We had a great opportunity this weekend to meet Mr. Will Allen of Milwaukee’s Growing Power and to learn about, and discuss, the incredible work that he does. As is often the case, his visit has prompted a lot of discussion regarding some interrelated questions—food deserts, food access, health, and poverty foremost among them—that merit thoughtful attention.
One example that stands out, for its detail and for the expertise of its author, is a blog post by Wayne Shingler of Frijolito Farm. Mr. Shingler, unfortunately, couldn’t attend Mr. Allen’s keynote address because, as he puts it, “I’m so busy doing it that I don’t have time to go listen to somebody talk about it.” He does, however, take the time to lend us his perspective on the problem of food access and health in low-income neighborhoods, and we’re glad.
One question that’s worth asking is whether food deserts, and “food swamps,” are really a problem. Put more precisely, is diminished access to healthy food a primary cause of poor diet, obesity, and disease? It might seem obvious that it is; but Mr. Shingler, whose farm is located in a low-income neighborhood, points out that fresh vegetables aren’t too far away, and even if they are, people can find a way to get to them, whether it’s a car, a friend’s car, or a bus.
This issue is often framed as a question of whether people exercise completely independent judgment—i.e. “personal responsibility”—or are subject to the effects of their environment (or “the system” that they live in). The two aren’t really exclusive, I’d argue, since people exercising good judgment should be influenced by their environment. In this case, there are costs involved in transportation and time: it might be possible to drive (or walk a mile) to get lettuce, but if one can walk a block or two to a Big Mac or a Snickers bar, that effectively raises the price of healthy food access relative to unhealthy food. A rational consumer will take those environmental costs into account.
Moreover, a quick look at the data (from Jeffrey and Harnack, “Evidence Implicating Eating as a Primary Driver for the Obesity Epidemic,” Diabetes, November 2007) at least suggest an environmental cause rather than an individual one:
What the graph tells us is that obesity rates began to skyrocket sometime in the early 1980s, across all age groups. If the change had been a result in a fundamental change in people or their habits or practices, it likely would have shown up in younger people first, and it didn’t.
A recent study from the journal Archives of Internal Medicine backs up this conclusion with more concrete, individual-level data. The Archives study is the first of its kind, in that it connects repeated measures of health-related variables over time to GIS-coded information about the location of food resources. It concludes that people living in closer proximity to fast food outlets were significantly more likely to have unhealthy diets—an effect that is more pronounced in low-income communities. The twist, however, is that the converse seems not to be true: precisely as Mr. Shingler argues, better access to fresh, healthy food does not generally translate into a healthier diet—at least, not directly.
The interesting question is why not. Mr. Shingler suggests that the root cause is fundamentally economic:
Since the advent of modern agriculture, hunger is almost never about there being a shortage of food. It’s about people not having the money to buy it. … So I reject the idea that the reason more poor people don’t eat more vegetables is because we’re too dumb or incapable of traveling to find a place that sells radishes. It’s a patronizing view, really. Don’t give poor people the food you think they ought to be eating. Give them a source of income so they can go to the same grocery stores you go to.
First of all, it’s worth noting that, while hunger is a substantial problem, and it generally is a fundamentally economic problem, it’s a different problem. In the case of food deserts we’re generally talking about low-income people who can afford to feed themselves (if only just) but are facing epidemics of obesity and related diseases like heart disease and type II diabetes. And there’s no reason to assume that the causes are the same.
Second, my own inclination is to resist any analysis that locates either the problem or the solution in any one place, wherever that place may be. The reason is that we’re dealing with a relatively complex system, one that involves consumers, producers, prices, and a nuanced relationship between people and food. In particular:
- Supply and demand are interrelated: increasing supply drives down price and increases sales, while increasing demand drives up price and increases production.
- The demand for vegetables depends on a lot more than the demand for fast food: put simply, a Big Mac doesn’t require instructions.
When you put these two points together, you realize that there shouldn’t necessarily be a direct relationship between increased availability and increased consumption, all else equal. There will be a few mitigating factors, such as how much people know (or don’t) about preparing and eating vegetables. The null result from the Archives study might just mean that increasing access to good food only increases its use among those who already know how to cook or are in the habit of cooking, but many people in the area of the study don’t fit that description.
If this argument holds water, the way to address large-scale diet-related problems like obesity and type II diabetes would be, essentially, a “weakest link” strategy: find the weakest link in the system and strengthen it. If people have access to wholesome food but don’t know how to prepare it, teach them. If the cost of wholesome food relative to fast food in their environment is unusually high, find a way to lower it. If they’re simply not aware of the impact of a fast food diet, set up free screenings of Super Size Me in local community centers—the segments with Morgan Spurlock’s wife will make half of the audience swear off fast food for life.
Another implication would be that simultaneously strengthening other links would not necessarily be a waste of time, in the long run, though it might not provide demonstrable payoffs in the short run. Why wouldn’t we see demonstrable payoffs in the short run? Simply put, if food access isn’t always the weak link, the net effect of improving it, across the board, will be pretty weak. Why is improving it still likely to be worthwhile? Because the weakest link at any given time probably won’t always be the weakest link.
Does anyone know with certainty what the root causes of these health outcomes are? I doubt it. But any explanation or policy has to take into account the known facts, and at this point that’s the best we can really hope to do.
If you’d like to discuss this and other issues of food justice, we recommend attending the Central Ohio Food Forum this Monday, July 18, from 5:30–8:00 p.m. at Wild Goose Creative on Summit Ave.