The food retail environment in an urban African township: An analysis of food availability, quality, pricing, and promotion

Abstract Objective: Describe the food environment in an urban African township by examining the availability, quality, pricing and promotion of food items in areas of higher and lower deprivation, defined according to household income, unemployment and economic activity, dwelling type and basic service availability. Design: Cross-sectional study applied an adapted Environmental Profile of Community Health (EPOCH) tool to audit the food environment. Data were collected on food outlets (formal, informal, food service, and specialty stores), grocery item quality and pricing and product advertising. Setting: Four areas (∼7.8 km 2 ) of Soweto, South Africa, purposively selected by deprivation level. Participants: This study did not involve human participants. Results: We audited 241 routes, identifying 1899 food outlets (1169 lower-, 730 higher-deprivation). Outlet distribution differed by deprivation ( p <0.001): supermarkets were more common in lower-deprivation areas (6.5% vs 1.1%), while convenience stores selling cigarettes were more prevalent in higher-deprivation areas (9.0% vs 3.8%). Fast-food outlets dominated both settings, though alcohol stores and pubs were more frequent in higher-deprivation areas. Specialty and informal outlets, fruit and vegetable quality and pricing, did not differ significantly. While some food items were marginally more expensive in lower-deprivation areas, the difference was modest. Advertising patterns varied, with more packaged snack and alcohol advertisements in lower-deprivation areas and more sugar-sweetened beverage advertisements in higher-deprivation areas ( p <0.01). Conclusion: Findings highlight the need to expand healthy food access in higher-deprivation areas and regulate unhealthy food advertising in lower-deprivation areas. Context-specific interventions are essential to promote equitable, health-supporting food environments in Soweto.