Why is Fixing Access So Hard?

An article in The Atlantic earlier this month discussed the New York City Department of Health’s Healthy Bodegas Initiative to increase nutritional offerings in at-risk neighborhoods. The logic is that low income neighborhoods have less access to quality food and that contributes to high levels of obesity.

Studies around the country have shown that less affluent communities tend to have high levels of obese and overweight residents. And New York City is no exception. According to the data, 60 percent of adults in East Harlem and Central Harlem are either overweight or obese. And less than 10 percent of Harlem residents eat the recommended servings of fruits and vegetables.

This concept of low access to healthy food options in low socio-economic communities led to the term “food desert.” A food dessert is defined by the U.S. government as “a low-income census tract where a substantial number or share of residents has low access to a supermarket or large grocery store.” There are more than 6,500 food deserts in the continental U.S. (food desserts are not yet defined for Hawaii and Alaska) and 75 percent of them are in urban areas. Some studies have correlated low access to healthy food options to higher obesity rates.

So the solution should be simple. Let’s work with grocery store and supermarket chains to open more retail locations in these food deserts. Once residents of food deserts have healthier options, they will surely eat better. Right?

Again, the solution is not that easy. According to the New York Times two new studies are challenging the notion of lack of access to fresh food in low-income neighborhoods.  The studies show that while poor, urban neighborhoods have a higher concentration of fast-food restaurants and convenience stores, they also have more grocery stores, supermarkets and full-serve restaurants. They don’t lack access to healthy options. The study concludes there is no relationship between the type of food available in a neighborhood and obesity rates among its children and adolescents.

So what does it all mean? Like an economic model, we need to look at the supply and demand side of the equation. In this case, the Field of Dreams approach of “build it and they will come” isn’t the solution. Building fresh food stores only addresses the supply portion of the equation – and the recent studies are calling into question whether supply is even an issue. We need to look closely at the demand side.  If it were a matter of supply only, the New York bodegas wouldn’t be able to keep their small supply of fruits and vegetables in stock. Instead, they are throwing out half their stock. Why aren’t consumers in poor, urban neighborhoods buying produce when it is available? Is it too expensive? Is it difficult or time-consuming to prepare? Are the fruits and vegetables available not part of a community’s culinary culture? For example, communities whose heritage comes from warm weather climates (such as the Caribbean) may be less familiar with fruits and vegetables grown and consumed in more temperate climates (such as North America and Europe). What factors are impacting the demand side of the equation?

There are many variables impacting eating behaviors that we need to consider in the fight for healthier eating habits. Prescriptive supply-side solutions won’t fix the obesity crisis.  Shaming the food industry or overweight people won’t do it either.  The answer lies on the demand side of the equation. And that’s the hard part of the equation. If the demand is there, the supply will follow. The overweight and obesity issue in this country requires comprehensive, societal change, one that impacts body, mind, soul and environment. It’s pretty daunting to think about it that way, but then again, so is the problem.

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2 thoughts on “Why is Fixing Access So Hard?

  1. Interesting post! I had not heard about the two recent food desert studies. Just when we think we have it figured out, a new wrinkle appears. You ask some great questions here, and I think the biggest, ongoing lesson is to keep challenging our assumptions.

  2. Great post! I grew up in a “food desert” in Brooklyn but my parents were into health food. They considered Cheerios to be junk cereal; I had to eat wheat germ and grap nuts. I was one of the few kids in school who had whole wheat bread sandwiches! Healthy bodegas are not the answer; the demand for healthy food must be created because it’s so easy to go get some fries and a six piece chicken nugget combo. This is the challenge, I think.

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