On food deserts

Gina Kolata, writing for the New York Times, has sparked some debate with this article: “Studies Question the Pairing of Food Deserts and Obesity”. In general I often wish that science reporting focused more on how the new studies fit in with the old, rather than just the (exciting) new ones. On first reading I noticed that one study is described as having explored the association of “the type of food within a mile and a half of their homes” with what people eat.

This raised a little question mark in my mind, as I know that prior studies have often looked at distances much shorter than 1.5 miles, but it was mostly a vague hesitation. And if you didn’t know that before reading the article, then you’ve missed a major difference between the old and new results (and one that could have been easily explained). Also, describing something as “an article of faith when it’s arguably something more like “the broad conclusion draw from most most prior research“… that certainly established an editorial tone from the beginning.

Intrigued, I sent the piece to a friend (and former public health classmate) who has work on food deserts, to get a more informed reaction. I’m sharing her thoughts here (with permission) because this is an area of research that I don’t follow as closely, and her reactions helped me to situate this story in the broader literature:

1. This quote from the article is so good!

“It is always easy to advocate for more grocery stores,” said Kelly D. Brownell, director of Yale University’s Rudd Center for Food Policy and Obesity, who was not involved in the studies. “But if you are looking for what you hope will change obesity, healthy food access is probably just wishful thinking.”

The “unhealthy food environment” has a much bigger impact on diet than the “healthy food environment”, but it’s politically more viable to work from an advocacy standpoint than a regulatory standpoint. (On that point, you still have to worry about what food is available – you can’t just take out small businesses in impoverished neighborhoods and not replace it with anything.)

2. The article is too eager to dismiss the health-food access relationship. There’s good research out there, but there’s constant difficulty with tightening methods/definitions and deciding what to control for. The thing that I think is really powerful about the “food desert” discourse is that it opens doors to talk about race, poverty, community, culture, and more. At the end of the day, grocery stores are good for low-income areas because they bring in money and raise property values. If the literature isn’t perfect on health effects, I’m still willing to advocate for them.

3. I want to know more about the geography of the study that found that low-income areas had more grocery stores than high-income areas. Were they a mix of urban, peri-urban, and rural areas? Because that’s a whole other bear. (Non-shocker shocker: rural areas have food deserts… rural poverty is still a problem!)

4. The article does a good job of pointing to how difficult it is to study this. Hopkins (and the Baltimore Food Czar) are doing some work with healthy food access scores for neighborhoods. This would take into account how many healthy food options there are (supermarkets, farmers’ markets, arabers, tiendas) and how many unhealthy food options there are (fast food, carry out, corner stores).

5. The studies they cite are with kids, but the relationship between food insecurity (which is different, but related to food access) and obesity is only well-established among women. (This, itself, is not talked about enough.) The thinking is that kids are often “shielded” from the effects of food insecurity by their mothers, who eat a yo-yo diet depending on the amount of food in the house.

My friend also suggested the following articles for additional reading:

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    About a year and a half ago a new grocery store was opened in a low-income neighborhood here in Toronto based on the food desert idea and as part of a broader revitalization project. I don’t know about health effects (and I bet nothing was put in place to evaluate that), but what I have seen is reflected by your friend’s comments in point #2. The store employs about 100 people from the immediate community, and they seem to do a good job of stocking foods that reflect the ethnic make up of the community. Another part of the revitalization project is to attract higher income families to create one of those mixed-income communities that seems to be a popular concept lately. A shiny new grocery store does seem to help that, too. Geographically it’s a great area close to the city centre and it’s safe, so the only thing really holding the neighbourhood back was the decades of neglect by the rest of the city and businesses. It’s a little pocketed community of mostly new immigrants, and historically, once they’re able to, they move out of the ‘hood, so the place remained a desert…not just a food desert, there’s pretty much nothing there. I think the whole project that the grocery store is a part of has the potential to affect the health of the residents in many ways but I’m curious to know how it’s shaking out. Not sure if it’s for better or worse. Is this new supermarket just diplacing the existing “healthy food environment” (independent new immigrant grocers)? Maybe the place wasn’t even a food desert to begin with? New condos are also going up in the area right now, and it blew my mind to see a Starbucks recently open up there. I’m a bit worried that this project might just hurt the community further 🙁



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