October 5, 2012 by Esther
A food desert right here in the Piedmont area of North Carolina:
Number of people living in the food desert: 9295
Number of people with low access: 9295
Percentage of total population that is low-income and has low access: 79.8%
Number of housing units without a vehicle with low access: 1013
Shocking to see so much unmet need? Maybe not… the census tract with so much apparent unmet need is our very own UNC campus, multiple dining halls, excellent free transportation to grocery stores and all.
The recent buzz over food deserts and the availability of healthy food has brought attention to an important environmental determinant of individual’s nutrition, but it is in no way the only or necessarily the most important issue at stake. It is especially hard to judge the importance of food deserts accurately because “accessibility” depends on a great deal more than proximity of healthy foods: availability of transport, cost, and whether individuals would buy them even if they were delivered to their doorsteps. The above example of UNC’s campus is tongue-in-cheek, but it shows that defining an area as a “food desert” may be misleading in its portrayal of the nutritional habits of a population. To take it a step further, does availability of grocery stores have an impact on long-term nutrition-related health outcomes like BMI? Some research suggests not—one recent study of elementary school children concluded that “differential exposure to food environments bears little relationship to the key outcome of interest, childhood obesity development” (Helen Lee, The role of local food availability in explaining obesity risk among young school-aged children) Of course, discounting the importance of food environment is highly controversial, but it is wise to think critically about what impact a food environment does have and why. Overabundance as well as lack of access may be problematic; the USDA stated in its 2009 report Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences: “Easy access to all food, rather than lack of access to specific healthy foods, may be a more important factor in explaining increases in obesity.” Such food swamps may present a bigger challenge than food deserts: while it is (theoretically speaking) simple to bring healthy food into an area whether through travelling veggie vans, new grocery stores, or putting more fruits and vegetables in the local Walgreens, decreasing access to food presents a mind-bending challenge. Even placing limits on one single food category is a huge political challenge, as illustrated by New York’s recent restrictions of sweetened beverages. Even with the political will, how practical would it be, really, to regulate the entire American diet item by item? And taking into account the fact that food choices are affected by many other determinants, including personal preference and cost, would such action even be wise? Might broadly decreasing access to less healthy foods negatively impact food security?
Perhaps the best way to improve nutrition would be to use food assistance, including SNAP, to encourage healthier eating. SNAP already helps improve food security, but unlike other food assistance programs such as WIC and the school lunch program, SNAP does not have nutrition associated restrictions on what can be purchased. Implementing any such restrictions may be viewed as unfair discrimination against poorer households, yet I believe that it is possible to both respect individual choice and encourage healthier diets. I would suggest doing so by implementing one of the methods used by WIC: either require nutrition education for participants or deliver a portion of SNAP benefits as vouchers for fruits and vegetables. By dedicating a limited portion of the benefits to healthy foods, the program could encourage individuals to eat healthy and encourage grocery stores to stock eligible items while still leaving flexibility in the expenditure in the majority of SNAP benefits. Changes in the WIC food package to include fruits and vegetables were shown to improve their availability, it is to be hoped that a similar change in SNAP could result in a comparable positive change in the food environment.
I know this is a controversial position—please comment below and we can discuss it!