43 64% Salt Lake City, UT 1,123,900 27,604 2% 50 68% 9 36 Atlanta Sandy Springs Marie a, GA 5,268, ,313 7% 28 47% San Francisco Oakland Fremont, CA 4,333, ,260 5% 39 51% Phoenix Mesa Sco sdale, AZ 4,191, ,011 8% 26 41% New York Northern New Jersey Long Island, NY NJ PA 18,894,316 1,190,504 6% 32 44% Orlando, FL 2,134, ,459 5% 40 49% Riverside San Bernardino Ontario, CA 4,224, ,421 8% 25 37% Oklahoma City, OK 1,252, ,170 9% 22 30% Indianapolis, IN 1,756, ,733 7% 31 39% Sacramento Arden Arcade Roseville, CA 2,148, ,443 6% 36 40% Las Vegas Paradise, NV 1,951, ,981 7% 30 31% Denver Aurora, CO 2,519, ,236 6% 35 38% Seattle Tacoma Bellevue, WA 3,438, ,158 6% 34 23% Portland Vancouver Beaverton, OR WA 2,225,457 47,821 2% 48 29% San Diego Carlsbad San Marcos, CA 3,095, ,149 3% 47 24% San Jose Sunnyvale Santa Clara, CA 1,836,506 23,147 1% 51 9% Source: Searching for Markets: The Geography of Inequitable Access to Healthy & Affordable Food in the United States, U.S. Department of the Treasury, CDFI Fund CCLXIX

280 Table 138: LSA Rankings for Metro Areas with Population between 500,000 and 1,000,000 Place Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Albany Schenectady Troy, NY 870, ,880 15% 7 65% 9 1 Baton Rouge, LA 802,302 86,095 11% 15 77% 3 2 New Haven Milford, CT 862, ,382 13% 11 67% 8 3 Harrisburg Carlisle, PA 549,353 96,668 18% 4 58% 18 4 Wichita, KS 623,024 60,649 10% 20 75% 4 5 Spring eld, MA 692, ,803 16% 6 56% 21 6 Youngstown Warren Boardman, OH PA 565,509 67,411 12% 14 58% 17 7 El Paso, TX 800,634 95,763 12% 13 57% 19 8 McAllen Edinburg Mission, TX 774, ,982 41% 1 45% 31 9 Greensboro High Point, NC 723,683 48,113 7% 26 71% 6 10 Des Moines, IA 569,534 33,474 6% 33 90% 1 11 Bakers eld, CA 839,430 50,302 6% 31 71% 5 12 Poughkeepsie Newburgh Middletown, NY 670, ,557 20% 3 44% Cha anooga, TN GA 528,050 32,481 6% 35 81% 2 14 Tulsa, OK 937,378 67,275 7% 25 62% Fresno, CA 930,636 77,872 8% 23 59% Charleston North Charleston, SC 664,439 72,613 11% 17 54% Tucson, AZ 979, ,777 21% 2 31% Knoxville, TN 697,848 77,756 11% 16 50% Dayton, OH 841,255 47,848 6% 30 63% Akron, OH 703,276 67,303 10% 19 52% Syracuse, NY 662,343 75,392 11% 18 51% Scranton Wilkes Barre, PA 563,331 41,179 7% 29 61% Jackson, MS 538,923 33,368 6% 34 65% Worcester, MA 798, ,950 14% 9 32% Allentown Bethlehem Easton, PA NJ 821, ,271 12% 12 40% Albuquerque, NM 886, ,171 17% 5 16% Bradenton Sarasota Venice, FL 702,196 49,287 7% 27 54% Ogden Clear eld, UT 547,057 29,412 5% 40 65% Li le Rock North Li le Rock, AR 699,723 19,360 3% 44 71% 7 30 Greenville, SC 636,825 52,896 8% 24 50% Toledo, OH 651,380 55,889 9% 22 46% Stockton, CA 685,071 25,280 4% 42 64% Bridgeport Stamford Norwalk, CT 916,108 48,827 5% 36 56% Palm Bay Melbourne Titusville, FL 543,278 74,660 14% 10 11% Provo Orem, UT 526,678 77,075 15% 8 5% Colorado Springs, CO 645,447 44,250 7% 28 45% Durham, NC 504,276 49,377 10% 21 30% Columbia, SC 767,471 35,783 5% 37 46% Madison, WI 568,422 29,326 5% 39 48% Cape Coral Fort Myers, FL 618,573 37,562 6% 32 26% Omaha Council Blu s, NE IA 865,324 34,307 4% 41 42% Lakeland, FL 601,963 31,202 5% 38 23% Augusta Richmond County, GA SC 556,733 12,258 2% 47 43% Grand Rapids Wyoming, MI 774,136 23,557 3% 43 32% Lancaster, PA 519,370 17,220 3% 45 36% Boise City Nampa, ID 616,434 8,347 1% 48 16% Portland South Portland Biddeford, ME 514,035 13,368 3% 46 8% Source: Searching for Markets: The Geography of Inequitable Access to Healthy & Affordable Food in the United States, U.S. Department of the Treasury, CDFI Fund CCLXX

281 Table 139: LSA Rankings for Metro Areas with Population between 250,000 to 500,000 Place Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population Composite in Low Rank Income Area Trenton Ewing, NJ 366,608 62,535 17% 11 70% 17 1 Columbus, GA AL 294,919 36,997 13% 17 73% 11 2 Savannah, GA 347,596 38,272 11% 22 83% 7 3 Erie, PA 280,523 34,465 12% 20 71% 13 4 Atlan c City, NJ 274,537 58,108 21% 4 57% 30 5 Lexington Fayette, KY 472,040 53,010 11% 21 70% 15 6 Lansing East Lansing, MI 464,028 64,196 14% 15 62% 22 7 Fort Wayne, IN 416,160 28,244 7% 34 94% 5 8 Hagerstown Martinsburg, MD WV 269,092 39,557 15% 14 59% 25 9 Ann Arbor, MI 344,783 65,925 19% 6 53% Corpus Christi, TX 428,043 96,968 23% 2 43% Beaumont Port Arthur, TX 388,667 33,613 9% 30 71% Kalamazoo Portage, MI 326,584 37,560 12% 19 59% Shreveport Bossier City, LA 398, ,994 27% 1 37% Rockford, IL 349,313 24,461 7% 36 76% Reno Sparks, NV 425,375 81,074 19% 5 38% Roanoke, VA 308,701 52,525 17% 12 49% Ocala, FL 331,247 38,000 11% 23 57% Binghamton, NY 251,607 42,940 17% 13 49% Manchester Nashua, NH 400,375 71,833 18% 7 38% York Hanover, PA 434,800 72,230 17% 10 38% Brownsville Harlingen, TX 406,129 89,288 22% 3 35% Norwich New London, CT 273,969 34,308 13% 18 51% Lafayette, LA 273,846 18,600 7% 39 71% South Bend Mishawaka, IN MI 319,213 33,033 10% 26 56% Utica Rome, NY 299,301 32,102 11% 24 55% Mobile, AL 412,889 29,524 7% 35 59% Charleston, WV 304,158 53,386 18% 8 34% Visalia Porterville, CA 442,011 17,624 4% 52 82% 8 29 Vallejo Fairfield, CA 413,767 23,136 6% 42 69% Deltona Daytona Beach Ormond Beach, FL 494,502 25,421 5% 44 68% Kingsport Bristol Bristol, TN VA 309,474 10,090 3% % 4 32 Canton Massillon, OH 404,283 8,070 2% % 2 33 Table continued on next page CCLXXI

282 Table 139 continued Place Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population Composite in Low Rank Income Area Duluth, MN WI 279,666 49,520 18% 9 27% Winston Salem, NC 477,702 36,157 8% 33 55% Flint, MI 425,782 21,209 5% 45 68% Peoria, IL 379,054 51,667 14% 16 32% Eugene Springfield, OR 351,601 5,306 2% % 3 38 Hunngton Ashland, WV KY OH 287,596 18,703 7% 38 57% Spokane, WA 471,082 6,849 1% % 1 40 Lubbock, TX 284,815 30,348 11% 25 37% Pensacola Ferry Pass Brent, FL 448,904 18,148 4% 51 64% Santa Barbara Santa Maria, CA 423,763 20,313 5% 46 57% Wilmington, NC 362,246 8,416 2% 63 76% 9 44 Fort Smith, AR OK 298,484 6,601 2% 66 90% 6 45 Huntsville, AL 417,502 12,649 3% 57 70% Lynchburg, VA 252,541 26,246 10% 27 37% Green Bay, WI 306,195 22,913 7% 37 45% Port St. Lucie, FL 423,968 23,743 6% 41 46% Davenport Moline Rock Island, IA IL 379,538 33,742 9% 31 27% Killeen Temple Fort Hood, TX 405,215 37,001 9% 29 16% Bremerton Silverdale, WA 251,090 16,641 7% 40 37% Montgomery, AL 374,432 35,501 9% 32 21% Naples Marco Island, FL 321,460 5,528 2% 65 57% Clarksville, TN KY 273,920 10,937 4% 55 39% Olympia, WA 252,136 25,198 10% 28 0% Asheville, NC 424,737 17,081 4% 53 27% Fayetteville, NC 366,305 15,504 4% 54 29% Merced, CA 255,311 13,711 5% 50 26% Salinas, CA 414,998 19,057 5% 47 0% Evansville, IN KY 358,571 17,256 5% 48 0% Cedar Rapids, IA 257,904 16,118 6% 43 0% Spartanburg, SC 284,121 12,830 5% 49 0% Hickory Lenoir Morganton, NC 365,390 10,343 3% 58 10% Reading, PA 411,336 6,645 2% 61 12% Holland Grand Haven, MI 263,797 10,066 4% 56 0% Santa Rosa Petaluma, CA 483,749 5,645 1% 69 23% San Luis Obispo Paso Robles, CA 269,545 8,992 3% 60 0% Gainesville, FL 264,360 4,318 2% 67 11% Boulder, CO 318, % 71 0% Santa Cruz Watsonville, CA 262,265 5,704 2% 68 0% Source: Searching for Markets: The Geography of Inequitable Access to Healthy & Affordable Food in the United States, U.S. Department of the Treasury, CDFI Fund CCLXXII

283 Table 140: LSA Rankings for Metro Areas with Populations less than 250,000 Place Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Decatur, IL 110,726 20,260 18% 15 81% 16 1 Muskegon Norton Shores, MI 172,186 25,131 15% 29 85% 12 2 College Sta on Bryan, TX 228,644 39,183 17% 17 61% 29 3 Lafayette, IN 201,731 31,146 15% 26 66% 24 4 Show Low, AZ 107,417 17,427 16% 24 63% 26 5 Racine, WI 195,337 31,253 16% 21 61% 30 6 Monroe, LA 176,384 45,279 26% 5 50% 46 7 Houma Bayou Cane Thibodaux, LA 208,158 57,119 27% 2 48% 52 8 Pueblo, CO 159,001 30,311 19% 11 51% 45 9 Sioux City, IA NE SD 143,521 29,835 21% 9 50% Janesville, WI 160,296 24,529 15% 30 62% Cheyenne, WY 91,712 14,050 15% 32 65% Amarillo, TX 249,818 33,584 13% 35 66% Bloomington Normal, IL 169,507 27,083 16% 22 54% Lewiston Auburn, ME 107,652 13,569 13% 41 76% Altoona, PA 127,041 21,981 17% 19 53% Farmington, NM 130,017 35,587 27% 4 45% Casper, WY 75,431 9,175 12% 49 76% Athens Clarke County, GA 192,538 16,155 8% % 3 19 Santa Fe, NM 144,136 30,794 21% 8 42% Kingston, NY 182,430 36,578 20% 10 41% Wheeling, WV OH 147,860 28,711 19% 12 42% Kankakee Bradley, IL 113,432 10,975 10% 59 85% Gulfport Biloxi, MS 248,763 24,437 10% 55 69% Saginaw Saginaw Township North, MI 200,169 15,964 8% 63 83% Niles Benton Harbor, MI 156,813 15,558 10% 58 75% Alexandria, LA 153,885 41,292 27% 3 26% Lawton, OK 124,062 51,462 41% 1 23% Macon, GA 232,278 15,279 7% 74 91% 9 29 El Centro, CA 174,488 25,752 15% 28 46% Yuba City, CA 166,849 42,703 26% 6 27% Brunswick, GA 112,364 8,444 8% 73 88% Waco, TX 234,904 39,561 17% 16 35% Topeka, KS 233,805 11,186 5% % 1 34 Springfield, IL 210,090 27,034 13% 37 49% Morgantown, WV 129,660 18,902 15% 31 46% Cumberland, MD WV 103,275 19,258 19% 13 31% Ithaca, NY 101,540 6,913 7% % 8 38 Ocean City, NJ 97,229 22,385 23% 7 22% Las Cruces, NM 209,197 27,570 13% 38 47% Table continued on next page CCLXXIII

284 Table 139 continued Place Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Dalton, GA 142,155 16,644 12% 46 50% Michigan City La Porte, IN 111,434 12,247 11% 52 53% Johnson City, TN 198,672 15,608 8% 65 58% Springfield, OH 138,326 6,578 5% 87 91% Bay City, MI 107,768 12,278 11% 54 53% Vineland Millville Bridgeton, NJ 156,853 22,260 14% 34 39% Jackson, MI 160,247 13,556 8% 70 60% Albany, GA 157,266 7,676 5% 86 80% Jackson, TN 115,444 5,319 5% 90 85% Anderson, SC 187,078 14,081 8% 67 53% Je erson City, MO 149,777 4,364 3% % 5 51 Weirton Steubenville, WV OH 124,384 14,272 11% 51 48% Terre Haute, IN 172,335 14,196 8% 68 53% Valdosta, GA 139,548 4,847 3% % 6 54 Champaign Urbana, IL 231,788 5,016 2% % 2 55 Waterloo Cedar Falls, IA 167,810 13,994 8% 69 53% Grand Forks, ND MN 98,443 13,070 13% 43 39% Muncie, IN 117,632 6,083 5% 89 74% Fargo, ND MN 208,759 37,454 18% 14 8% Oshkosh Neenah, WI 166,973 20,484 12% 45 38% Sherman Denison, TX 120,831 20,430 17% 20 13% Barnstable Town, MA 215,802 27,589 13% 36 28% Lake Havasu City Kingman, AZ 200,146 16,932 8% 64 49% Danville, VA 106,533 17,498 16% 25 14% St. George, UT 138,092 23,881 17% 18 9% Rocky Mount, NC 152,352 3,104 2% % 4 66 Flagstaff, AZ 134,386 15,723 12% 47 35% Burlington, NC 151,088 24,150 16% 23 9% Wausau, WI 133,940 17,217 13% 39 26% Gainesville, GA 179,645 26,565 15% 27 10% Salisbury, MD 125,195 9,781 8% 72 49% Goldsboro, NC 122,598 9,181 7% 79 52% Wenatchee, WA 110,850 5,279 5% 91 55% Sumter, SC 107,421 1,916 2% % 7 74 Florence, SC 205,495 14,989 7% 75 48% Battle Creek, MI 136,146 10,554 8% 71 45% Parkersburg Mariettaa, WV OH 162,002 21,938 14% 33 8% Sandusky, OH 77,075 9,752 13% 44 14% Winchester, VA WV 128,434 15,544 12% 48 17% Danville, IL 81,595 7,225 9% 61 33% Fort Walton Beach Crestview Destin, FL 180,789 4,649 3% 98 53% Table continued on next page CCLXXIV

285 Table 139 continued CCLXXV

286 Table 141: LSA Rankings for Micropolitan Areas Place Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Amsterdam, NY 50,215 18,152 36% 9 58% 31 1 Macomb, IL 32,604 8,045 25% 39 87% 15 2 Clarksdale, MS 26,140 9,216 35% 13 48% 47 3 Tallulah, LA 12,091 3,080 25% 40 69% 23 4 Gallup, NM 71,476 39,824 56% 2 40% 63 5 Marion, OH 66,490 17,266 26% 32 55% 38 6 Ottumwa, IA 35,611 8,117 23% 46 59% 30 7 Sierra Vista Douglas, AZ 131,299 30,887 24% 41 54% 40 8 Price, UT 21,396 7,548 35% 14 39% 69 9 New Castle, PA 91,095 24,911 27% 28 43% Greenville, MS 51,113 9,441 18% 71 81% Austin, MN 39,152 11,867 30% 21 38% Los Alamos, NM 17,943 7,942 44% 5 30% Somerset, PA 77,724 26,247 34% 15 32% Payson, AZ 53,575 11,875 22% 50 47% Taos, NM 32,925 13,421 41% 6 28% De Ridder, LA 35,646 10,771 30% 22 31% Helena West Helena, AR 21,697 7,880 36% 11 26% Cortland, NY 49,322 11,124 23% 45 40% Cordele, GA 23,432 4,794 20% 61 46% Zanesville, OH 86,039 17,153 20% 55 41% Fairmont, WV 56,389 8,475 15% 83 57% Bonham, TX 33,907 11,035 33% 17 25% Williman c, CT 118,398 20,945 18% 69 47% Rio Grande City, TX 60,955 39,477 65% 1 18% Butte Silver Bow, MT 34,181 6,207 18% 72 48% Bay City, TX 36,689 4,273 12% % 7 27 Minot, ND 69,537 17,951 26% 31 29% Marine e, WI MI 65,772 15,286 23% 43 34% Oneonta, NY 62,246 12,394 20% 57 39% Key West, FL 73,041 22,298 31% 18 20% Lake City, FL 67,516 19,951 30% 19 20% Klamath Falls, OR 66,349 14,765 22% 48 34% Uvalde, TX 26,396 7,261 28% 27 25% Selma, AL 43,804 5,812 13% % Harrisburg, IL 24,912 4,781 19% 67 41% Deming, NM 25,087 2,944 12% % Greenwood, SC 69,661 9,072 13% 96 55% Vicksburg, MS 48,760 14,298 29% 24 20% Ardmore, OK 56,967 14,844 26% 33 23% Greenwood, MS 42,899 5,508 13% % Pittsburg, KS 39,118 5,061 13% % Morgan City, LA 54,645 10,664 20% 58 33% Table continued on next page CCLXXVI

287 Place Total Population Total LSA Population Table 141 continued Total % of Population in LSA Rank for Total % of Population in LSA Table continued on next page % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Wauchula, FL 27,724 2,668 10% % Pierre Part, LA 23,421 9,548 41% 7 13% Liberal, KS 22,944 5,121 22% 51 30% Beckley, WV 78,837 14,146 18% 70 38% Elizabeth City, NC 64,078 13,055 20% 56 32% Cornelia, GA 43,041 4,731 11% % Kill Devil Hills, NC 33,913 6,481 19% 65 36% Pahrump, NV 43,907 23,516 54% 3 10% Oak Harbor, WA 78,494 19,351 25% 38 21% Havre, MT 16,090 3,508 22% 52 28% Espanola, NM 40,232 19,721 49% 4 8% Big Rapids, MI 42,797 5,800 14% 91 43% Astoria, OR 37,039 13,966 38% 8 10% Martinsville, VA 67,952 19,973 29% 23 15% Meridian, MS 107,412 11,620 11% % Wilson, NC 81,218 6,735 8% % 3 59 Corning, NY 98,952 8,533 9% % Hudson, NY 63,077 7,472 12% % Sikeston, MO 39,174 14,298 36% 10 7% Plattsburgh, NY 82,109 20,687 25% 37 17% Lexington Park, MD 105,145 28,996 28% 25 12% Adrian, MI 99,888 10,754 11% % Palatka, FL 74,340 14,309 19% 62 26% Chambersburg, PA 149,575 17,509 12% % Helena, MT 74,797 6,628 9% % Elko, NV 50,794 10,329 20% 59 23% Grants, NM 27,210 2,079 8% % Homosassa Springs, FL 141,196 33,175 23% 42 14% Ashtabula, OH 101,497 7,990 8% % Oak Hill, WV 46,016 3,998 9% % Sevierville, TN 89,872 22,397 25% 36 10% Carbondale, IL 60,204 6,003 10% % Middlesborough, KY 28,686 5,643 20% 60 19% Centralia, WA 75,430 13,013 17% 73 22% Cleveland, MS 34,134 2,499 7% % Pecos, TX 13, % % Clearlake, CA 64,659 13,904 22% 49 12% Bogalusa, LA 47,168 6,130 13% 98 32% Gardnerville Ranchos, NV 46,986 8,153 17% 75 20% Harrison, AR 45,216 2,178 5% % 6 83 Shelton, WA 60,681 21,353 35% 12 0% Granbury, TX 59,671 6,689 11% % Mount Sterling, KY 44,386 7,710 17% 77 19% Ada, OK 37,475 4,903 13% % CCLXXVII

288 Table 141 continued Place Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA Table continued on next page % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Port Angeles, WA 71,383 6,091 9% % Cedar City, UT 46,158 7,462 16% 82 20% Muscatine, IA 54,107 4,963 9% % Hilton Head Island Beaufort, 186,977 10,702 6% % Wahpeton, ND MN 22,894 3,788 17% 79 18% Morehead City, NC 66,449 8,075 12% % Crescent City, CA 28,610 1,373 5% % Palestine, TX 58,438 17,374 30% 20 0% Roswell, NM 65,632 11,400 17% 74 14% Brookings, OR 22,358 1,029 5% % Norfolk, NE 48,259 9,244 19% 63 9% Seneca, SC 74,253 11,780 16% 81 15% Watertown Fort Drum, NY 116,203 16,767 14% 90 16% Jamestown Dunkirk Fredonia 134,863 5,129 4% % Coldwater, MI 45,247 7,895 17% 76 11% Fort Polk South, LA 52,319 14,334 27% 29 0% Natchez, MS LA 53,103 3,336 6% % Bemidji, MN 44,428 3,499 8% % Ottawa Streator, IL 154,951 12,344 8% % Calhoun, GA 55,173 1,407 3% % La Grande, OR 25,736 3,915 15% 89 13% McComb, MS 53,517 1,913 4% % Lewistown, PA 46,668 13,070 28% 26 0% Sebring, FL 98,755 5,863 6% % Rockland, ME 39,721 13,460 34% 16 0% East Stroudsburg, PA 169,806 27,099 16% 80 5% Crossville, TN 56,045 12,830 23% 44 0% Kearney, NE 51,024 3,555 7% % Muskogee, OK 70,957 2,651 4% % Cullman, AL 80,387 9,666 12% % Stillwater, OK 77,333 5,631 7% % Truckee Grass Valley, CA 98,738 2,198 2% % Manitowoc, WI 81,418 5,177 6% % Marion Herrin, IL 66,328 8,378 13% 97 9% Hastings, NE 37,906 1,721 5% % The Villages, FL 93,410 3,913 4% % Oxford, MS 47,343 1,155 2% % Alice, TX 40,825 2,686 7% % East Liverpool Salem, OH 107,840 4,630 4% % Sanford, AZ 45,644 5,250 12% % Mankato North Mankato, MN 96,715 7,901 8% % Madisonville, KY 46,908 4,355 9% % Grants Pass, OR 82,687 1,214 1% % McAlester, OK 45,816 4,128 9% % CCLXXVIII

289 Table 141 continued Place Total Population Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Eufaula, AL GA 29, % % Phoenix Lake Cedar Ridge, CA 55,341 2,700 5% % Danville, KY 53,185 5,294 10% % Batavia, NY 60,063 1,646 3% % Arkadelphia, AR 22,988 1,709 7% % Aberdeen, WA 72,768 9,565 13% 95 0% Cambridge, MD 32,618 8,349 26% 34 0% Kingsville, TX 32, % % Thomasville Lexington, NC 162,832 14,972 9% % Pottsville, PA 148,217 2,857 2% % Moses Lake, WA 89,108 6,710 8% % El Dorado, AR 41,622 3,369 8% % Augusta Waterville, ME 122,116 9,481 8% % Lebanon, NH VT 174,696 2,082 1% % Paris, TX 49,793 7,297 15% 84 0% City of The Dalles, OR 25,203 6,793 27% 30 0% Wooster, OH 114,525 11,030 10% 122 0% Eureka Arcata Fortuna, CA 134,623 4,143 3% % Susanville, CA 34,894 7,333 21% 53 0% Roseburg, OR 107,622 11,181 10% 123 0% Indiana, PA 88,878 3,405 4% % Brookings, SD 31,965 7,208 23% 47 0% Gettysburg, PA 101,362 10,259 10% 124 0% Rock Springs, WY 43,795 7,311 17% 78 0% Traverse City, MI 143,365 12,409 9% 131 0% Watertown, SD 33,129 6,948 21% 54 0% Whitewater, WI 102,209 6,878 7% % Coshocton, OH 36,901 7,166 19% 64 0% Raymondville, TX 22,128 5,774 26% 35 0% Bozeman, MT 89,493 3,076 3% % Blue eld, WV VA 107,297 7,735 7% % Greeneville, TN 68,803 3,344 5% % Fort Madison Keokuk, IA MO 42,985 6,442 15% 85 0% Sunbury, PA 94,508 3,525 4% % Ukiah, CA 87,821 7,468 9% 133 0% Harriman, TN 54,164 6,621 12% 109 0% Manhattan, KS 127,048 10,593 8% 143 0% Selinsgrove, PA 39,690 5,763 15% 86 0% Huntingdon, PA 45,887 5,802 13% 99 0% Miami, OK 31,837 6,127 19% 66 0% Minden, LA 41,189 5,408 13% 102 0% Newport, TN 35,651 5,449 15% 87 0% Culpeper, VA 46,684 5,190 11% 118 0% Burley, ID 43,012 5,092 12% 111 0% Brigham City, UT 49,962 1,625 3% % Table continued on next page CCLXXIX

290 Place Total Total LSA Population Population Table 141 continued Total % of Population in LSA Rank for Total % of Population in LSA Table continued on next page % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Woodward, OK 20,076 3,832 19% 68 0% Grand Island, NE 72,708 4,829 7% 159 0% Great Bend, KS 27,659 4,104 15% 88 0% Lumberton, NC 134,138 7,102 5% 179 0% Galesburg, IL 70,605 4,693 7% 160 0% Mineral Wells, TX 28,111 4,060 14% 92 0% Pendleton Hermiston, OR 87,034 5,518 6% 170 0% Athens, OH 64,755 4,746 7% 161 0% Lancaster, SC 76,636 4,257 6% 172 0% Scottsbluff, NE 37,645 4,223 11% 120 0% Marshfield Wisconsin Rapids, WI 74,721 4,800 6% 173 0% Plymouth, IN 47,034 3,791 8% 149 0% Forest City, NC 67,791 3,997 6% 174 0% Jamestown, ND 21,100 2,931 14% 93 0% Guymon, OK 20,635 2,939 14% 94 0% Brevard, NC 33,080 3,408 10% 127 0% Dickinson, ND 24,982 2,980 12% 114 0% Garden City, KS 36,776 3,309 9% 140 0% Twin Falls, ID 99,577 2,834 3% 210 0% Stephenville, TX 37,889 3,054 8% 152 0% Clinton, IA 49,104 2,407 5% 182 0% Gillette, WY 46,124 2,578 6% 176 0% Findlay, OH 74,781 1,904 3% 212 0% Borger, TX 22,142 2,242 10% 129 0% Pella, IA 33,299 2,763 8% 153 0% Huron, SD 17,398 1,999 11% 121 0% Ogdensburg Massena, NY 111,909 2,470 2% 228 0% La Follette, TN 40,699 2,522 6% 177 0% Duncan, OK 45,031 2,091 5% 184 0% Cape Girardeau Jackson, MO IL 96,242 1,456 2% 230 0% Brainerd, MN 91,008 2,039 2% 231 0% Kalispell, MT 90,902 1,442 2% 232 0% Torrington, CT 189,854 2,732 1% 246 0% Georgetown, SC 60,169 1,670 3% 213 0% Natchitoches, LA 39,550 2,167 5% 185 0% Boone, IA 26,295 2,051 8% 155 0% Bishop, CA 18,546 1,583 9% 141 0% Las Vegas, NM 29,382 2,050 7% 165 0% Fernley, NV 51,973 1,676 3% 216 0% Daphne Fairhope, AL 182, % 257 0% Charleston Mattoon, IL 64,909 1,394 2% 233 0% Durant, OK 42,403 1,565 4% 202 0% Newton, IA 36,831 1,983 5% 187 0% Hobbs, NM 64,702 1,402 2% 234 0% Branson, MO 83, % 248 0% CCLXXX

291 Place Total Population Table 141 continued Total LSA Population Total % of Population in LSA Rank for Total % of Population in LSA % of LSA Population in Low Income Area Rank for % of LSA Population in Low Income Area Composite Rank Washington, NC 47,743 1,355 3% 218 0% Coos Bay, OR 63, % 235 0% Opelousas Eunice, LA 83, % 249 0% Lock Haven, PA 39,228 1,466 4% 203 0% Pon ac, IL 38,831 1,495 4% 204 0% Henderson, NC 45,413 1,542 3% 219 0% Gloversville, NY 55,507 1,200 2% 236 0% Marshall, TX 65, % 251 0% Ontario, OR ID 53, % 237 0% Lincoln, IL 30,290 1,627 5% 188 0% Malone, NY 51, % 238 0% Alamogordo, NM 63, % 252 0% Okeechobee, FL 39,985 1,265 3% 220 0% Kerrville, TX 49, % 239 0% Ruston, LA 62, % 253 0% Mountain Home, ID 27,030 1,455 5% 190 0% Fremont, OH 60, % 254 0% Troy, AL 32,838 1,436 4% 205 0% Portales, NM 19,842 1,163 6% 178 0% Canon City, CO 46, % 241 0% Sault Ste. Marie, MI 38,512 1,158 3% 221 0% North Pla e, NE 37,575 1,302 3% 222 0% Hood River, OR 22,342 1,153 5% 192 0% Silver City, NM 29,512 1,065 4% 206 0% Tuskegee, AL 21,443 1,024 5% 193 0% Laramie, WY 36,288 1,046 3% 223 0% Yazoo City, MS 28,055 1,197 4% 207 0% Fairmont, MN 20,829 1,067 5% 194 0% Dodge City, KS 33,837 1,061 3% 224 0% Mitchell, SD 22, % 208 0% Camden, AR 31, % 225 0% Houghton, MI 38, % 255 0% Mount Pleasant, TX 32, % 242 0% Ruidoso, NM 20, % 226 0% Marshall, MN 25, % 244 0% Williston, ND 22, % 245 0% Source: Searching for Markets: The Geography of Inequitable Access to Healthy & Affordable Food in the United States, U.S. Department of the Treasury, CDFI Fund CCLXXXI

292 The Mission Statement of The Stennis Institute of Government and Community Development Elected to the United States Senate in 1947 with the promise to "plow a straight furrow to the end of the row," John C. Stennis recognized the need for an organization to assist governments with a wide range of issues and to better equip citizens to participate in the political process. In 1976, Senator Stennis set the mission parameters and ushered in the development of a policy research and assistance institute which was to bear his name as an acknowledgment of his service to the people of Mississippi. Created as a service and research arm of Mississippi State University, the John C. Stennis Institute of Government was established on February 9, Announcing its formation during a two-day Forum on Politics honoring U.S. Senators John Stennis and Margaret Chase Smith, MSU President William L. Giles outlined the Institute's mission and goals. According to Giles, the Institute would seek to integrate research, service, and teaching activities to improve government in the state, as well as promote the training of students who seek careers in public service. Thirty-nine years later, the Stennis Institute of Government has remained true to that initial charge. By providing meaningful, applied research to both local and state units of Mississippi government, the Institute brings a wealth of experience and knowledge to bear on real-world issues. Through its economic and community development research, executive development education programs, training activities, and technical assistance programs, the Institute provides support for today's policy-makers from the courthouse to the classroom. And, by playing an active role in the development of tomorrow's leaders, the Institute is working to ensure that Mississippi's future remains strong.

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294 Website: Mississippi State University does not discriminate on the basis of race, color, religion, national origin, sex, age, disability, sexual orientation, group affiliation, or veteran status. THE JOHN C. STENNIS INSTITUTE OF GOVERNMENT Post Office Drawer LV, Mississippi State, MS Voice Fax