Our client-partners work with data that contains information about the retail environment, including retailer locations, products sold, pricing, and proximity to youth-centered spaces. While this information is important, it’s difficult to advise on policy without a clear understanding of what impact a particular change may have. A spreadsheet filled with data may have a crucial story to tell, but it’s not always easy to see. 

This is where data visualization can help. Data visualization is the process of turning information into visual tools such as maps, graphs, and dashboards. It allows individuals to see beyond the raw numbers and connect with the meaning behind the data. Visuals can help reveal patterns, trends, and disparities that hide in large datasets, helping public health professionals understand the data and the community it represents. For example, a spreadsheet can show the number of retailers in a county, but a map can display where those retailers are located relative to schools, parks, and other places with higher concentrations of youth. A dashboard containing descriptive and context-based visuals lays out data in a way that can help organizations identify the areas where prevention efforts and policy changes are most needed. These visuals help turn dense data into a clearer story.

Storytelling matters in public health. Advocates are looking to explain why an issue deserves attention, funding, and policy action. When data is presented visually, complex challenges become easier to understand and feel more actionable. It also highlights inequities, allowing policymakers to identify communities that may experience greater exposure to harmful products and health disparities. Data visualization strengthens public health expertise, community voices, and advocacy. When data is clear and accessible, it becomes easier to communicate problems, identify solutions, and guide decision-making. Data visualization can support community members in actively participating in community change work and helping shape the solutions that directly impact their lives. 

At Counter Tools, we help bridge the gap between data and action by creating high-quality visualizations that allow our client-partners to understand the retail environment in their communities. These insights can support evidence-based strategies and informed policy decisions. Contact Counter Tools to learn more about how you can use data visualization in your education and advocacy efforts.

In this webinar, the APRC will share their recently published Environmental Scan Toolkit, and Counter Tools will share why the point of sale matters for alcohol and your community. Register for the webinar here.

Obtaining a comprehensive understanding of the retail environment is a key first step to implementing successful point-of-sale policy changes. Store assessments (also referred to as store audits or observations) allow communities to collect data about what is happening in the retail environment. This information is important for educating the public, policymakers, and youth about the deceptive marketing tactics that are used by the tobacco and alcohol industries. Using store assessments, public health practitioners can get insight into the types of products available and how these products are advertised, information that can be instrumental in formulating policy solutions to address a community’s specific problems. 

Along with providing useful evidence for guiding policy goals, store assessments have several additional benefits: 

1. Conducting store assessments can be a great opportunity to engage community members and educate decision makers, allowing them a firsthand look at the ways harmful products are being promoted near the places they live, work and play. 
2. Using a standardized store assessment allows for comparison between neighborhoods. Rather than simply comparing differences in tobacco or alcohol use, store assessment data can tell the story of how the retail environment drives these disparities. For example, store assessments might show that one neighborhood has more alcohol or tobacco outlets with lower prices, making it easier for price sensitive groups, like youth, to purchase these products. 
3. Lastly, store assessments are a valuable tool for evaluating changes – Have retailers moved products from children’s eye level following your merchant education campaign? Have prices increased following a ban on coupons? Answering these types of questions would not be possible without the ability to compare the retail environment before and after using store assessments. 

For the past 10 years, Counter Tools has provided training, technology tools, and technical assistance to public health practitioners conducting store assessments all across the country. To find out more about how we can support your store assessment efforts, contact hello@countertools.org.

Need more help with mapping? Counter Tools works with clients across the country to understand how the spaces where we live, work, learn, and play — our homes, schools, neighborhoods, and nearby stores — determine our access to healthy living. To learn more about the mapping capabilities in our software tools or our other GIS mapping and data visualization services, contact hello@countertools.org.

An alcohol outlet is a term used to describe the retail environment, specifically referring to a place where alcohol may be legally sold for the buyer to drink there (on-premises outlets, such as bars or restaurants) or elsewhere (off-premises outlets, such as liquor stores). Knowing where these outlets are located throughout your community can be beneficial in informing policy and programmatic strategies. 

Mapping alcohol outlets can answer a number of questions about the retail environment:

What is alcohol outlet density? 

Alcohol outlet density is defined as the number of physical locations in which alcoholic beverages are available for purchase either per area or per population. Increased alcohol availability is associated with increased alcohol consumption that can lead to a number of public health and safety concerns, such as violence, traffic crashes, and property damage. 

How does the alcohol outlet density compare to other locations? How does the measure change based on demographics? 

Because alcohol outlet density varies widely among states and communities, an understanding of these differences across geographies and across demographics should guide the development of public health interventions for reducing alcohol outlet density. Research shows that neighborhoods with a higher proportion of Black residents or more families living in poverty tend to have a higher alcohol outlet density. 

• How would policy impact the retailer landscape?

There is strong scientific evidence that regulating alcohol outlet density is one of the most effective strategies for reducing excessive alcohol consumption and related harms. Alcohol outlet density can be regulated through licensing or zoning restrictions that can cap the number of alcohol outlets or restrict the locations where alcohol can be sold. Mapping offers the ability to visualize the specific retailers that will be impacted by a policy and the potential of the policy to address disparities in retailer density. 

The images included in this post are screenshots from Counter Tools’ Virginia Store Mapper. The Store Mapper is a web-based software tool for visualizing, analyzing, and synthesizing the retailer landscape. The Store Mapper can incorporate point locations for tobacco, alcohol, and cannabis retailers. To learn more about strategies for addressing the retail environment or to inquire about our software tool, contact help@countertools.org. 

Listen below or on Apple Podcasts, Spotify, Stitcher, iHeartRadio, or LibSyn.

Read a transcript of this episode.

Store Assessment Resources and Case Studies:

• Store Assessment Tools, CounterTobacco.org
  • STARS
  • fSTARS
    • Summary report: Surveying How the Tobacco Industry Markets Flavors in Five Midwestern Cities 
    • Full report and fSTARS form: Retail Store Assessments for Flavored Tobacco Products: Pilots in Tobacco Nation 
  • vSTARS
    • vSTARS was used to complete a statewide census of vape shops in the state of New Hampshire. They were able to assess product availability, price promotions, product messaging, as well as see how vape shops distinguish themselves from conventional tobacco retailers.
    • Kong AY, Eaddy JL, Morrison SL, Asbury D, Lindell KM, Ribisl KM. Using the Vape Shop Standardized Tobacco Assessment for Retail Settings (V-STARS) to Assess Product Availability, Price Promotions, and Messaging in New Hampshire Vape Shop Retailers. Tob Regul Sci. 2017;3(2):174-182. doi:10.18001/TRS.3.2.
  • Video: Conducting Store Observations for Tobacco Control
  • Video: Using Store Observations for Point of Sale Tobacco Control Policy Change
• Feld AL, Johnson TO, Byerly KW, Ribisl KM. How to Conduct Store Observations of Tobacco Marketing and Products. Prev Chronic Dis 2016;13:150504. DOI: http://dx.doi.org/10.5888/pcd13.150504external icon.
• Combs, T. B., Brosi, D., Chaitan, V. L., He, E., Luke, D. A., & Henriksen, L. (2019). Local retail tobacco environment regulation: Early adoption in the United States. Tobacco Regulatory Science, 5(1), 76-86. https://doi.org/10.18001/TRS.5.1.7
• Assessing Retail Environments with STARS: Standardized Tobacco Assessment for Retail Settings, Center for Public Health Systems Science
• Addressing Tobacco-Related Health Inequities: Resources to Inform Point-of-Sale Policies, ChangeLab Solutions
• Assessing and Improving the Landscape of Food and Alcohol Products in Stores – A Wisconsin Success Story, Counter Tools
• Healthy Stores for a Healthy Community
• Vermont Tobacco Control 2014 Counter Tools Store Audit Report, Vermont Department of Health, Division of Health Promotion and Disease Prevention
• Point-of-Sale Scavenger Hunt, CounterTobacco.org

Other research and resources cited:

• Henriksen L, Schleicher NC, Johnson TO, Roeseler A, Zhu S-H. Retail Tobacco Marketing in Rural Versus Nonrural Counties: Product Availability, Discounts, and Prices. Health Promotion Practice. 2020;21(1_suppl):27S-36S. doi:10.1177/1524839919888652
• Keller-Hamilton B, Ferketich AK, Berman M, Conrad E, Roberts ME. Cigarette Prices in Rural and Urban Ohio: Effects of Census Tract Demographics. Health Promotion Practice. 2020;21(1_suppl):37S-43S. doi:10.1177/1524839919881141
• Kong AY, Queen TL, Golden SD, Ribisl KM. Neighborhood Disparities in the Availability, Advertising, Promotion, and Youth Appeal of Little Cigars and Cigarillos, United States, 2015, Nicotine & Tobacco Research, Volume 22, Issue 12, December 2020, Pages 2170–2177, https://doi.org/10.1093/ntr/ntaa005
• Mills SD, Golden SD, Henriksen L, Kong AY, Queen TL, Ribisl KM. Neighbourhood disparities in the price of the cheapest cigarettes in the USA. J Epidemiol Community Health. 2019;73(9):894-896. doi:10.1136/jech-2018-210998
• Ribisl KM, D’Angelo H, Feld AL, et al. Disparities in tobacco marketing and product availability at the point of sale: Results of a national study. Prev Med. 2017;105:381-388. doi:10.1016/j.ypmed.2017.04.010
• Tobacco Company Marketing to African Americans, Campaign for Tobacco Free Kids 

The Federal Trade Commission (FTC) has reported on tobacco companies’ marketing expenditures for cigarettes and smokeless tobacco for decades. In October 2019, the FTC issued orders to 6 major e-cigarette companies (Fontem US, Inc.; JUUL Labs, Inc.; Logic Technology Department LLC; NJOY, LLC; Nu Mark LLC; and R.J. Reynolds Vapor Company) seeking information on their sales, advertising, and promotional activities from 2015-2018. This month, the FTC published their first report on e-cigarettes using that data.

The data show that most e-cigarette sales are happening at retail stores – total e-cigarette sales, including both disposable units and those using changeable cartridges, increased more than six-fold from 2015-2018. It also makes evident the rise in popularity of sweet, fruity flavors that have helped drive youth e-cigarette use. The sales of fruit and other flavored e-cigarette cartridges preferred by youth increased seven-fold during the three year period. These sales numbers are prior to any federal regulations on flavored e-cigarettes, and we expect to see a new report on 2019-2020 sales at some point, since the FTC issued another order in September 2021.

The retail setting is where e-cigarette companies are spending the vast majority of their money. The FTC found that the e-cigarette companies more than tripled their spending on advertising and promotion in three years. Research shows that exposure to tobacco marketing can cause youth to start smoking, keep people who currently smoke hooked, and make it harder for people to quit and stay quit. Point-of-sale marketing often disproportionately targets minority and low-income neighborhoods, and research shows this targeted marketing works, with higher rates of smoking among individuals of lower socioeconomic status and education level.

The expenditure from e-cigarette companies include pricing strategies such as free or deeply discounted e-cigarette products and price discounts paid to retailers or wholesalers, so they can reduce the price of e-cigarettes to consumers. While research on the impacts of e-cigarette pricing is less extensive than on the impacts of cigarette pricing, the existing data show that both disposable and reusable e-cigarette sales are responsive to price changes. When e-cigarette prices increase, sales decrease, particularly among price-sensitive groups like youth. We know that lower prices, along with coupons and price discounts, encourage youth to start smoking and move them along from experimentation to regular cigarette use.

E-cigarette companies engage in these practices because the same thing is likely to happen with e-cigarettes. These FTC reports emphasize the critical need to monitor and address tobacco industry activity in the retail environment. Policies that raise the price of tobacco products, such as increasing excise taxes, banning coupons, or setting minimum price floors, are just a few examples of effective strategies for addressing significant spending on tobacco marketing and promotion at the point-of-sale.

Read a more in-depth analysis on CounterTobacco.org, read the press release from the FTC or download the full report.

There were some grand ideas touted by the tech world at the start of the pandemic, such as the promise of a Google-powered site where anyone in the U.S. could find a place to get a test. A testing system was piloted by Verily, but was eventually phased out over concerns about patient data and accessibility to low-income groups. Tech companies built some helpful tools like Google’s Community Mobility Reports, apps that monitored social distancing, and large-scale data crunching websites, but these were not incorporated into existing public health systems. It became clear that new tech needed to be partnered with guidance on how communities should interpret and use the data, and how communities would be supported by social systems when risk levels are high and daily life is affected.

With the endemic spread of COVID-19, data dashboards became popular as a way to share data about cases, tests, hospitalizations, deaths, and eventually vaccinations. The democratized data was used to support community organizations, health advocates, hospitals, physicians, public health officials and policymakers as they responded to the pandemic. The Johns Hopkins Coronavirus Resource Center (CRC) quickly became a leading resource used by public health policymakers and major news outlets around the world and continues to be two years later.

State public health departments built dedicated COVID-19 websites and data dashboards to educate the public and share data on local trends. Some ventures were in partnership with private companies or universities to supplement outdated data systems and lack of resources. Michigan’s online dashboard, MI Safe Start Map, was a partnership between the Michigan Departments of Health and Human Services (MDHHS) and the University of Michigan School of Public Health. Washington State Department of Health partnered with Microsoft’s AI for Health team to build a COVID-19 Data Dashboard that shares daily data updates for the state where many Microsoft employees live and work.

In California, Blue Shield built the Neighborhood Health Dashboard to increase transparency around community health and help address health disparities that were further highlighted by the pandemic. Dashboards use demographic data for race & ethnicity, income, and other factors to help public health departments and communities identify and address inequities. California’s data hub was used to produce a new vulnerability index, which focused on social and economic vulnerability of communities to assist in prioritizing the resources for COVID-19 recovery efforts.

Mapping of local areas is key to understanding how different neighborhoods are impacted by COVID-19. NYC’s neighborhood-level COVID-19 maps in April 2020 from New York City Department of Health and Mental Hygiene helped communities address risk and showed how ongoing technology investments minimize the time needed to build something when it is urgently needed.

New mobile apps were available to report symptoms, help with contract tracing or warn of potential exposure areas. The North Carolina Department of Health and Human Services SlowCOVIDNC app uses location data and notifies a user if they have been in close contact with someone who has shared a positive COVID-19 test result.

These technology innovations helped our understanding of the pandemic’s spread and risk levels, as well as the disparate effect on some communities. Public health departments have an opportunity to use these successes as evidence for increasing investment in digital public health tools. This will help ensure that we are building a systems-level approach that invests in the infrastructure needed to ensure that the pieces are integrated, data is standardized and accessible, and public health agencies are ready for the next crisis.

Data gives a strong evidence-base when developing and implementing policy. Mapping data is often a strategic element that helps educate and raise awareness around issues that impact communities. For examples of our work with mapping data, check out our relevant success stories: in Minnesota’s Golden Valley our mapping technology software was used to understand tobacco retailer density and proximity to schools, and in Florida’s Alachua County, we created local area maps to show potential effects of proposed policy changes. To learn more about how we can help reach your policy goals, reach out to us at hello@countertools.org.

Download Materials

• Summary report: Surveying How the Tobacco Industry Markets Flavors in Five Midwestern Cities 
• Full report and fSTARS form: Retail Store Assessments for Flavored Tobacco Products: Pilots in Tobacco Nation 
• fSTARS form

Counter Tools and Truth Initiative initially partnered in 2018 to develop a set of retail tobacco store assessment questions specifically focused on menthol and other flavored commercial tobacco products. These questions were added to the Standardized Tobacco Assessment for Retail Settings (STARS) form. The new form fSTARS was piloted in two cities within Tobacco Nation in order to field-test the questions and to facilitate the cities’ consideration of flavor-based policies and other point-of-sale tobacco control policies.

The pilot study “Colorful and Close to Candy: Surveying how the tobacco industry markets flavored products in stores” examined marketing in stores in Ohio (Dayton and Cleveland) from 2018 to 2019. The data showed that tobacco prices were cheaper in neighborhoods that had more youth, and almost every tobacco retailer located near schools displayed ads for flavored tobacco products outside.

Following the initial pilot, the form was revised to reflect the evolving market for flavored e-cigarette products, to be able to better compare flavored and non-flavored products, and to compare local data with national trends in disparities in the availability and marketing of flavored products. The most recent study “Surveying How the Tobacco Industry Markets Flavors in Five Midwestern Cities” spans from 2019 to 2020 and examines marketing in cities in Missouri (Columbia and Lee’s Summit) and Illinois (Evanston). E-cigarette products were more widely available in the cities where stores were assessed in 2020 than in those assessed in 2018-2019.

The participating cities received training and technical assistance from Counter Tools and Truth Initiative, and data analysis was completed by Counter Tools.

The Census Bureau has released data summary files from the 2020 census that show population changes as the nation becomes more racially and ethnically diverse.

The Census Bureau has provided an interactive map viewer as well as helpful data visualizations to explore population sizes, racial and ethnic diversity, housing data, and more.

The overall racial and ethnic diversity of the country has increased since 2010. The Hispanic or Latino population grew by 23%, the Asian alone population by 35%, and the Black population by 5.6%. The number of people who identify as multiracial (two or more races) increased by 276%. The White alone population declined by 8.6%.

The Census Bureau updated the race question in 2020 by allowing respondents to write additional details about their race, so someone who selected “Black” could also write “African American” or “Jamaican.” New codes were added while analyzing the data to account for a wider variety of how people self-identify.

The significant changes in race and ethnicity is clearly a sign that our country is becoming more diverse. It may also be partially explained by the way we talk about race and ethnicity. There is less stigma around being multiracial, and younger people may be more open to describing themselves as multiracial. Some people who chose White only on the 2010 census may have felt more comfortable choosing multiple races in 2020. As DNA testing becomes more popular, it may also be changing the way people think about themselves. A Stanford study found that people who have taken ancestry tests are more likely to identify as multiracial.

The census is taken every 10 years to count the number of residents in each county. Census data is used primarily to determine the distribution of Congressional seats and define districts, but it is also used to help determine how to distribute billions of dollars in federal funding to support public health initiatives, build roads and schools, improve transportation, and more.

At Counter Tools, we use census data in our data collection and mapping tools to help states identify disparities in tobacco and alcohol retailer density and advertising. Evidence shows there are more tobacco outlets in communities with higher Black and Hispanic populations. Just as these industries use census data to target their marketing and product availability, those who work in public health can use it to keep an eye on disparities and inform policy decisions.

The data summary files can be downloaded here and the complete data toolkit will be available by Sept. 30, 2021.