October 2008 Issue

Food Deserts: Where Healthy Options Are Only a Mirage
By Lindsey Getz
Today’s Dietitian
Vol. 10 No. 10 P. 48

Nutritious choices have all but dried up in some communities across America, where fast-food restaurants and gas station convenience stores rule the land.

Imagine a place where access to healthy foods such as fresh fruits and vegetables is either limited, too expensive, or even nonexistent. Inhabitants must opt for cheap and unhealthy foods based on whatever is available. You may be picturing a Third World country, but the scene described—what’s being termed a food desert—is found right here in the United States.

Also known as grocery gaps, food deserts are places where supermarkets or farmers’ markets offering healthy and affordable foods are located too far away. Individuals who live in a food desert have poor access to a variety of healthy foods, especially fruits and vegetables, while fast-food restaurants and gas station convenience stores are often abundant. These deserts exist in both rural areas, where the nearest supermarket is miles away, and urban areas, where the only food available within walking distance is at fast-food joints.

One such area is East Palo Alto, Calif. While the region hasn’t had a supermarket in almost 40 years, it has two McDonald’s, a Pizza Hut, and a Taco Bell. To obtain fresh fruits and veggies, residents must travel outside the city; thus, they often rely on fast food for their meals.

A lack of nutritional choices in food deserts such as East Palo Alto can be detrimental to residents in more ways than one. “When there are few healthy food options available, you run the risk of a decline in overall health,” says Jillian Davis, RD, a family and consumer sciences extension agent with the Virginia Cooperative Extension. “There is a lot of research supporting the important role of a diet rich in fruits and vegetables, and fruits and vegetables play a role in disease management as well.”

Families who aren’t consuming any fresh foods, namely fruits and vegetables, are putting their health at risk. But unfortunately, their options for buying these types of foods are often limited.

Deserts Across the Nation
Kelly D. Horton, MS, RD, CD, founder and director of Connect Nutrition, an organization created to address the problems of inadequate nutrition, hunger, and food insecurity, has been working with residents of food deserts in Seattle. Horton says the “Sound Food Report: Enhancing Seattle’s Food System,” prepared by City of Seattle staff and members of the University of Washington’s environmental management program, revealed that there are pockets within Seattle where no grocery stores are available. “One of the neighborhoods in north Seattle, for instance, has a bus stop and tons of stores like Target, but no grocery store,” she says. “This area also has a lot of low-income housing. Because they are limited to what they can carry on the bus and because there isn’t much available in the line of food choices, generally people [in these types of areas] will end up with more items with a long shelf life than produce.”

Horton adds that there is a misconception caused by the link between low-income families and obesity. “Because low-income families often struggle with obesity, people assume there isn’t a problem with food access,” she explains. “But these families are malnourished. They may not be hungry, but they certainly are not meeting their nutritional needs.”

On the other side of the country in Washington, D.C., Alexandra Ashbrook, director of D.C. Hunger Solutions (a project of the Food Research and Action Center), is also working to combat food insecurity, which her organization describes as occurring when “the availability of nutritionally adequate and safe food, or the ability to acquire such food, is limited or uncertain.” The organization has found that District residents without a supermarket in their neighborhood can pay as much as $80 round trip for transportation to a store—a cost that is simply impossible for individuals who are already living in poverty. On top of that, it found that fresh foods were higher priced and often unaffordable to those who were able to access a grocery store, making the food unattainable. “The problem is not just the availability of healthy options but also making them affordable,” says Ashbrook.

Horton has found the same situation through research she’s done in Seattle and Massachusetts, her former home state. “I did a project in Massachusetts called the ‘Real Cost of a Healthy Meal’ and found that healthy food can often cost a lot more than unhealthy alternatives,” she says. When fruits and vegetables are priced high, many low-income families are forced to turn to the dollar menu at the local fast-food restaurant for their nightly meals.

But urban communities aren’t the only ones affected by food deserts. Because supermarkets are usually located in heavily populated areas, rural communities don’t always have access to a variety of fresh foods either. “The trend [in supermarket development] has been toward larger and larger stores,” says Jim Harrison, president of the Vermont Grocers’ Association. “These large stores offer convenient, one-stop shopping but are built where most of the people are, so the downside is that some of the more rural communities tend to be underserved in terms of the full array of offerings. They may have a small local store, but it doesn’t have the space to carry the variety that the supermarket has. And this isn’t just happening in Vermont—it’s a nationwide trend.”

No Hope on the Corner
Besides fast-food restaurants, many lower income neighborhoods are ripe with what have been termed corner stores. These are small, mom-and-pop locations or the convenience stores at local gas stations that have limited shelf space and very little, if any, fresh foods. The Food Trust, a Philadelphia organization dedicated to making nutritious food affordable and accessible, found that in Chester, Pa., there was not a single grocery store. Families were regularly buying their food from the local gas station. “Another research study we did in Philadelphia looked at corner stores and found that kids were spending up to $2 per visit and were visiting at least twice a day—before and after school,” says Yael Lehmann, executive director. “We found the kids were obtaining more than 600 calories per day at these stores, so it is a big part of their diet. The food items at corner stores are priced so that kids can afford them—a lot of items are only a quarter. So for $2, you can come away with a whole grocery bag of junk food.”

“Corner stores are packed with foods that are high in sodium or carbs,” says Ashbrook. “The best you might find is some canned fruits and vegetables, but fresh fruit and vegetable options are rare.”

Transportation is often one of the biggest issues. Bus or train fares can be expensive, not to mention that juggling groceries on public transportation can be difficult. “The bus fare just went up in Seattle, and that extra cost can really be hard on some people,” notes Horton. Even walking to the store can be tricky. “If a parent has kids with them and needs to hold the kids’ hands, it becomes almost impossible to walk home with groceries,” adds Ashbrook.

Helping Hands
The solutions are not simple, but many organizations have put plans into action to help combat the nation’s food desert problem. The Food Trust, for example, operates a farmers’ market program that manages 30 different affordable markets in the state of Pennsylvania. The organization also works with more than 100 public schools in southeast Pennsylvania and has recently begun working in Illinois, Louisiana, and New York to explore the possibility of enacting some of the programs that have been successful at their home base.

Providing grants to supermarkets that otherwise could not afford to expand their businesses into lower income neighborhoods has also been a core goal of The Food Trust. “Essentially, we’ve created a financing pool that grocery stores can tap into for their initial costs,” explains Lehmann. “Once they are up and running, they are successful, so they just need help getting that start.”

D.C. Hunger Solutions also has a variety of solutions underway. They are looking closely at the infrastructure of corner stores and seeing what can be done to encourage store owners to offer healthier foods. “We found that owners were very willing to look at getting healthier products into their stores, but for small businesses, it’s a question of whether or not they will be able to sell it,” says Ashbrook. The problem is that implementing healthier foods actually raises a lot of issues, especially the concern of added costs. Corner stores need different refrigeration units, possibly more shelving, and new advertisement messaging to start carrying fresh produce. “These are some things that communities need to invest in to help solve the food desert problem,” says Ashbrook.

In addition, D.C. Hunger’s mission focuses on helping ensure food is not only accessible but also affordable. “One thing we’re doing is working with local farmers’ markets to have them accept food stamps,” says Ashbrook. “We found that most of the corner stores in D.C. already do accept stamps, but it’s important to make sure they all do. The bottom line is it’s not all about accessibility. People need to have the resources to be able to buy the food.”

Education has also been crucial in giving low-income families the tools they need to make wise and affordable dietary decisions. “As the old saying goes, I don’t want to just give these people a fish; I want to teach them to fish,” says Horton. “I’m involved in a program that offers cooking classes for low-income families. It teaches them how to cook healthy foods on a budget. We even take the participants on shopping trips to teach them how to shop the perimeter of the store where the healthy, fresh foods are located and how to make smart buying decisions.”

And in East Palo Alto, where the residents haven’t had access to fresh produce in nearly 40 years, the nonprofit organization Collective Roots has successfully launched a community farmers’ market. These efforts are all proof that despite the difficulties, changes are being made to help fresh foods be more available to underserved areas, but there is still a long road ahead.

Your Hometown
How can you help? Get to know your clients so you can point them in the right direction. “I think it’s important for dietitians who are working with clients to be aware of not only their geographic location but also what food sources are available to them or what their perception of obtaining those foods is,” says Davis. “Any education on what to eat is irrelevant if people don’t realize those kinds of healthy foods are available.”

Davis adds that many people who don’t have access to a large grocery store may not be aware of food banks, farmers’ markets, or other supermarket alternatives in their own neighborhoods. Be aware of places where clients can obtain fresh foods in your surrounding neighborhoods, especially if you know of an underserved area.

You may also want to encourage clients to consider gardening. This is another way low-income families in particular can have access to healthy foods at a lower cost. “The Virginia Cooperative Extension has a program that helps teach people to grow vegetables,” says Davis. “Obviously buying a packet of seeds that will grow fresh produce is much cheaper than buying it at the store. We provide the community with assistance in getting their garden started and tackling issues that might arise.”

If land is not available for gardening, community gardens are another option for affordable produce. Seek out community gardens that you can recommend to clients in low-income neighborhoods. “In some communities, plots are even offered at a discount rate to those who need assistance,” says Davis. Or perhaps even consider helping start a community garden initiative if one doesn’t exist in your area.

Remember that the problem may not be as obvious or extreme as some of the areas described previously. Even families who have supermarkets in their town may have created their own food deserts if they don’t have easy access to transportation, can’t carry all of their groceries when walking, or don’t believe they are in a safe enough area to venture far beyond their home. Anyone who is unable to access or afford healthy foods for whatever reason is in need of a solution to get out of the desert.

— Lindsey Getz is a freelance writer based in Royersford, Pa.