the second opinion

Hiking America’s food deserts

The Food Police (part 2): Tools for adding context to stories about the soda-ban battle, and other tales of nutrition
March 22, 2013

This is the second installment in an occasional series that will examine media coverage of public initiatives aimed at ending the nation’s unhealthy-food habit. The first installment, about the crusade against salt, is here.

As I monitor the “progress” in the burgeoning national debate over sugary soda legislation, I can’t keep thinking about an assignment for my Health Promotion/Disease Prevention class back in nursing school, a course I wish every healthcare reporter could take to understand what’s at stake. Dr. Norma Hannigan, my professor at Columbia University’s School of Nursing, sent our class out into the streets of Washington Heights to survey the area’s nutritional offerings.

Our task was to count the number of supermarkets and bodegas, list the fast-food restaurants, and try to find some semblance of a health food store. We were also asked to evaluate the fresh/healthy offerings of all these places–if and when we found any–and compare their amounts to those of available processed and junk foods.

You go in suspecting that healthy food will be somewhat hard to find, but wow: this exercise was an eye-opener for many of my classmates, and I suspect it would be for many reporters, too. They were astonished at the paltry amounts of fresh produce available, and at the inflated prices of what little is offered. I remember one young student from Southern California who cringed at the sight of a mound of limp, browning romaine lettuce that cost more than $3 a head. “Who would eat this?” she wanted to know.

Another relevant question is, “Who could afford this in this neighborhood?” The unsavory combination of unappetizing supplies and inflated pricing is the force behind the phenomenon that public health experts call a “food desert.” Washington Heights is hardly alone in its designation as a food desert, and neither are many other low-income urban areas. The definition is not limited to neighborhoods without any decent food supply; in many cases, some food is there, but a food desert can be defined by the residents’ inability to access it–either because they are poor, or they lack transportation, or they face prohibitive walking distances to shopping.

The hardships faced by Americans living in food deserts is the largely untold story behind legal and other efforts to fix the American diet–stories on the failed soda ban in New York, for example; the state law in Mississippi that prevents municipalities from adopting nutrition rules (like soda bans or menu calorie and fat information); and repeated soda tax proposals in Nebraska, Hawaii, and many other states. The food desert problem is context that reporters might consider adding to such stories.

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There are some helpful resources for that kind of reporting. Earlier this month, the US Department of Agriculture’s Economic Research Service updated the data in its suite of research tools, including the Food Environment Atlas and the Food Access Research Atlas, both user friendly and full of data to help quantify stories about who has access to healthy food. They provide census-based, county-level data on numerous demographics including (but not limited to) household income, the number of supermarkets or fast-food restaurants per 1,000 residents, and the number of households without a vehicle.

A reporter covering debates over such things as a soda ban or soda tax, or working on obesity stories, can go out and do a nutritional walk-about like my class did. If that’s not possible, they can take a look at the USDA’s data and build stories around that. That’s what food blogger Rick Paulas did for KCET.com in Los Angeles, in a piece about LA’s food deserts. Nancy Shute did the same in a recent column for npr.com’s The Salt–“How to find a food desert near you”–which was picked up by several local NPR affiliates.

During our Washington Heights survey, we found shelves full of cheap, ready-to-eat packaged products–plenty of empty calories within reach, physically and financially. Of course, children are easy targets. But so are their parents, some of whom might be dashing between two or three jobs, grabbing whatever they can find (and afford) to quickly feed their families. Busy reporters sometimes forget that there are myriad reasons people rely on fast food as dietary mainstay, another reason context is missing from some diet-related stories.

What’s also missing is stories about what some cities and public health experts, not waiting around for legislative “fixes” to the food-desert problems, are doing in the meantime. Little has been written lately about New York City’s “Healthy Bodega” Initiative, for example, which launched in 2005. Its aim was to convince bodega owners to stock healthier options, such as low-fat milk and fruits and vegetables, by convincing them that there is demand for such products The city armed neighborhood residents with fairly sophisticated campaign materials and asked them to make their pleas one-on-one with local store owners. A 2010 report suggests the program was beginning to work. A progress (and fiscal) update is way overdue.

Similar “corner store” efforts are underway in many cities around the country, either going it alone or with the support of organizations such as the Healthy Corner Store Network. There have been nice profiles on such efforts through the years, although none I could find recently.

In the context of today’s hyped-up legal and legislative battles about soda bans and the like–in which the term “civil liberties” is thrown around–it’s good to remember that these fights are not just about the press conference personalities and courtroom dramas. They are about the secret lives of people in neighborhoods where the best options for dinner might be a $1.29-box of mac and cheese or a $3 head of slimy lettuce.

Take a walk there and you’ll see.

Sibyl Shalo Wilmont covers healthcare policy issues for The Second Opinion, part of CJR’s politics and policy desk, the United States Project. Follow the project’s work on Twitter @USProjectCJR and follow her @nursesibyl.

Related story:

Policing the food police: the assault on salt

Sibyl Shalo Wilmont is a healthcare journalist and emergency department nurse with insider experience in the pharmaceutical industry, academic medicine, and patient advocacy. She is a graduate student in Hunter College’s dual-degree Master’s in Community/Public Health Nursing/Master’s in Public Health program. Follow her on Twitter @nursesibyl.