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!


Media and its Impact on America’s Children

We are nearly four months out from Michelle Obama’s speech about marketing to kids, a major issue in these times. There are many things to say about the rising trend of growing (and thickening) Americans – it is certainly a subject that has cast a wide shadow over the discussion of the state of nutrition in the United States. Study after study, we are more confused about what is right and what to tell our kids. And here it is: we’ve all heard the stats about childhood obesity; that childhood obesity has more than doubled in kids and has tripled in adolescents in the last 30 years. Those are pretty staggering, and what is astonishing is the relation advertising has with the success of these weighty and wealthy food companies to convince kids to keep shoving detrimental food into their mouths. The scariest part is wondering whether we have control over these new trends.


With parents having less time to spend on kids’ diet preferences (and on their own) as well as children having much more control over a family’s expenditures on food-related items – an estimated $485 billion in 1999 – the dynamic has changed. Children no longer get most of their messages from their parents about what they should eat like the advertising companies suggest they should – they’re getting social cues from friends, menu choices from school lunch programs, and nudges from advertisement. Large food companies get a lot of time with them in the form of t.v. ads, product placement, branded merchandise, and online games. Whereas parents will spend an average of 21 hours split between mom and dad caring for their kids (which is on the rise), kids aged 8-17 watch an average of 1 hour and 7 minutes per week of purely food advertisement.


While this statistic alone may not haunt you, the advertising content and hours of media consumed by children might. Of the food advertising seen on television, 20% promote a website and kids, on average, spend more than 53 hours per week using entertainment media. All of the major brands offer online games – played without having to sign up or on and without requiring parental consent. Online media, as well as all other forms of advertisement, inform what kids want; what they think is cool, how they perceive taste (even carrots packaged in McDonald’s packaging), as well as appealing to their refined sugar-loving taste buds – all of which highly influence the family’s dietary dollars. And the truth is that kids do ask for well-branded products and parents start with an uphill battle from the time that child is exposed to our branded world.


And though Mrs. Obama says that obesity rates among low-income preschoolers have dropped in 19 states and territories across the country and that childhood obesity rates are falling in major cities (from 2008 to 2011), it isn’t the weight in particular I’m worried about. Weight is a symptom of the issue at hand but the health effects of the lifestyles that cause the weight gain are indeed something to discuss. Issues like: 5-17 year olds with risk factors for heart disease, adolescents with a likelihood to have prediabetes, kids and adolescents alike who suffer greater risk for bone and joint problems, sleep apnea, and an increased risk in the long-term for many types of cancer (breast, colon, edometrium, esophagus, kidney, pancreas, gall bladder, thyroid, ovary, cervix, prostate, multiple myeloma and Hodgkin’s lyphoma). These health issues correlate with kids not meeting their daily nutritional requirements, even though they are going over their daily recommended caloric intake as a result of an overabundance of unhealthy food in the United States.


It’s the chronic disease-suited lifestyle that eating poorly every day will do for you. And it’s branding and advertising that contribute to our nation’s consumption of foods that aren’t actually “heart healthy” or “Diabetes friendly.” Chronic diseases that used to only plague adults are making their mark on our nation’s kids.

My question is: How do we disseminate empowering nutritional information? How do we get science to agree on what we should do in such a way to inform policy? With our tastebuds tuned to the flavor of High Fructose Corn Syrup or sugar in everything… How long will it be until the American Public can appreciate healthful food, or will it ever?