Starving in food deserts, drowning in food swamps? Understanding the labels and their link to obesity

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October 8, 2012 by eldavies3

“Food desert” is quite the buzzword these days not only in public health vernacular but also in mainstream media. As public health nutrition students, we’ve heard the term countless times and have discussed and presented on them in a wide variety of classes. It’s true that standard definitions are lacking; the CDC defines food deserts as “areas that lack access to affordable fruits, vegetables, whole grains, lowfat milk, and other foods that make up the full range of a healthy diet,” whereas Michelle Obama’s Healthy Food Financing Initiative working group describes them as “low-income census tract[s] where a substantial number or share of residents has low access to a supermarket or large grocery store” (1, 2). The gist, however, is the same: a food desert is a geographical region in which access to healthy foods is limited. The lack of healthy options is often extrapolated to the nation’s obesity epidemic: according to the USDA’s Economic Research Service, “limited access to nutritious food… may be linked to poor diets and, ultimately, diet-related diseases” (3).

First Lady Michelle Obama has helped increase awareness of these food deserts through her Let’s Move! campaign to address childhood obesity. In a 2011 speech, Ms. Obama described the difficulties of lack of access, stating, “If people want to buy a head of lettuce or salad or some fruit for their kid’s lunch, they have to take two or three buses, maybe pay for a taxicab in order to do it” (4). The USDA is similarly enthusiastic about food deserts. You can visit their Economic Research Service’s website to view a United States map showing census tracts that are considered to be food deserts:

“Food swamps” are an alternative way to think about the variety of choices available in a given geographic region. Whereas food deserts are lacking in healthy options, food swamps have an abundance of unhealthy options. According to Roland Sturm, author of a recent study on the food environment and adolescent obesity, food swamps are urban environments in which “you can get basically any type of food” (4). Although food swamps do not lack grocery stores or supermarkets, they have a multitude of fast food restaurants and convenience stores. The CDC asserts that even after healthy food products are made available in food deserts, many consumers continue to purchase unhealthy foods “based on personal preferences” (1). This pattern may hold true in food swamps as well, with preferences for abundant unhealthy options rather than healthy ones.

Whether we think in terms of food deserts or food swamps to address the issue of obesity through promoting healthy food choices, finding solutions will be a challenge. However, one option may be to capitalize on use of food assistance programs, which could help address both swamps and deserts. According to a recent USDA report, one in four Americans utilizes a food assistance program (5). Furthermore, expenditures and participation in many of these programs is increasing. In particular, the American Recovery and Reinvestment Act of 2009 increased benefits and eligibility for the Supplemental Nutrition Assistance Program (Nord). Clearly, more Americans than ever can be reached through these programs. Using funding and existing infrastructure to not only provide nutrition education but also to incentivize healthier choices may allow greater access to healthier foods and shift preferences toward healthier options.

References:

1. “A Look Inside Food Deserts.” Centers for Disease Control and Prevention, 24 Sept. 2012. Web. 5 Oct. 2012. <http://www.cdc.gov/features/fooddeserts/&gt;.

  1. 2. “USDA ERS Food Desert Locator.” USDA Economic Research Service. USDA, 12 Aug. 2012. Web. 05 Oct. 2012. <http://www.ers.usda.gov/data-products/food-desert-locator/about-the-locator.aspx&gt;.3. Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences. Rep. USDA Economic Research Service, June 2009. Web. 5 Oct. 2012. <http://www.ers.usda.gov/media/242654/ap036_reportsummary_1_.pdf&gt;.4. Kolata, Gina. “Food Deserts and Obesity Role Challenged.” The New York Times. N.p., 17 Apr. 2012. Web. 5 Oct. 2012. <http://www.nytimes.com/2012/04/18/health/research/pairing-of-food-deserts-and-obesity-challenged-in-studies.html&gt;.

    5. Food Assistance Landscape FY 2011 Annual Report. Rep. N.p.: USDA Economic Research Service, 2012. Print.

    6. Nord, Mark. “Food Security of SNAP Recipients Improved Following the 2009 Stimulus Package.” Amber Waves. USDA Economic Research Service, n.d. Web.

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6 thoughts on “Starving in food deserts, drowning in food swamps? Understanding the labels and their link to obesity

  1. yuiweng says:

    The discussions that even people live in food swamp do not necessarily make healthy food choices is an interesting point. It reminds us that obesity and healthy diet is not only a question of access to healthy foods but also people’s preference to food. Fast food is typically an inexpensive and a convenient meal-mix for many resource and time-crunched Americans. They successfully invested in places where other grocery stores or restaurants abandoned, and creates job opportunities at local communities. Instead of fighting with fast food industry, perhaps we can take some lessons from their efficient operation system and work with them. Since the awareness of healthy food increase, fast food restaurants like McDonald’s and Burger King bring salads, fruits, oatmeal, and yogurt to their menus. All their foods have calorie and nutrient content that can be easily found on their websites. It’s really surprising to me that the blueberry and maple oatmeal is so great that it’s one of my favorites breakfast items now! Obesity is a complicated issue and there is no one single perfect solution for all. No matter it is food desert or food swamp, it raise our awareness to the environment and hopefully we are on the right start.

    McDonald’s new oatmeal breakfast
    http://www.mcdonalds.com/us/en/food/product_nutrition.breakfast.711.Fruit-Maple-Oatmeal-.html

    Wendy’s garden sensation salads
    http://www.wendys.com/food/Family.jsp?family=3

    • eldavies3 says:

      Thanks for your comment, Yu-I! I like the idea of working with fast food, to the extent possible. Cooperation between public health nutrition and the food industry would probably make changes such as a shift toward healthier products a lot easier!

  2. waboyd says:

    With my school and work schedule, I often don’t have the time or energy to purchase the ingredients and prepare nutritious meal from scratch. But I am fortunate that I have the financial means to go to my local coop and purchase delicious, healthy prepared foods and fresh fruits & veggies when I am crunched for time. Many Americans simply do not have access to such high quality food due to lack of healthy food choices in food desserts and lack of funds for millions of poor Americans. Several federal food assistance programs provide assistance to those with the lowest incomes including SNAP, School Lunch and Breakfast Programs, and WIC – which we have learned provides assistance to approximately half of all American children at some point in their lives. The USDA, the agency responsible for overseeing these programs, is aware of the problem of food desserts and other access issues and has made several attempts to provide healthier food options to people receiving assistance. The WIC Fruit and Vegetable Cash Voucher for example provides $14 per participant (for the mother and each child) each month for purchase of fresh, frozen, or canned produce. While the dollar amount is small, the impact has the potential to make an impact on healthy food choices for children living in low-income households who are at increased risk of obesity. But, I had problems locating any reports on whether these vouchers really do increase healthy food choices in families receiving WIC. Why aren’t similar vouchers offered for SNAP recipients? Many farmers markets do offer voucher programs for SNAP participants, but how many of these participants can get to a farmers market? Or know how to select and purchase fresh produce? And what about the shame of having to acquire these vouchers at a table in full view of other people entering the farmers market? Many SNAP-eligible Americans don’t claim benefits due in part to the stigma attached with food stamps, so I would think it would be just as embarrassing to stand in line at the SNAP voucher table at the market. Maybe cash vouchers for fruits and vegetables in participating farmers markets and grocery stores could be distributed to SNAP participants as part of their regular package rather than attaching more stigma to obtaining supplemental food assistance.

    • eldavies3 says:

      Great points! During my internship this summer, the health department offered gift certificates to the local farmer’s market in exchange for completing a fruit and vegetable survey (it asked about amount eaten, where it was purchased, etc.) The survey and vouchers were given at the local branch of Dept. of Social Services, meaning that many of the people who participated were there to apply for WIC, Medicaid, or unemployment. I think the concept was nice, but I remember wondering how many people would actually use the gift certificates when, as you pointed out, farmer’s markets often have a bourgeois culture that could potentially make some people uncomfortable (at least the ones I’ve been to.) I definitely think efforts should be made to encourage inclusion at farmer’s markets and do everything possible to get rid of the stigma attached to using vouchers there.

  3. Olivia Dong says:

    Elizabeth – I agree that using food assistance programs as a way to provide nutrition education and incentivize healthier choices has the capacity the to shift preferences toward healthier options. With these programs reaching so many Americans, there is the potential to shape the eating habits of many, especially for children who are somehow affected by them. These children will grow up being exposed to the fruits and vegetables they get from these programs and will hopefully develop a preference for these items. Then, they can pass these healthier eating habits, along with the information they learn from the nutrition education component, to the next generation.

    It’s interesting that the CDC cites that food decisions, which turn out to be driven by food preferences, continue to be unhealthy ones even after healthy food products are made available in food deserts. I tried to look for the studies that found this but couldn’t find them, but it would be interesting to know how far out the researchers looked for changes in dietary choices after the healthier foods were introduced. Changing dietary habits is a slow process and it may not be seen in the short term (or within the context of the study’s timeframe), but it has the potential to change food preferences overtime. Children pick up a lot of eating habits from their parents, but as they get older are able to develop their own unique preferences, which can include some of these healthier items that are introduced into the environment. In the long term, introducing healthy choices may make a difference – it just might not be able to be captured in a research study.

    • eldavies3 says:

      I agree that changing dietary habits in a community could take too long for a study conducted soon after introduction of healthy food options would be able to measure. I’m sure we all hope that’s the case, anyway, or else we’re going to need to think of some big, new ideas in public health nutrition.

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