Why are Food Deserts a Problem?
Public health in the United States continues to be an ongoing problem, especially because as obesity trends upwards and access to healthy food options becomes more and more difficult. Despite advances in technology, medicine, and education, obesity in the United States has become a bigger issue. Our younger generations will be living shorter, unhealthier lives than ever before. The Harvard School of Public Health reports that obesity increases the risk of two of the deadliest diseases we see in the US today: cardiovascular disease and type-2 diabetes. According to the Center for Disease Control using 2015 data, heart disease is the leading cause of death in the United States, with 2.4 million deaths every year mainly due by a diet of unhealthy fats and low-density cholesterol. The graph below showcases the increase of obesity in the US over the past decade.
Trends in Obesity Among US Adults
When observing the issue over obesity, it is important to look at the issues that are driving this rapid increase. In particular, the lack of healthy foods being consumed across the US has led to higher rates of obesity, cardiovascular disease, type-2 diabetes, and additional dietary conditions.
Although this problem has persisted throughout the US, some regions are more heavily affected than others. According to a 2008 report by the US Department of Agriculture, rates of obesity increase 9% in counties with high percentages of households living in food deserts. Additionally, and even more concerning, death rates for diabetes is two times higher in food deserts than areas with access to healthy food options.
Food deserts get their name because they are short on healthy foods and therefore often have a high concentration of local “quickie marts” and other fast food. These most readily available, high calorie foods are putting these communities at a greater risk for diabetes, and make it extremely hard to control blood sugar levels once diagnosed.
Healthy foods can be a confusing topic, especially with marketing schemes heavily pushing unhealthy products, it is important to be able to distinguish what contributes to making something a healthy food option. Currently, the FDA defines ‘healthy' standards based on low levels of total fats, sodium, and cholesterol, and also require the food to have 10% of daily vitamins, fibers and other nutrients.
Dr. Roxanne Sukol of the Wellness Institute at the Cleveland Clinic says in an interview on CNN with Jacqueline Howard that the term “healthy” is confusing to many and should be replaced with “nourishing,” as too many products nowadays are marked as ‘healthy' when they actually are not. She also goes on to say that she believes obesity is in part due to a malnourished state not the overindulged state which is a societal perception.
So, what is a Food Desert?
Specifically defined, a food desert is an area that lacks reputable food providers such as grocery stores and farmers markets, and therefore lacks fresh fruit, vegetables, and other nutritional foods. To classify as a food desert, you must live more than one mile away from a supermarket in an urban area, and more than 10 miles in a rural area. The US Department of Agriculture estimates that 19 million people live in low-income areas and that are either 1 or 10 miles away from a supermarket.
The problem of low access to healthy foods not only affects many people, but it mainly affects people who struggle to find transportation to stores that offer nutritious food. A report done by the US Department of Agriculture reports that 2.3 million Americans, or 2.2% of US households, that live more than one mile away from a supermarket and also do not own a car.
The disproportionate distribution of supermarkets is made worse when also considering socioeconomic factors. Not only are supermarkets three times more frequent in wealthy districts, but predominantly black neighborhoods have an average of four times less supermarkets than predominantly white neighborhoods. Not only do these neighborhoods have less supermarkets, but they also generally have much lower food selections. The US Department of Agriculture also reports that low-income zip codes even have 30% more convenience stores than middle-income zip codes, which puts unhealthy promotes much easier access to unhealthy foods.
For all these reasons, food deserts disproportionately affect the poor. Surveys of low income households indicate that the top factors in food choice are convenience, taste, and price. However, the higher costs of nutritious foods in these communities can put the products out of reach for income consumers. Studies have also shown that the same grocery items cost between 3% - 7% more for urban residents than suburbanites. There is also an issue of pricing at these small corner stores where there is no price so the price is set at the discretion of the clerk.
However, higher pricing is not the sole problem; healthy foods, in general, are more expensive than unhealthy foods and the price difference is growing. For example, Bryan Walsh of Time Magazine reported in 2008 that the price of fruits and vegetables increased almost 75% between 1989 – 2005, while the price of fatty foods dropped over 26%. This prices out many lower income families, and forces them to buy less nutritious foods that are affordable and easily available.
Not only can it be hard for families to buy the right kinds of nutritional foods but it is also restricting their ability to find culturally appropriate foods, not to mention finding acceptable food for dietary restrictions.
As this problem trickles down to the younger generation, the young kids in these neighborhoods are in real danger of unhealthy habits being formed and even being born overweight. A study in Washington DC performed by Mari Gallagher, who studies food deserts across the nation, illustrates that pregnant woman have a 10% higher probability of giving birth to an overweight child when the closest supermarket is a half-mile to a mile away, and a 20% higher probability when a mile or more away.
Has anything been done to help combat this issue, and what has come out of it?
There have been multiple attempts to help mitigate this issue, one of the more notable is Michelle Obama's Let's Move! Campaign, aimed at ending childhood obesity. Other initiatives have been less publicized, such as states passing proposals to fund new grocery stores in underserved areas, as well as national programs like the HealthyFood Initiative, an initiative passed by congress to allocate $125 million dollars to underserved American communities.
Unfortunately, the problem does not end there. Just because a new grocery store is built in these areas doesn't mean that people will necessarily go to it. Many of the people living in these areas already have eating habits and places they routinely shop. Steven Cummins, a professor of population health at the London School of Hygiene and Tropical Medicine, performed a study to evaluate whether adding grocery stores alone will impact food deserts. He discovered that making these additions positively affects consumers' perceptions of their access to healthy foods, but does not entirely lead to a change in behavior. Furthermore, he found that many consumers were reluctant to switch grocery habits and that their overall diets were not impacted.
The main takeaway from Cummins' study is that there is no single solution, and improving the access to food in these neighborhoods isn't enough. We must also try to implement policies that will help lead to actionable results, such as economic initiatives in the form of taxes on unhealthy foods or subsidies for healthy foods or using in-store marketing programs to promote healthy foods. His last point is that there is also evidence suggesting the enactment of educational programs teaching skills for buying and cooking healthy foods.
Brian Lang, the director of the Food Trust's National Campaign for Healthy Food Access, adds on to this idea in saying,
“We don't think any of these interventions on their own are a silver bullet, but taken together they've had an impact. And researchers in the field seem to be gravitating toward this idea, too—that for these things to improve health, they need to be done in coordination with one another.”
Pennsylvania exemplifies this in how they have implemented a Fresh Food Initiative that will fund 88 new grocery stores in these areas thereby giving better food access to 500,000 kids and adults. The state is also enacting several other programs, such as banning soda in schools, opening new farmer markets and passing fast food menu labeling laws.
This initiative is close to home for Mr. Lang, whose organization is in Philadelphia. In the last 20 years, he has undertaken many similar initiatives on his own, including nutritional education. He claims that his efforts have led to a decline in obesity rates in some of the most vulnerable youth in the area since working to improve these areas.
The link between health and education is growing, as more schools around the country are focusing more on health and nutrition. Dr. Helen Lee studies ways to improve health as a senior associate at a social-policy research organization, and has asserted that,
“What matters most for good health…is education, higher incomes and access to quality care. No one policy or program can address these things entirely…investing in evidence-based early preschool programs or initiatives that help low-income young adults attend and complete college or promising work-development strategies might do more for improving the health status of the most vulnerable than building farmers' markets or grocery stores.”
A great example of what Dr. Lee promotes is the Perea preschool in Memphis, Tennessee, which has embraced a unique approach to teaching kids about nutrition and healthy eating habits. With funding from a local health care organization, Perea has prioritized nutrition in their curriculum with the goal of supporting brain and cognitive skill developments. The focus of the curriculum is to explain the health benefits of certain foods, allowing students the chance to explore different foods, and encouraging the use of fresh food. A former Perea parent had experienced great results with the school, saying that, “If my kids didn't go to Perea, they wouldn't want to eat vegetables.”
Although this is a good example of how education on nutrition can benefit young minds, data illustrates how one aspect alone cannot be the sole fix. There are clearly places to start and good ideas to begin the process, but it takes a complex effort for these to succeed. Dr. Lee also notes that for the poor, socioeconomic disadvantages like income disparity and lack of education and health care are far more problematic issues than merely food deserts.
As a country, we have a long way to go to becoming anywhere close to eradicating food deserts. Fortunately, we have started to lay the groundwork for ways of combating this issue effectively. As a member of society, it is important to recognize these issues as a whole and when we can use our voices to positively help these communities in need and stop ignoring this dire situation.
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