Food Deserts Are Complex and Real

These studies add another layer of understanding to the complex issue of equitable access to healthy food. Working with the Baltimore Food Policy Initiative, my colleagues and I have re-defined what constitutes a food desert in Baltimore. Here, as in many urban areas, food deserts are not just about supermarkets. Back in 2009, we looked at household income and access to supermarkets. For the 2012 Baltimore City Food Environment Map, we looked at more subtle factors, such as distance to the nearest supermarket, and what kind of transportation options were available in households. Transportation is key here—we feel strongly that if 40 percent or more of a community’s households live more than one-quarter of a mile from a supermarket and don’t have access to a vehicle, that community is a food desert. Helen Lee, one of the researchers quoted, also looked at distance to supermarkets, but does not take into account access to vehicles. Other studies have considered access to public transportation, but as was found in the USDA “Food Desert Report,” 93 percent of people living in low-income areas travel to grocery stores in a vehicle, rather than using public transportation. For this reason, and through other research CLF has conducted in the city that corroborates this fact, we felt that including access to vehicles was important in defining food deserts and access to healthy foods.

While we stand by our food desert research in Baltimore, both of these new studies are useful, as all of us grappling with understanding the effects of varying food environments on health and well being continue to find new ways to analyze the multiple potential factors. Another unique and important aspect of our food desert definition is that it takes into account the quality of food available not only at supermarkets, but at smaller format food stores also like convenience and corner stores. Using the Nutrition Environment Measurement Survey, we scored each store based on the amount and quality of healthy food available. These scores were part of our food desert measurement, such that a community with the lowest average score (that also met the other criteria) is a food desert. And as was quoted in the New York Times article, “Not all grocery stores are equal.” We found here in Baltimore that 18 percent of supermarkets had produce and/or meats that were of low quality.

As for the link between obesity and access to healthy foods, this too is a very complicated issue. Many researchers are looking into this, and a lot of good studies are finding no correlation.  In addition, obesity and other diet-related diseases are only one reason why we study food access and inequity. Yes, it would be great to reduce obesity nationwide. But food access and inequity is important for reasons of social justice, too. Regardless of whether living in a food desert makes you more likely to be obese, everyone should have access to healthy food.

I’d like to close by saying that the discussion of food access, inequity, and health is really a systems issue. No single factor will ever be able to explain such a complex phenomenon, which the researchers clearly acknowledge as well. We do our work on food deserts so that it can be a guide for policymakers, who can enact multiple policies that work in concert with each other. The Baltimore City Food Policy Initiative is pursuing a comprehensive plan, as referenced by our Food Policy Director, Holly Freishtat, earlier today.  And here at CLF, we have undertaken a comprehensive supermarket study to further explore the role and impact of supermarkets in low-income neighborhoods. This intervention involves developing and tracking in-store promotions of healthy foods in a supermarket in a low-income neighborhood. The promotions were developed after extensive surveys and focus groups with local residents, so that they are specifically geared toward their preferences, on what would actually work to influence choosing healthier foods. This is a unique study in that it is focusing on a supermarket in a low-income neighborhood and that it is using specific feedback to create the promotions, not generic messages. We cannot discount the role that marketing also plays in our food choices, either.  Marketing is a huge piece of what happens in the supermarket environment, and millions of dollars are spent on it annually. This, too, is part of the food environment system. We have to address inequities in access to healthy food from many angles.