The Food Environment Doesn’t Impact Your Health…Unless You Use It

A lot of public attention has focused on so-called “food deserts.” These are food environments that lack low-priced healthy food options, and are often identified as areas that lack a full-service supermarket. (See Figure 1 for a map of Ohio.)

I have argued elsewhere that I prefer not to use the popularized terms of “food deserts” or “food swamps.” Food deserts suggest a lack of food, when these locations, particularly urban locations, often have a plethora of unhealthy food. Further, the terms “desert” and “swamps” are not asset-based approaches to characterizing community members’ residential locations.

Poor food environments are disproportionately found in poor urban and rural communities and communities of color. These communities are also associated with relatively higher levels of poor mental and physical health outcomes, such as greater levels of stress, diet-related disease, and insecurity [1-4].

Figure 1. USDA’s Low income, Low Access Census Tracts (previously termed “food deserts”) [7]

While an increasing amount of public funds at the federal, state and local level aim to improve food environments with the hopes of improving diet, many researchers have dismissed any significant relationship between the food environments and diet. There are two reasons for the lack of consistent and significant findings: (1) the way people go about measuring the food environment, and (2) people do leave poor food environments for better ones, particularly if they have a car, enough time and money, and feel safe (e.g., not going to face personal racism)[5].

A recent study lead by my advisee and PhD candidate, Alannah Glickman, and co-authored by myself and Darcy Freedman, addressed these issues by studying how people use their immediate food environment, rather than assuming everyone uses the space in the same way [5].  This gets to a fundamental way in which to conceptualize space [6]: as absolute – envision two convenience stores and one grocery store in a neighborhood; as relative – think about the position of the household relative to stores and the distance households travel; and as relational – how do households use the stores in their neighborhood. Nearly all research focuses on the second approach; we focus on the third.

Using a novel approach applied to two Ohio neighborhoods (Figure 2), we found that there is a significant relationship between the food environment and diet if people shop in their immediate, poor food environments. For people who do more than 50% of their shopping within their poor food environments, we found, all else equal, an eight point decrease in their healthy eating index (which is measured on a 100-pt. scale; the average American’s score is 58.7).

Figure 2. These are two images of the food environment taken in our study areas – Columbus, Ohio (left) and Cleveland, Ohio (right) [Google maps]

In my position now as an associate professor in the John Glenn College of Public Affairs, I ask questions, such as: is there a public purpose to intervene in the food environment? However, to understand the complexities of the food environment, I returned to my training in geography!

 

Jill Clark, Associate Professor

John Glenn College of Public Affairs

 

References Cited

  1. Walker, R.E., C.R. Keane, and J.G. Burke, Disparities and access to healthy food in the United States: A review of food deserts literature. Health & Place, 2010. 16(5): p. 876-884.
  2. Caspi, C.E., et al., The local food environment and diet: a systematic review. Health & place, 2012. 18(5): p. 1172-1187.
  3. Clifton, K.J., Mobility Strategies and Food Shopping for Low-Income Families A Case Study. Journal of Planning Education and Research, 2004. 23(4): p. 402-413.
  4. Ver Ploeg, M., Access to affordable and nutritious food: updated estimates of distance to supermarkets using 2010 data. 2012: United States Department of Agriculture, Economic Research Service.
  5. Glickman, A., J.K. Clark, and D. Freedman, Residential Proximity to Low-Quality Food Retailers and Diet Behavior: Exploring the Micro Food Environment within Low-Income Neighborhoods, in Association of Public Policy Analysis and Management. 2020: Virtual.
  6. Harvey, D., Social Justice and the City 1973, London: Edward Arnold
  7. USDA. Food Access Research Atlas. 2020 [cited 2021 February 22]; Available from: https://www.ers.usda.gov/data-products/food-access-research-atlas/go-to-the-atlas/.