Food Retail Inequities in the Capital with Greatest Income Inequality in Brazil

Background/Objectives: The uneven distribution of food stores is a key determinant of health inequities. This ecological study aimed to map socioeconomic inequalities in the food environment of Joao Pessoa, Brazil. Methods: Stores were classified into three categories, according to the main type of food sold: unprocessed, processed, or ultra-processed. The Socioeconomic Index of Geographic Context for Health Studies (GeoSES) and its dimensions (Education, Income, Poverty, Material Deprivation, and Mobility) were used to analyze the territory. The association between the number of food stores and socioeconomic indicators was analyzed through thematic maps, correlation coefficients, and negative binomial regression models. Results: A total of 5087 food stores were mapped. A strong positive correlation was observed between the number of stores selling unprocessed foods and the GeoSES index (r = 0.85; p < 0.001), Education (r = 0.83; p < 0.001), Income (r = 0.85; p < 0.001), and Material Deprivation (r = 0.85; p < 0.001), while Mobility showed a moderate positive correlation (r = 0.59; p = 0.04). In the negative binomial regression model, each one-unit increase in the GeoSES index was associated with a 2.05-fold increase in the expected number of stores selling unprocessed foods (RR = 2.05; 95% CI: 1.48–2.84; p < 0.001). Conclusions: The food environment in Joao Pessoa, Brazil was associated with socioeconomic characteristics, with greater availability of unprocessed food stores in higher socioeconomic areas, while ultra-processed food stores were more evenly distributed across the municipality.