On Wednesday, November 2nd, I attended a talk hosted by the Arthur M. Blank Foundation Speakers Series, called ‘Street Food: Attacking Obesity and Wiping Out Food Deserts One City Block At a Time.’ I was appalled by how many Americans are living in areas where they have limited access to nutritious foods – the so-called food deserts. With limited consumption of healthy foods, many of our Americans are at risk of developing obesity and other preventable diseases that can severely impact their quality of life. As a physician who frequently counsels my patients on healthy diets and lifestyles to improve their health and well-being, I find this unacceptable.
I am reminded of a middle-aged, obese male patient who recently visited me in my clinic. After spending the majority of the clinic visit discussing the benefits of fruits and vegetables in the diet, he finally stated, ‘Hey doc, it isn’t like I don’t want to listen to you and eat my fruits and veggies. I just can’t.’
‘What do you mean?’
‘Well, I live a couple miles from a grocery store. It ain’t easy for me to walk to a grocery store and carry all those veggies back. I don’t own a car. There is no bus that takes me there. I just find it easy to pick up food at the Burger King down the street or at our convenient store.’
I was shocked. My patient is living in a food desert! The reason for his inability to consume a healthy diet is not coming from a lack of desire, but from a lack of physical access to high quality food.
A food desert is an area that lacks access to affordable fruits, vegetables, whole grains, and other foods that make up the full range of a healthy diet. A food desert can contribute to social disparities in diet and diet-related outcomes, such as cardiovascular disease and obesity. In the United States, geographically poor areas have fewer supermarkets or chain stores per capita than less disadvantaged areas. Further compounding the situation is that many low-income individuals lack transportation capacity to access grocery stores, even if one is available within a couple miles.
Increased access to supermarkets is associated with lower prevalence of overweight and obesity, improved fruit and vegetable consumption, and better diet quality among low-income households. In contrast, increased access to convenience stores is associated with increased risk of obesity.
At the Speakers Series event, the speakers discussed the green cart – a mobile food cart that offers fresh produce—as a strategy to combat food deserts. In New York City, the Green Cart initiative has already permitted 1,000 green carts to be established throughout the city to increase availability of fresh fruit and vegetables in NYC neighborhoods. The program has not only been able to improve access to healthy food, but it has also stimulated economic development and job creation. Although further data needs to be obtained regarding overall effect on chronic disease rates and other health-related outcomes, this initiative is already at the forefront of tackling a nation-wide problem regarding access to nutritious foods for our vulnerable populations.
We need to first investigate the myriad of reasons that are conducive towards minimal access to nutritious foods. Are grocery stores available? Are they adequate in number? Are they physically accessible? Are fruits and vegetables affordable? Are they culturally acceptable? Are fruits and vegetables desirable?
Then, we need to advocate for policies that promote equitable access to high quality foods for our patients. We need to work aggressively with our local, state, and federal governments to introduce supermarkets, green carts, and other food stores that sell healthy food items in lower income areas, reduce price disparities between healthy and unhealthy foods, enhance transportation mechanisms for people living in remote areas to access grocery stores, and foster the development of community food projects.
We cannot afford to waste any more time while many of our Americans cannot access nutritious foods, placing them at risk for developing deleterious chronic conditions. As a society, let us work to actively advocate for broader policy changes that impact access to nutritious foods.
In the meantime, let us roll in the green carts into as many American food deserts as is physically possible.