According to recent statistics, in the U.S. alone an estimated 23 million people live in what are known as food deserts. The term has gained popularity as a way to refer to areas where residents lack access to healthy food options, especially produce. People in these areas often live below the poverty line, don’t own cars, and don’t have a grocery store within walking distance.

In such neighborhoods, small corner stores tend to stock low-nutrient, processed foods and carry few, if any, fruits and vegetables, which nutritionists tell us are critical to good health. In rural areas, there may not be a grocery store within an hour’s drive. An interactive map developed by the USDA shows how widespread this problem is.

In Nutrition Digest, the American Nutrition Association noted that “food deserts are often short on whole food providers, especially fresh fruits and vegetables, [and] instead…provide a wealth of processed, sugar, and fat laden foods that are known contributors to our nation’s obesity epidemic.” Low-income communities of color suffer especially high rates of obesity, diabetes, and other metabolic health issues. Such diseases are largely preventable with a healthy diet.

Improving Food Deserts

Concerns about the health impacts of food deserts have prompted numerous initiatives to bring grocery stores and produce stands to areas that lack them. As part of Michelle Obama’s Let’s Move campaign to address America’s obesity epidemic, the Healthy Food Financing Initiative (HFFI) was created to “expand the availability of nutritious food to food deserts…by developing and equipping grocery stores, small retailers, corner stores, and farmers markets with fresh and healthy food.” More than $500 million in federal financing has gone to opening supermarkets in areas without them, and the Agricultural Act of 2014 included $125 million per year for five years to further this work.

In the popular imagination, food deserts are primarily urban, but 98% of counties classified as food deserts fall outside metropolitan areas. As rural populations have dropped, grocery stores have found it more difficult to survive. When a small town loses its grocery store, residents often drive for more than an hour to buy food. Then they must find additional money for gas, leaving them with less for their groceries. People in this situation purchase less fresh food because they need to get by on items that don’t spoil before the next trip to the store. This can mean lots of high-sodium, chemical-laden canned and boxed food.

If You Bring Fresh Food to a Food Desert, Will People Buy It?

More access equals better diet” seems like a logical premise. However, some studies examining the effectiveness of such interventions have revealed that giving people in these areas access to healthier food has little impact on their food choices or on measures of diet-related health, such as body mass index (BMI).

However, a recent study examining food habits in a neighborhood where a local supermarket opened found “positive changes in overall dietary quality,” with reduced intakes of added sugars, solid fats, and alcohol—as well as a significant drop in overall calories when compared to a control neighborhood without a grocery store. Surprisingly, even infrequent shoppers at the new store saw similar improvements.

Such investment in neighborhoods may promote hope about the future, which in turn may encourage more healthy food choices.

Tamara Dubowitz, Senior Policy Researcher at the RAND corporation and lead author in the study, speculates that the increased community engagement and local media coverage around the opening of the market called attention to healthy food and food access, which may have affected dietary choices.

One of the study’s most striking findings may help to explain the dietary changes researchers found. Surveys showed a remarkable increase in neighborhood satisfaction after the grocery store opened. Dubowitz posits that such investment in neighborhoods may promote hope about the future, which in turn may encourage more healthy food choices. If there’s a promising future to look forward to, she thinks, residents may be more likely to care about making healthier choices.

The study found that while many elements of residents’ diet quality improved, intake of fruits and vegetables did not, nor did BMI. Dubowitz points out that “markets also provide access to unhealthy foods” and that marketing and store displays “promote unhealthy foods more than healthy foods.” Follow-up surveys were conducted just months after the store opened, and changes in BMI might need longer to surface given the drop in calories consumed. A proposal for a follow-up study to better understand their findings is currently under consideration.

“People are recognizing that access is small part of the story and distance to a grocery store might not be a magic bullet,” Dubowitz says. While programs promoting neighborhood grocery stores have excellent intentions, without adequate money to purchase the healthy options these stores carry, the benefits grocery stores bring to residents is sharply limited. Additionally, studies suggest that the stress of poverty is far more important in health outcomes than access to fresh food.

In addition to access, people must understand the impact of food choices on health and be motivated to makes changes accordingly.

It’s also worth noting that food habits of a lifetime are not changed overnight, and while access to fruits and vegetables is important, the new grocery stores feature plenty of unhealthy processed food far more convenient than cooking whole foods from scratch. In addition to access, people must understand the impact of food choices on health and be motivated to makes changes accordingly. As research continues to evaluate what works, new programs may address other elements necessary to support healthier eating habits.

The Argument for Access to Fresh Food

To be sure, residents can’t eat what they can’t get, so access to healthy food will remain a critical first step to improving the health of millions of Americans. But programs focused on this issue must take into account the economics and cultural issues that affect food choices as well.

One such program is the “Double Bucks” program, which doubles benefits for users of the Supplemental Nutritional Assistance Program (SNAP) when used for fresh produce. The 2014 Agricultural Act included $100 million over five years for the program, with a requirement for matching private funding. By bringing down the cost of produce, such measures make healthy eating more affordable. Other obstacles programs may need to address include lifelong habits, marketing, and lack of time for or knowledge about food preparation.

If you live in or near a food desert, look into the funding available through state and local governments as well as non-profits. You can find more resources at Healthy Food Access.

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