Aside

How are Public Health and Food Deserts related?

I’ve been wanting to talk about Food Deserts for a while. The idea fascinates me and I just want to know everything about them. Sound weird? I know. I’m a nerd.

 

The concept of the Food Desert came around in the mid/late-’90’s in the UK to describe populated areas with little to no food availability, generally seen in poorer neighborhoods. And then a miracle happened: the sky opened up, raining hamburgers to cure this ill! Thus, the book Cloudy with a Chance of Meatballs was born. Just kidding. Rigorous study of the multifactorial nature of obesity’s link to poverty happened, resulting in what was recently published in Health Affairs: a study revealing that adding a supermarket with healthier food options had no significant impact on improving residents’ obesity or vegetable/fruit consumption.

 

But why?

 

The results of this study remind me of the worst/best teacher I’ve ever had: a tenured professor at the University of Colorado in the Ethnics Studies Department. He attended class maybe 10 times that semester (that may be overestimating), but set the class a semester-long project that he called the “Community Development Project.” It was a fake assignment that intended to show us (the class) the effects of implanting a government project into an impoverished, ethnic area. About once every two weeks, he finally would show up to class, see what we had accomplished within his parameters and added a new set of them, saying things like “You have this (read: super low) budget… work within that,” or “1 out of 5 people have a car and/or have reliable transportation – how will they attend regular visits to the hospital?” or “The community distrusts organizations handed down by the government. How do you get around this?”

 

The lesson learned was that language barriers, cultural barriers, habits, mistrust and this entire idea of “From the top-down” are all at play here in the multifactorial world of health issues and how to change a nation’s relation with… anything.

 

Apply this to food. How would you feel if someone planted a store in your neighborhood and expected you to shop there? Would you like it if someone told you – in an unsolicited way – that your diet was no good? That you needed to change? That you were too fat?

 

What we are coming to realize as a country is that health problems related to our food intake are multifactorial. We are dealing with social, environmental and biological problems that encourage the symptoms we see daily, and even though the AMA defined obesity as a disease last year, the health problems associated with our poor diets are what concerns me.

 

This is a concern for a lot of people – clearly Michelle Obama cares and clearly this study was carried out. The economic burden on our healthcare system of people who suffer from the ills of our sit-down, eat-this society have been made clear many times over. We have all (or most of us, anyway) heard about hypertension, diabetes, visceral fat, and fat people definitely know how this culture feels about fatness in relation with their health. They hear it every day.

 

So where do we start?

 

If I learned anything from my worst/best teacher, I have several questions:

  • Which communities want to change?

  • What pieces of their diet are cultural and which pieces aren’t?

  • What can we do to encourage communities to work within themselves to encourage healthy eating?

  • How can a government structure/organization lend a hand without being intrusive?
  • What are the systemic (within the system) barriers nation-wide to a collectively better nutrient density of our food?

  • What combination of branding, marketing, pricing and promotions would be effective in implementing change long-term?

  • How do we address cultural issues that root people to their diets?

  • Who – within each community – do we talk to about issues like this?

  • How do others (community leaders, countries, people) work within their communities to encourage positive change?

I really want to hear your ideas!

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