Food deserts in the United States

Food deserts are generally defined as regions that lack access to supermarkets and affordable, healthy foods, particularly in low-income communities.^[1] According to the USDA's most recent report on food access, as of 2017, approximately 39.5 million people - 12.9% of the US population - lived in low-income and low food access.

In urban areas, higher levels of poverty have been associated with lower access to supermarkets.^[2] Food access has been shown to disproportionately affect Black communities: several studies have observed that neighborhoods with higher proportions of Black residents tend to have fewer supermarkets and further retail access, disproportionately affecting food security levels within the community.^[2]

While food deserts have historically been assessed through geographical measures of food access, aspects of a region's food environment, built environment, and socioeconomic characteristics are becoming increasingly recognized in defining and identifying food deserts.^[3] The USDA measures food access across different geographical regions by considering different indicators of food access such as proximity to a store, individual-level resources, and neighborhood-level structures that influence a household's access to food.^[4]

Distance-based measurements measure food accessibility to identify food deserts. The United States Department of Agriculture (USDA) Economic Research Service measures distance by dividing the country into multiple 0.5 km square grids. The distance from the geographic center of each grid to the nearest grocery store gauges food accessibility for the people living in that grid.^[6][7]

Different factors are excluded or included that affect the scale of distance. The USDA maintains an online interactive mapping tool for the United States, the "Food Access Research Atlas", which applies four different measurement standards to identify areas of low food access, based on distance from the nearest supermarket.^[8]

The first standard uses the original USDA food desert mapping tool "Food Desert Locator". It defines food deserts as having at least 33% or 500 people of a census tract's population in an urban area living 1 mile (10 miles for rural area) from a large grocery store or supermarket.^[6][9]

The second and third standards adjust the scale of distance and factor income to define a food desert. In the US, a food desert is a low-income census tract residing at least 0.5 miles (0.80 km) in urban areas (10 miles (16 km) in rural areas), or 1 mile (1.6 km) away in urban areas (20 miles in rural areas) from a large grocery store.^[8] The availability of other fresh food sources like community gardens and food banks are not included in mapping, and can change the number of communities that should be classified as food deserts.^[10]

A 2014 geographical survey found that the average distance from a grocery store was 1.76 kilometers (1.09 miles) in Edmonton but only 1.44 kilometers (0.89 miles) when farmers' markets and community gardens were included, which makes it 0.11 miles under the latter definition for an urban food desert.^[11]

The fourth standard takes vehicular mobility into account. In the US, a food desert has 100 households or more with no vehicle access living at least 0.5 miles (0.80 km) from the nearest large grocery store. For populations with vehicle access, the standard changes to 500 households or more living at least 20 miles (32 km) away.^[8][12] Travel duration and mode may be other important factors.^[13] As of 2011, public transport is not included in mapping tools.^[10]

A food retailer is typically considered to be a healthful food provider if it sells a variety of fresh food, including fruits and vegetables. Food retailers like fast-food restaurants and convenience stores are typically not in this category as they usually offer a limited variety of foods that constitutes a healthy diet.^[6] Frequently, even if there is produce sold at convenience stores, it is of poor quality.^[14] A "healthy" bodega, as defined by the New York City Department of Health and Mental Hygiene, stocks seven or more varieties of fresh fruits and vegetables and low-fat milk.^[15]

Different countries have different dietary models and views on nutrition. The distinct national nutrition guides add to the controversy surrounding the definition of food deserts. Since a food desert is defined as an area with limited access to nutritious foods, a universal identification of them cannot be created without a global consensus on nutrition.

Other criteria include affordability and income level. According to the USDA, researchers should "consider... [the] prices of foods faced by individuals and areas" and how "prices affect the shopping and consumption behaviors of consumers."^[16] A 2012 study maintains that estimates of how many people live in food deserts must include the cost of food in supermarkets that can be reached in relation to their income.^[13]

For instance, in 2013, Whole Foods Market opened a store in the New Center area of Detroit, where one third of the population lives below the poverty line. Whole Foods is known for its more expensive healthy and organic foods. To attract low income residents, the Detroit store offered lower prices than other Whole Foods stores.^[17] If Whole Foods had not lowered the prices, residents would not be willing to shop there, and that area of Detroit would still be considered a food desert.^[17]

The differences between a rural and an urban food desert are the population density of residents and their distance from the nearest supermarket. Twenty percent of rural areas in the U.S. are classified as food deserts.^[18] There are small areas within each state in the U.S. that are classified as rural food deserts, but they occur most prominently in the Midwest.^[19] Within these counties, approximately 2.4 million individuals have low access to a large supermarket.^[8][20] The difference in distance translates into pronounced economic and transportation differences between rural and urban areas.^[21][22] Rural food deserts are mostly the result of large supermarket stores moving into areas and creating competition that makes it impossible for small businesses to survive. The competition causes many small grocers to go out of business. That makes the task of getting nutritious whole ingredients much more difficult for those who live far away from large supermarkets.^[23]

A 2007 study found that people who live in rural food deserts are more likely to lack a high school degree or GED, to experience increased poverty rates, and to have lower median family income. People who live in rural food deserts also tend to be older, because of an exodus of young people (ages 20–29) born in such areas who decide to leave once they can.^[19]

From 2013 County Health Ratings data, residents who live in rural U.S. food deserts are more likely to have poorer health than those who live in urban food deserts. People who live in rural communities have significantly lower scores in the areas of health behavior, morbidity factors, clinical care, and physical environment. Research attributes the discrepancies to a variety of factors, including limitations in infrastructure, socioeconomic differences, insurance coverage deficiencies, and a higher rate of traffic fatalities and accidents.^[24]

A 2009 study showed that of the people polled, 64% did not have access to adequate daily amounts of vegetables, and 44.8% did not have access to adequate daily amounts of fruits. Comparatively, only 29.8% of those polled lacked access to adequate protein. The lack of access to fruits and vegetables often results in vitamin deficiencies, which eventually causes health problems for those who live within these areas.^[19] Tasked with finding a solution to the problem, research has shown that it takes individual and community actions, as well as public policy improvements, to maintain and increase the capacity of rural grocery stores to provide nutritious high-quality affordable foods and to be profitable enough to stay in business.^[19]

A 2009 study found that although personal factors impact eating behavior for rural people, it is the physical and social environments that place constraints on food access, even in civically engaged communities. Food access may be improved in communities in which civic engagement is strong and local organizations join in providing solutions to help decrease barriers of food access. Some ways that communities can do so are increasing access to the normal and food safety net systems and creating informal alternatives. Some informal communal alternatives could be community food gardens and informal transportation networks. Existing federal programs could be boosted through greater volunteer involvement.^[23]

A 2009 study of rural food deserts found key differences in overall health, access to food, and the social environment of rural residents when they were compared to urban dwellers.^[23] Rural residents report overall poorer health and more physical limitations, with 12% rating their health as fair or poor, compared to 9% of urban residents.^[23] They believed their current health conditions to be shaped by their eating behaviors when the future chronic disease risk was affected by the history of dietary intake.^[23]

The 57 recruited rural residents from Minnesota and Iowa in one study perceived that food quality and variety in their area were poor at times.^[23] The researchers reached the conclusion that for a community of people, food choice bound by family and household socioeconomic status remained as a personal challenge, but social and physical environments played a significant role in stressing and in shaping their dietary behaviors.^[23]

Food deserts occur in poor urban areas with limited or no access to healthful affordable food options.^[25][26] Low income families are more likely to not have access to transportation so tend to be negatively affected by food deserts.^[25] An influx of people moving into such urban areas has magnified the existing problems of food access.^[27] A 2018 study found that urban areas have been progressing in terms of certain opportunities, but the poor continue to struggle.^[27] As people move to urban areas, they have been forced to adopt new methods for cooking and acquiring food.^[27] In 2018, adults in urban areas tend to be obese, but they have malnourished and underweight children.^[27]

A 2012 study found that for many people, the reason for not being able to get nutritious food is a lack of supermarkets or grocery stores.^[13] When supermarkets are inaccessible, it has been shown that vegetable and fruit consumption are lower.^[25] When prices are high and there is a lack of financial assistance, many living in places with limited grocery stores find themselves in a situation of being unable to get the food that they need.^[28] A 2017 study found that food deserts tend to be in places where poor minority communities reside.^[28] Sometimes, the issue with urban food deserts is not the lack of food in the area, but rather the lack of nutritional knowledge about food.^[29]

In 2009 research by Tulane University, 2.3 million Americans lived more than one mile away from a supermarket and did not own a car.^[30] For those that live in urban food deserts, they often do not have access to culturally-appropriate foods.^[30] For many people who have health restrictions and food allergies, the effects of food deserts are further compounded.^[30] The time and cost it takes for people to go to the grocery store makes fast food more desirable.^[30][31] There is also a price variance in small grocery stores that prevents people in lower-income areas from purchasing healthier food options. Smaller grocery stores can be more expensive than the larger chains.^[30]

Recognition of food deserts as a major public health concern has prompted a number of initiatives to address the lack of resources available for those living in both urban and rural areas. On the larger scale, there have been national public policy initiatives.

The United States government responded to food insecurity with several programs, one of which being the Domestic Nutrition Assistance Programs (DNAPs). Other programs include the Supplemental Nutrition Assistance Program (SNAP), the Special Supplement Nutrition Program for Women, Infants, and Children (WIC), and food pantries and emergency kitchens. In 2013, there was a significant lack of legislation on local and state levels to address the problem efficiently and adequately. As food insecurity has reached drastic levels, significant pressure for the government to qualify the problem as a human rights issue has proven futile.^[32]

In 2010, the US Department of Health and Human Services, the US Department of Agriculture, and the US Department of the Treasury announced their partnership in the development of the Healthy Food Financing Initiative (HFFI). Intending to expand access to healthy food options in both urban and rural communities across the country, HFFI has helped expand and develop grocery stores, corner stores, and farmers' markets by providing financial and technical assistance to communities. The creation of such resources provides nutritious food options to those living in food deserts.^[33] HFFI has awarded $195 million to community development organizations in 35 states. Between 2011 and 2015, HFFI created or supported 958 projects aimed at healthy food access.^[34]

The HFFI has supported the development of statewide programs across the country, in California, Colorado, Illinois, Louisiana, Michigan, New Jersey, New York, Ohio, and Pennsylvania.^[35] In Pennsylvania, the state program, the Fresh Food Financing Initiative (FFFI), provides grants and loans to healthy food retailers to create or renovate markets, including supermarkets, small stores, and farmers' markets, in low-income urban and rural areas across Pennsylvania. Because operating in underserved areas is more financially straining on retailers, the program provides subsidized financing incentives for retailers to open in areas with a high need. The Pennsylvania program's success influenced many other states to launch similar programs.^[36]

Local and community efforts have made strides in combating a lack of access to nutritious food in food deserts. Farmers' markets provide residents with fresh fruits and vegetables. Usually in public and central areas of a community, such as a park, farmers' markets are most effective if they are easily accessible. Farmers' markets tend to be more successful in urban than rural areas due to large geographic distances in rural areas that make the markets difficult to access.^[37]

The expansion of SNAP to farmers' markets helps make nutritious foods increasingly affordable. Each year, SNAP participants spend around $70 billion in benefits. As of 2015, more than $19.4 billion were redeemed at farmers' markets.^[38] The Double Up Food Bucks program doubles what every Electronic Benefit Transfer (EBT) dollar spent at a farm stand is worth.^[39] This incentivizes locals to shop for fresh foods, rather than processed foods. Community gardens can play a similar role in food deserts, generating fresh produce by having residents share in the maintenance of food production.^[40]

In 2018, The Food Trust, a nonprofit organization based in Pennsylvania, had 22 farmers' markets in operation throughout Philadelphia. To increase accessibility for healthier food and fresh produce, Food Trust farmers' markets accept SNAP benefits.^[41] Customers have reported improved diets with an increase in vegetable intake as well as healthier snacking habits.^[42]

Community gardens address fresh food scarcity. The nonprofit group DC Urban Greens operates a community garden in Southeast Washington, DC, an area labeled by the US Department of Agriculture as a food desert. The garden provides fresh produce to those in the city who do not have easily-accessible grocery stores nearby. The organization also sets up farmers' markets in the city.^[43]

In the food desert of North Las Vegas, a neighborhood with one of the highest levels of food insecurity, another community garden is addressing food scarcity.^[44] The community gardens can aid in education and access to new foods. Organizations such as the Detroit Black Community Food Security Networkuse community-building gardens to promote community around healthy food.^[45]

Food cooperatives (co-ops) are defined as being community driven produce markets. Food co-ops have become a mechanism that communities have used in response to food deserts. Since they are run by community members, these groups can have a more direct decision to sell more culturally relevant and healthier produce to the overall community. Proponents to the implementation of food co-ops argue that it offers better dietary options which can uplift the most impacted communities in food deserts.^[46]

There have been efforts by urban American cities to implement food co-operations as a larger policy reform. Organizations like the West Oakland Food Collaborative have made food co-operations one of the components to their larger proposal to tackle food insecurity.^{[citation needed]} There have also been efforts to integrate current federal aid to food co-operations.The Virginia Fresh Match (VFM) program worked with community efforts such as food co-ops to accept federally funded initiatives such as Supplemental Nutrition Assistance Program (SNAP) as a way to promote healthier eating habits.^[47]

Limitations to food co-operations come with the emphasis of community governance and different approaches to reallocate federal funding. Given that food co-ops are community run, maintaining the market requires community members to dedicate hours to it.^[48] However, all members of the community can shop at food co-ops. As well, previous government policy agreements with market chains have made it difficult for repurposing these now enclosed spaces, with the discontinued Albertsons market chains being a leading example of this predicament.^[49] Cities with food deserts, such as Detroit, Michigan, have advocated instead to create policies that financially incentivize healthy markets to build their establishments in these communities.^[50] Yet, research conducted in Flint, Michigan's food desert found that it is not community access that policy reform should focus on since the implementation of healthy grocery stores will not decrease food insecurity or create healthier diets.^[51]

Urban agriculture (UA) is another way that helps when it comes to having access to fresh food in urban cities. Urban agriculture is one of the responses combating the lack of fresh foods in communities that need fresh foods. There are communities that are turning vacant lots into a community gardens and urban areas in which they can use agriculture to grow fresh foods for the community.^[52] Urban agriculture has many benefits such as being a "local source of fresh healthy food", and bringing communities together and reducing environmental problems.^[52] An issue with urban agriculture is that in many food desert communities, the soil has been contaminated from local pollutants, which makes it harder to use plots of land as a garden to grow fresh food.^[53] For example, in Oakland, California, there has been a rise in using urban agriculture as a means to get areas that are in the middle of food deserts to grow and produce their own food.^[54]

An entrepreneurial solution to food insecurity in food deserts is food trucks due to their capacities to transport groceries to residents living in areas with low retail access. In major urban centers such as Boston, mobile food markets travel to low-income areas with fresh produce. The trucks travel to assisted living communities, schools, workplaces, and health centers.^[55] The increased availability of online food retailers and delivery services, such as AmazonFresh and FreshDirect, can also help in food deserts by delivering food straight to residences. The ability of elderly people, disabled people, and people who live far from supermarkets to use SNAP benefits online to order groceries is a major resource.^[56] For those who lack transportation options, vehicle for hire services may be vital resources to increase access to nutritious foods in food deserts.^[57]

Several studies have cited improved dietary behaviors through educating children on healthy nutrition practices and food systems in school settings.^[58] Empowering children to make healthy food choices and learn about the origins of their food can encourage long-term healthy habits and attitudes around food, helping to promote consumption of healthy foods to the best of their extent in areas deemed food deserts. Youth education programs around nutrition, gardening, and food systems that establish and maintain community gardens can also make nutritious, fresh produce more easily accessible by residents living in food deserts.^[59]

For example, the Grow Hartford Program was implemented in a school in Connecticut to have students address an issue in their community and they chose to focus on food justice.^[60] The youth involved worked on farms in the area to learn about the processes of food production and the importance and variety of vegetables. The program even led kids to start a community garden at their school. The program allowed the students to engage in hands-on learning to educate them about agriculture, food scarcity, and nutrition while helping bridge the gap of food access for some of their peers who could now bring home food from the surrounding farms or the school garden.^[60] Another example of an organization that educates community members is Oakland Food Connection, located in East Oakland where they teach children about production and consumption through lessons on urban gardening with cooking classes. This program helps educate children about their own food culture and others while also learning about nutrition.^[54]