Recent initiatives to reduce obesity have focused on the elimination of food deserts. Food deserts are defined by the US government as low-income census tracts where a substantial number of residents have low access to supermarkets and healthy foods; the argument for their elimination is that if low-income families can easily shop at grocery stores with fresh fruits and vegetables, they will eat healthier foods. Critics have pointed out that several low-income urban neighborhoods have nearly twice as many supermarkets or grocers as affluent neighborhoods do — this fact questions the very concept of food deserts.
The current debate is missing a more nuanced aspect of the concept of access to healthy food. We must understand access not only as the mere existence of fresh produce on supermarket shelves, but also as the availability of affordable healthy food, as well as access to education on the benefits of healthy eating.
Research on food prices revealed that from 1985 to 2000 the prices of fresh fruits and vegetables rose 40%, while prices of fats and soft drinks decreased by roughly 15% and 25%, respectively. Unless the fresh produce in supermarkets, or green food carts, is affordable to low-income families, they will have little incentive to buy healthy food. As a USDA report reveals, decisions to buy expensive produce appears particularly unlikely due to the prevalence of food swamps: neighborhoods where junk and fast food is cheap and widely available.
Cost is undoubtedly an obstacle to eating healthy, but this can be addressed with food stamps and subsidies that are specifically for use at farmers markets, or for the purchase of fresh produce at supermarkets.
A more deep-rooted cause of obesity is the lack of education regarding the benefits of healthy eating. Even if substantial efforts are made to reduce the costs of healthy food, energy-dense junk food will continue to be cheaper, not to mention it will continue to taste good. None of us can claim complete imperviousness to the satisfaction of eating food that is bad for us — fries instead of salad, or three cookies instead of one, are choices that all of us can relate to. The temptation to eat McDonalds (it saves money, time, and arguably tastes good) becomes more acute in a neighborhood that lacks proximity to a supermarket.
The only way to ensure that the unhealthy choice becomes the exception, instead of the norm, is through adequate education. However, part of the problem with focusing on education is that we are constantly being bombarded with information about what constitutes healthy and unhealthy eating. Nutrition experts often disagree on what people should and shouldn’t eat, and this is only exacerbated by fad diets, and unrealistic ideals of attaining a specific body shape or size. Devoting greater attention and resources to education initiatives on the benefits of healthy eating for students and adults in food deserts is the most effective long-term way to reduce obesity.
Contradictory recent studies, for example studies by Helen Lee at the Public Policy Institute of California and Ronald Sturm at the Rand Corporation, question the existence of food deserts. Lee’s study found that poor neighborhoods had nearly twice as many fast food restaurants and convenience stores as wealthy neighborhoods. Low-income neighborhoods also had more than three times as many corner stores per square mile, and nearly twice as many supermarkets and large-scale grocers per square mile. Sturm also found no relationship between what type of food students said they ate, what they weighed, and the type of food was available within a mile and a half of their homes.
These studies point out that in neighborhoods with easy access to fast food and convenience stores, the resultant food swamp, and over access of food, accounts for obesity -- not the lack of access to healthy food. However, these studies define "access" very narrowly as a sense of physical proximity to a supermarket or a large grocery store. Broadening our understanding of access to account for both affordability, and nutrition education, reveals that in low-income neighborhoods, the mere existence of a supermarket is insufficient. If residents cannot afford to buy fresh fruits and vegetables, or do not receive education on the benefits of healthy eating, a neighborhood that has several supermarkets can still be a food desert.
As a report released by two non-profits, PolicyLink and the Food Trust, reveals, low-income neighborhoods face significant challenges in accessing healthy food. Better access corresponds with healthier eating, and reduces the risk of obesity. The first step to addressing obesity is increasing physical proximity to healthy food. But if initiatives to increase access are narrowly interpreted as building a new supermarket in order to remove the designation of a region as a food desert, their success will be limited.
Rethinking “access” means that food deserts need more than just new or green grocery stores; they need education program for both children and adults to make them aware of the benefits of healthy eating. A targeted effort to improve the nutritional quality of school lunches (which are notorious for being unhealthy) must also be made in food deserts. Changing the way that people eat through education is a gradual and long-term process that is only possible if steps to make healthy alternatives are taken. Reducing obesity is possible only if eating healthy becomes an informed decision, supported through the availability, and affordability of fresh food.